Heart Health & Menopausal Hormone Therapy: What Women Need to Know | Dr. Susan Hardwick-Smith
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- เผยแพร่เมื่อ 27 ก.ย. 2024
- The most common killer of both men and women is heart attack, so understanding how to reduce our risk could not be more important. Since the 1980's, studies have consistently shown that menopausal hormone therapy (particularly estrogen) reduces the risk of heart disease in women.
The now infamous Women's Health Initiative study surprised the medical community in 2002 by suggesting that hormone therapy increased the risk of heart attack in a small subset of women. After 22 years of gathering more data, multiple large studies have now confirmed what we previously understood, which is that estrogen has a highly beneficial effect for the heart if it's started in the first 10 years after menopause, and benefit seems to be negligible if it's started later (but not harmful).
We no longer recommend taking the lowest dose for the shortest time, but rather suggest starting menopausal hormone therapy as early as possible and continuing it long term. For the great majority of patients the benefits far outweigh any potential risks.
Dr. Susan Hardwick-Smith is a Board-Certified Gynecologist and Certified Menopause Practitioner specializing in women's midlife wellness, hormone optimization, and sexual wellness. She is the founder of Complete Midlife Wellness Center in Houston, TX, and the best-selling author of "Sexually Woke- Awaken the Secrets to Your Best Sex Life in Midlife and Beyond." She also hosts the popular podcast "Empowering Midlife Wellness."
Dr. Susan is the recipient of the Texas Super Doctor award over a dozen times, as well as a multiple-time recipient of H-Texas magazine's Top Doctor and Top Doctor for Women awards. She also has been chosen as one of Houston's "3 best-rated" gynecologists for several consecutive years. Dr. Susan is also an ICF-certified life and leadership coach, multiple-time marathoner and Ironman triathlete, and mother of 3 young adults.
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Thanks for explaining this to us! Thankfully, I bucked the trend when I went through menopause and decided after much discussion, to stay on a low-dose of HRT. I did that from the age of 52 until 59 or 60. At that point, on the advice of my doctor and after much thought, I went off the hormones. After about six or seven years, I discovered a wonderful gynecologist who specialized in hormone therapy. I am now 66 and happily on a dose of estradiol and progesterone. It is life-changing! I am, however, angry that people of my generation were advised not to take what our bodies crave just because of one faulty study!
Reading your comment, I’m glad that I started HRT at 62 and am feeling so much better.
Thanks doc for another video that gives me less stress. I do have some calcification but I feel so much better with this estrogen spray and progesterone.
This is frustrating, as a young woman just going through menopause I was told I couldn't do HRT because it was dangerous. Now I am 70 have had a heart attack and learn that had I taken HRT I might not have had a heart attack. So I deal with -vaginal dryness, fatigue, etc... Thankfully because of your You Tube channel I learned about menopause specialists and found one. I am working with her on some of these issues. Why some doctors are ignorant in this area amaze me.
I went through early menopause at 32, primarily because of restrictive, disordered eating. Strict dieting and fasting over ten years almost killed me, and I am so glad I began, finally, to eat to thrive at that age. So, I have been on various forms of estrogen and progesterone for 43 years. Fortunately, I have had doctors / gynecologists who worked with me. I had to fire a couple of them because of wanting to stay on it and them “having a cow” about it. Over time I went off of it for a a month, two times, which was educational. At 75, I am still very active, I look much younger than my age, and feel great. My bone density is excellent. I feel badly for the many women who have been convinced that HRT is going to kill them, when it could have made such a huge positive difference to them. I am so grateful for my naturopathic medical doctor who figured out what I was doing to myself with restrictive eating at age 32, and prescribed HRT. I was lucky! But, I also continued to follow the research and didn’t give up on finding well educated doctors on the subject.
I’m 67. I started estradiol, progesterone and testosterone 12 years ago. I’ve been on blood pressure medicine since I was in my early 30’s. I didn’t get high cholesterol until I reached menopause.
I want to thank you for all you do for women not just patients but for educating everyone about menopause and HRT...you rock Dr.H!!
Listing the papers you mentioned would be super helpful. Thank you!
