Rejuvenating Your Health: Can You Start BHRT After 60?

Presented by Immanence Health

Written by Heathar Parisi, FNP-C

Many women experience a significant hormonal shift around menopause, often in their 40s and 50s. As I have discussed in the last few blogs, hormones have a significant effect on virtually every single system within our precious bodies. One of the most important of those is the cardiovascular system. Estrogen plays a vital role in keeping our blood vessels healthy and flexible. Healthy estrogen levels help maintain the lining, or endothelium, of blood vessels, acting like a protective shield. This healthy endothelium produces nitric oxide, a molecule that keeps blood vessels relaxed and allows blood to flow freely and reduces the pressure within the circulatory system. Sounds like something we’d want to keep around, right?

As estrogen levels decline with menopause, the endothelium can become inflamed and dysfunctional. This can lead to the buildup of soft and hard plaques within the arteries. While these plaque may not completely block the vessel, soft plaque can be more susceptible to rupture. When a soft plaque ruptures, it can trigger a blood clot that could lead to a heart attack or stroke.

Cleerly: Unveiling a Clearer Picture of Your Heart Health

A standard coronary CT scan can reveal blockages in your arteries, but Cleerly goes a step further. It provides us with an in-depth analysis of your scan, visually defining the type and amount of plaque buildup in your arteries. This plaque can be a precursor to heart disease, even if it doesn't cause complete blockage yet. So, it’s valuable information to have.

Additional Benefits:

• Personalized Treatment Plans: By giving your medical provider a more detailed picture of your heart health, these results help to guide and create a treatment plan tailored to your specific needs and risk factors, including the potential use of BHRT.
• Proactive Approach: Cleerly's "Track Your Plaque" feature allows us to monitor changes in your plaque buildup over time, enabling early intervention if needed. This can be particularly important for women considering BHRT later in life.
• Empowering Patients: The Patient Report provides you with clear, easy-to-understand information about your plaque score and the results of your scan. This knowledge helps you actively participate in managing your heart health and adhere to any recommendations, including potential lifestyle changes or medication alongside BHRT.

In essence, the CCTA with Cleerly along with your blood work and other imaging studies provide actionable insights to medical providers and patients to make informed decisions about your overall health, especially when considering BHRT after 60+.

The Power of BHRT: It’s Never to Late!

For women considering BHRT, even later in life, the benefits can be significant. Bio-identical hormone replacement therapy uses hormones that mimic those naturally produced by the body. Here's some ways BHRT can positively impact your health:

• Stronger Bones: Estrogen, progesterone and testosterone all play a role in bone health. BHRT can help prevent bone loss and reduce the risk of osteoporosis, a condition that weakens bones and increases fracture risk.
• Cognitive Boost: Many studies have shown that estrogen and progesterone may help support cognitive function and memory, reducing the risk of dementia later in life.
• Genitourinary Health: BHRT can improve vaginal dryness, painful intercourse, and urinary incontinence—common issues associated with declining estrogen and testosterone.
• Cardiovascular Support: BHRT may improve the health of the endothelium and potentially decrease the risk of heart disease. An analysis can provide valuable information when considering BHRT and its potential impact on your cardiovascular health.
• Enhanced Vitality and Mood: BHRT may help alleviate symptoms like hot flashes, fatigue, and low mood, leading to increased energy and motivation. It can also improve libido in some women.
• Skin Health: Estrogen helps to promote more collagen and gives elasticity to the skin. We can receive these benefits with both systemic replacement as well as using a very low dose estriol applied on the face. It stays right in the tissue and can give us that little extra plump and glow. 

Finding the Right Path: Consulting a Menopause Specialist

If you're considering BHRT, especially after 60+, consulting with a menopause specialist is crucial. These healthcare professionals possess a deep understanding of hormonal changes and can help you determine if BHRT is the right choice for your specific needs. 

Here's what to expect when you consult a menopause specialist:

• Comprehensive Evaluation: They will conduct a thorough evaluation, which may include:
• Blood work to assess hormone levels and overall health.
• Bone density testing to check for osteoporosis risk.
• Breast imaging for routine screening.
• Potentially, a CCTA scan with Cleerly analysis to assess plaque buildup and cardiovascular health.
• Personalized Plan: Following the evaluation, your menopause specialist will discuss the potential benefits and risks of BHRT in the context of your individual situation. Together, you'll develop a personalized BHRT treatment plan that may include bio-identical hnormones, supplements, lifestyle modifications, and other recommendations.
  

Remember, menopause is a natural transition, but it shouldn't come with diminished health and misery. The proper tools are available to us all so we might well use them! With proper evaluation and potentially BHRT, you can continue to thrive well into your golden years.

Additional Sources:

• Coronary computed tomography angiography (CCTA). (2021, August 23). Retrieved from https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/coronary-computed-tomography-angiography-ccta
• El Khoudary, S. R., Aggarwal, B., Beckie, T. M., Hodis, H. N., Johnson, A. E., Langer, R. D., … Limacher, M. C. (2020). Menopause transition and cardiovascular disease risk: Implications for timing of early prevention: A scientific statement from the American Heart Association. Circulation, 142(25). doi:10.1161/cir.0000000000000912
• Gersh, F., O'Keefe, J. H., Elagizi, A., Lavie, C. J., & Laukkanen, J. A. (2024). Estrogen and cardiovascular disease. Progress in Cardiovascular Diseases. doi:10.1016/j.pcad.2024.01.015
• Mompeón, A., Lázaro-Franco, M., Bueno-Betí, C., Pérez-Cremades, D., Vidal-Gómez, X., Monsalve, E., … Gironacci, M. M. (2016). Estradiol, acting through ERα, induces endothelial non-classic renin-angiotensin system increasing angiotensin 1–7 production. Molecular and Cellular Endocrinology, 422, 1-8. doi:10.1016/j.mce.2015.11.004
  

About Heathar Parisi, FNP-C

Advanced Nurse Practitioner, Heathar Parisi, is a women’s health and hormone expert. As a family nurse practitioner, herbalist, and functional medicine provider, she uses a holistic approach when treating women in perimenopause and menopause, always keeping connection and humor as the centerpiece of her interactions. She has specialty training in the Menopause Method for the use of BHRT through the Institute of Bioidentical Medicine (IOBIM). She is a mother of three and resides in Scottsdale, AZ with her family. Consultations are available through Immanence Health.

To learn more about working with  Heathar Parisi, FNP-C  in person or virtually (US and Worldwide), set up a free discovery call with our team.

Disclaimer: this post is for informational purposes only and is not meant to treat, diagnose, cure, or prevent any disease. Please do your own research and consult with your own personal licensed health care provider before making any treatment decisions.