Menopause can bring increased cholesterol levels and other heart risks. Here’s why and what to do about it
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Menopause is a natural biological process that marks the end of a woman’s reproductive years, typically between 45 and 55. As women approach or experience menopause, common “change of life” concerns include hot flushes, sweats and mood swings, brain fog and fatigue.
But many women may not be aware of the long-term effects of menopause on the heart and blood vessels that make up the cardiovascular system. Heart disease accounts for 35% of deaths in women each year – more than all cancers combined.
What should women – and their doctors – know about these risks?
Hormones protect hearts – until they don’t
As early as 1976, the Framingham Heart Study reported more than twice the rates of cardiovascular events in postmenopausal than pre-menopausal women of the same age. Early menopause (younger than age 40) also increases heart risk.
Before menopause, women tend to be protected by their circulating hormones: oestrogen, to a lesser extent progesterone and low levels of testosterone.
These sex hormones help to relax and dilate blood vessels, reduce inflammation and improve lipid (cholesterol) levels. From the mid-40s, a decline in these hormone levels can contribute to unfavourable changes in cholesterol levels, blood pressure and weight gain – all risk factors for heart disease.
4 ways hormone changes impact heart risk
1. Dyslipidaemia– Menopause often involves atherogenic changes – an unhealthy imbalance of lipids in the blood, with higher levels of total cholesterol, triglycerides, and low-density lipoprotein (LDL-C), dubbed the “bad” cholesterol. There are also reduced levels of high-density lipoprotein (HDL-C) – the “good” cholesterol that helps remove LDL-C from blood. These changes are a major risk factor for heart attack or stroke.
2. Hypertension – Declines in oestrogen and progesterone levels during menopause contribute to narrowing of the large blood vessels on the heart’s surface, arterial stiffness and raise blood pressure.
3. Weight gain – Females are born with one to two million eggs, which develop in follicles. By the time they stop ovulating in midlife, fewer than 1,000 remain. This depletion progressively changes fat distribution and storage, from the hips to the waist and abdomen. Increased waist circumference (greater than 80–88 cm) has been reported to contribute to heart risk – though it is not the only factor to consider.
4. Comorbidities – Changes in body composition, sex hormone decline, increased food consumption, weight gain and sedentary lifestyles impair the body’s ability to effectively use insulin. This increases the risk of developing metabolic syndromes such as type 2 diabetes.
While risk factors apply to both genders, hypertension, smoking, obesity and type 2 diabetes confer a greater relative risk for heart disease in women.
So, what can women do?
Every woman has a different level of baseline cardiovascular and metabolic risk pre-menopause. This is based on their genetics and family history, diet, and lifestyle. But all women can reduce their post-menopause heart risk with:
- regular moderate intensity exercise such as brisk walking, pushing a lawn mower, riding a bike or water aerobics for 30 minutes, four or five times every week
- a healthy heart diet with smaller portion sizes (try using a smaller plate or bowl) and more low-calorie, nutrient-rich foods such as vegetables, fruit and whole grains
- plant sterols (unrefined vegetable oil spreads, nuts, seeds and grains) each day. A review of 14 clinical trials found plant sterols, at doses of at least 2 grams a day, produced an average reduction in serum LDL-C (bad cholesterol) of about 9–14%. This could reduce the risk of heart disease by 25% in two years
- less unhealthy (saturated or trans) fats and more low-fat protein sources (lean meat, poultry, fish – especially oily fish high in omega-3 fatty acids), legumes and low-fat dairy
- less high-calorie, high-sodium foods such as processed or fast foods
- a reduction or cessation of smoking (nicotine or cannabis) and alcohol
- weight-gain management or prevention.
What about hormone therapy medications?
Hormone therapy remains the most effective means of managing hot flushes and night sweats and is beneficial for slowing the loss of bone mineral density.
