The most common killer of both men and women is heart attack, so understanding how to reduce our risk could not be more important. Since the 1980's, studies have consistently shown that menopausal hormone therapy (particularly estrogen) reduces the risk of heart disease in women.

The now infamous Women's Health Initiative study surprised the medical community in 2002 by suggesting that hormone therapy increased the risk of heart attack in a small subset of women. After 22 years of gathering more data, multiple large studies have now confirmed what we previously understood, which is that estrogen has a highly beneficial effect for the heart if it's started in the first 10 years after menopause, and benefit seems to be negligible if it's started later (but not harmful).

We no longer recommend taking the lowest dose for the shortest time, but rather suggest starting menopausal hormone therapy as early as possible and continuing it long term. For the great majority of patients the benefits far outweigh any potential risks.

Dr. Susan Hardwick-Smith is a Board-Certified Gynecologist and Certified Menopause Practitioner specializing in women's midlife wellness, hormone optimization, and sexual wellness. She is the founder of Complete Midlife Wellness Center in Houston, TX, and the best-selling author of "Sexually Woke- Awaken the Secrets to Your Best Sex Life in Midlife and Beyond." She also hosts the popular podcast "Empowering Midlife Wellness."

Dr. Susan is the recipient of the Texas Super Doctor award over a dozen times, as well as a multiple-time recipient of H-Texas magazine's Top Doctor and Top Doctor for Women awards. She also has been chosen as one of Houston's "3 best-rated" gynecologists for several consecutive years. Dr. Susan is also an ICF-certified life and leadership coach, multiple-time marathoner and Ironman triathlete, and mother of 3 young adults.

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