Research & Education

The Postmenopausal Decline of Estrogen and How it May Influence Cardiovascular Health

Cardiovascular disease (CVD) is the leading cause of death among women. Epidemiological studies suggest that premenopausal women have a lower incidence of CVD when compared to age-matched men. However, the incidence and severity of CVD in women increases after menopause compared to men of the same age. This is primarily attributed to the postmenopausal decline of estrogen – the primary female sex hormone. 

Estrogen is a fat-soluble steroid hormone recognized for its cardioprotective properties in vitro and in rodent models. It plays a critical role in the development and physiology of multiple organs, including the cardiovascular system, breast, uterus, and bone. Research indicates estrogen promotes cardiovascular health by supporting mitochondrial function, normal vasodilation, endothelial health, and reducing oxidative stress.

Oxidative stress is a key player in the development of CVD. Estrogen has been shown to help attenuate oxidative stress due to its antioxidant properties, including free-radical scavenging, neutralizing excess reactive oxygen species, and increasing antioxidant molecules like superoxide dismutase (SOD). Estrogen's ability to mitigate oxidative stress extends to the brainstem neurons regulating the cardiovascular system via sympathetic/parasympathetic activity. Additionally, estrogen may promote healthy inflammatory responses by downregulating inflammatory markers like chemokines and cell adhesion molecules associated with atherosclerosis.

That being said, the postmenopausal decline of estrogen is a natural part of the aging process in women. Consequently, it is important for postmenopausal women to promote optimal antioxidant status and cardiovascular health through other clinically beneficial means. 

Phytoestrogens, such as genistein and spruce lignans, demonstrate antioxidant and anti-inflammatory properties in vivo and in vitro, which may help promote cardiovascular health. Phytoestrogens are plant compounds structurally similar to estrogen, allowing them to bind to estrogen receptor transcription factors in the body and modulate their activation. However, phytoestrogens are 100 to 1,000 times weaker in potency and activation of estrogen receptors compared to endogenous estrogen.

Genistein and spruce lignans may also help diminish mild hot flashes, a common vasomotor complaint of menopause. There may be an association between vasomotor complaints and disrupted cardiovascular health. Two large-scale meta-analyses conducted on tens of thousands of women concluded that the women experiencing vasomotor complaints “have significantly higher systolic and diastolic blood pressures, higher circulating total cholesterol levels, and a higher body mass index than their counterparts with no symptoms.”

Gamma-oryzanol (GO), derived from rice bran oil, may support cardiovascular health by promoting normal lipid metabolism. In a small clinical study (n = 40), menopausal women with hyperlipidemia who were supplemented with GO for 4 to 8 weeks experienced significant reductions in total cholesterol, triglyceride, and increased high-density lipoprotein (HDL)-cholesterol, along with decreased atherogenic index scores and serum lipid peroxide levels. Moreover, 90% of the women who received GO supplementation experienced an improvement in menopausal symptoms. 

Taurine, a sulfur-containing amino acid, may promote normal blood pressure through its demonstrated antioxidant and anti-inflammatory properties. In a double-blind study (n = 24) on women aged 55 to 70, those supplemented with taurine experienced increased antioxidant status, as indicated by higher plasma levels of SOD, potentially supporting cardiovascular health and healthy aging

The postmenopausal decline of estrogen is a natural part of the healthy aging process in women despite estrogen’s cardioprotective properties. Seeking ways to promote cardiovascular health through nutritional support, such as with phytoestrogens, gamma-oryzanol, and taurine, may be clinically relevant to postmenopausal women to support healthy aging and menopausal comfort. 

By Danielle Moyer, MS, CNS, LDN