Matters of the Heart

How hormones, happiness, and love promote cardiovascular health
By Laurie Heap, MD

February is all about the heart! Love is in the air and this month has been set aside by the American Heart Association to promote education on how to reduce your risk for cardiovascular disease.

We all know that hitting the gym multiple times a week, maintaining a healthy weight, monitoring your blood pressure, and eating a diet rich in veggies and low in animal fats can work wonders to avoid having a heart attack or stroke later in life (not to mention making women look good in a red dress).

But there is more to the story here—much more. There are three factors that have also been linked with decreased cardiovascular disease but are rarely discussed: hormonal health, your level of happiness, and having an intimate, loving relationship.

Begin a love affair with your hormones this February

Hormonal health is not just about reproduction or having a very romantic ending to a wonderful evening on Valentine’s Day! We have hormone receptors in every system of the body, including our cardiovascular system.

For the guys When it comes to hormonal health, it is about having the proper amount of testosterone and its derivatives, called androgens. According to an article published in 2010 in Current Opinions in Endocrinology, decreased androgen levels in men have been associated with insulin resistance, metabolic syndrome, and diabetes. All these conditions promote atherosclerosis (clogging of the arteries) and lead to heart attack and stroke. About 30 percent of men over 60 struggle with this condition. Signs of low testosterone include: dry eyes, decreased muscle mass and strength, poor concentration, trouble with memory, joint aches, hot flashes, depressed mood, irritability, anxiety, low self-esteem, and decreased sex drive. In some respects these symptoms are the same for menopausal women—you could call this the male version of menopause.

If this describes you, an integrative medicine physician can easily determine if low testosterone is the underlying cause with a simple blood test, which can also help rule out other possible causes. The following are ways of naturally boosting testosterone and staying at a healthy level throughout your life:

>> Maintain a healthy body weight.

>> Implement a resistance training exercise program (resistance training is the type of exercise that has been shown to have the most positive impact on testosterone levels).

>> Eat small meals consisting of lean proteins, vegetables, and high-fiber fruits every two to three hours to decrease insulin resistance.

>> Avoid toxins such as BPA found in plastic containers.

>> Limit alcohol intake.

>> Supplement daily with zinc, saw palmetto, and chrysin.

For us ladies Women’s hormonal issues are a bit more complex. (Women are complicated … imagine that!) It is a well-established fact that premenopausal women have a dramatically lower risk of cardiovascular disease compared to men and menopausal women the same age.

Although scientists are still trying to determine how a woman’s reproductive hormones decrease atherosclerosis, the research demonstrates that the major hormones in women—estrogen and progesterone—have a yin/yang effect on all the modifiable risk factors we are actively trying to reduce. Estrogen increases blood pressure, but progesterone lowers it. Estrogen increases insulin resistance, progesterone decreases it. Estrogen lowers bad cholesterol (LDL) and increases good cholesterol (HDL), while progesterone has the opposite effect. Estrogen increases the blood’s clotting factors, progesterone normalizes them.

Now we can see that common symptoms like PMS, painful periods, and irregular cycles are indications of hormonal imbalance. That balance needs to be restored to normal for a woman’s long-term health, including her heart health!

For premenopausal women with hormone-related issues, the knee-jerk reaction in conventional medicine is to prescribe a hormonal contraceptive and other medications to treat symptoms.

If you have headaches … you get a headache medicine. If you have cyclical depression, an antidepressant; cyclical anxiety, anti-anxiety meds; and if you have trouble sleeping, a sleeping pill. This symptom-masking approach to medicine only compounds women’s problems and is not correcting the underlying hormonal imbalance.

So what is the solution? Simply put, we must restore balance with a more holistic and heart-friendly approach.

In 2007, a research paper presented at the European Cardiovascular Disease conference showed that women who had been on synthetic hormones for 10 years had a 40 percent increase in plaque formation in the arteries of the neck and legs. In 2011, a study published in the Scandinavian Journal of Laboratory & Clinical Investigation found that the elevations in cholesterol caused by hormonal contraceptives increase the “atherogenic index of plasma.” (The atherogenic index of plasma is a way researchers determine if a person is at increased risk for atherosclerosis.)

These findings further confirm the conviction that we cannot improve upon nature. Empowering women with natural solutions for avoiding pregnancy and for the treatment of women’s health issues is a superior approach.

The following are ways to restore hormonal balance for the sake of your heart:

>> Learn to track your cycle. There are multiple excellent resources to help you. Taking Charge of Your Fertility gives a good overview of these systems.

>> Know the signs of hormonal imbalance like low progesterone: three days of tail-end brown bleeding after your period, two or more days of spotting leading up to your period, a variability of more than two days from ovulation to the beginning of your next period.

>> Monitor your symptoms. If headaches, depression, anxiety, or irritability start in the second half of your cycle, you have concrete evidence that a hormonal imbalance is at the root of these problems.

>> Start a bioidentical progesterone cream three days after ovulation and continue for nine days.

>> Avoid exposure to synthetic hormones by using glass instead of plastic, drinking distilled water, eating organic foods, and steering clear of medications like the pill.

>> Supplements that help with symptoms of PMS include vitamin B6 and calcium citrate.

If you are already menopausal, it is not too late to benefit from information on the risks of hormonal imbalance—knowledge is power when it comes to prevention of cardiovascular disease. Recognizing past risks increases motivation to implement lifestyle changes like exercise programs and diet modifications.

Allowing your body to make the transition into a new state of natural hormone balance in menopause is ideal, but may not be possible if your symptoms are disrupting your life.

