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Menopause and heart disease. A review
M J Stampfer1, G A Colditz, W C Willett
1Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Annals of the New York Academy of Sciences
|January 1, 1990
Summary
Early surgical menopause (bilateral oophorectomy) significantly increases coronary heart disease risk in women. Estrogen deficiency is the likely cause, as hormone replacement therapy mitigates this risk.
Area of Science:
- Cardiovascular Health
- Reproductive Endocrinology
Background:
- Early bilateral oophorectomy is linked to increased coronary heart disease (CHD) risk.
- Surgical menopause without oophorectomy shows inconclusive evidence for increased CHD risk, potentially due to reduced ovarian function.
Purpose of the Study:
- To investigate the relationship between menopause, estrogen deficiency, and coronary heart disease risk.
- To evaluate the protective effect of estrogen replacement therapy against CHD in postmenopausal women.
Main Methods:
- Review of studies examining women with early bilateral oophorectomy and surgical menopause.
- Analysis of data on estrogen replacement therapy and its impact on lipid profiles and CHD risk.
Main Results:
- Consistent evidence shows increased CHD risk in women with early bilateral oophorectomy.
- Lack of excess risk in oophorectomized women on estrogen replacement therapy supports estrogen deficiency as the cause.
- Estrogen replacement therapy improves lipid profiles in postmenopausal women.
Conclusions:
- Estrogen deficiency, particularly following early bilateral oophorectomy, is a significant factor in increased coronary heart disease risk.
- Natural menopause signals a period of increasing CHD risk, influenced by age and declining estrogen levels.
- Estrogen replacement therapy may offer cardiovascular protection for postmenopausal women.