The decision to recommend oestrogen alone or a combination of oestrogen plus progesterone hormone therapy depends on whether a woman has had a hysterectomy or not. The choice also depends on whether the hormone therapy benefit outweighs the woman’s disease risks. Where symptoms are bothersome, hormone therapy has favourable or neutral effects on coronary heart disease risk and medication risks are low for healthy women younger than 60 or within ten years of menopause.
Depending on the level of stroke or heart risk and the response to lifestyle strategies, some women may also require medication management to control high blood pressure or elevated cholesterol levels. Up until the early 2000s, women were underrepresented in most outcome trials with lipid-lowering medicines.
The Cholesterol Treatment Trialists’ Collaboration analysed 27 clinical trials of statins (medications commonly prescribed to lower cholesterol) with a total of 174,000 participants, of whom 27% were women. Statins were about as effective in women and men who had similar risk of heart disease in preventing events such as stroke and heart attack.
Every woman approaching menopause should ask their GP for a 20-minute Heart Health Check to help better understand their risk of a heart attack or stroke and get tailored strategies to reduce it.
Treasure McGuire, Assistant Director of Pharmacy, Mater Health SEQ in conjoint appointment as Associate Professor of Pharmacology, Bond University and as Associate Professor (Clinical), The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Lower Your Cortisol! (Here’s Why & How)
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Cortisol, or “the stress hormone” to its friends, is produced by your adrenal glands, and is generally considered “not fun”.
It does serve a purpose, of course, just like almost everything else our body does. It serves as part of the “fight or flight” response, for example, and helps you to wake up in the morning.
While you do need some cortisol (and a small percentage of people have too little), most of us have too much.
Why? Simply put, modern life is not what 200,000* years of human evolution prepared us for:
- Agriculture (which allowed us to settle down and cease being nomadic) happened during the last 6% of those 200,000 years.
- The Industrial Revolution and the onset of modern capitalism happened during only during the last 0.1% of those 200,000 years.
*the 200,000 years figure is conservative and doesn’t take into account the 200,000,000 years of pre-hominid mammalian evolution. Doing so, on the basis of the mammalian brain & physiology being what’s important here, means our modern stressors have been around for <0.0001% of the time we have.
So guess what, our bodies haven’t caught up. As far as our bodies are concerned, we are supposed to be enjoying the sunshine of grassy plains and the shade of woodland while eating fruit.
- When the alarm clock goes off, our body panics and prepares us to either flee or help fight the predator, because why else would we have been woken so?
- When we have a pressing deadline for work, our brain processes this as “if we don’t do this, we will literally starve and die”.
- When people are upset or angry with us, there’s a part of our brain that fears exile from the tribe and resultant death.
…and so on.
Health Risks of High Cortisol
The long-term stressors are the biggest issue for health. Unless you have a heart condition or other relevant health problem, almost anyone can weather a brief unpleasant surprise. But if something persists? That prompts the body to try to protect you, bless it. The body’s attempts backfire, because…
- One way it does this by making sure to save as much food as possible in the form of body fat
- It’ll also increase your appetite, to make sure you eat anything you can while you still can
- It additionally tries to protect you by keeping you on the brink of fight-or-flight readiness, e.g:
- High blood pressure
- High blood sugar levels
- Rapid mood changes—gotta be able to do those heel-turns as necessary and react quickly to any possible threat!
Suffice it to say, these things are not good for your long-term health.
That’s the “Why”—now here’s the “How”:
Lowering your cortisol levels mostly means lowering your stress and/or lowering your stress response. We previously gave some powerful tools for lowering anxiety, which for these purposes amounts to the same thing.
However, we can also make nutritional and lifestyle changes that will reduce our cortisol levels, for example:
- Reduce (ideally: eliminate from your lifestyle) caffeine
- Reduce (ideally: eliminate from your lifestyle) alcohol
- Yes, really. While many understandably turn to alcohol specifically to help manage stress, it only makes it worse long-term.
- Additionally, alcohol directly stimulates cortisol production, counterintuitive as that may be.
