Does low estrogen increase the likelihood of cardiovascular disease? That's the question experts and medical professionals have been asking for decades. More and more studies show a link, and new research shows the danger isn't reserved only for menopausal women.
It's a topic recognized by The Mayo Clinic, who covered it in their 20th Annual Women's Health Update for 2024.So, do you need to worry? And what can you do about it?
Menopause and Cardiovascular Disease
Studies show cardiovascular disease risks rise as women reach menopausal age. This happens for several reasons:
During menopause, women produce less estrogen and tend to increase their belly fat. Excess abdominal fat is a key factor in metabolic syndrome, along with:
- high triglycerides
- low HDL cholesterol
- high blood pressure
- high blood sugar
You have metabolic syndrome when you have three of these conditions. Metabolic syndrome increases your risk of heart disease, stroke and type 2 diabetes.
- During menopause, arteries get thicker and stiffer, making them more vulnerable to disease.
- Hot flashes and night sweats, two telltale signs of menopause, are linked to an increased risk of high blood pressure and cardiovascular disease.
- Depression, which is common during the transition from premenopause to menopause, may also increase cardiovascular disease risk.
Younger Women and Low Estrogen
Recent studies show a troubling relationship between rising rates of cardiovascular disease and low estrogen in young women. The WISE study (Women's Ischemia Syndrome Evaluation) showed that 69% of young women with coronary artery disease have low estrogen levels. In heart-healthy women, only 29% had low estrogen.
The culprit: missed periods.
Functional hypothalamic amenorrhea, or FHA, is the official name for a condition that causes missed periods because of an issue with the hypothalamus. The hypothalamus is the brain's “control center."
Younger women can miss periods for several reasons, including:
- over-exercising – Exercising too much can cause skipped periods or make them stop completely. This is common in athletes and many fitness-focused women.
- undereating – Not eating enough calories or having poor nutrition can cause the hypothalamus to go into survival mode. Body processes like menstruation may stop while the focus is on basic functions like breathing.
- extreme stress – Severe emotional distress may disrupt the menstrual cycle. Medical professionals recommend seeing a doctor after three missed or unusually irregular periods, if pregnancy is ruled out.
“The Walking Well”
What can you do?
- Understand your risk. Heart disease is the leading cause of death for women in the U.S. But many women not only don't know the typical risk, they're also unaware of these new findings that could put them in danger.
- Talk to your doctor – especially if you're at or nearing menopause or if you're younger and have skipped periods.
- Listen to your doctor. If you're at risk for cardiovascular disease, your doctor may recommend nutrition or exercise changes.
Lowering your risk
If you're not currently at risk for cardiovascular disease – that's great! Here's what you can do to keep that risk low:
- Get regular preventive care to check your cholesterol, blood sugar and get other key screenings.
- Get some exercise. It only takes 30 minutes of moderate intensity exercise each day to make a difference.
- Lose a little weight. A 10-pound weight loss can lower blood pressure and reduce strain on your heart.
- Regularly check your blood pressure. High blood pressure is a leading cause of heart disease and 75% of those with hypertension don't have their condition under control.
- Eat a balanced diet. Focus on lean meat, fish, low-fat dairy, whole grains, and fruits and vegetables. Cut back on sugar, salt, and drink in moderation.
- Quit smoking. Cigarette smoking can damage the heart and blood vessels.
- Manage your stress. Chronic stress can raise bad cholesterol and lower good cholesterol.
Resources for TRS-ActiveCare and TRS-Care Standard
Provider Finder®
Keep up with preventive care or see a specialist when needed.
The Fitness Program
Choose from large gyms, boutique classes and digital options.
Find a Mental Health Provider
Find healthy ways to cope with stress.Chronic stress can raise your blood pressure, which increases your risk for heart attack. Seeing a professional can help. Find a therapist or other mental health professional.
Find a Therapist on Headway
Use Headway to find a therapist quickly and easily. You can get same-day matching with in-network providers who have openings within 48 hours.
Virtual Health Care from Teladoc™
Make a virtual appointment with a licensed therapist, psychologist or psychiatrist with Teladoc. Appointments are no-cost for TRS-ActiveCare Primary and TRS-ActiveCare Primary+ participants.
