Understanding Women's Health Risk Factors

Women's health presents unique risk factors that can influence overall well-being, particularly concerning cardiovascular health. Conditions such as obesity and smoking are common risk factors that affect both genders; however, certain factors such as pregnancy and estrogen deficiency are exclusive to women and can elevate cardiovascular risks.

Globally, cardiovascular diseases represent the leading cause of death among women, accounting for 35% of female fatalities in 2019. While the age-adjusted mortality rate from cardiovascular diseases in women has seen a decline over recent decades, reports indicate a disturbing rise in heart attack rates among younger women over the past ten years.

An interdisciplinary team of specialists, including experts from gynecology, endocrinology, pediatrics, and family medicine, has collaborated to compile a consensus paper outlining these risk factors across various life stages. This comprehensive document identifies specific risks faced by women and highlights areas requiring further research while providing recommendations for prevention.

During adolescence, girls aged 10 to 21 are particularly vulnerable to three key risk factors: an increase in body fat percentage, a decline in physical activity, and a rise in smoking rates, with girls starting to smoke at higher rates than boys.

For women of reproductive age (over 21 years), conditions such as polycystic ovary syndrome (PCOS), hypogonadotropic hypogonadism (a deficiency in gonadal function), and premature ovarian insufficiency (POI) are critical gender-specific risk factors for cardiovascular diseases. These conditions are characterized by low estrogen levels and are associated with metabolic issues like insulin resistance, central obesity, dyslipidemia, and hypertension.

The authors of the consensus paper recommend hormone replacement therapy (HRT) for women suffering from POI or hypogonadism prior to menopause, ideally with transdermal estrogen and, if necessary, a progestogen. However, they refrain from making a blanket recommendation for HRT for all women. They do note that HRT has proven to be an effective intervention for alleviating menopausal symptoms and improving quality of life. Moreover, HRT may reduce cardiovascular risk and overall mortality in women under 60 and up to ten years post-menopause. Nonetheless, it is not advised for women with a high cardiovascular risk or existing cardiovascular disease.