How Estrogen Affects a Woman's Heart

Prior to menopause, natural estrogen production helps decrease the risk of a heart attack. After menopause, though, estrogen levels fall, and by age 60 to 65, men and women have approximately the same risk of developing heart disease.

As estrogen levels decline and stay low with age, recent data suggests women over the age of 75 may surpass men of the same age when it comes to heart disease risk.​

Senior with Chest Pain
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How Estrogen Affects Cholesterol Levels

The majority of estrogen’s protective effects are likely to come from its influence on regulating cholesterol levels. Estrogen acts on the liver to cause an overall reduction in the total amount of cholesterol in the body, an increase in the amount of high-density lipoprotein (HDL) good cholesterol. and a decrease in the amount of low-density lipoprotein (LDL) bad cholesterol.

Over time, bad cholesterol can accumulate as deposits in your blood vessels. This can lead to blockages that interfere with the delivery of blood to your heart. Decreasing your level of bad cholesterol reduces the likelihood of these blockages forming.

Good cholesterol, on the other hand, is actually an anti-blockage type of cholesterol. Good cholesterol reduces both the amount of bad cholesterol present in the body and makes bad cholesterol less able to accumulate into the types of deposits that cause blockages.

Estrogen and the Immune System

There is some evidence that estrogen also has an effect on the immune system, which further decreases the danger posed by deposits of bad cholesterol.

Once bad cholesterol has deposited in the blood vessels, a complicated immune system reaction causes the affected vessel to become inflamed. This inflammation leads to further blockage while increasing the risk that a part of the deposit may break off and travel downstream to a narrow area of your vessel. Here it can lodge and cause a heart attack or stroke.

Preventing Heart Disease

Regardless of your age or estrogen level, you can lower your risk of heart disease through lifestyle adjustments. One of the best things you can do for your heart is to stop smoking. If you smoke, talk to your healthcare provider about quitting; your healthcare provider can give you tips, resources, and medications that can make quitting easier.

Regular exercise and maintaining a healthy diet are also greatly beneficial for heart health. If you want to adopt a healthier lifestyle, but aren't sure where to begin, talk to a nutritionist about your diet and work with a personal trainer to identify which workouts are best for your body and activity level. 

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Crescioli C. The role of estrogens and vitamin D in cardiomyocyte protection: A female perspective. Biomolecules. 2021 Dec 2;11(12):1815. doi:10.3390/biom11121815

  2. Niță AR, Knock GA, Heads RJ. Signalling mechanisms in the cardiovascular protective effects of estrogen: With a focus on rapid/membrane signalling. Curr Res Physiol. 2021 Mar 28;4:103-118. doi:10.1016/j.crphys.2021.03.003

Additional Reading

By Craig O. Weber, MD
Craig O. Weber, MD, is a board-certified occupational specialist who has practiced for over 36 years.