Coronary heart disease behaves differently in women and is a frequent cause of confusion and delay in diagnosis and treatment, says interventional cardiologist Akshay K Mehta, who is affiliated to Breach Candy, Holy Family, Nanavati and BSES MG hospitals.

“Angina, a characteristic chest discomfort lasting few minutes, is more common as a presenting symptom of coronary disease in women than in men. Paradoxically, however, many women with angina, or abnormal ECGs or ‘stress tests’ have normal coronary arteries,” says Dr Mehta.

But, more importantly, compared to men, women with blockages are more likely to have “atypical” or “non classical” symptoms, he says, like nausea, fatigue, gas or indigestion. “This can be misleading and can cause delay in getting prompt treatment,” he warns. 

It is best to weigh the pros and cons when considering going in for Hormone Replacement Therapy, suggests Dr Nandita Palshetkar, fertility expert and a leading gynaecologist.

Hormone Replacement Therapy is the use of hormones, synthetic or natural, to treat a woman who is lacking them, usually prescribed to pre and post-menopausal women. HRT consists of supplementing women with either oestrogen alone or oestrogen and progesterone together. 

While HRT effectively treats hot flushes, night sweats, sleep disturbances and other symptoms, it is also effective in the management of symptoms related to degenerative changes in the vagina or urinary tract.

“HRT also helps in the prevention and treatment of osteoporosis. Oestrogen prevents the accelerated loss of bone associated with menopause, maintains bone density and reduces the risk of hip fracture by up to 50 per cent,” says Dr Palshetkar. “The risk of vertebral fractures may be decreased by upto 90 per cent, depending upon when HRT was initiated,” Dr Palshetkar says.