Read: Alcohol, Aging, and the Stress Response ← full article (with 37 sources of its own) from the NYMC covering how alcohol stimulates cortisol production and what that means for us
As well as reductions/eliminations, are some things you can add into your lifestyle that will help!
We’ve written previously about some:
Read: Ashwagandha / Read: L-Theanine / Read: CBD Oil
Other things include, no surprises here:
- The Mediterranean diet (nutritious and delicious): https://10almonds.com/mediterranean-diet
- Get 7–9 hours (good quality!) sleep per night: https://10almonds.com/time-pillow-talk
- Get regular exercise (the regularity matters most!): https://10almonds.com/keep-on-keeping-on
Progressive Relaxation
We’ll give this one its own section because we’ve not talked about it before. Maybe you’re familiar. If not, then in a nutshell: progressive relaxation means progressively tensing and then relaxing each part of your body in turn.
Why does this work? Part of it is just a physical trick involving biofeedback and the natural function of muscles to contract and relax in turn, but the other part is even cleverer:
It basically tricks the most primitive part of your brain, the limbic system, into thinking you had a fight and won, telling it “thank you very much for the cortisol but we don’t need it anymore”.
Take a Hike! Or a Stroll… You Do You!
Last but not least: go connect with your roots. Spend time in the park, or at least the garden. Have a picnic, if the weather suits. Go somewhere you can spend time around leafy green things under a blue sky (we realize the blue sky may be subject to availability in some locations, but do what you can!).
Remember also: just as your body’s responses will be tricked by the alarm clock or the housework, they will also be easily tricked by blue and green stuff around you. If a sunny garden isn’t available in your location, a picture of one as your desktop background is the next best thing.
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Great Sex Never Gets Old – by Kimberly Cunningham – by Kimberly Cunningham
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Here some readers may be thinking “after 40? But I am 70 already” or such, so be assured, there’s no upper limit on the applicability of this book’s writings. The number of 40 was chosen more as the start point of things, because it is an age after which the majority of hormonal declines happen (and with them, often, sex drive and/or physical ability). But, as she explains, this is by no means necessarily an end, and can instead be an exciting new beginning.
She kicks things off with a “wellness check”, before diving into the science of the menopause—and yes, the andropause too.
She doesn’t stop there though, and discusses other hormones besides the obvious ones, and other non-hormonal factors that can affect sex in what for most people is the later half of life.
Nurse Cunningham, much like most of modern science, is strongly pro-HRT, and/but doesn’t claim it to be a magic bullet (though honestly, it can feel like it is! But here we’re reviewing the book, not HRT, so let’s continue), or else this book could have been a leaflet. Instead, she talks about the side-effects to expect (mostly good or neutral, but still, things you don’t want to be taken by surprise by), and what things will just be “a little different” now if you’re running on exogenous bioidentical hormones rather than ones your own body made. A lot of this comes down to how and when one takes them, by the way, since this can be different to your body making its own natural peaks and troughs.
But it’s not all about hormones; there are also plenty of chapters on social and psychological issues, as well as medical issues other than hormones.
The style is very light and conversational, while also casually dropping about 30 pages of scientific references. Like many nurses, the author knows at least as much as doctors when it comes to her area of expertise, and it shows.
Bottom line: if your sex has ever hit a slump, and/or you simply recognize that it could, this book could make a very important difference.
Click here to check out Great Sex Never Gets Old, and enjoy the best of life in the bedroom too!
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You May Have More Air Pollution In Your Home Than In The Street
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Certainly, gas stoves and heaters can cause indoor air pollution, with carbon monoxide (CO) being the main risk. Even if you have a CO alarm, the level at which it will go off is usually the “this will kill you tonight if you don’t do something about it soon” level, rather than the “this will slowly kill your brain cells but you’ll keep functioning otherwise, until one day you don’t” levels of CO.
Still, do by all means have a CO alarm if you have anything in your house that can release CO!
Fun fact about those stoves:
❝Just 1 kilogram of cooking fuel emits 10 quadrillion particles smaller than 3 nanometers, which matches or exceeds what’s emitted from cars with internal combustion engines.
