Taking HRT before the menopause may prevent heart disease

According to American researcher Jay Kaplan, taking the "Pill" before the menopause or starting hormone replacement therapy before menopausal symptoms begin could actually help prevent heart disease in women.

In what is a rare positive comment on, in particular HRT, Kaplan is urging women to consider boosting their oestrogen levels before they reach the menopause after studies have shown its importance in preventing heart disease and osteoporosis later in life.

Professor Jay Kaplan, from Wake Forest University Baptist Medical Centre in North Carolina, has studied female monkeys in the perimenopausal period, which is five to 10 years before the menopause.

He says that waiting until the menopause arrives is not the time to start thinking about prevention, as perimenopause is a time of increased vulnerability to chronic disease.

Professor Kaplan was speaking to the American College of Veterinary Pathologists in Boston, Massachusetts about his research with female monkeys.

He says the monkey studies have shown that a deficiency of oestrogen before menopause places these females on a high-risk trajectory, and primary prevention of heart disease should start pre-menopause.

His research has shown that treating female monkeys with oestrogen pre-menopause slowed the growth of fatty deposits in their arteries.

The study raises new questions over an already controversial issue.

It is already known that women are less prone to heart disease than men before the menopause.

It is now also thought that both the Pill and HRT may increase a woman's risk of breast cancer.

The American Women's Health Initiative, the largest study on the effects of HRT, also found that oestrogen and progesterone supplements increased the risk of blood clots, stroke and heart attack in older women.

Despite this, Kaplan says that some American doctors still recommended that women use the Pill right up to the menopause and then go straight on to HRT.

He says that animal research suggests that oral contraceptives could effectively protect against heart disease.

Other research also conducted by Professor Kaplan has demonstrated that stress in younger women can interfere with ovulation and reduce oestrogen levels, and this could set the stage for heart disease to develop later.

Critics of the Women's Health Initiative say it studied women in their sixties and seventies and did not consider whether HRT might be protective in younger women.