Let’s get to the heart of the matter; that is, the link between heart health and menopause. The risk of heart disease rises for both men and women as they age, and it is still the number one cause of death among both genders. For women going through menopause, what stands out is that symptoms can become more apparent at that time.

It’s important to mention that despite what you may infer from commercials and other advertisements, menopause is not a disease. This natural phase of a woman’s life typically occurs around age 54, notes cardiologist Dr. Nieca Goldberg, and is marked by when menstrual periods stop permanently. Menopause is not something to be “fixed,” but rather a phase of life with bodily changes and symptoms that can be managed.

What happens at menopause that affects heart health?

More than one-third of women have some type of cardiovascular (CV) disease. The risk of CV events such as heart attacks increases among women about one decade after menopause.

It appears the decline in estrogen plays a part in the increase in heart disease among postmenopausal women. This hormone has many roles in the body, and among them is the ability to keep blood vessels flexible. Relaxed blood vessels allow for optimal blood flow. Once estrogen levels significantly drop, this benefit goes away, and the risk of heart-related disease climbs.

For example, menopausal and postmenopausal women often see a rise in blood pressure, levels of bad cholesterol (low-density lipoprotein, LDL), and triglycerides with an accompanying decline in good cholesterol (high-density lipoprotein, HDL).

How well your heart and your body respond to the changes associated with menopause depends on several factors. One is the state of your health upon entering menopause. If you have maintained a healthy weight, don’t smoke, follow a healthy diet, exercise regularly, and manage stress, then your risk of heart disease is lower than if none or most of these factors are not true.

Genetics and family history also play a part. Other risk factors for heart disease include black ethnicity, high blood pressure, history of preeclampsia or gestational diabetes, high cholesterol, diabetes, premature menopause (before age 35), and the presence of autoimmune diseases, such as rheumatoid arthritis, lupus, or multiple sclerosis.

Read about vegetarians have lower heart disease risk

How can you protect your heart health in menopause and post-menopause?

You can protect your heart health every single day by adopting healthy habits. The best time to start? Now!

• Diet. The Mediterranean diet and the DASH diet have been named as tops for heart health. Both include lots of fresh fruits and vegetables, whole grains, beans and legumes, nuts and seeds, and moderate amounts of fish. Red meat, poultry, and low-fat dairy should be limited, and sugary foods and beverages should be avoided or used only occasionally.
• Exercise. If you don’t need to lose weight, 150 minutes of moderate physical activity per week is recommended to help prevent heart disease. Three hundred minutes or more weekly may be needed to lose weight. A combination of aerobic (walking, swimming, spinning, rowing, dancing) and strength exercises is recommended.
• Smoking. It’s simple: don’t. Women who smoke are two to six times more likely to experience a heart attack than their nonsmoking peers. No matter when you quit, you will begin to benefit.
• Weight control. Strive to maintain a healthy weight. The old-fashioned method still rings true: eat a healthy diet and exercise regularly—at least five times a week for 60 to 90 minutes.
• Blood pressure control. Have your blood pressure checked regularly, especially if you tend to be high. High blood pressure is 130 mmHg or higher for systolic or 80 mmHg or higher for diastolic. A nutritious diet, regular exercise, weight control, reduction in salt intake, limited or no alcohol consumption, and stress management can go a long way toward bringing blood pressure down.
• Cholesterol. Levels of bad (low-density lipoprotein, LDL) cholesterol are common during menopause and are also a risk factor for heart disease. Take steps to lower cholesterol through diet (e.g., eating high-fiber foods, adding fiber supplements, and drinking lots of water), exercise, and maintaining a healthy weight.
• Diabetes. Women who have diabetes are significantly more likely to develop heart disease than are individuals without the disease. Diabetes is largely a disease of diet, so modifying your eating habits and exercising often can help keep blood sugar levels under control and benefit your heart as well. Consider a blood sugar supporting supplement like berberine to improve isnulin sensitivity.

What about hormone replacement therapy?

Some doctors may suggest hormone therapy (HT) as a way to cope with menopausal symptoms. However, HT may actually cause an increased risk of heart disease. According to Mayo Clinic, the largest randomized, controlled trial thus far uncovered a small increase in heart disease among postmenopausal women who used HT that contained both estrogen and progestin. Use of HT has also been associated with an increased risk of stroke, blood clots, and breast cancer, and the symptoms of abnormal vaginal bleeding, headache, nausea, and breast pain, among others.

Bottom line

Heart health is intimately associated with menopause largely because of the estrogen factor. Women are urged to take care of their hearts at any age, but it is especially important around menopause. Healthy lifestyle habits and attention to heart-related factors are encouraged.