How does menopause affect heart health?

Doctors generally agree that heart disease is more common in men than in women. American Heart Association (AHA) recently highlighted that heart disease kills more women than all forms of cancer.

Moreover, a woman’s risk of developing heart disease may increase significantly in the years leading up to and following menopausestage of life after the end of the menstrual cycle.

The periods before, during and after the cessation of the menstrual cycle are called:

• perimenopausewhich may begin several years before the last menstrual period and end 12 months after the last menstrual period.
• menopause, which occurs 12 months after the last menstrual period in middle age 52 or after surgery, such as spay removal, that stops menstruation
• And postmenopauseyears after menopause.

For some people, perimenopause and menopause may go through little to no notice other than the cessation of menstruation. But for most, time can bring a range of symptoms that may include:

• tides
• irregular periods
• mood changes
• night sweats
• breast tenderness
• vaginal dryness
• decreased libido
• thinning hair and brittle nails.

Many of these symptoms are caused by decreased levels of reproductive hormones. estrogen And progesteronewhich accompanies menopause.

“Estrogen is very protective of women’s heart health. Premenopausal women, who have high estrogen levels, have a much lower risk of heart disease and high blood pressure than men. After menopause, when estrogen levels drop, women’s risk of heart disease increases and becomes higher than that of men of the same age.”

Estrogen protects the cardiovascular system in several ways. Robin Noble, MDBoard Certified Obstetrician and Gynecologist and Chief Medical Consultant Let’s talk about menopauseexplained some of them for MNT.

“We don’t see serious cardiovascular disease in women before menopause, probably because estrogen has a vasodilatory effect on the vasculature. Moreover, estrogen has anti-inflammatory effects, and inflammation and oxidative stress appear to be major mechanisms in the development of cardiovascular plaque,” ​​Noble told us.

Once estrogen levels drop, these cardioprotective effects are lost, increasing the risk of cardiovascular disease.

“As estrogen levels decline during menopause, cholesterol levels may rise, blood pressure may rise, and visceral fat will increase, leading to plaque buildup and hardening of the arteries,” they noted. Jennifer Wong, MDboard-certified cardiologist and medical director of non-invasive cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California.

“There may also be increased inflammation associated with increased atherosclerotic plaqueespecially unstable plaque. autonomous Changes during menopause can lead to an increase in heart rate and a decrease in heart rate variability,” she added.

According to AHASome of the common symptoms of menopause—hot flashes, night sweats, depression, sleep disturbances, and increased fat around the belly—are associated with a higher risk cardiovascular diseases.

And the risk of cardiovascular disease higher those who experience early menopause before age 40 than those who experience menopause later.

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

• coronary heart disease — Estrogen deficiency can contribute to atherosclerosis, the buildup of plaque in the arteries, increasing the risk of heart attacks.
• high blood pressure (hypertension) – estrogen maintains tissue elasticity and promotes vasodilation, so loss of estrogen can lead to increased blood pressure
• arrhythmias – Hormonal fluctuations can affect your heart rhythm, potentially leading to palpitations or atrial fibrillation.
• iron – the risk of stroke increases due to higher blood pressure and arterial stiffness
• heart failure – Reduced heart efficiency may develop due to weakening of the heart muscle, often as a result of untreated high blood pressure or coronary artery disease.
• high cholesterol – Estrogen is actually made of cholesterol, and estrogen deficiency after menopause can lead to increased levels of LDL (bad) cholesterol and HDL (good) cholesterol.
• insulin resistance or prediabetes—after menopause, women become more resistant to insulin, which increases the risk of prediabetes and diabetes, which in turn are important risk factors for heart disease and strokes.

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

“Women with cardiovascular disease may have more severe menopausal symptoms such as hot flashes, anxiety and fatigue. A drop in estrogen levels during menopause can worsen existing cardiovascular conditions such as atherosclerosis, high cholesterol and high blood pressure, increasing the risk of heart attacks and strokes,” she told us.

Noble shared a similar comment:

“Menopause and the characteristic changes associated with menopause can certainly make (cardiovascular disease) worse. People with obesity may be more likely to experience hot flashes, sleep disturbances and sleep apnea, a serious condition that needs to be assessed and treated.”

“Pre-existing cardiovascular disease and other health problems may prevent a person from adhering to some of the healthy lifestyle measures recommended to mitigate symptoms,” she added.

During the menopause years, people should follow general healthy lifestyle tips to maintain heart health. Noble advised, “Lifestyle changes that include increased exercise, stress management, healthy eating—increasing consumption of plant-based foods and whole grains.”

“The green Mediterranean diet, which includes fish, is probably the healthiest diet: less animal fat and animal protein, and no ultra-processed foods. Intermittent fasting can also be a healthy strategy,” she said. MNT.

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

One studyThe study, not yet published in a peer-reviewed journal, suggests that estrogen therapy may have long-term benefits in reducing the risk of heart disease.

They had increased levels of HDL cholesterol (“good” cholesterol), decreased levels of LDL cholesterol (“bad” cholesterol), decreased insulin resistance, and decreased lipoprotein levels—all of which may be beneficial for heart health.

“Estrogen replacement therapy, when started within 10 years of menopause, is associated with slowing the progression of atherosclerosis and reducing the risk of death from heart disease (and reducing all-cause mortality). Discussions about hormone therapy should be done individually with a women’s health care provider,” Matthew advised.

One review also suggests that transdermal estrogen (eg, gels and patches) may have greater cardioprotective effects than oral estrogen or estrogen plus progesterone. However, estrogen itself can increase risk endometrial (uterine) cancer, so it is usually prescribed only after a hysterectomy.

The timing of initiation of estrogen therapy may also be important. One 2016 study showed that cardiovascular benefits were greater when HRT was started within 6 years of menopause than when it was started later.

Although women’s risk of heart disease increases during menopause, there are several measures that can be taken to minimize this risk.

Experts advise maintaining a healthy lifestyle, including a healthy diet and regular physical activity, quitting smoking and drinking alcohol in moderation.

For many women, hormone therapy not only helps manage menopausal symptoms, but can also reduce cardiovascular risk.

However, experts advise discussing any hormone therapy with your doctor to ensure the most appropriate type is prescribed.

So while a person’s risk of heart disease does increase with menopause, there are many ways to help keep your heart healthy later in life.