Ep. 356 Menopause, Heart Health and HRT with Dr. Felice Gersh
Apr 27, 2024
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Dr. Felice Gersh, an expert on women's hormones, discusses menopause, heart health, and hormone replacement therapy. They explore the impact of hormonal changes on cardiovascular risks, the use of oral contraceptives, metabolic health in menopause, and proactive strategies for supporting the body during this transition. Topics include the role of estradiol, timing of hormone replacement therapy, risks related to circadian rhythm disruption, arterial changes, cholesterol dynamics, gut health, and cardiac wellness.
Understanding female physiology is vital for metabolic health in pregnancy and menopause.
Risk factors like preeclampsia, gestational diabetes, and early puberty impact women's cardiovascular health.
Hormone replacement therapy should be initiated strategically to support overall health and prevent hormonal imbalances.
Deep dives
Impact of Hormones on Cardiovascular System
The podcast emphasizes the critical impact of female hormones, especially estradiol, on the cardiovascular system, highlighting how these hormones are essential for maintaining vascular health, blood flow regulation, immune response, and organ system coordination. The discussion delves into the evolutionary perspective of female hormones in ensuring reproductive success and the metabolic transition during menopause, underlining the significance of hormone replacement therapy in supporting overall health.
Cardiovascular Risks and Menopause
The conversation expands on the cardiovascular risks associated with menopause, including factors like preeclampsia, gestational diabetes, early puberty, oral contraceptive use before 20, and premature ovarian failure. The discussion underscores how these factors impact cardiovascular health in women, leading to increased risks of hypertension, diabetes, and vascular complications.
Timing and Approach to Hormone Replacement Therapy
The podcast explores the importance of addressing hormone insufficiency in perimenopause and menopause through hormone replacement therapy (HRT). It discusses the optimal timing for initiating HRT, suggesting a window of at least five to ten years before the last ovulation, considering the gradual hormonal changes leading to menopause. The conversation advocates for a proactive approach to hormonal supplementation based on individual hormone profiles and the broader implications on health and fertility.
The Importance of Estradiol in Menopause Symptoms and Overall Health
Estradiol plays a critical role in menopause symptoms and overall health, impacting various functions like sex drive, sleep, circadian rhythm, and energy production. Lack of estradiol can lead to symptoms like night sweats, hot flashes, palpitations, joint pains, mood swings, and fatigue. Additionally, estradiol is essential for hormonal balance, including the production of oxytocin, which is crucial for sexual function and overall well-being. Maintaining adequate estradiol levels is vital in preventing early collagen, bone loss, vascular decline, changes in the brain, and a rise in cancer incidence post-menopause.
Estradiol's Impact on Cardiovascular Health and Disease Risk
Estradiol plays a significant role in cardiovascular health, affecting arterial health, nitric oxide production, platelet function, inflammation, glucose regulation, and cholesterol metabolism. Estradiol is crucial in preventing vascular damage, maintaining proper cholesterol levels, and regulating glucose transport and mitochondrial function. In the absence of estradiol, women may experience issues like diastolic dysfunction, heart failure with preserved ejection fraction, and higher risks of cardiovascular events like heart attacks and strokes. Estradiol also influences the electrical conduction system, neurotransmitter regulation, and mitochondrial energy production in the heart, highlighting its importance in overall cardiovascular health and disease prevention.
I am delighted to reconnect with Dr. Felice Gersh today for our fourth discussion.
Dr. Gersh is a globally recognized expert on women's hormones. As the Medical Director of the Integrative Medical Group of Irvine, she often collaborates with numerous research organizations.
In our discussion today, we dive into cardiovascular disease risks and menopause, highlighting the metabolic transition that menopause represents and exploring risk factors like preeclampsia, gestational diabetes, and PCOS. We get into the use of oral contraceptives, particularly before the age of 20, early puberty, and premature ovarian failure, while examining the role of the RAS system, synthetic hormones, and the differences between estrone and estradiol. We discuss the optimal timing for starting hormone replacement therapy and explain why we should love our menstrual cycles, addressing the risks related to circadian rhythm disruption. We also look at arterial changes, cholesterol dynamics, the autonomic nervous system, gut health and cardiac wellness in menopause, and proactive ways to support our bodies.
I am confident you will find today’s conversation with Dr. Felice Gersh most enlightening and informative.
IN THIS EPISODE YOU WILL LEARN:
Why women need to understand basic female physiology
How pregnancy-induced insulin resistance and leaky gut can lead to cardiovascular issues later in life
Dr. Gersh highlights the importance of metabolic health in pregnancy and menopause
Why it is risky for young women to use oral contraceptives
What irregular bleeding in perimenopausal women might indicate
Why the inflammatory response is critical for survival, even though it may become problematic if not properly regulated
How estrogen is a family of hormones, not a single hormone
How estradiol differs from estrone
Why should menopause be treated like any other hormone deficiency state?
The optimal time for hormone replacement therapy
Why post-menopausal women are more susceptible to heart attacks than men
