Hormone replacement therapy (HRT) is a treatment that involves the use of hormones, typically estrogen and progesterone, to replace the hormones that the body no longer produces in adequate amounts. HRT is often prescribed to women who are experiencing symptoms related to menopause, such as hot flashes, night sweats, and vaginal dryness. However, the use of HRT for heart health remains controversial and is not routinely recommended.

Although hormone replacement therapy is not approved for the prevention of heart disease, research has shown that estrogen has several cardiovascular benefits, including improving cholesterol levels, reducing inflammation, improving blood vessel function, and increasing HDL (good cholesterol). We should not be generalizing that hormone replacement is good or bad for any woman, but rather stratifying the risk and benefits based on the individual situation. For example, hormone replacement increases the risk of blood clots in women older than 60 or more than 10 years from the onset of menopause with complex health history and multiple chronic health conditions, such as high cholesterol, high blood pressure, diabetes, nicotine dependance, etc. Conversely, bio-identical hormones prescribed at the physiologic doses can maintain the beneficial level of good cholesterol, that protects from heart disease, as well as help with insulin resistance and unwanted weight gain in women who start hormone restoration in their 40-50s. We need to learn to respect our unique bodies and avoid generalized approach to health. One size does NOT fit all.

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