Women Urged to Take Pill to Ward Off Heart Disease

By John Von Radowitz

Women are being urged to boost their oestrogen levels up to 10 years before the menopause to ward off heart disease.

In practice, that would mean taking the contraceptive Pill as a health protection measure rather than to prevent pregnancy.

To reduce their chances of heart disease, women should take the Pill right up to the menopause – or start an early course of Hormone Replacement Therapy, new research suggests.

A US study of monkeys showed that the perimenopause – the period five to 10 years before the menopause – is critical for preventing heart disease and brittle bones.

Professor Jay Kaplan, from Wake Forest University Baptist Medical Centre in North Carolina, said, ‘Waiting until the menopause is not the time to start thinking about prevention.’

Research conducted by the professor has demonstrated that stress in younger women can interfere with ovulation and reduce oestrogen levels. This in turn can set the stage for heart disease in later life.

But all women are affected by declining oestrogen in the years leading up to the menopause, according to Prof Kaplan.

Women have traditionally been considered immune from heart disease until after the menopause, when their oestrogen levels dramatically drop.

The research on monkeys suggests that the process actually starts much earlier.

‘This isn’t just a problem in younger women,’ said Prof Kaplan, who presented his findings at a meeting of the American College of Veterinary Pathologists in Boston, Massachusetts.

‘At perimenopause, all women are affected by variably changing and ultimately declining oestrogen levels. Perimenopause is a time of increased vulnerability to chronic disease.

‘Our monkey studies showed that a deficiency of oestrogen before menopause places these females on a high-risk trajectory, even if they got oestrogen treatment after the menopause.

‘The results emphasise that primary prevention of heart disease should start pre-menopausally.’

The research showed that treating female monkeys with oestrogen before the menopause markedly slowed the growth of fatty deposits in the arteries.

‘Applied to women, this lifetime study suggests that having an oestrogen deficiency in the pre-menopausal years predicts a higher rate of heart disease after the menopause,’ said Prof Kaplan.

He pointed out that some physicians recommended women taking oral contraceptives right up to the menopause before beginning HRT. Animal research suggested that oral contraceptives could effectively protect against heart disease.

However controversy surrounds the use of HRT to safeguard the heart.

The largest HRT study to date, the Women’s Health Initiative, found that treatment with a combination therapy containing the hormones oestrogen and progestin increased the risk of breast cancer, heart attack and stroke.

In light of the findings, doctors are now advised not to prescribe HRT in order to prevent heart problems.

But critics point out that the Women’s Health Initiative study only recruited ‘older’ women in their sixties and seventies.

It did not consider whether HRT might be protective in younger women. A new five-year study is now under way looking at the effect of HRT on perimenopausal women aged 45-54