(Family Features) Most people think of heart attacks as debilitating pain in the chest. However, that’s not always the case, especially for women, and missing the signs can be a matter of life and death.

Although heart disease is the leading cause of death among American women, according to the American Heart Association, symptoms are often overlooked or explained away as less worrisome conditions.
“Men and women experience many aspects of life differently, and heart disease is no exception,” said LeAnne Bloedon, MS, RD, vice president of clinical development, Esperion Therapeutics. “Symptoms of a heart attack aren’t as obvious as many women think, and failing to recognize the danger and get help can have catastrophic results.”

One heart disease risk factor, for example, is high LDL cholesterol. Often referred to as a “silent killer,” it doesn’t always present noticeable symptoms. In fact, data suggests women with high LDL cholesterol are not diagnosed or treated as early or aggressively as men, which can put women at an increased risk for cardiovascular events. Understanding how men’s and women’s risk and symptoms differ may help identify and treat a serious heart health problem before it causes lasting damage.

Anatomy Differences
Some differences between men and women are present in the body’s internal systems, including the cardiovascular system. Women generally have smaller hearts and narrower blood vessels.

This can affect heart health in numerous ways, including less efficient stress responses and greater risk of widespread plaque buildup, especially in smaller vessels, called microvasculature, which can pose treatment challenges.

Cholesterol Buildup
Hormones influence aspects of the body’s function, including cholesterol levels. Estrogen, a female sex hormone, raises HDL (good) cholesterol levels. This may be why women tend to have more HDL cholesterol and lower LDL (bad) cholesterol than men, especially before they reach menopause, though inherited high cholesterol can affect women of all ages.

“It’s critical to raise awareness about the importance of measuring LDL cholesterol, diagnosing high cholesterol and treating elevated LDL cholesterol per guidelines and individual patient needs,” Bloedon said.

Risk Factors
While there are shared risk factors for heart disease among men and women (such as obesity, high blood pressure and diabetes), some risk factors disproportionately affect women. For example, uncontrolled cholesterol in women, particularly after menopause, can increase the risk of heart disease and stroke.

Care and Treatment
“While you may not be able to fully prevent heart disease, you can understand the risks and take proactive steps,” Bloedon said. “Commit to a healthy, smoke-free lifestyle. Exercise regularly and eat a well-balanced diet with limits on processed foods, sugar, sodium and alcohol. Take any medications as directed by your health care provider.”

Statins, which reduce the production of cholesterol in the liver and lower cholesterol levels in the bloodstream, are the medications most often prescribed to help manage high LDL cholesterol. While generally well-tolerated, statin intolerance (the inability to take a statin at any dose or the recommended dose) does occur in some patients and is more common in women.

Talk with your doctor about other steps you can take to manage elevated LDL cholesterol levels and learn more about women’s heart health at goredforwomen.org.

Symptoms of Heart Attacks in Women
Women’s experiences with heart disease may be quite different from men.

For example, according to the Heart Disease Foundation, women are likely to be older when they experience a heart attack. They may also attribute symptoms to other conditions, such as diabetes or arthritis.

Further complicating matters, several diseases mimic heart attacks so getting to the root of the problem can be tricky. Women are more apt than men to experience a coronary spasm, coronary dissection or broken heart syndrome.

What to Watch For:

• Like men, women experiencing a heart attack may notice prolonged or reoccurring chest pain or pressure.
• In women, that pain may extend to the arms, back, neck, jaw and stomach.
• Some women experience shortness of breath with no chest pain at all.
• Other symptoms women are more likely to report can be easily mistaken for other conditions. Some of these signs include unexplained fatigue, disruptions to normal sleep patterns, lightheadedness, nausea and cold sweats.

Photo courtesy of Shutterstock

SOURCE:

Esperion

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Last Updated on November 19, 2025 by Daily News Staff

I treat menopause and its symptoms, and hormone replacement therapy can help – here’s the science behind the FDA’s decision to remove warnings

Genevieve Hofmann, University of Colorado Anschutz Medical Campus

For more than 20 years, hormone therapy for menopause has carried a warning label from the Food and Drug Administration describing the medication’s risk of serious harms – namely, cancer, cardiovascular disease and possibly dementia.

On Nov. 10, 2025, the FDA announced that drugmakers should remove these “black box” safety warnings.

The Conversation U.S. asked Genevieve Hofmann, a women’s health nurse practitioner at the University of Colorado Anschutz Medical Campus, to explain how the decision will affect health care for people going through menopause or postmenopause.

How did the FDA’s decision come about?

When people think of hormone therapy for menopause, they generally think of systemic estrogen and progestogens – for example, pills or patches that deliver hormones throughout the body.

Health care providers prescribed hormone therapy to manage symptoms of menopause such as hot flashes, night sweats and brain fog much more widely in the 1980s and 1990s than they do today. That’s because in the early 2000s, researchers analyzed data from a study called the Women’s Health Initiative and reported that hormone therapy increased the risk of breast cancer, heart disease, blood clots and stroke, as well as cognitive decline after menopause.

