How to Minimize Your Risk of Heart Disease During Menopause
Heart disease risk increases for everyone as they age, but for women, symptoms can become more evident after the onset of menopause. Not only does a woman’s risk for heart disease increase around the same age she enters natural menopause,1 but heart disease is also the leading cause of death for women in the United States causing 1 out every 5 deaths each year.2 In honor of National Wear Red Day supporting women’s heart health, here are a few important things to know about managing heart health during the menopause transition.
Estrogen’s important role in heart health
While a woman is young, estrogen actually protects her against heart disease.1 During menopause, however, some unseen changes begin to occur. Blood vessel walls begin to change which can lead to more plaque build-up, and blood clots. Additionally, fat found within the blood begins to change, which can affect the way it flows through blood vessels.1 Levels of fibrinogen increase (a substance that helps blood clot), which has been linked to strokes and heart disease.1
Estrogen affects nearly every tissue and organ in our bodies, including heart and blood vessels.1 This connection was so well known that hormone replacement therapy was once thought to actually protect women from against heart disease.1 We now know that HRT does not protect women from heart disease, but the logic behind that assumption was founded in respect for the nature of this powerful hormone.
While scientists are still learning about the many effects of estrogen on the body, here is some of what we know about estrogen’s role in our cardiovascular system:1
- Increases HDL cholesterol (the good kind)1
- Decreases LDL cholesterol (the bad kind)1
- Relaxes, smooths, and dilates blood vessels so blood flow increases1
- Soaks up free radicals, naturally occurring particles in the blood that can damage the arteries and other tissues1
All of these processes are naturally affected when estrogen begins to decline. LDL levels increase and HDL levels decrease, all of which can lead to fat and cholesterol build-up in the arteries (the signature contributors to strokes and heart attacks).1
There are likely even more ways in which estrogen affects the cardiovascular system that we don’t know about yet. New research leads to more information, but can also lead to more questions.1 While we may not have control over the answers that scientists have yet to uncover, we have the power to listen to our body’s signals and to be as proactive as possible when it comes to managing our heart disease risks. The first step in this is to know our symptoms.
Power begins with knowing your symptoms
Women often exhibit different heart attack symptoms than men do, which can lead to delayed treatment and even a higher death rate.3 Symptoms that require immediate medical attention include, but are not limited to:3
- Chest pain
- Pain in the jaw, arms, back, or neck
- Extreme fatigue
- Shortness of breath, nausea, and feeling lightheaded
- Unusual sweating
- Upper stomach pain
Underlying symptoms may have gone easily unnoticed or dismissed for other problems before, but menopause can exacerbate them. Pay attention to the way your body is changing, even if it’s subtle. Evaluate your risk factors to see if you may be experiencing more symptoms during menopause than meet the eye.
Check in on your risk factors
Age isn’t the only factor when it comes to increased heart disease risk. Younger women who’ve undergone early or surgical menopause also have an increased risk as well.1 Both of these conditions can increase risk when combined with other factors, such as:1
- Diabetes and prediabetes3
- High blood pressure
- Elevated LDL cholesterol
- Sedentary lifestyle
- Unhealthy diet3
- Family history of heart disease
If you meet any of these and you want to be proactive about protecting your heart as you age, check in with your doctor to start taking active steps to protect your heart.
Start with some steps to reduce your risk factors
No matter what your risk factors are, there is still a lot you can do now to take control of your future health. Studies show women with the lowest risk of heart disease are those who:1
- Quit or avoid smoking1
- Do aerobic exercise 3–5 times a week for 30–40 minutes each1
- Keep a diet low in saturated fat (<7% daily amount) and in trans-fats, but high in Omega 3 fats found in fish and other seafood1
- Follow a diet that’s high in fiber, whole grains, vegetables, legumes, fruits, fish and folate-rich foods1
- Treat and control medical conditions such as diabetes, high cholesterol, and high blood pressure (all of which are known heart disease risk factors for heart disease)1
Regular exercise and good nutrition seem to be the most common tips when it comes to avoiding heart disease. Aerobic exercises can include activities like walking, cycling, swimming, or dancing.4 Good nutrition emphasizes fruits, veggies, whole grains, low-fat dairy products, poultry, fish, and nuts (but limits red meat plus most sugary foods and beverages).4 Surround yourself with loved ones who cheer you on and support you, and tackle any changes you make one day at a time.
Stay educated and in touch with your body
Your doctor should be able to do regular screenings to test your blood pressure, cholesterol, and weight which can all help to assess your risk.3 These consistent checkups are important even if you don’t have any symptoms. These updates can help us stay informed and ultimately decide for ourselves which steps to take when it comes to managing our lifestyle and habits. It all starts with education, and if you’ve made it to the end of this blog post you’re already well on your way toward that!
- Cleveland Clinic. “Estrogen & Hormones.” 2019. Cleveland Clinic. Accessed on: January 28, 2020. <https://my.clevelandclinic.org/health/articles/16979-estrogen--hormones>
- Center for Disease Control and Prevention. “Heart Disease: Women and Heart Disease.” 2019. U.S. Department of Health & Human Services. Accessed on: January 28, 2020. <https://www.cdc.gov/heartdisease/women.htm>
- The North American Menopause Society. “Keeping Your Heart Healthy at Menopause.” 2020. Accessed on: January 28, 2020. <https://www.menopause.org/for-women/menopauseflashes/bone-health-and-heart-health/keeping-your-heart-healthy-at-menopause>
- American Heart Association. “Menopause and Heart Disease.” 2015. Accessed on: January 28, 2020. <https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/menopause-and-heart-disease>