It has been recognized for many years that women, generally, suffer much less heart disease than men – especially younger women. The difference is normally about 300 per cent. This is despite the fact that women have higher average cholesterol levels. The widest gap I found was in New Zealand in the 1970s.
Here, women aged 45-55 had onetenth the mortality rate of men. Now that is what I call a gap. Women, therefore, present a problem for the cholesterol hypothesis. Higher cholesterol levels than men, but much lower rates of heart disease. Many findings for women were discrepant from those for men. Of particular importance in women was considered to be the essentially flat relation of total cholesterol to total mortality, total cardiovascular, and total cancer mortality.
For many years, everyone said it, everyone believed that women were protected by their sex hormones. After all, protection disappeared after the menopause, does not it? I am sure I have read that many times. Well, in 1963, a study was carried out on women who had had hysterectomies. Half of the women had their ovaries removed at the same time, thus they had no sex hormones, and half retained their ovaries. (I think I should make it clear that the removal, or retention, of the ovaries was done purely on medical need, if not, this would have been one of the world’s least ethical studies … )
The results: We found no difference in the prevalence of coronary heart disease in the oopherectomised (both ovaries removed) and hysterectomised (no ovaries removed)women. The finding of no difference in the arteriosclerotic heart disease rates in the two groups suggests that some factor, or factors, apart from ovarian function are responsible for the relative freedom from coronary heart disease in women as compared to men. I think that this was the first time anyone actually put the sex hormone ad-hoc hypothesis to the test, and it failed utterly and completely. Of course, the results had no discernible effect on anyone, or anything.
Eyes tightly closed to the available evidence, researchers continued to study female sex hormones and the menopause, in relation to heart disease, and they continued to find the same thing: The normal menopause, which causes a gradual decrease in oestrogen production, was not associated with any increase in the risk of coronary heart disease.
Nevertheless, the idea of male sex hormones putting men at extra risk is more plausible than that of female sex hormones being protective, since large doses of oestrogen given to men for prostatic cancer, and the use of oral contraceptives containing oestrogen and progesterone have been shown to increase the risk of dying from coronary heart disease … Furthermore, the idea that female sex hormones protect against coronary heart disease should probably be abandoned.
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