In the last instalment we learnt the basic facts about heart disease, and discussed how it is related to choices we make about our lifestyles: what we choose to eat, and whether we choose to exercise. According to the Women's Heart Association, heart disease remains the number one killer of women worldwide.
In the last instalment we learnt the basic facts about heart disease, and discussed how it is related to choices we make about our lifestyles: what we choose to eat, and whether we choose to exercise. According to the Women's Heart Association, heart disease remains the number one killer of women worldwide.
Women possess oestrogen and progesterone, among other sex-specific hormones. Men possess oestrogen too, but in very small quantities – just as women have testosterone but in much lower doses than men. Oestrogen is perhaps the primary female hormone for our discussion today. From the point of menarche, which is when a girl begins menstruating, until menopause, when a woman stops menstruating, there is a very potent form of oestrogen known as estradiol at work in the body.
Estradiol not only has important functions in sexual reproduction – it plays a large role in the cardiovascular system, the system comprising the heart and all the blood vessels in the body. It affects fluid balance, thus blood pressure, and assists in monitoring and controlling this via a feedback system. Estradiol, also known as E2, helps keep the arteries and veins elastic and smooth on the inside.
This is important because if the inside lining of blood vessels is smooth, it is very difficult for any fat molecules (plaque) to stick to the blood vessel and cause a blockage. E2 is a built-in safeguard against heart disease in women, and it does a very good job. Estradiol is the potent oestrogen and menopause happens because there is less and less oestrogen in the body.
Menopause itself can be dated in time – it is the date of a woman's last menstruation – but the process doesn't happen overnight. There are three phases: pre-menopause (approximately age 45-50) when a woman is approaching menopause; peri-menopause (approximately age 48-52) during which menstruation may be irregular and some symptoms (such as hot flushes) may be experienced; and finally post-menopause which is the stage reached once menstruation has completely stopped.
How do these phases affect the cardiovascular system?
The loss of naturally occurring oestrogen correlates with the exponentially increasing risk of a cardiovascular event. Because of this, women aged 55 and older are at the same risk of developing heart disease as age-matched men. Women catch up in less than 10 years. Because this risk is there for all women, they need to take great care of their health. Making sure your diet is sensible, ensuring you get regular physical activity and having regular health checks are ways to ensure you are taking the best possible care of your health. Health checks should include monitoring your blood pressure, cholesterol – through a total cholesterol screening, not just a pin-prick, blood glucose, body mass index and waist circumference.
We can't change the fact that oestrogen will leave the system, but we can change our habits to help prevent the onset of a life-threatening disease. In the next instalment I will cover the question of hormone replacement therapy. I invite readers to send me questions about the topics I am highlighting in these instalments.
Send me an email at janet.viljoen78@gmail.com, or call me at 072 180 7757.
*Janet Viljoen is a researcher in the Department of Human Kinetics and Ergonomics, Rhodes University. This is the second in a four-part series on heart health.
