SOUTHWESTERN INTERNAL-MEDICINE CONFERENCE - POSTMENOPAUSAL ESTROGEN SUPPLEMENTATION - A CARDIOLOGISTS PERSPECTIVE

Women live nearly one third of their lives after ovarian function has ceased. The implications of menopause for both health and disease as w ell as the risks and benefits of hormonal replacement therapy are impo rtant considerations in the management of postmenopausal women. The au thor discusses the relation between menopause and coronary heart disea se (CHD) risk and evaluates the risks and benefits of hormonal replace ment therapy from a cardiologist's perspective. During menopause, ther e are changes in the lipid profile that favor the development of CHD. In addition, there is convincing evidence that the risk of CHD increas es with surgical menopause and that natural menopause also may signal a period of increasing risk. Data from angiographic and prospective st udies suggest that a reduction in CHD risk is associated with estrogen use in postmenopausal women and that a large part of the beneficial e ffect of estrogen on CHD risk is through changes in the lipid profile. The benefit of hormonal replacement therapy for reduced risk of CHD, however, must be viewed in the setting of the overall risks and benefi ts of hormonal replacement therapy for each individual patient. ,