$0 Health Coaching
Work one-on-one with a credentialed health expert to help manage your stress, lower your cholesterol or plan a healthy diet. This service is available at no cost.
Well onTarget®
Access self-management programs, tips and resources to help you manage stress. Videos, podcasts, 12-week programs and other tools are available anytime, day or night.
TRS-ActiveCareTRS-Care Standard
Learn to Live Access digital programs anytime, anywhere for stress, anxiety, depression, insomnia and more.
TRS-ActiveCareTRS-Care Standard
24/7 Live Help
Connect with a Personal Health Guide (PHG). Call 1-866-355-5999 or chat in the BCBSTX App 24/7. A PHG can help you find a provider and even make an appointment for you.
Resources for TRS-Care Medicare
Annual Wellness Visits
Your plan covers one physical exam and one wellness visit per calendar year. You can ask your provider to combine the visits into one convenient annual care appointment. You and your provider can work as a team to create a preventive care plan for the year.
24/7 Nurse Support
Helps make your health decisions simple and convenient while providing:
- Quick answers to your health questions anytime, anywhere
- Access to registered nurses with clinical experience
- Information to guide your health care decisions
Call 1-877-365-7949, TTY 711 any time for health information and support – at no added cost to you.
Virtual Doctor Visit
See a doctor anytime using live video chat from your computer, tablet or smartphone. With Virtual Doctor Visits, you can ask questions, get a diagnosis or even get medication prescribed and have it sent to your pharmacy. All you need is a strong internet connection. Consider setting up an account with a Virtual Doctor Visit provider so you're ready when it's time to make an appointment.Ways to access Virtual Doctor Visits:1. On your computer, visituhcvirtualvisits.com and click on Choose a Medical Provider 2. On your tablet or smartphone:
- Download the American Well (Amwell) app
- Download the Doctor on Demand app
Download the Teladoc app or call 1-855-615-8335 to set up an account and request a visit by phone.
Mental Health Virtual Visits
Connect with a mental health expert on your computer, tablet or smartphone. Visit VirtualVisitsMentalHealth.uhc.com to select a health care provider. They can evaluate and treat conditions such as depression and anxiety, and address substance use concerns.
On-demand Self Care
Self Care from AbleTo gives you access to self-care techniques, coping tools, meditations, and more—anytime, anywhere. With Self Care, you get personalized content to help boost your mood and shift your perspectives. Tap into tools created by clinicians and suggested for you based on your responses to a short, optional assessment. Self Care is here to help you feel better — at no added cost to you. To start, visit ableto.com/begin. Questions? We're here to help.
Call UnitedHealthcare at 1-866-347-9507, TTY 711, 7 a.m.–6 p.m. CT, Monday–Friday.
Optum Behavioral Health
Optum Behavioral Health has more than 87,000 network providers offering inpatient and outpatient services, such as therapy, behavioral health assessment and medication management. To start, call the behavioral health number on your member ID card or visit yourmember website and select “Find Care."Silver SneakersAs a TRS-Care Medicare Advantage participant you have access to SilverSneakers, a fitness and lifestyle program, at no added cost.What does SilverSneakers include?
- Memberships to thousands of fitness locations — visit as many times as you wish
- Group exercise classes for all abilities — fun activities held outside the gym
- SilverSneakers On-DemandTM — online workout videos that feature tips on fitness and nutrition
- SilverSneakers LIVE — virtual classes and workshops throughout the week
- SilverSneakers GOTM mobile app
Get started today. Visit SilverSneakers.com or call 1-888-423-4632, TTY 711.
Personal Emergency Response System (PERS)
As a TRS-Care Medicare Advantage participant, you can access a Personal Emergency Response System (PERS) at no added cost. The Lifeline PERS lets you ask for help when you need it — 365 days a year, 24/7. Just push the help button on your wearable device and a trained care specialist will quickly connect you to help.
Members, family members, caregivers, and health care professionals may enroll an eligible member by calling 1-855-595-8485, TTY 711, or visiting lifeline.com/uhcgroup. Please be sure to have the member address (where we'll provide the service), telephone number, date of birth and preferred language.