Menopausal hormone therapy (MHT), or also called hormone replacement therapy, is a treatment that contains estrogen. The estrogens are female hormones that the woman’s body gradually stops producing until its production stops at menopause (which is the time of the last period or menstruation) and even a little earlier, during the climacteric period that extends even after the menopause.
Hormone therapy is most often used to treat common symptoms associated with menopause, such as hot flashes, insomnia, mood swings, and vaginal dryness. In addition, estrogens play an important role in calcium uptake in the bones, so MHT helps prevent bone weakening and reduces the risk of fractures in postmenopausal women.
One benefit that isn’t talked about much, however, is estrogen’s role in women’s cardiovascular health. In this sense, we can observe how the cardiovascular risk in this segment of the population increases after 40 years of age (according to the National Health Survey (ENS) of 2016-2017), which coincides with the climacteric stage and which also It is related to factors such as smoking, sedentary lifestyle and obesity, among others.
Can MHT help women’s heart health?
In this regard, Dr. Margot Acuña, obstetrician-gynecologist, epidemiologist, President of the Chilean Climacteric Society (Sochiclim)professor and director of the Department of Obstetrics and Gynecology at the Universidad de la Frontera and a Latin American expert in climacteric and menopause, explains that: “Heart disease, not cancer, is the leading cause of death for women over 40. Hormonal therapy can reduce this risk by between 30% and 50% when treatment is indicated during the window of opportunity, that is, (women with recent menopause and under 60 years of age).
In this regard, highlights the role of estrogens as cardioprotectors «since they slow down the advance of atherosclerotic plaques, which is the pathophysiological basis of cardiovascular disease, this has to go hand in hand with healthy lifestyles and adequate management of modifiable cardiovascular risk factors».
In simple words, estrogens reduce the rate at which fat adheres to the blood vessel wall.
“Numerous studies have related early or early menopausal age with an increase in heart attacks and cardiovascular accidents as an independent risk factor, therefore, they relate the presence of estrogens with a lower risk of developing the different forms of manifestations of cardiovascular damage itself. of aging”warns the specialist.
Medical evaluation before starting treatment
Hormonal therapy consists of the administration of estrogenic sex hormones at menopause. As a general concept, estrogen alone can be indicated in hysterectomized patients, and combined estrogen-progestin therapy in patients with a uterus. Dr. Acuña explains that it is important to make the distinction since there are significant differences in its indication and risk – benefit.
“The use of hormone therapy, as a therapeutic option in menopausal women, should be considered in the context of improving quality of life, taking into account their symptoms and preferences or concerns, concomitant diseases, their risk factors, therefore, individualizing the therapy»he points out.
demolish myths
It is also important to demolish some myths about the consumption of hormones during menopause, such as the relationship it would have with breast cancer, which has already been widely disproved in recent studies.
In this regard, the Dr. Margot Acuna emphasizes that the use of THM in women who present symptoms related to the climacteric, under 60 years of age, it presents varied benefits in women’s health, both to improve quality of life and to prevent chronic non-communicable diseases.
«With regard to other benefits that hormone therapy could provide, there are numerous studies in animals and humans that indicate that estrogen would be neuroprotective, therefore, it would have a role in the prevention of Alzheimer’s disease and other forms of dementia in women»emphasizes the Dr. Acuna.
With a life expectancy that exceeds 80 years], it is important to focus on prevention and the promotion of healthy habits in women, in order to have a good quality of life, especially during old age.
Among the specialist’s recommendations is eating a balanced diet and performing physical activity, annual medical control focused on routine check-ups, adequately treating possible chronic diseases, taking care of emotional health and giving yourself moments of relaxation.
It is important to keep in mind that to start the use of hormone therapy, the patient must go to a specialist so that, based on her clinical history, physical examination and complementary tests, her case can be evaluated and thus decide the best therapy according to her needs. the profile of each woman.