Do Premenopausal Hormones Protect Women from Heart Attacks?

When I was writing The Menopause Book, I knew that I had to include a chapter on women and heart disease. Many doctors I interviewed cited research showing that women's odds of getting a fatal heart attack increase after menopause.  The thinking was that premenopausal hormones protected women; after menopause, those hormones no longer did the job. A decade after menopause, women had the same heart attack risk as men.

But a new study in the British Medical Journal suggests that a very different mechanism may be at work. Researchers say it's aging, not menopause, that's behind women's increased risk of heart attacks.

To reach that conclusion, they looked at 50 years of mortality data and found that there was no spike in deaths from heart disease right after menopause, which occurs at around the age of 51. Instead, the researchers say, the cells of the heart and arteries are aging just like every other part of the body. That means they're not doing as good a job of keeping blood pumping.

In the past, scientists were comparing women's heart disease rates with men's. In general, men tend to be at greater risk of fatal heart attacks at younger ages than women. But the reason for that, these researchers say, is not because premenopausal hormones protect women's arteries. It's just as likely that men's vascular protection is faulty and that is why they are more vulnerable.

This study provides another example of how medical science is constantly evolving. It's a process that shouldn't really change your own behavior in this case. The best thing you can do to protect your heart is to exercise, maintain a normal weight, stick to a healthy diet and get regular check-ups.