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Natural Awakenings of the Coastal Carolinas

Heart Health and Hormones

by Karla Vavra Melcher

Heart disease is the leading cause of deaths, not only in the United States, but also globally. Once thought to be a “man’s disease”, women are just as affected and have the same number of deaths as men each year from heart disease in the United States.

While staying at a healthy weight, eating a healthy diet, getting regular exercise, managing your stress and blood sugar, as well as controlling your blood pressure, cholesterol and triglyceride levels are all keys to reducing your chances of getting heart disease, we may be missing an important part of the puzzle—the effect our hormones have on heart health and helping to accomplish the aforementioned positive health goals.

Estrogen and Heart Disease
Studies have shown women experience an increased risk of heart disease after menopause, increasing to one in four women dying of the disease each year. Researchers have connected this pattern to decreasing levels of estrogen during menopause. 

In fact, low estrogen before menopause also puts women at risk. A study in the Journal of Clinical Endocrinology & Metabolism in 2016 noted premenopausal women with estradiol concentrations at or below the 10th percentile had a higher risk of stroke. Thus it’s important to have hormones levels checked and at optimal range as you enter your mid-to-late 30s.

Proper estrogen balance is associated with higher levels of high-density lipoprotein (HDL or “good cholesterol”) and lower levels of low-density lipoprotein (LDL or “bad cholesterol”).  The decline of natural estrogen that occurs in menopause leads to lower HDL and higher LDL, leading to the increased risk of heart disease and stroke.

Men need estrogen, too. A study from the Journal of the American Medical Association in 2009 found in 501 men with chronic heart failure, those with both low testosterone and estrogen had an 96 percent increase in overall mortality. In fact, men with the lowest estradiol levels were 21 percent more likely to die during a three-year follow up.

Testosterone Decline and Increase in Disease
Men ages 30 to 70 lose 1 to 3 percent of total testosterone production per year. Women ages 20 to 40 lose 50 percent of their testosterone production.

Low testosterone appears to be a predictive marker for those at high risk for cardiovascular disease. Not only does low testosterone in men and women increase their risk of heart disease and stroke, but testosterone deficiency is also associated with Type 2 diabetes, metabolic syndrome, cancer, coronary artery disease, transient ischemic attacks and dementia.

The Need to Optimize Hormones
As people live longer, more and more people are entering menopause and andropause. (Andropause typically occurs between the ages of 40 and 60, but men as young as 30 may begin to experience male menopause symptoms which are attributed to a gradual decline in testosterone levels.)

As hormones are depleted cholesterol goes up, blood pressure rises and inflammation in blood vessels increases. 

However, when we optimize the hormones that have been depleted in men and women, we see restored blood flow to the coronary arteries, decreased plaque formation, increased HDL and decreased LDL, triglycerides and inflammation in the blood vessels.

“For far too long, testosterone has been stigmatized by its undeserved association with the over-use and abuse anabolic steroids,” states Dr. Jerald Bain, an endocrinologist at the University of Toronto’s Department of Medicine and the Toronto Mount Sinai Hospital.

While there’s a concern about synthetic oral hormones (which pass through the liver), hormones delivered by subcutaneous bioidentical hormone replacement therapy (BHRT) pellet implants bypass the liver, don’t affect clotting factors and don’t increase the risk of thrombosis. Bioidentical hormone therapy is a compound that’s identical to the natural molecules that the body produces. They are formulated from plant sources by pharmacists to identically match the body’s hormones.

Testosterone and estradiol delivered by pellet implantation don’t adversely affect blood pressure, glucose or liver functions. Testosterone BHRT implants have been used in both men and women in five continents since the 1930s. The longevity of this science-based modality attests to the fact that, when properly managed, 
bioidentical hormone replacement through the use of pellets is scientifically recognized as effective, safe and the most effective method available for administering such a therapy.

When optimized, natural estrogen, testosterone and progesterone protect the heart, brain and other body systems. When in balance, the natural bioidentical hormones work as antioxidants, reduce inflammation in the blood vessels, improve blood flow to the coronary and other arteries, and decrease plaque format.

There are numerous studies showing that testosterone protects the heart. For example, researchers from the University of Texas at Galveston performed a large study using testosterone in elderly men. Their results, published in the Annals of Pharmacotherapy in 2014, showed 50 percent fewer deaths and a reduction in heart attacks in men using testosterone.

Testosterone and estradiol improve lipid profiles by reducing total cholesterol, triglycerides, and LDL levels while increasing HDL cholesterol and decreasing blood pressure. This all has positive benefits on the cardiovascular system and helps to meet the goals of maintaining cardiovascular health.

Long term, men and women will not only have a reduced incidence of heart disease when they optimize their hormones through BHRT pellet therapy, but also Alzheimer’s disease and osteoporosis.

For those concerned about the risk of breast cancer with hormone therapy, there are multiple studies showing the long-term reduction in breast cancer in women using bioidentical hormone replacement therapy through the use of pellets rather than the increase in the incidence of breast cancer that has been associated with oral, synthetic hormones. Even after 20 years of therapy with hormone implants, the risk of breast cancer is not increased.

Given this information, the conclusion is that hormone balance and optimization play a larger role in cardiovascular and overall health than many people are aware of. Consider having your hormones levels checked to see if they are in optimal range and if you could benefit from having BHRT pellet therapy to optimize your hormones and health.
Karla Vavra Melcher, RN, BSN, is a nurse and certified BioTE provider at Restore Health & Wellness Center, located at 1010 S. 16th St.,Wilmington, which is owned and operated by Tabetha L. Smith, FNP-C. In 2005, Smith, who has a certification specialty as a Menopause Clinician with the National Certification Corporation, began studying and prescribing Bio-Identical Hormone Replacement Therapy (BHRT) to her patients and in October 2014 become a certified BioTE provider, becoming the first medical provider in the Wilmington area to provide BHRT implant therapy. For more information, call 910-763-1960 or visit


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