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March 06, 2024

 Women’s complex and incredible bodies are uniquely impacted by hormone changes throughout their lives. The ebb and flow of hormones during menstruation, pregnancy, perimenopause, and menopause impact every body system, not just reproductive functions. Your circulatory system and heart health can be significantly affected by hormones. Considering that heart disease is the number one cause of death for women in the United States, affecting up to one out of every five women, it is essential to understand how hormones like estrogen can contribute to heart disease and how to keep your heart healthy at every stage in life.

 One of the most important female sex hormones responsible for many functions in the body is estrogen. While estrogen is primarily responsible for helping the female reproductive system develop, it is also an important component of many skeletal, cardiovascular, and endocrine functions. Estrogen levels change dramatically throughout life, sometimes even day to day. During a woman’s fertile years, her estrogen levels will rise and fall during a regular menstrual cycle. During pregnancy, estrogen levels are high and increase every trimester, and in perimenopause and menopause, estrogen levels drop. These varying changes impact heart health in several important ways.

Typically, estrogen is protective of the cardiovascular system throughout a woman’s fertile years. This critical hormone helps dilate blood vessels, regulate lipids and metabolism, and protect the heart from oxidative stress and inflammation. Prevalence of heart disease is significantly higher in men than in women of similar age until a woman reaches menopause. During the later stages of life, the rate of occurrence of heart disease in women and men of the same age is similar. Low estrogen levels can contribute to high blood cholesterol levels, high blood pressure, and weight gain (specifically around the abdomen). Low estrogen can also increase the risk of Type II diabetes in perimenopausal and menopausal women which, in turn, damages blood vessels and increases the risk of heart disease.

 Estrogen also plays a role in thyroid production. The hormones produced by the thyroid gland are crucial to the body’s metabolism, growth, and development. Low estrogen levels contribute to low thyroid function which increases the risk of developing more risk factors for heart disease, such as high blood pressure and high cholesterol.

 Estrogen, however, is not the only hormone that can impact heart health. For instance, there are several hormones that impact the kidneys and help regulate blood pressure and blood volume in the body. One of the most important hormones, erythropoietin, stimulates red blood cell production. Impaired kidney function can cause low erythropoietin levels which can negatively impact heart health.


Imbalance or dysfunction of another common hormone, insulin, can harm your heart especially if you have insulin resistance or diabetes. When insulin is not functioning properly, your blood sugar levels will tend to be high and uncontrolled. This increases the risk of high blood pressure, high triglycerides, and high cholesterol which all contribute to a higher chance of heart disease.

 When the levels of another common hormone, cortisol, are disrupted, the heart is also weakened. Adrenal insufficiency, also known as Addison’s disease, occurs when the body produces too little cortisol. Low cortisol can lead to low blood pressure and low blood volume which can negatively impact cardiovascular health.

So how can you protect your heart from the harmful effects of hormonal imbalance? Balancing your hormones is a great start to preventing hormone-related heart diseases. Many ways to balance your hormones naturally include maintaining a healthy weight, prioritizing sleep, managing stress, eating a proper diet, maintaining a proper gut health including detoxifying your liver, eating an estrogen-balancing diet, and avoiding endocrine disruptors. Other ways to keep your heart healthy while balancing your hormones include: 

  1.   Know your medical history: Be aware of any genetic predispositions you might have toward heart disease. Do you have close family with high blood pressure, high cholesterol, or a history of heart disease? Knowing your genetic risk can help you effectively plan for a healthy future while developing a preventative plan with your primary care provider (PCP) and other healthcare providers. 
  1.   Prioritize regular physical activity: Exercise is well-known to decrease the risk of developing heart disease. Regular physical movement will make you healthier and make your heart stronger. You don’t have to become an athlete to reap the benefits of exercise. Even low-intensity activities can improve your health and decrease your risk of heart disease. Move daily, avoid a sedentary lifestyle and your heart will thank you. 
  1.   Fine-tune your diet: Aim for a heart-protective diet rich in plants, fruits, beans, lean meat, whole grains, healthy fats, and fiber. Diets such as the Mediterranean and DASH diet have positive effects on the cardiovascular system. Avoid diets full of saturated fats, trans-fats, sodium, and excess sugar as this often causes inflammation in blood vessels, increasing cholesterol levels and blood pressure, thus increasing the risk of heart disease. 
  1.   Drink alcohol sparingly: Alcohol increases the risk of developing high blood pressure, atherosclerosis, and stroke. The risk of these negative effects on your heart increases the more you drink, so either avoid alcohol altogether or keep your consumption moderate. The Center for Disease Control and Prevention (CDC) recommends that adults of legal drinking age can choose not to drink, or if you have to drink, consume no more than one alcoholic beverage per day to prevent negative effects on your health. 
  1.   Give up smoking: Even in minute amounts, smoking can damage your heart and blood vessels significantly. Smoking is a major cause of cardiovascular disease (CVD) and one of every four deaths from CVD is smoking-related.  Smokers are more likely to have atherosclerosis, coronary heart disease, strokes, and heart attacks. The good news is that your body can recover from the damaging effects of smoking over time. Four years after quitting smoking, your risk of stroke goes down to levels comparable with people who have never smoked.
  1. Consider hormone therapy during perimenopause: Although hormone replacement therapy (HRT) does not directly improve your risk of heart disease, it can improve several risk factors that low estrogen levels cause. HRT can minimize weight gain, keep blood vessels flexible, and help maintain healthy cholesterol levels – all factors that can directly protect your heart.
  1.   Manage any underlying health conditions: It is important to work with your healthcare team if you have any health issues or take medications that could impact your cardiovascular health. Appropriate preventative medical care can help manage disease symptoms as well as mitigate any negative side effects of potential medications on the heart. 

Your heart health is closely tied to your hormones and keeping your hormones in check can help minimize your risk for hormone-related heart disease. 

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