Risk factors for heart disease are primarily the same in women as they are in men. Smoking, high blood pressure, excessive weight, sedentary lifestyle (little or no exercise), high Homocystine levels, diabetes, high cholesterol, age and family history of heart problems all increase a woman's chances of having heart disease.

The one addition for women is HRT. Since July 2002 HRT can be considered a risk for heart disease according to the WHI study which evaluated PremPro a premarin and provera combination therapy which was gaining popularity with medical practitioners.

Research shows that anovulatory cycles and lowered progesterone levels occur prior to menopause. Then progesterone levels after menopause and continue to fall to close to zero. Estrogen, on the other hand, falls only 40 to 60 percent with menopause.

A womans passage through menopause then results in a greater loss of progesterone than of estrogen. It is believed that perhaps the increase in heart disease risk after menopause is due more to progesterone deficiency than to estrogen deficiency. Dr. John R Lee author of the book "What Your Doctor May Not Tell You About Menopause" states that in his clinical experience, lipid profiles improve when bio-identical progesterone is supplemented. The synthetic versions of progesterone called progestins or progestagens do not offer the same effects. In fact, the WHI study and more recent studies from Harvard and the UK all point to the fact that HRT- Estrogen plus a progestin increases a woman's risk for heart disease and may even contribute to heart disease.

Bio-identical progesterone on the other hand appears to increase the burning of fats for energy and, in addition, has anti-inflammatory effects. Both of these actions would be protective against coronary heart disease. Progesterone protects the integrity and function of cell membranes, whereas estrogen allows an influx of sodium and water while allowing loss of potassium and magnesium. Progesterone, a natural diuretic, promotes better sleep patterns and helps us deal with stress. When one reviews the known actions of progesterone, it is clear that many of its actions are also beneficial to the heart.

The key to reducing a woman's risk of heart disease is to maintain a balance of hormones in her body and at the same time actively pursue a program to prevent heart disease.

Steps to take would be:

1. Use a Saliva test to determine the status of estradiol and progersterone.

2. If either are deficient increase progesterone levels first using a bio-identical cream

3. Increase Fiber in the diet and use a supplement like Fiber Source 7 which has the additional advantage of containing probiotics. High fiber diets have been shown to improve hormone levels and to assist with heart health

4. Increase EFA's in the diet. Essential Fats promote good hormone production as well as heart health.

5. Increase the consumption of fruits and vegetables focusing on greeny leafy vegetables and cruciferous vegetables which contain anti oxidants and indole-3-carbinol. Taking a fruit and vegetable concentrate and an indoles supplement in addition to eating more makes sense to guarantee you are getting all the nutrients needed and to fill the gaps in your diet.

6. Using a calcium/magnesium supplement for your bones and for your heart health is often suggested in prevention programs.

We must take charge of our health. Prevention is always the best medicine. It is never too late to make lifestyle changes. Exercise, a healthy diet and the right supplements and perhaps a little hormone balancing can all ensure that we don't fall victim to the silent killer that is relentlessly stalking our heart and ultimately - our life."