heart treatment hormone therapy
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Hormones. These tiny chemical messengers are essential for every process in the body. Be it the growth of bones or puberty. They are known to have a role in the function of your kidney too. Why would the heart be left behind? Hormones can also influence your heart functions. 

Various hormones that regulate the level of water in the blood are known to influence heart function. The roles of thyroid, growth and sex hormones are being explored in multiple clinical trials today. Looking for novel therapeutic strategies is becoming necessary due to a rise in heart conditions.1 About 23 million people worldwide are known to be affected by heart failure, making heart failure one of the significant healthcare concerns.2

How do hormones affect heart function?

The thyroid hormone can regulate the way your heart contracts and relaxes. It even participates in regulating the blood flow to the heart muscles.1 Doctors from the Cardiac Society of India are now recommending a check of thyroid functions in some instances of heart failure too.3

The role of growth hormone in the maintenance of healthy structure and function of the heart is well known. A review article published by Lei L and Mao Y in 2018 indicated the benefits of growth hormone infusion in the treatment of congestive heart failure.1

Lei L and Mao Y reviewed several articles and also reported the possible benefits of testosterone administration in men with congestive heart failure. However, testosterone was found to have potential safety concerns, causing salt-water retention and cardiovascular side effects due to which the testosterone trial was discontinued. They also noted that large-scale clinical trials are being carried out for hormone replacement therapy (HRT) for women. This kind of treatment is usually carried out after menopause to bestow women with the protective effects of oestrogen. This review article also included a large-scale analysis which showed that HRT could reduce the incidence of congestive heart failure by 32% in women who started the therapy before the age of 60.1

What is HRT, exactly?

Hormone replacement therapy (HRT) has been a debatable topic in the scientific community lately. Dr Suvarna Khadilkar, Associate professor at Grant Medical College, Mumbai, clears this confusion in her latest publication from February 2019. She writes that post-menopausal women lose the protective effect of oestrogen and are at a higher risk of heart disease. It reduces the life expectancy of women after menopause. Hormone replacement therapy relies on supplementing these women with a combination of oestrogen and progesterone to regain the benefits of the hormones.4

Why is every doctor not recommending hormone therapy?

The Women’s Health Initiative (WHI) study was a large-scale study that explored the use of HRT for preventing the risk of heart failure in women. It was stopped after 7 years of HRT in approximately 25,000 women. The study did not present benefits as expected and, instead, had negative side effects. After the release of this information, many doctors are cautious in recommending HRT to post-menopausal women to reduce the risk of any heart-related disorders.4,5

What should women after menopause do?

Dr Khadilkar has come to our rescue by presenting an ‘opportunity window’ where the usage of HRT is safe and beneficial to women. HRT must be started immediately after menopause, she suggests, and a combination of oestrogen and progesterone can be given when the uterus is still in place. Apart from this, she also writes that a more personalised approach must be maintained in recommending the therapy. The doctors must take a detailed history of the woman and evaluate the risk before starting therapy.4

To cut a long story short, hormone therapy after menopause is more like personalised medicine. Every doctor may have a different opinion about the therapy, but what is common between their views is the stress on physical activity and a healthy lifestyle. A natural approach is always better than any artificial supplementation!

References:

  1. Lei L, Mao Y. Hormone treatments in congestive heart failure. J Int Med Res. 2018;46(6):2063-2081. doi:10.1177/0300060518761262.
  2. Bui AL, Horwich TB, Fonarow GC. Epidemiology and risk profile of heart failure. Nat Rev Cardiol. 2011 Jan;8(1):30-41. doi:10.1038/nrcardio.2010.165.
  3. Guha S, Harikrishnan S, Ray S, Sethi R, Ramakrishnan S, Banerjee S, et al. CSI position statement on management of heart failure in India. Indian Heart J. 2018 Jul;70(Suppl 1):S1-S72. doi:10.1016/j.ihj.2018.05.003.
  4. Khadilkar SS. Post-reproductive health: Window of opportunity for preventing comorbidities. J Obstet Gynecol India. 2019 Feb;69(1):1-5. doi:10.1007/s13224-019-01202-w.
  5. Louise Newson. IMS menopause live [Internet]. 2017 Jun 12 [cited 2019 Jul 24]. Available from: https://www.menopause.org.au/members/ims-menopause-live/991-hrt-and-cardiovascular-disease.

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