Cedars-Sinai Women's Heart Center Launches Advanced Preventive Women's Clinic For Women With Menopause Symptoms Who Are At Risk For Heart Disease

Main Category: Heart Disease
Also Included In: Women's Health / Gynecology
Article Date: 25 May 2009 - 2:00 PDT

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Women who are at risk for heart disease and who are also experiencing menopause symptoms now have an added resource - a highly specialized clinic in the Division of Cardiology at the Cedars-Sinai Heart Institute. The Advanced Preventive Women's Clinic at the Women's Heart Center recently opened and is offering comprehensive cardiac risk assessments designed specifically for women who are in menopause. The clinic also offers menopausal patients state-of-the-art screenings, as well as personalized medicine therapies and counseling, including high-risk hormone counseling.

"This clinic is designed for women who are at higher risk for heart disease and who are seeking to treat their menopause symptoms while simultaneously taking steps to prevent heart problems," said Chrisandra Shufelt, M.D., assistant director of the Cedars-Sinai Women's Heart Center. "Menopause is a time to assess your heart health so that the next chapter of your life can be as productive as your youth."

Each woman who comes to the clinic completes a comprehensive questionnaire that includes her heart risk factors as well as her own menopause symptoms. This personalized medicine approach enables her doctors to tailor a treatment plan that is uniquely hers - one that is based on her medical history, risk factors and symptoms. Risk factors include a family history of heart disease, elevated blood pressure, obesity, and a woman's own medical history - such as pre-diabetes, complex blood cholesterol disorders or resistant high blood pressure.

"Hormone treatment counseling is important for all women experiencing menopause, but it's especially important for women who are also at risk for heart disease," said Shufelt. "Before menopause, a woman's natural estrogen levels often help maintain a healthy balance between HDL (good cholesterol) and LDL (bad cholesterol) levels. However, during menopause, as a woman's estrogen levels shift, so, too, do her cholesterol levels, with the bad cholesterol levels typically increasing, which can lead to heart disease."

The Advanced Preventive Women's Clinic offers hormone therapy counseling as well as non-hormonal options, said Shufelt. The decision as to which provides the better treatment for each individual is determined by the woman's own symptoms, risk factors and medical history.

Some women - especially those who have had a prior heart attack, bypass surgery or mini-strokes - may not be appropriate for hormone therapy, but no one needs to suffer with menopause symptoms, Shufelt said. In cases where hormone therapy is not advisable, there are other non-hormonal options and lifestyle modification to consider.

"Hormones can be a confusing area," said Shufelt. "While there are some compound hormones or mixed hormones available on the market, these are not FDA regulated, and we do not offer them," she said. Instead, the Clinic offers only FDA-approved synthetic or bio-identical hormones, which are a form of hormone that are made from natural substances such as yams. Bio-identical hormones mimic the body's own form of estrogen.

Beyond hormone counseling, the Clinic also provides lifestyle recommendations. Avoiding alcohol and caffeine can help reduce hot flashes, said Shufelt. Other tips include layering clothing and choosing fabrics that wick away moisture.

Research is also part of the equation. "There is currently a study underway to evaluate the possible benefits of acupuncture for women who experience hot flashes, and there have also been studies on the benefits of yoga and meditation for women with heart disease," said Shufelt.

"Many women who have already been on hormone therapy for an extended period of time (more than five years), have questions," said Shufelt. "We work with them to provide the information they need to be a part of their own treatment planning. Women who are on hormone therapy should be re-evaluated each year to assess their risks and benefits and determine the course of action that is best for them."

Source
The Cedars-Sinai Heart Institute