Menopause and the heart

Menopause: For women, it’s part of the aging process that happens when the body begins to produce fewer reproductive hormones and the ovaries no longer release eggs. Most women may associate menopause with common symptoms such as hot flashes, vaginal dryness and trouble sleeping. But menopause can also have a significant impact on a woman’s heart.

Menopause occurs 12 months after a woman’s last period. The time leading up to menopause is called perimenopause, or menopausal transition. Changes in the body during this time have been linked to cardiovascular disease risk.

“Menopause and the time leading up to it is a natural part of a woman’s life,” says Dr. Marin Nishimura, a cardiologist affiliated with the Burr Heart & Vascular Center at Sharp Grossmont Hospital. “However, researchers have noted that the hormonal and physiological changes that occur during this stage of life can have a direct impact on the heart.”

Heart disease risk factors
According to the American Heart Association, the following symptoms and bodily changes that occur during perimenopause have been associated with an increased risk for cardiovascular disease:

• Hot flashes and night sweats

• Depression and trouble sleeping

• Fat around the abdomen, known as belly fat or visceral fat

• Metabolic syndrome, a group of five conditions that affect heart health

• Estrogen levels decline

Moreover, the type and timing of menopause may influence a woman’s risk for heart disease. Menopause typically occurs between ages 45 to 55, with the median age being 50 years old. Menopause between ages 40 to 45 is considered early menopause.

Researchers have found that early menopause is a marker for increased risk of cardiovascular disease. Early menopause is associated in women who are Black or Hispanic, smoke, have short menstrual cycles, or have poor heart health in their reproductive years.

Menopause caused by surgery, such as removal of the ovaries, has also been associated with higher cardiovascular disease risk. However, a hysterectomy (removal of the uterus) did not appear to affect cardiovascular risk.

Keeping your heart healthy
Although there is ample research on women’s heart health, there is limited data to help answer the question of what women of perimenopausal or menopausal age can do to prevent heart disease.

However, doctors and researchers advise that all women — no matter their age — can still reduce their risk for cardiovascular disease by practicing a healthy lifestyle aimed toward reducing risk factors. The American Heart Association recommends practicing “Life’s Simple 7”:

• Manage blood pressure

• Lose weight

• Control cholesterol

• Reduce blood sugar

• Stop smoking

• Get active — at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity per week

• Eat a healthy diet consisting mostly of fruits, vegetables, whole grains, poultry and fish; limit foods that are high in salt and sugar

“Women of reproductive age can help protect their heart from disease later in life by practicing a healthy lifestyle,” says Dr. Nishimura. “For those who are in the menopausal or perimenopausal stage of life, it’s also important to work with your doctor to develop a lifestyle or treatment plan to reduce or address any cardiovascular issues that may arise in order to live a longer, healthier life.”

Learn more about women's heart health.