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by by Sherrill Sellman
Hormones and the Heart
Why HRT Causes Cardiovascular Disease
Only by incorporating a healthy diet, proper nutritional support,
natural progesterone, exercise and stress reduction strategies, can women
successfully and naturally protect their cardiovascular system.
“Steer clear of prescribing hormone
replacement therapy for the sole purpose of
preventing heart attack and stroke in
women who already have cardiovascular
disease.” This warning, which was sent out
by The American Heart Association,
reversed its previous guidelines recommending
hormone replacement therapy
(HRT) for heart disease. In effect, the AHA
withdrew its approval of HRT as a treatment.
A recent study published in the journal
Circulation in July 2001, further validated
a growing body of evidence showing
that women who have had heart disease,
bypass surgery or angioplasty should not
start hormone therapy for the purpose of
cardiac protection because HRT can actually
cause heart attacks and strokes.
Once again medical science has
blundered. When it comes to hormones
and women’s health, there is a long
history of inappropriate, dangerous and
life-threatening treatments. Half-baked
theories and untested hypotheses have
jeopardized the health of millions of
women. The use of HRT for preventing
heart disease had never been substantiated
by fact. In a reckless desire to extend the
reach of the billion dollar hormone industry,
the pharmaceutical companies and the
medical profession have in fact contributed
to the spiralling incidence of cardiovascular
disease.
Heart disease and stroke are known as
cardiovascular diseases. Stroke, like heart
disease, is a vascular disease, a disease of the
blood vessels. In both cases the blood
vessels become narrow either through
spasm or through atherosclerosis, the
narrowing of the arteries that feed the
heart; therefore, not enough blood gets to a
critical place. In the case of heart disease it is the heart. With strokes, it is
the brain. Cardiovascular disease
also encompasses high
blood pressure and coronary
artery disease.
The hormones which comprise
HRT, estrogen and synthetic
progesterone have always carried
warnings that they increase the incidence of
blood clots, strokes and high blood pressure.
In total disregard of that knowledge, the
hormone industry enthusiastically embraced
HRT for the heart.
The Estrogen Deficiency Myth
In the face of the side effects which have
been known for over 40 years, why was
HRT enthusiastically embraced by the medical
community to become a universally
recommended treatment for heart disease?
To answer that question, it is first crucial
to understand that women’s physiology
has been grossly misunderstood by medical
science. Myths and misinformation about
the hormonal nature of women have fueled
a multi-billion dollar industry. Women’s
natural life changes have been medicalized
and pathologized for profit. The two key
ingredients of HRT, estrogen and progestin,
have been listed by the U.S. government as
known cancer-causing drugs.
The argument is made that deaths due
to heart disease in women are very uncommon
prior to menopause, but after
menopause they sharply increase. Declining
levels of estrogen (known as estrogen
deficiency) in the menopausal woman has
been blamed for this increase. It was therefore
recommended that menopausal women
should be placed on HRT as a preventative
treatment. Menopause itself has been
perceived as a dangerous risk factor for the
increasing incidence of heart disease. But is
this really true?
“Absolutely not!” says Professor Hugh
Tunstall-Pedoe, a renowned Scottish cardiovascular
epidemiologist. According to
him it is a myth that menopause is bad for
women’s hearts. “It is unarguable that risk
of myocardial infarction (heart attacks) and
coronary death is lower in women than in
men in (their) middle ages. However, there
is a myth that risk in women is held low
only until menopause, around age 50 years,
when it rebounds, equalling and later surpassing
that in men.” The myth implies
that coronary deaths in women should
accelerate more rapidly after the age of 50.
However, Professor Tunstall-Pedoe’s analysis
shows women’s death rates do not surge
after menopause and in fact, never catch up
to those of men. The reason the numbers of
elderly women dying from cardiovascular
heart disease (CHD) are greater than elderly
men is simply due to women living longer.
The corollary to the menopause/heart
disease myth is belief that estrogen becomes
deficient at menopause. In fact, it is often
erroneously stated that the ovaries fail
at menopause, resulting in a significant
depletion of estrogen. This estrogen loss is
then attributed to a higher incidence of
postmenopausal heart disease. Women
have also been misled to believe that
menopausal symptoms and potentially
debilitating conditions are the result of
declining estrogen levels. There is a growing body of evidence that disputes the idea
that estrogen deficiency is a common occurrence
for menopausal women. As it turns
out, estrogen deficiency rarely occurs in
Western women. Quite the opposite is occurring.
The real problem for the majority of
perimenopausal and menopausal women in
western countries is an excess of estrogen and
a deficiency of natural progesterone.
Estrogen levels decline at menopause but
not to zero. They usually fall only to 40–60
percent of premenopausal levels. As a backup
system, the fat cells and the adrenal glands
also make estrogen, assuring that most
menopausal women make more than enough
estrogen. Mother Nature never intended for
menopausal women to become totally
depleted in estrogen. Lower levels of estrogen
at menopause are, in fact, a natural adjustment
to that stage of life. It does not mean a
pathology of “estrogen deficiency” requiring
HRT. Prescribing additional estrogen to
women who already have normal or above
average levels can be devastating since higher
non-physiologic levels of estrogen have serious
side effects.