After this research was first published in 2002, the use of hormone therapy fell by 46% within six months – both because clinicians were reluctant to prescribe it and patients were fearful of taking it. In 2003, the FDA added black box warnings – the most serious warnings, indicating a risk of serious harm or death – to all estrogen-containing hormone products for menopause.

But researchers soon pointed out methodological flaws in the analysis. And over the past two decades, careful reanalyses of data from that study, as well as newer studies, have shown that systemic hormone therapy is very safe for most women, though there are nuances surrounding its use.

Meanwhile, women’s health experts have been increasingly vocal in the past five years in calling to remove the black box warnings from a form of hormone menopause therapy that’s applied locally, not systemically. Topical localized estrogen is applied directly to the vagina and surrounding areas, usually in the form of a cream or vaginal insert. It’s used to treat the genitourinary syndrome of menopause, which manifests as genital and urinary symptoms.

Even though topical estrogen products are extremely safe and were not evaluated in the Women’s Health Initiative study, the FDA warnings were added to them, too.

In July 2025, the FDA held an expert panel to discuss what’s currently known about the risks and benefits of hormone therapy for menopause. At the meeting, most experts urged the agency to remove the warning labels on topical vaginal estrogen products.

The Nov. 10 announcement was the outcome of that discussion, and it included both systemic and topical hormone therapy.

Why is systemic estrogen no longer considered unsafe?

Researchers are now finding that the balance of risks and benefits of systemic hormone therapy for menopause seems to depend strongly on when someone starts hormones, as well as the type, dose and length of use.

For women under 60 or within 10 years of their final period, the therapy is much safer than it is for older women. A 2017 follow-up of Women’s Health Initiative participants showed that overall deaths from any causes actually decreased in this younger cohort of menopausal women taking hormones.

For women who are more than 10 years from their final menstrual period, starting hormone therapy may increase their risk of cardiovascular disease. Researchers now refer to this as the timing hypothesis. Newer studies also support this idea.

Also, some ways of delivering hormones to the body turned out to be safer than others. Taking estrogen orally, as pills or tablets, carries a higher risk of blood clots. Those risks go away when it’s delivered through the skin using a patch, gel or spray. Many more options for hormone therapy exist today than in the early 2000s.

Additionally, it’s well established that hormone therapy improves bone health by preventing bone loss. Some studies suggest that in younger menopausal women, it may actually protect against cardiovascular disease, though this link is not yet proven and needs more study.

Unfortunately, many people missed out on the timing window. In my practice, I see patients who went through menopause 10 or 15 years ago and either didn’t get hormone therapy at the time or stopped taking it when the initial Women’s Health Initiative results came out. Now, they are hearing about the benefits, and many want to try it. But their higher cardiovascular risk may overshadow the benefit.

What about topical estrogen?

Genitourinary syndrome of menopause is ubiquitous – it affects every person with ovaries who goes through menopause, and the symptoms tend to worsen with age.

They include vaginal dryness, painful sex and urinary issues such as an increase in urgency or frequency, along with incontinence. Urinary tract infections often tend to get more frequent with menopause, particularly in older women. Treating them can require multiple courses of antibiotics.

Tissues in the genitourinary area are loaded with estrogen receptors – proteins in cells that bind the hormone. So adding some estrogen back to these areas can help restore the quality and thickness of these tissues, and possibly even promote the growth of healthy bacteria around the vagina and the urinary tract. The treatment can greatly improve quality of life and promote better health and longevity.

Despite topical estrogen’s safety and effectiveness, the FDA did not distinguish between it and systemic estrogen when adding the black box warnings in 2003. For this reason, many providers whose patients have symptoms relating to the genitourinary syndrome of menopause have been reluctant to prescribe it. Often, providers simply don’t know that it has a different safety profile than systemic estrogen.

How will removing the black box warnings affect patients?

Overall, I see this as a big win for women and their ability to manage the symptoms of menopause. I think this will make clinicians and patients far less anxious about prescribing and taking this medication.

Clinicians like me who specialize in women’s health and menopause – and who have been following the research – have been safely prescribing hormone therapy all along. But many general practitioners who often lacked either menopause-specific training or the time and resources to stay on top of the latest findings have been more reluctant to do so.

Safety concerns that led to the black box warnings, especially in regard to local vaginal estrogen, have turned out to be overblown. While clinicians still need to consider who is a good candidate for systemic hormone use, the evidence shows that for most people, it is a safe option.

Even more important, patients who were previously convinced that hormone therapy was unsafe may feel more comfortable discussing it with their provider and considering it. And if they do receive a prescription for hormone therapy, I hope that the likelihood of them starting this effective treatment is no longer hindered by reading a scary package insert that was based on outdated evidence.