At that rate, you might be inhaling 10-100 times more of these sub-3 nanometer particles from cooking on a gas stove indoors than you would from car exhaust while standing on a busy street.❞
But today, we’re not here about that
Rather, we are looking at some more innocent-seeming things, such as scented cleaning products and air fresheners. Notably, the biggest problem is often not even the cleaning chemicals themselves. Of course: please don’t breathe bleach fumes, etc.
But that’s an obvious risk, and today we’re about the less obvious risks.
So… What is the less obvious risk here?
It’s the fragrances. The terpenes used to hold them react with ozone in the air, to create new nanoparticles. And, just like the nanoparticles from the stove, these can reach very high concentrations indoors, and suffice it to say, if you can smell the fragrance then you have the pollutants inside you.
You can read about how badly different products score, here:
Rapid Nucleation and Growth of Indoor Atmospheric Nanocluster Aerosol during the Use of Scented Volatile Chemical Products in Residential Buildings ← you’ll need to scroll down to the table with different cleaning products and air fresheners
Further, the seemingly-harmless scented candle is, as it turns out, quite a menace too:
❝Full-scale emission experiments were conducted in the Purdue zEDGE Test House using a variety of scented candles (n = 5) and wax warmers/melts (n = 14) under different outdoor air exchange rates (AERs). Terpene concentrations were measured in real-time using a proton transfer reaction time-of-flight mass spectrometer (PTR-TOF-MS). PTR-TOF-MS measurements revealed that scented candle and wax warmer/melt products emit a variety of monoterpenes (C10H16) and oxygen-containing monoterpenoids (C10H14O, C10H16O, C10H18O, C10H20O), with peak concentrations in the range of 10−1 to 102 ppb. Monoterpene EFs were much greater for scented wax warmers/melts (C10H16 EFs ∼ 102 mg per g wax consumed) compared to scented candles (C10H16 EFs ∼ 10−1 to 100 mg per g wax consumed). Significant emissions of reactive terpenes from both products, along with nitrogen oxides (NO, NO2) from candles, depleted indoor ozone (O3) concentrations. Terpene iFs were similar between the two products (iFs ∼ 103 ppm) and increased with decreasing outdoor AER. Terpene iFs during concentration decay periods were similar to, or greater than, iFs during active emission periods for outdoor AERs ≤ 3.0 h−1.
Overall, scented wax warmers/melts were found to release greater quantities of monoterpenes compared to other fragranced consumer products used in the home, including botanical disinfectants, hair care products, air fresheners, and scented sprays.❞
Put in fewer words: scented candles are bad, and wax melts (the kind with no flame, that one might easily expect to thus produce fewer emissions) are at least as bad if not worse, and both are even worse than cleaning products.
Some of the same research team conducted further studies, because of this this, finding:
❝We performed field measurements in a residential test house to investigate atmospheric nanoparticle formation from scented wax melt use. We employed a high-resolution particle size magnifier-scanning mobility particle sizer (PSMPS) and a proton transfer reaction time-of-flight mass spectrometer (PTR-TOF-MS) for real-time monitoring of indoor atmospheric nanoparticle size distributions and terpene mixing ratios, respectively.
Our findings reveal that terpenes released from scented wax melts react with indoor atmospheric ozone (O3) to initiate new particle formation (NPF) events, resulting in significant indoor atmospheric nanoparticle concentrations (>106 cm–3) comparable to those emitted by combustion-based scented candles, gas stoves, diesel engines, and natural gas engines.
We show that scented wax melt-initiated NPF events can result in significant respiratory exposures, with nanoparticle respiratory tract deposited dose rates similar to those determined for combustion-based sources.
Our results challenge the perception of scented wax melts as a safer alternative to combustion-based aromatherapy❞
Read in full: Flame-Free Candles Are Not Pollution-Free: Scented Wax Melts as a Significant Source of Atmospheric Nanoparticles
In short: you might want to ditch the fragranced products!
Want to do more?
