A Brief Pause for Menopause and Heart Disease

An increase in testosterone levels during menopause is linked to a higher risk for heart disease

By Dawn Klingensmith
CTW Features

Hormonal changes preceding menopause are known to cause hot flashes, night sweats, irritability and loss of libido. Now, new research suggests shifting hormone levels puts certain women at risk for cardiovascular disease - and the so-called "male" hormone, testosterone, is to blame.

Estrogen levels nosedive as a woman transitions into menopause, so the naturally occurring testosterone in her body eventually predominates. Testosterone exists in either a bound or "free" state. Bound testosterone is partnered with a protein that renders it inactive, while free - or bioavailable -testosterone is at liberty to "cause some action" in the body, says lead investigator Imke Janssen, a statistician at Rush University Medical Center, Chicago. As her study shows, free testosterone might also cause some trouble.

It had already been established that women tend to develop cardiovascular disease 10 years later than men, with a marked increase throughout the menopausal years. In fact, women older than 55 are more likely than men to have the disease.

Janssen's nine-year study of 949 women shows a link between elevated bioavailable testosterone levels and the development of metabolic syndrome, a constellation of health risks that increases the chance of getting heart disease, stroke and diabetes. Over the course of the study, 24 percent of the women developed the syndrome; of those, 55 percent had rising levels of active testosterone. By comparison, only 39 percent of women who did not develop the syndrome had rising amounts. After adjusting for age, weight and a host of other factors, the researchers estimated that women with an increase in testosterone are almost twice as likely to develop metabolic syndrome. The Archives of Internal Medicine published their findings in July.

Getting diagnosed with metabolic syndrome "doesn't mean you're about to die," Janssen says. "But it's an early warning sign of diseases that might develop over time."

Although the syndrome correlates with an increase in testosterone activity while estrogen plays no part, in general, testosterone isn't a trouble maker - nor is it truly a "male" hormone since it naturally occurs in women, as well, says Dr. Holly Thacker, director of the Center for Specialized Women's Health, Cleveland Clinic, Ohio. Overall testosterone levels decrease throughout adulthood and by the time a woman is approaching menopause, the deficiency can diminish or kill her sex drive, among other unfortunate outcomes.

A woman suffering from menopausal symptoms associated with low testosterone should not be afraid to incorporate it into her hormone replacement therapy, if her physician recommends that course of action, Thacker says. Generally speaking, though, hormone therapy is not as widely prescribed as it once was, and women who glide through "the change" with relative ease probably should forgo it.

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