mature woman smiling while standing with her arms folded in her home

The Impact of Early Estrogen Loss on Cardiovascular Health

Estrogen plays a vital role in the proper function of nearly every tissue and organ. Its role in cardiovascular health includes the ability to modulate vascular function and inflammatory response, improve metabolism, assist with cardiac myocyte and stem cell survival, and reduce risks for hypertrophy.1 Estrogen also improves insulin sensitivity,2 which is essential for proper metabolic function and weight management, two additional things that play a critical role in cardiovascular health.

Heart disease is a leading cause of death for women. According to the National Institutes of Health, more than 75 percent of women aged 40-60 have at least one risk factor for cardiovascular disease.3 However, recent studies have found that women in their 30s are seeing heightened risks as well, with three out of ten heart attacks now occurring in women under the age of 55.4

At an October 12th presentation at the North American Menopause Society (NAMS) annual meeting in Atlanta, Chrisandra L. Shufelt, MD, chair of the division of general internal medicine and associate director of the Women’s Health Research Center at Mayo Clinic in Jacksonville, suggested to attendees that premature estrogen loss may play a key role in the development of cardiovascular disease in younger women.5

Citing two studies specifically, Dr. Shufelt discussed how both surgical premature menopause and natural premature menopause had been shown to increase risks for heart disease. However, these studies found that surgical premature menopause increases chances significantly more. Dr. Shufelt believes that functional hypothalamic amenorrhea, a cessation of menses caused by the suppression of the hypothalamic-pituitary-ovarian axis, may also contribute to increased cardiovascular risks, and advised attendees to talk to their patients about these risks and how estrogen-based hormone therapy may help to reduce them.

BHRT and Estrogen Deficiencies

Bio-identical hormone replacement therapy (BHRT) can treat premature estrogen loss. For this course of treatment, the NAMS recommends women continue therapy until they have reached the average age of natural menopause. However, BHRT can be used to address menopausal symptoms as well, including hot flashes, memory and concentration problems, and vaginal dryness, and it is something many women may choose to continue even after menopause has started. This is a decision that is best made between patients and their providers.

Pellecome® is a leader in BHRT technology. Our partners are carefully selected, helping to ensure those we work with are equipped to deal with the many ways hormone imbalance can impact physical and emotional health. If you are experiencing any of the symptoms of estrogen loss or if you have been diagnosed with low estrogen levels, use our provider locator to find a physician in your area and learn how BHRT may be able to assist you in maintaining peak cardiovascular health.

  1. Introduction to the Nuclear Receptor Review Series [Circ Res. 2010;106:1557–1558]; Control of Macrophage Activation and Function by PPARs [Circ Res. 2010;106:1559–1569]; PGC Coactivators in the Developing and Diseased Heart [Circ Res. 2010;107:825–838]; Liver X Receptors in Atherosclerosis and Inflammation [Circ Res. 2011;108:996–1001]; PPARs and the Vessel Wall [Circ Res. 2011;108:1002–1016]. Available From:
  2. Yan H, Yang W, Zhou F, et al. Estrogen Improves Insulin Sensitivity and Suppresses Gluconeogenesis via the Transcription Factor For Diabetes. 2019;68(2):291-304. doi:10.2337/db18-0638 Available From:
  3. Rodgers JL, Jones J, Bolleddu SI, et al. Cardiovascular Risks Associated with Gender and Aging. J Cardiovasc Dev Dis. 2019;6(2):19. Published 2019 Apr 27. doi:10.3390/jcdd6020019. Available From:
  4. Colliver, Virginina, MD. Heart Attacks Striking Younger Women. Johns Hopkins Medicine. Available From:
  5. Haelle, Tara, (2022). Early estrogen loss increases cardiovascular risk in women. MDedge. Available From:

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