Fasting for Healthy Longevity New Directions for Women in Menopause By: Felice Gersh, M.D. The following article is not endorsed and/or supported by The American Academy of Anti-Aging Medicine. The purposes of this publication do not imply endorsement and/or support of any author, company or theme related to this article.
Menopause is a universal event for women. The exact age varies somewhat, but the eventual permanent loss of ovarian hormone production is inevitable. Although a natural and “normal” event, the menopausal transition and subsequent years in a menopausal state do not benefit women’s overall health. This is especially true for cardiovascular health. Cardiovascular disease is the number one killer of women in the United States and the risk of a cardiovascular event is directly related to decreasing levels of estrogen as women progress through the menopausal transition. Women who experience menopause early, before age 40, are twice as likely to suffer from a non-fatal heart attack, stroke, or angina before age 60 compared to women who go through menopause at ages 50 or 51, which is the U.S. average.1 They are also more likely to suffer from fatal cardiac events and have an overall lower life expectancy.2 In contrast, women who go through menopause after age 51 have lower rates of cardiovascular disease and enjoy longer life expectancy. Menopause, and the resulting state of permanent estrogen deficiency, is a powerful risk factor for cardiovascular disease that is greatly underappreciated. Loss of estrogen causes systemic vascular inflammation, immune dysregulation, loss of glucose homeostasis, and gut microbiome dysbiosis.3 These dysfunctions set the stage for metabolic disease and ever escalating cardiovascular risk.
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Typical therapies offered to women to reduce cardiovascular events are pharmaceuticals, such as blood pressure drugs, statins, and diabetes medications. Although pharmaceuticals can be warranted and valuable in certain situations, they don’t access the body’s innate mechanisms to maintain metabolic homeostasis and don’t address the multitude of dysfunctions developing in the menopausal female body. Hormone therapy is also available, but the FDA does not yet recognize or endorse the use of hormones in women to reduce cardiovascular risk. This is despite a substantial body of science supporting the beneficial impact of hormones on the cardiovascular system.4 However, even if the implementation of bio-identical hormones becomes routine for women transitioning into menopause and thereafter, the reality is that we cannot yet administer hormones in a way that replicates the complex hormonal levels and rhythms of a healthy 25-year old woman. Too many women, including those who use hormones, suffer from cardiometabolic diseases. Fasting has been an integral part of the human experience since the beginning of our species and plays a significant role in many religions and societies. Simply put, fasting is any time one is not eating. There are several variations that are associated with different health benefits.
ANTI-AGING MEDICAL NEWS
• SUMMER 2020
