Menstrual Suppression, Iron Homeostasis, and Disease Risk

摘要

Data from The Women's Health Initiative (WHY) showed that postmenopausal women with a uterus who used HRT were not protected from heart disease and the study was closed. Subsequently, HRT was found to be associated with increased risk of breast cancer, stroke, and MI in postmenopausal women,6 prompting closure of the estrogen-only arm of this trial. The AHA subsequently withdrew its earlier recommendation of HRT to reduce risk of coronary disease or stroke. An alternative to the estrogen-deficiency hypothesis was required but not provided.In 1981, Sullivan7 first postulated that the delay in heart disease risk in women until after menopause might be a result of rising body iron burden, associated with cessation of menstrual blood loss. Correspondingly, the greater incidence of heart disease in men compared to premenopausal women could be explained by the higher levels of stored iron in men compared to premenopausal women of comparable age. Ferritin levels increase 2- to 3-fold upon transition from pre- to postmenopausal status.