While this medication is not a silver bullet that reverses aging, starting hormones at the right time can safely improve symptoms that diminish people’s quality of life. So if you’re having symptoms that are bothersome, consider asking your provider about menopause hormone therapy to help manage them.

Genevieve Hofmann, Assistant Professor of Nursing and Women’s Health, University of Colorado Anschutz Medical Campus

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Last Updated on September 2, 2025 by Daily News Staff

Hot flashes may be one of the better-known indicators of menopause, but women may experience a wide range of symptoms as they enter this stage of life. Consider these tips to provide support and relief, empowering women to take control of their menopause journey at every stage.

(Family Features) Hot flashes may be one of the better-known indicators of menopause, but women may experience a wide range of symptoms as they enter this stage of life. However, treatment options can ease, if not alleviate, most of these experiences.

Menopause signals the end of a woman’s reproductive years, beginning as early as their 30s for some women. This natural process results in the stop of menstruation with the shifting hormones also creating a list of physical and emotional symptoms.

Perimenopause, which commonly occurs in the mid-to-late-40s, lasts 4-8 years. This transitional stage is characterized by fluctuating ovarian activity, which can alter the frequency and duration of a woman’s period and disrupt estrogen production. Menopause is officially reached when the ovaries cease ovulation and a woman has gone 12 months without a menstrual period.

Despite increasing conversations among peers, many women experience disruptive symptoms and have difficulty managing them, according to a Nielsen IQ Aging America Forecast. Additionally, 90% of women reported never having been taught about menopause in school, according to a study published in “Post Reproductive Health.”

Uncomfortable symptoms like hot flashes, vaginal dryness and weight gain often begin during perimenopause and may continue through post-menopause – in some cases, for the rest of a woman’s life. The intensity and duration of these symptoms can vary from person to person.

With 45% of women in the U.S. currently experiencing some phase of menopause, per the Nielsen IQ Aging America Forecast, K-Y, is on a mission to provide support and relief where it’s most needed and empower women to take control of their menopause journey at every stage – because if you know, you know.

Beat the Heat and Soothe Hot Flashes
Prevention is one of the most effective ways to manage hot flashes – those sudden waves of heat that often affect a woman’s chest, neck and face, sometimes accompanied by sweating and redness. Identifying and avoiding common triggers such as caffeine, alcohol or spicy foods can make a difference. Calming exercises, like slow, steady breathing, can help bring a hot flash under control as can a cold drink, cool shower or portable fan.

Deal with Dryness to Restore Moisture
Hormonal changes can cause vaginal dryness, often leading to discomfort. To alleviate this discomfort, try a non-prescription product designed to add moisture, such as K-Y Liquibeads. Uniquely formulated and hormone-free, the vaginal moisturizer is designed to provide long-lasting relief to discomfort, caused by menopause and everyday activities, for up to three days.

Master Moods Caused by Hormone Changes
Fluctuating hormones during menopause can impact your mood, leading to unexpected emotional highs and lows. While some doctors prescribe hormone treatment, such as birth control pills, to help regulate hormone swings, you can also manage mood issues by doing activities that bring joy and minimize stress. Mindful exercise, like yoga or tai chi, can help manage your shifting moods.

Ease Your Headaches to Restore Your Day
If you’re susceptible to migraines, it’s important to know menopause can exacerbate them or even be the trigger that causes migraines to start. Knowing what sets off your migraines may be your best line of defense. However, if you’re unable to relieve the discomfort through self-care measures, consult with your doctor to adjust your current treatment plan or create a new one.

Nurture Lost Desire and Reconnect with Intimacy
As your libido fades, you may need to make a more conscious effort to maintain an active sex life. While factors like poor sleep, stress and depression can lower your interest in intimacy, maintaining regular sexual activity can support overall health, including minimizing problems with dryness and improving your mood. If comfort is a concern, a product like K-Y Ultragel lubricant can help supplement your natural lubrication. The unique water-based formula is non-sticky and non-greasy, so the natural feeling of enhanced intimacy is all you and your partner experience.

Quiet the Heat to Sleep in Comfort
Night sweats – hot flashes that happen at night – can be managed by wearing cool, cotton pajamas and using layers of covers you can easily shed. You may find extra relief from sleeping with a fan or using cooling pillows and sheets. Keeping your room cool and dark can also help promote more comfortable, uninterrupted rest.

Clear Acne and Take Control with Confidence
Pimples aren’t just for teens; they often make a return appearance as you’re walking through this new transitional stage of life. However, you’re likely more confident and better equipped to care for your skin this time around. To help prevent flare-ups, avoid oily products like sunscreens and cosmetics. Stick with oil-free options designed to keep pores clear. If necessary, talk with a dermatologist about a program designed for your unique skin care needs.

Find more information on the full menopause product portfolio at k-y.com.

Photos courtesy of Shutterstock

SOURCE:
K-Y