Excellent information - I am 64 and “missed the bosat” in early postmenopause. I have now booked an appointment with my doctor and will insist on having my health and heart checked and then hopefully get HRT. I still have symptoms😬
Thank you so much for taking time to do these videos. I had hysterectomy at age 42 (13 years ago) and no discussion about HRT. I'm now 55 and starting to really feel like crap. Fatigue, joint stiffness and body aches, and no libido. Also, I'm not depressed but feel completely flat......like nothing excites me, I'm just existing. I really want to feel better but in my area there is no one to talk to. You give hope to so many.❤
I had a hysterectomy at 38, almost 13 yrs ago, and my gynecologist refused to put me on hrt. I am almost 51, went through menopause officially last year, didn’t realize all the symptoms I had was peri, but talked to my dr, who happens to be a naturopath, and she has started me on progesterone and testosterone. I tried estrogen, but it causes severe migraines with aura, so I’ll live with it low. As for the other two, game changer! I sleep better and I have so much more energy now. And my joint aches are 80% better! I was absolutely like you two months back! Find a naturopath. They are amazing. Best of luck to you.
@@Faithb73 Oh, thank you so much for this reply. I will look into finding a naturopath. It is so helpful when we come together and share experiences. Thank you!!❤
@@lisabrooks844 you’re welcome. Sometimes the internet can have a positive impact for us! Haha…..it’s a shame we have to really fight for our health though. Most drs are really good about slapping an antidepressant prescription or way, never once considering hormone replacement is a much better option. Naturopathic drs care about the patient. They will prescribe pharmaceuticals or a natural alternative, but they seem to always want to get to the root cause before handing out anything.
you have changed my way of thinking my husband and i just recently 2 weeks ago we to women’s wellness clinic in columbia mo to see Dr. Mark Grant and while there we started our first round of pellets and progesterone 200 mg along with estradiol and testosterone pellets for me we both are seeing changes i have
a little more energy and so does my husband
my joints are not as sore and i am sleeping through the night for the first time in 20 since my hysterectomy 😅😊😊😊
I am so so scared of all the stories I hear , I just stopped taking my HRT stuff . I can’t even sleep thinking of the many scary stories 😩
I am 70 and have been trying to get hormones for years. I was always refused stating the nursing study. I am going to try get hormones because I still have hot flashes and fatigue
Does A-fib, HBP and high cholesterol take me off the list as far as being a candidate for HRT? I am 65 and have been in menopause for 8 years.
So frustrating. My first doctor ogb (2021) wanted to prescribe Prempro. New doctor prescribed Premarin cream and a patch or progesterone with estradiol. I asked for oral progesterone and he gave me Medroxyprogesterone or Provera. Why are these doctors so behind??
Damn it. I need another doctor.
Premarin is not good for the pregnant horse or her baby…read PETA’s report on the cruelty in its production.😢
Thank you.
My sisters and mum have had both DVT and PE early in life. One sister at 22, other sister late 30s and mum at 50. We’ve all been tested and there is no family link apparently (I see it as researchers haven’t discovered it yet cause 3 out of 4 females in one family!!!).
I’m definitely in peri stage. Scared to start on hormone replacement because of family blood clot history. Haven’t found any doctors in my area that know about peri symptoms (beyond hot flashes) or hormone replacement benefits. No dr has suggested hormones. Therefore I can’t be confident on what to do.
Is there research on blood clots and hormone replacements?
I had Spontaneous Cornary Artery Dissection while in permenopause at 52… cardiologist said it was related to fluctuating hormones…. I am 60 now and want to take HRT… wondering if they will say no?
I wish this was known when I started going through perimenopause. I'm seventy . Was one hrt for five years starting when I was sixty. Stage 1 breast cancer was discovered four years ago and now doctors will not let me use hrt.
my dr will only prescribe synthetic hrt... prob cheaper.. i have to think about what i'm going to do
What about if you are 75?
Better late than never! I’m 65 & just started HRT, it’s been wonderful for me.
I'm 51years. Still having heavy periods and last until I take medicine. Should I go for operation. Please suggest me
I'm curious. I started bio-identical hormones at the onset of menopause. I'm now 74 and my doctor took me off of them 2 years ago because she said the mortality issues of a woman over 70. I have felt crappy since and my health stats are getting worse. What do you think of the starting and stopping and starting again at 74?
I'd find a better informed doctor
I’m working on it. Thanks for your reply.
