Dr. Sharolyn Dihigo, DNP, RN, CPNP // Feb 05, 2018

As we look around the stores, Valentine’s day chocolates, cute stuffed animals, and Valentine’s Day cards are filling the shelves. For the month of February and in light of Valentine’s Day, I thought we would focus on the heart of women, specifically heart health in the perimenopausal and menopausal years.

The Women’s Health Initiative (WHI) of the early 1990s set out to identify the causes of death and disability in postmenopausal women.  One arm of the WHI examined the effects of synthetic, man-made hormones (not bioidentical) on women’s health.  The goal of the study was to develop strategies for preventing heart attacks and strokes, breast and colorectal cancer, and osteoporosis since these conditions seemed to worsen after the menopausal years. 

If you remember this study, then you remember the frightening results that were publicized all over the news encouraging women to stop all hormone replacement immediately.   The WHI study was halted abruptly due to an increase in heart attacks, strokes, and breast cancer in women using synthetic estrogen alone or synthetic estrogen in combination with synthetic progesterone. Women have been very afraid of any hormone replacement for menopausal symptoms ever since.

What have we learned since the early 1990s?  Synthetic estrogen and progesterone have a bad reputation, and women are afraid to seek treatment for their menopausal symptoms, and women have been left to just “tough it out.”  Some women go through menopause rather seamlessly without a lot of issues while others struggle for 10 to 15 years through perimenopause before they actually achieve menopause or 12 consecutive months without a period.

The American Heart Association recognizes there is a sharp increase in heart attacks 10 years after a woman experiences menopause, and estrogen is known to be protective of the heart.  Estrogen also helps to maintain the flexibility of the arteries, so they can relax or expand as needed to increase or decrease blood flow.  We all know “hardening of the arteries” leads to hypertension, an increase in plaque in the arteries, and subsequently provides the setting for an increased risk of heart attacks and strokes.

What alternatives does a woman have?  Women have safely used bioidentical hormones made from foods such as soy and yams yet there is not a lot of long-term studies available yet. There are also bioidentical prescriptions for estrogen and progesterone.  Just make sure you discuss all of this with your healthcare provider and ask for bioidentical hormones if hormones are right for you.  If you do not feel comfortable with hormones at all, then you can use supplements such as the Smooth Transition Internal Balance made with phytoestrogens.  Internal Balance is made with high-quality ingredients and must meet safety and purity standards.  Products bought at retail stores often to do not meet these same standards.

What else can I do for heart health?  Some of the most important strategies for heart health include exercising, not smoking, and maintaining a healthy weight.  Exercise alone has so many heart health benefits, I could write another newsletter or a book on the great benefits of exercise.  Most people say they don’t want to exercise, but simply walking 10 minutes a day has been shown to significantly reduce high blood pressure! Yoga is a light exercise that also has incredible benefits. 

Smoking is one of the worst habits for your heart and causes premature aging of the heart, your blood vessels, and damages your lungs, skin, and entire body.  Maintaining a healthy weight is critically important as well because being overweight is extremely hard on your body. The extra added weight causes blood sugar fluctuations which damage the body in a similar fashion to diabetes. Get active!

Working at a sedentary job and living a sedentary lifestyle has been shown to damage the body just as much as smoking! And finally, drinking alcohol is the same as drinking straight sugar. Alcohol quickly converts to sugar in the body and can also cause the same changes as blood sugar fluctuations we have already discussed.

Get Heart Healthy!  Simply adapting any one of the strategies listed below increases your heart health.  Once you feel the benefits of eating healthy and exercising, you will begin to feel so great, you will want to adopt them all.


Quick Bullet Points for Heart Health

  • Eat healthy
    • Eat lots of colorful fruits and vegetables and high-quality fats such as coconut oil, avocado oil, olive oil, and fatty fishes such as salmon, and nuts and seeds
    • Portion control is also very important for weight loss
  • Cut out sugars and empty carbohydrates
    • Cut out processed foods, fast food, anything that comes in a box or plastic container, decrease or cut out grains such as bread, rice, potatoes that quickly raise blood sugar, and cut out all sugary beverages and decrease the amount of sugar you consume
  • Exercise
    • Even 10 minutes of walking a day is heart healthy and can lower blood pressure; an exercise goal is to work up a sweat or exercise vigorously 5 days a week for 30 minutes
  • Maintain a healthy weight
    • Eating healthy and starting or maintaining an exercise routine can help with weight loss
  • Decrease your alcohol intake or eliminate completely for weight loss
    • Research shows one glass of red wine is heart healthy
  • Balance your hormones for heart health
    • Talk to your healthcare provider about what is right for you!


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