Give your household hair a makeover with this multi-vector approach to deal with different risks:
What’s Lurking In Your Household Air?
For that matter, the air is a very important factor for the health of your lungs (and thus, for the health of everything that’s fed oxygen by your lungs), and there are more things we can do in that regard as well:
Seven Things To Do For Good Lung Health!
Take care!
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Superfood Broccoli Pesto
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Cruciferous vegetables have many health benefits of their own (especially: a lot of anticancer benefits). But, it can be hard to include them in every day’s menu, so this is just one more way that’ll broaden your options! It’s delicious mixed into pasta, or served as a dip, or even on toast.
You will need
- 4 cups small broccoli florets
- 1 cup fresh basil leaves
- ½ cup pine nuts
- ¼ bulb garlic
- 3 tbsp extra virgin olive oil
- 2 tbsp nutritional yeast
- 1 tbsp lemon juice
- 2 tsp black pepper, coarse ground
- 1 tsp red pepper flakes
- ½ tsp MSG or 1 tsp low-sodium salt
Method
(we suggest you read everything at least once before doing anything)
1) Steam the broccoli for 3–5 minutes. Allow to cool.
2) Blend the pine nuts, garlic, lemon juice, and nutritional yeast.
3) Add the broccoli, basil, olive oil, black pepper, red pepper, and MSG or salt, and blend in the food processor again until well-combined.
4) Serve:
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Broccoli vs Cauliflower – Which is Healthier?
- Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
- Herbs for (Evidence-Based) Health & Healing ← Basil features here! It’s easy to think that medicinal herbs have to be some kind of arcane obscurity, but it’s often not so.
- Our Top 5 Spices: How Much Is Enough For Benefits? ← Black pepper, red pepper, and garlic all feature here
- All About Olive Oil: Is “Extra Virgin” Worth It?
- Monosodium Glutamate: Sinless Flavor-Enhancer Or Terrible Health Risk?
Take care!
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The Telomere Effect – by Dr. Elizabeth Blackburn and Dr. Elissa Epel
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Telomeres can be pretty mystifying to the person with a lay interest in longevity. Beyond “they’re the little caps that sit on the end of your DNA, and longer is better, and when they get short, damage occurs, and aging”, how do they fit into the big picture?
Dr. Elizabeth Blackburn and Dr. Elissa Epel excel at explaining the marvelous world of telomeres…
- how they work
- what affects them
- and how and why
…and the extent to which changes are or aren’t reversible.
For some of us, the ship has sailed on avoiding a lot of early-life damage to our telomeres, and now we have a damage-mitigation task ahead. That’s where the authors get practical.
Indeed, the whole third part of the book is titled “Help Your Body Protect Its Cells“, and indeed covers not just “from now on” protection, but undoing some of the damage already done (yes, telomeres can be lengthened—it gets harder as we get older, but absolutely can be done).
In short: if you’d like to avoid further damage to your telomeres where possible, and reverse some of the damage done already, this book will set you on the right track.
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The Book Of Hormones – by Dr. Shweta Patel
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The subtitle promising “through every stage of life” is a slight overstatement, as the book barely touches on puberty, but we know that the vast majority of our readers have left that one far behind in the past, so probably this is not such an issue.
Where the book gives more attention is in general adult life, through the years of potential fertility, into menopause and beyond. This means lots about the hormonal fluctuations inherent to the menstrual cycle (both the normal, and the still-quite-commonly abnormal, e.g. in cases of PCOS etc), the before-during-after of pregnancy, and many hormonal matters that are not related to sex hormones, such as stress-related hormones and food-related hormones. As such, the book certainly lives up to its title; it is indeed “the book of hormones”.
The style is light and conversational; we get a lot of lessons in chemistry here, but it never feels like it, and there’s certainly no hard science, just clear and easy explanations.
Bottom line: if you’d like to understand hormones quite comprehensively but in a light-hearted manner, this book is a very pleasant and educational read.
Click here to check out The Book Of Hormones, and understand them!
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