What gives weight to the estrogen
deficiency myth is the manner in which
hormones are tested. While the gold standard
in traditional medicine is blood serum testing,
it is now acknowledged by major studies
that blood testing only measures 1–9 percent
of biologically active hormones. This means
that the vast majority of hormones in the tissues
are not measured, resulting in a misdiagnosis
of estrogen deficiency, when in fact, a
majority of women actually have normal or
excess levels of estrogen. According to the
World Health Organization and other
recent research, the only valid way to measure
hormone levels is with salivary testing,
an inexpensive method that can be done
even at home.
Estrogen’s Many Harmful Effects On The Cardiovascular System
In the pursuit of establishing a definite beneficial
link between HRT and the heart,
Wyeth-Ayerst (the pharmaceutical company
manufacturing Premarin) funded the Heart
and Estrogen-Progestin Study (HERS), which
was to investigate Premarin’s effect on
women with pre-existing coronary artery disease.
The findings from this study sent shock
waves throughout the medical community
worldwide. In the study the women taking
hormones increased their risk of myocardial
infarction by about 50 percent the first year.
In addition, there was a threefold increase of
blood clots in the legs and lungs and a significant
increase in gall bladder disease.
Estrogen also causes major deficiencies
of nutrients that are essential for maintaining
a healthy cardiovascular system. It
depletes the body of the vitamin Bs, folic
acid, vitamin C, vitamin E, magnesium,
selenium, zinc and tyrosine. A well established
marker for cardiovascular risk is high
homocysteine levels caused by low levels of
B6 and folic acid.
In addition, estrogen increases vitamin
K levels which can lead to blood clot
formations. Also, estrogen causes high copper,
fueling the inflammatory process of
heart disease. Evidence also suggests that
this can trigger a more destructive form of
LDL (bad cholesterol) causing increased
clotting, plaque deposits, blood vessel constriction
and damage to the inner vascular
lining.
Another important marker for heart disease
is high C-Reactive Protein levels which
indicate inflammation. Since estrogen has a
known pro-inflammatory effect, it will
increase inflammation in the body, producing
conditions such as allergies, asthma,
arthritis, phlebitis and pancreatitis as well as
heart disease.
Estrogen excess can impair various physiological
functions. It impairs the uptake of
thyroid hormone, contributing to hypothyroidism.
One side effect of a sluggish thyroid
is high cholesterol levels. Estrogen is also
toxic to the liver which will raise bad
cholesterol levels. Diabetes, a disease that
carries a greater risk of heart disease, can be
caused by estrogen.
Natural Progesterone and Heart Health
Synthetic progestins (such as Provera) are
another culprit in the HRT-heart disease connection.
They also increase the incidence of
strokes and blood clots. Research has also
been conducted on the connection between
Provera and vasospasms in women. Studies
with monkeys found that progestins caused
unrelenting vasospasms (tightening of the
blood vessels) which caused complete blockage
of the artery resulting in death. At
London’s National Heart and Lung Institute,
Dr. Peter Collins conducted a study which
found that women taking Provera had similar
physiological effects to their vascular system
as their monkey counterparts. This
could explain why autopsies of postmenopausal
women who died of heart attacks only showed a 30–50 percent blockage.
The increased risk of cardiovascular
disease now associated with menopause may
not be due to relatively minor cholesterol
plaque or to hormone changes per se, but to
increased risk of coronary vasospasm caused
by synthetic progestins, such as Provera, used
in HRT.
Natural progesterone, which is the bioidentical
hormone made by the body, plays a
significant role in protecting women from
cardiovascular disease. While the synthetic
progestins can cause unrelenting vasospasm,
natural progesterone has the totally opposite
effect. Dr. Jerilynn C. Prior, a professor of
endocrinopathy at the University of British
Columbia, conducted a study in which she
found that natural progesterone was protective
to blood vessels by restoring normal
vascular tone. Previous studies have found
increased risk of heart disease in perimenopausal
women who have high or
normal estradiol but low progesterone levels.
Dr. Prior’s study concluded that “progesterone
may play a role in protection from
cardiovascular disease in premenopausal
women.”
Progesterone is also beneficial to the heart
in other ways. It supports healthy thyroid
function, increases the burning of fats
for energy, has anti-inflammatory effects,
normalizes blood clotting, improves lipid
profiles, balances blood sugar levels,
improves sleeping patterns and moods, supports
the production of stress hormones and
normalizes zinc/copper levels. All of these
actions are cardio-protective.
While it is undeniable that heart disease is
a major cause of death among women,
evidence clearly reveals that neither
menopause nor estrogen deficiency can be
assigned the role of villains. It is alarming to
realize that HRT not only contributes to
heart disease but actually can cause it.
Switching from HRT to cholesterol-lowering
drugs is by no means the answer since they
too can increase the risk of heart disease.
Only by incorporating a healthy diet, proper
nutritional support, natural progesterone,
exercise and stress reduction strategies, can
women successfully and naturally protect
their cardiovascular system.
Sherrill Sellman is the author of the bestselling
book Hormone Heresy: What Women
MUST Know About Their Hormones can be
contacted at
This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
or at
1-877-215-1721. Her free, monthly
HormoneWise e-Digest is available at
www.ssellman.com
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