WEST MICHIGAN — Heart disease doesn't suddenly appear, it builds over decades. Menopause is one condition that can make the process speed up, and for years, women and healthcare providers were given a simple yet frightening message: hormone therapy is bad for the heart.
Dr. Diana Bitner is the co-founder and Chief Medican Officer of True. Women's Health, and she says that message is incomplete for many women. The idea delayed care that could improve quality of life and long-term health, and for too long, Dr. Bitner says evidence and education are changing the options we have for women.
New research confirms how menopause hormone therapy (MHT} is used matters. its effects on the heart depend on:
- When it started
- Who uses it
- How it is delivered
Women starting hormone therapy before age 60, within 10 years of menopause, and who do not already have advanced cardiovascular disease, did not show an increased risk of heart attack in most modern studies. Evidence suggests blood vessels may function better when estrogen is replaced during this early window.
What potentially has risk:
- Starting hormone therapy late, long after menopause
- Usin synthetic oral estrogen combined with synthetic progestins in higher-risk women
- Ignoring underlying risks like insulin resistance, elevated blood pressure, or genetic cholesterol disorders
Menopause matters for the heart because estrogen is not only a reproductive hormone. Dr. Bitner says it helps blood vessels stay flexible, responding better to increased blood flow demands, and remaining less inflamed. When estrogen levels drop during menopause, LDL cholesterol rises, blood sugar control worsens, blood pressure rises, and existing plaque becomes more active.
Menopause does not cause heart disease, but it can accelerate it. Dr. Bitner says menopause should be treated as a checkpoint for heart health, not just a symptom moment. Hormone therapy is not heart disease prevention, and medication should never replace:
- Blood pressure control
- Cholesterol treatment when indicated
- Diabetes prevention
- exercise, sleep and nutrition
For the right women at the right time, hormone therapy can treat menopausal symptoms without increasing heart risk, especially when:
- MHT starts early
- Non-oral routes are chosen
- Care is individualized
- MHT is used with a heart disease risk prevention strategy
Heart disease is preventable, and menopause is one of our most powerful moments to intervene. Menopause hormone therapy is much safer than you think. Dr. Bitner says you should make decisions based on your biology, and not outdated headlines and studies.
Read more stories from the FOX 17 Morning News team
Do you have an idea for the Morning News team or maybe an idea for a guest segment or something for the gang to come out and try? Send them an email at mornings@fox17online.com or call 616-447-5252 and leave a message.
Follow FOX 17: Facebook - X (formerly Twitter) - Instagram - YouTube
