Women’s health and pulmonary hypertension

Join Lung Foundation Australia and Dr Rachel Cordina (Clinic Academic Cardiologist) for our Women’s Health and Pulmonary Arterial Hypertension (PAH) webinar. This webinar focuses on how PAH impacts women’s health and what precautions to take especially with pregnancy, fertility, and menopause.

Some of the discussion on Women’s health and PAH can be confronting and it is advised to reach out to family, friends and your healthcare team for support if needed.

PAH is a disease affecting the blood vessels of the lungs, causing high pressure in the lungs. The arterial walls become stiff and thickened, increasing resistance and making the right ventricle work harder.
PAH is more common in women, but men with PAH tend to have worse outcomes. This phenomenon is known as the “estrogen paradox,” though the reasons are unclear.

PAH can affect fertility, particularly in women with low oxygen saturation or congenital heart disease. Women on blood thinners may experience heavier periods, and those with autoimmune diseases may have altered fertility.

Severe illness can reduce intimacy. Physical exertion safety varies; mild PAH may allow good exercise capacity, while severe PAH can make vigorous exercise unsafe.

Reliable contraception is crucial for women with PAH, as pregnancy can be unsafe. Options like the Mirena IUD and Implanon are recommended over estrogen-containing contraceptives, which can increase blood clot risks.

Hormonal replacement is generally avoided in PAH. Alternative therapies for severe symptoms include SSRIs and acupuncture.

Pregnancy significantly stresses the body, increasing blood volume and heart workload. Women with PAH face high risks, including heart failure, dangerous heart rhythms, and blood clots. The risk of maternal death can be as high as 30-35%.

Preconception planning is essential for women with PAH, involving detailed discussions with doctors. Some women with mild PAH and good heart function may pursue pregnancy, but it’s not without risks and should be discussed thoroughly with your healthcare team.