Consider the following steps to help with the transition and avoid the use of synthetic HRT:

>> Ask your doctor to look for other factors that could be making your symptoms worse like adrenal fatigue, hypothyroidism, or vitamin D deficiency—addressing these issues also promotes cardiovascular health.

>> Supplements with vitamin E and vitamin C have been shown in clinical studies to reduce hot flashes.

>> Increase soy intake (but limit to 100mg of soy per day).

>> Avoid synthetic HRT: Synthetic hormone replacement therapy has been known to increase cardiovascular disease (as well as breast cancer) since 2001, and is no longer necessary. Bioidentical hormone therapy usually includes bioidentical progesterone with two different types of estrogens, estradiol and estriol. These estrogens can decrease cholesterol levels without significantly increasing the risk for breast cancer.

The bottom line is that hormones have a dramatic effect on cardiovascular disease risk factors in both men and women. Taking a look at your hormone status and taking exquisite care of this aspect of your body is an essential part of living a heart-healthy lifestyle.

Get happy for your heart’s sake

The second factor that has a significant effect on heart health is happiness. But happiness is not a modifiable risk factor (meaning something I can change) is it?

Yes! Of course it is. Research has shown that happy people live longer and have fewer health problems in the winter of their lives. Scientists believe the connection between happiness and decreased cardiovascular disease is found in the stress hormone cortisol. Cortisol is released into the bloodstream in response to physical and psychological stress. In short bursts, cortisol is good and can help us rise to the occasion and resolve the problems triggering its release. But chronic stress is another story—too much cortisol for an extended period of time causes insulin resistance, belly fat, and increased triglycerides and blood sugar.

So are happy people just lucky people who live a life free from physical and psychological stress or do they deal with stress in a way that doesn’t release cortisol and strip them of happiness? Psychological research has shown it is the latter.

Though we’ve all tried to implement stress management techniques—learn to say no, eliminate unnecessary stressors and toxic relationships, try to manage time better, plan, plan, plan—very few of us succeed in effectively transforming how we deal with stress So what’s the solution? Let’s take a look at the surprisingly straightforward skills of happiness.

The sense of well-being most people call happiness consists of using character strengths to promote meaning, accomplishment, and positive emotions and relationships. According to positive psychologists, the foundation of happiness is self-discipline and grit. Self-discipline helps us put our appetites in balance in our lives, and grit is the ability to persevere in the face of difficulty. These two qualities free us to look at the world with a clearer vision and give us the ability to fulfill our obligations to others, to love with greater passion and selflessness, and find a purpose for our lives that will benefit the world around us. You can do a self-assessment of your character strengths and a grit survey at

Once you determine your strengths (and begin working on your weaknesses), the next step is to focus on how you respond to adversity in your head. When something unexpected and unpleasant crops up during the day, where do your thoughts take you? Do you immediately imagine the worst-case scenario and convince yourself it will become reality?

Psychologists call this negative superhighway in our brains “learned helplessness.” Learned helplessness occurs when we respond to adversity with the belief that the bad situation is all-encompassing, permanent, and personal. This mental response is what triggers cortisol release in the face of stress.

The key to happy people’s lower cortisol levels is responding to adversity with learned optimism. Learned optimism is the opposite of learned helplessness—the bad event is passing, not personal, and confined to this one aspect of life. Learned optimism is a skill that can be mastered with practice.

Lay the groundwork for stress management with the following suggestions:

>> Take a look at the happiness characteristics, namely, self-regulation, perseverance, wisdom, justice, love, transcendence, and optimism.

>> Go to and take the VIA questionnaire to determine what your particular strengths are. Start using them regularly.

>> Read about and begin incorporating learned optimism into your response to adversity to stop cortisol release.

It is essential to both your overall health and heart health that you maintain a low cortisol level. Knowing this connection gives new meaning to the phrase “a long and happy life.”

What’s love got to do with it?

A third factor that can have a profoundly positive impact on cardiovascular health is fostering loving, intimate relationships. (Once we have our hormones in balance and our stress under control, this may be easier than you think.)

Though love is considered an action of the heart, in reality we love with our brains and it benefits our hearts. Oxytocin is the chemical responsible for the calming, euphoric feeling of love. It is released in the brains of those in a deeply intimate, loving relationship.

In consistent doses, oxytocin has been shown to decrease blood pressure and decrease the cortisol release in response to psychological stress. It is believed that low oxytocin levels are responsible for an increase in cardiovascular disease in lonely, socially isolated individuals.

The beauty of exercises that boost oxytocin is that they protect us from the metaphorical heartache of falling out of love and the literal heartache of a heart attack. What better way to spend time on Valentine’s Day than to naturally boost oxytocin with the following exercises?

>> Hug for thirty seconds to one minute, without it going anywhere else.

>> Talk about a mission you would like to help promote together as a couple.

>> Have an intimate conversation—talk about your dreams for the future.

>> Gaze left eye to left eye for five minutes. This will seem like an eternity, but if you try it you will understand.

>> Feed each other; strawberries and champagne are a suggestion, but any healthy food will do!

>> Dance to your favorite song.

>> Sing to each other.

Although nothing can beat the effect of an intimate, romantic relationship on oxytocin levels, reaching out to family and friends can have a similar effect on the brain. The key is to form meaningful relationships.

When it comes to matters of the heart, looking beyond standard risk factors to issues like hormonal balance, psychological well-being, and love (factors addressed through lifestyle changes and natural living) will do wonders to promote your health. And you will be happier and more in love in the process!


Laurie Heap, MD, has been educating women on addressing hormonal issues with natural therapies that restore hormonal balance to the body. Stress management, promoting happiness, and hormonal balance are all part of a lifestyle that produces well-being in women. Visit for more information.