Menopause occurs when menstrual cycles end. In the years before and after menopause, the body undergoes many changes, leading to symptoms such as hot flashes, emotional changes and sleep disturbances. But its effect on the body can be even more profound. Today’s Medical News explores why menopause can affect cardiovascular health and how women can maintain a healthy heart as they age.

Doctors generally believe that cardiovascular disease affects men more than women, but American Heart Association (AHA) recently emphasized that heart disease kills more women than all types of cancer.

Additionally, the woman’s risk heart disease It can increase significantly before and after. menopausethe stage of life after the end of the menstrual cycle.

The periods until, during and after the end of the menstrual cycle are called:

• perimenopauseIt can start several years before the last menstrual period and end up to 12 months after the last menstrual period.

• Menopause occurs, on average, 12 months after the last menstrual period. 52 or following surgery, such as removal of the ovaries, to stop menstrual bleeding

• And post menopauseyears following menopause.

For some people, perimenopause and menopause can go almost unnoticed, except when menstrual periods stop. But for many people, time can bring with it a host of symptoms. may contain:

Many of these symptoms are due to a decrease in reproductive hormones. estrogen And progesteroneaccompanying menopause.

Although progesterone is thought to have little effect on heart health, the decline in estrogen is likely to contribute to heart health. increased risk of cardiovascular disease.

How does estrogen protect the heart?

Deborah Matthew, MDChief Medical Advisor and founder of BHRT Training Academy Signature Healthy Livingsaid Today’s Medical News HE:

Estrogen protects the cardiovascular system in several ways. Robin Noble, MDa board-certified OB/GYN and Chief Medical Consultant. Let’s Talk Menopauseexplained some MNT.

“We don’t see a lot of cardiovascular disease in women until after menopause, which is probably because estrogen has a vasodilating effect on the vessels (system). Moreover, estrogen has anti-inflammatory effects, and inflammation and oxidative stress appear to be the primary mechanisms for the development of cardiovascular plaques,” Noble told us .

When estrogen drops, these cardioprotective effects are lost and a person’s risk of heart disease increases.

What other conditions does menopause increase the risk of?

“As estrogen levels decrease in menopause, there can be an increase in cholesterol levels, an increase in blood pressure and an increase in visceral fat, which can lead to plaque formation and hardening of the arteries,” he said. Jennifer Wong, MDHe is a board-certified cardiologist and medical director of Non-Invasive Cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, CA.

“There may also be increased inflammation, which is associated with increased inflammation. atherosclerotic plaqueparticularly unstable plaque. autonomous “Changes in menopause can lead to increased heart rate and decreased heart rate variability,” he added.

according to AHASome of the common menopause symptoms, such as hot flashes, night sweats, depression, sleep disturbances, and increased fat around the abdomen, are associated with higher risk. cardiovascular disease.

In addition, A study from 2023 It turns out that post-menopausal stress and insomnia are linked to higher risk. atrial fibrillation (AFib).

and cardiovascular disease risk higher It is more common in those who entered early menopause before the age of 40 than in those who entered menopause later.

Matthew highlighted a number of cardiovascular risks that may increase after menopause. These include:

• coronary artery disease — Lack of estrogen can increase the risk of heart attack by promoting atherosclerosis, the buildup of plaque in the arteries.

• high blood pressure (hypertension) — estrogen maintains the elasticity of tissues and promotes vasodilation, so loss of estrogen can lead to higher blood pressure

• arrhythmias — hormonal fluctuations can affect heart rhythm, causing palpitations or AFib

• paralysis — Increased risk of stroke due to high blood pressure and arterial stiffness

• heart failure — Decreased heart efficiency may occur due to weakening of the heart muscle, usually as a result of untreated high blood pressure or coronary artery disease.

• high cholesterol — Estrogen is actually made up of cholesterol, and a lack of estrogen after menopause can lead to higher levels of LDL (bad) cholesterol and HDL (good) cholesterol.

• insulin resistance or prediabetes – after menopause, women become more resistant to insulin, increasing the risk of prediabetes and diabetes, which are major risk factors for heart disease and stroke.

How might menopause affect pre-existing heart conditions?

As Matthew explains, some pre-existing heart conditions can worsen menopause symptoms, and hormonal changes during menopause can affect pre-existing conditions.

“Menopausal symptoms such as hot flashes, anxiety and fatigue may be more severe in women with cardiovascular disease. The decrease in estrogen with menopause can worsen existing cardiovascular conditions such as atherosclerosis, high cholesterol and high blood pressure, increasing the risk of heart attack and stroke,” he said.

Noble shared a similar comment:

“Pre-existing cardiovascular disease and other health problems may hinder a person’s ability to follow some of the healthy lifestyle interventions recommended to relieve symptoms,” he added.

3 ways to minimize your risk of heart disease

In the years close to menopause, people should follow general healthy lifestyle recommendations to protect their heart health. “Lifestyle changes that include more exercise, stress management, healthy eating — with an increase in plant-based foods and whole grains,” Noble says. he advised.

“A green Mediterranean diet that includes fish is probably the healthiest diet; less animal fat and animal protein, elimination of overly processed foods. “Intermittent fasting can also be a healthy strategy,” he said. MNT.

In addition to a healthy lifestyle, hormone replacement therapy (HRT) may be an effective way to reduce the risk of heart disease during this period of life.

a studyThe research, which has not yet been published in a peer-reviewed journal, suggests that estrogen therapy may provide long-term benefits in reducing the risk of heart disease.

In this study, women using oral conjugated equine estrogens (CEE), the most commonly used estrogen formulation and those using CEE plus medroxyprogesterone acetate (MPA) showed improvement in all cardiovascular biomarkers except triglycerides.

Increased levels of HDL-C (“good” cholesterol), decreased levels of LDL-C (“bad” cholesterol), decreased insulin resistance, and decreased lipoproteins were seen; All of these may benefit heart health.

“If estrogen replacement is started within 10 years of menopause, it is associated with a reduced progression of atherosclerosis and a reduced risk of death from heart disease (and a reduction in all-cause mortality). The discussion about hormone therapy should be individualized with the woman’s doctor,” advised Matthew.

One review also suggests that transdermal estrogen (such as gels and patches) may have a greater cardioprotective effect than oral estrogen or estrogen combined with progesterone. However, estrogen alone increase risk In the treatment of endometrial (uterine) cancer, it is therefore usually given only after hysterectomy.

The timing of starting estrogen therapy may also be important. A study from 2016 It showed that starting HRT within 6 years after menopause provided greater cardiovascular benefits than starting it later.

Essential things you need to know about menopause and heart health

Although the risk of cardiovascular disease increases in women during menopause, there are various measures a person can take to help minimize this risk.

Experts recommend following a healthy lifestyle, including a healthy diet and regular physical activity, not smoking and reducing alcohol consumption.

For many women, hormone therapy will not only help manage menopause symptoms but may also reduce cardiovascular risk.

However, experts advise that any hormone therapy should be discussed with a clinician to ensure the most appropriate type is prescribed.

So, although a person’s risk of cardiovascular disease increases with the onset of menopause, there are many ways to help keep the heart healthy later in life.

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