Menopause and Heart Disease: Understanding the Connection

Menopause is a natural transitional phase in a woman’s life, typically occurring between ages 45 and 55, which marks the end of her menstrual cycles. During this time, the ovaries begin to produce less hormones like estrogen and progesterone, causing a wide variety of symptoms and changes to the body. While hot flashes, mood swings and fatigue may be among the most noticeable symptoms, one of the most significant and often overlooked changes is the increased risk of heart disease.

Hormonal Changes and the Impact on Heart Health

Estrogen is a hormone that affects various aspects of a woman’s body, including reproductive, bone and brain health. It plays a vital role in maintaining heart health, too, by supporting healthy blood flow and regulating cholesterol levels.

However, as women enter menopause and estrogen levels decrease, they may experience an increase in “bad cholesterol,” or low-density lipoprotein (LDL). High LDL levels can lead to the buildup of plaque in the arteries, known as atherosclerosis, which restricts blood flow and increases risk of heart attack and stroke. Other heart disease risk factors caused by low estrogen levels include an increase in blood sugar, high blood pressure and weight gain.

Heart Disease Risk Factors: Post-Menopause

The following are heart disease risk factors that can be expected as women transition through menopause:

1. Changes in Cholesterol: As covered, lower estrogen levels directly impact cholesterol levels. Menopause can cause higher LDL, along with lower HDL (high-density lipoprotein), known as “good cholesterol,” which helps remove fat from the bloodstream. The chance of developing heart disease rises significantly with these changes in cholesterol levels.
2. Higher Blood Pressure: Although the exact reason is not fully understood, blood pressure tends to rise after menopause, and high blood pressure (hypertension) is a major risk factor for heart disease. As blood pressure rises, there is more strain put on the cardiovascular system, increasing the likelihood of heart attack and stroke.
3. Increased Abdominal Fat: Menopause can lead to a shift in fat distribution across the body, with more fat concentrating in the abdomen. This type of fat is called “visceral fat,” which accumulates around vital organs like the liver, heart and intestines, and contributes to heart disease, diabetes and high blood pressure.
4. Insulin Resistance: Insulin is the hormone responsible for regulating the body’s blood sugar. As women go through menopause, their body can develop insulin resistance where the body no longer responds well to the hormone. This leads to higher blood sugar levels and, over time, can cause type 2 diabetes which is closely linked to increased risk of heart disease.
5. Mental and Emotional Health: The changes menopause brings can take a toll on a woman’s mental and emotional wellbeing, and can increase the likelihood of conditions like depression and anxiety. These mental health challenges can lead to unhealthy lifestyle choices such as poor diet, lack of exercise, smoking and increased alcohol consumption. These behaviors all contribute to heart disease.

What Can Be Done to Prevent Heart Disease?

Although menopausal women are at higher risk for heart disease, that does not mean it is inevitable. The following strategies can help women protect their heart health before, during and post-menopause:

1. Regular Exercise: Taking time to focus on regular physical activity is crucial to maintaining good health through menopause. Moderate-intensity aerobic exercises like swimming, biking or brisk walking are great ways to lower cholesterol, reduce blood pressure, manage weight and improve overall cardiovascular health. Exercise can also be very beneficial in combatting the negative mental health symptoms that menopause may bring.
2. Eating Healthy: A well-balanced diet is key to managing cholesterol and maintaining a healthy weight. Menopausal women should consider incorporating a variety of fruits, vegetables, whole grains, lean proteins and omega-3 fatty acids into their diets. For those who find it difficult to formulate and stick to a healthy diet, help is available. Healthcare providers and dietitians are valuable assets when navigating these challenges.
3. Regular Check-Ups: While going through menopause, keeping track of cholesterol and blood pressure levels is essential. Scheduling with a healthcare provider on a regular basis is crucial to catching any concerning changes in these numbers, and if necessary, medication can be prescribed to bring these levels back to the normal range.
4. Stress Management: Life can be stressful, and going through the difficulties of menopause only exacerbates this tension. Chronic stress is a factor in heart disease, so it’s important to dedicate time to self-care and stress reduction. This could be prioritizing sleep and relaxation, practicing yoga or meditation, connecting with nature or enjoying a peaceful walk outdoors, or finding a hobby that brings inner peace.
5. Quit Smoking and Limit Alcohol: Smoking and excessive alcohol consumption are detrimental to heart health. Quitting smoking and reducing alcohol intake can significantly reduce the risk of cardiovascular disease.

Menopause is an important transitional phase in a woman’s life, but it can be difficult to handle at times. From the physical and mental symptoms to the increased risk of heart disease, there are a lot of changes that women must endure. But, they do not need to face these challenges alone. An invaluable relationship during the menopausal years is one’s women’s health provider. They are there to provide support, address any questions or concerns, and offer tailored treatment plans to help ease symptoms.