@@Alexa4Grace❤❤❤
Dr Hardwick, what is the type of measurement used for estradiol you use? is it picogram per millilitre? (you recccommend for ex. 40-80 but please add the rest! I am in Canada
What do you consider a minimal estradiol patch level? Do you start your patients at .05 mg?
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Great info! Really wish there was discussion about side effects that women go through starting hrt after 10 years. It would help knowing if it's common and will pass. Example making varicose veins worse and legs feeling achy. Or dizziness. Thanks for any info.
I’m 55 and went on HRT at 50 and I feel amazing!
My poor girlfriend who is my age and went into early menopause 15 years ago and wasn’t offered HRT. Over time she gained 40 lbs, was diabetic and didn’t know it, depressed , had high blood pressure and finally had a massive heart attack at 54 in March of 24. Her cardiologist said her not being offered HRT was “criminal” and said he believes she’d be much healthier if she’d had that option.
What happens if you start before 10 years post menopause but you're 60, do you have benefits? That's my case , I've started this february, I didn't start before because I didn't have hot flashes and my ginecologist didn't recommend it. Now another doctor thought I am a good candidate to HRT because I'm healthy, I do a lot of exercice, eat healthy, and I'm fit. My blood tests were good, but after starting HRT are even better, my cholesterol has lowered and now is optimal
But, When I read the "side effects" label on my estradiol patch, the number 1 side effect is heart attack, then stroke, blood clots, breast cancer, dementia, cancer of the lining of the womb and more. The manufacturer has listed these effects. I just got off HRT after 6 years. I'm fine. Its not worth the risk
That is based on old and faulty research from the WHI.
@@nancybass1962 Yes I've heard about that study for 9 years, or as long as Menopause Taylor has been on you tube. If its not true, then the manufacturer of the drug has to tell us different.
@@nancybass1962 So true, the women who were started in the trial were 65!!!!! The black box label needs to be rewritten! it is the same for vaginal estrogen which is not even systemic. It infuriates me because women are reading that misinformation and not taking there hrt:*( There have been proposals to the medical arm of the government that it be revised with the real data. Women are last on the list.
I just did too. You 50-50 cons and pros I don’t even think it’s worth the risk
@@nancybass1962 I've know about that faulty WHI study for 9-10 yrs. I"ve been following Menopause Taylor and learned that from her before I started my HRT. If the manufacturer list these effects, I believe them.
Great information, thank you!
A Godsend! Thank you!
Great summary and info. Depressed, 0:45 62, heart disease and probably not a candidate. A. Call out to all younger women, I wish I had opportunity to start HRT. May have prevented the madness that I am going thru -despite being healthy athlete all my life. Now I feel like I am fighting for my life (yes genetically predisposed with lipo little “a” and apo 4 gene). Hope I can share this message with my younger family members.
@@HOSHitiwa It's so confusing because if you read the side effects inside the box of estradiol patches, the manufacturer list all the side effects that you said you have a risk for. I took HRT for 6 years but now off it for three weeks and surprisingly, I'm sleeping better and I'm losing weight not so puffy and bloated. Stay tuned. Ill see how I do over time.
@@r-anne7375 "Read the side effects inside the box of estradiol patches", Yes, I understand how you are confused I was too until I watched one of DR. Susan's recent videos. She addresses the inaccuracies of the insert. Basically (she is much more thorough) it says the insert has never been updated for the past 20 years. We are not taking the same hormones we took 20 years ago. The insert is based on the 2002 results which are no longer relevant.
"lists all the side effects that you said you have a risk" The point I was trying to make, because I have these risks the best time for me to have taken HRT was in 2002, not stopping it. If I had continued to take Estradiol my risks would have been reduced over my lifetime. I would not have osteopenia now or high cholesterol, on the brink of heart disease, etc. I'm not even talking about all the emotional and physical pain and suffering I went through from 0 hormones. I had an awful time with vaginal atrophy, UTIs, yeast infections, 14 years of chronic insomnia, 13 years of hot flashes, painful sex...my husband wanted sex and had resentments that I couldn't....it goes on and on. There is so much more I want to say....please do more research and read "Estrogen Matters" or The New Menopause" or watch Dr. Shawn Tassone or others on TH-cam. Dr. Susan posted this, did you read it?
drive.google.com/file/d/1dOvEDenP3pYFWwknm73pjsh7W1YL2MXz/view?pli=1
Wow!😮 my friend how are you!❤