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Feature Article

Women, hormones and heart disease

Jennifer Johns

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Abstract

There is no evidence that currently available postmenopausal hormone therapies or hormonal contraceptives are effective in the prevention of coronary heart disease.

Key Points

  • Cardiovascular disease (CVD) is the main cause of death in women. Advancing age and postmenopausal status are associated with a higher prevalence of coronary heart disease (CHD).
  • Hormone therapy (HT) is not recommended for the primary or secondary prevention of CHD in postmenopausal women.
  • Women with known CHD or risk factors for CHD who have menopausal symptoms should be carefully evaluated for their individual risk before deciding whether to initiate HT. They should be advised not to take HT unless their quality of life is significantly affected by menopausal symptoms.
  • The lowest effective dose of HT should be used and women should be reviewed regularly to determine if ongoing treatment is required.
  • The combined oral contraceptive pill is very safe in healthy younger women. Women over the age of 35 years, or with cardiovascular risk factors, should be carefully assessed and other forms of contraception considered.

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