Menopause and Your Heart: What’s the Connection?

February is American Heart Month. For our women’s wellness team at Panhandle Obstetrics and Gynecology in Amarillo, Texas, there’s no better time to talk about women and heart disease — and how menopause amplifies and accelerates the cardiovascular risk factors that make heart disease more likely. 

Women and heart disease, by the numbers

As the leading cause of mortality in the United States for men and women across most ethnicities and racial backgrounds, heart disease is responsible for one-third of American deaths each year: Every 34 seconds, another person in the U.S. dies of heart disease. 

Many are women. 

Over 60 million women (44%) in the United States have some form of heart disease, which shares the same major risk factors as male heart disease, including high blood pressure, high cholesterol, diabetes, unhealthy eating, excess weight, physical inactivity, smoking, regular alcohol consumption, and chronic stress. 

But women also face other gender-specific, hormone-related risk factors for heart disease — one of which is menopause. 

How menopause can affect your heart health

Since experts started tracking gender-specific heart disease statistics in the 1980s, more women than men have died from heart disease each year. 

This is partly because women often live longer than men, and partly because, on average, men develop heart disease 10 years earlier than women — but women’s risk increases significantly after menopause, catching up to, and then surpassing, men’s risk. 

Why? Estrogen acts as a protective shield for cardiovascular health that keeps blood vessel linings flexible and promotes healthy cholesterol levels. Menopause — specifically, dwindling estrogen levels — creates a more favorable environment for heart disease. 

Arterial stiffening 

Declining estrogen levels lead to loss of vascular elasticity and flexibility, making your blood vessels stiffer and more susceptible to high blood pressure.

Sodium sensitivity

After menopause, women’s bodies become more sensitive to the effects of sodium; consuming even moderate amounts can raise blood pressure. 

Cholesterol shifts

After menopause, bad artery-clogging LDL cholesterol tends to rise, while good HDL cholesterol tends to decline, becoming less effective at removing excess LDL cholesterol from the arteries before it accumulates as plaque. 

Metabolic changes

Lower estrogen levels trigger metabolic changes that can result in easy weight gain and insulin resistance, increasing your risk of systemic inflammation and diabetes. 

Fat redistribution

Menopause prompts your body to store more fat in your midsection. Belly fat, including deep visceral fat around your abdominal organs, is a major risk factor for heart disease. 

Factors that can heighten your risk even more

All women have a greater risk of heart disease following menopause, but that risk is even higher for women who enter menopause early (before the age of 45) — whether it happens naturally (premature menopause) or following the surgical removal of both ovaries. 

Other factors can also raise your heart disease risk following menopause, including:

Pregnancy complications

Pregnancy complications earlier in life can play a significant role in your heart disease risk later on, especially once menopause arrives. Up to 20% of women are diagnosed with high blood pressure, preeclampsia, or gestational diabetes during pregnancy, leaving them at a greatly increased risk of heart disease as they age. 

Preeclampsia is especially worrisome: Pregnant women who have it are 75% more likely to die of heart disease later on, compared to those who don’t develop the condition.

Polycystic ovary syndrome

Strongly linked to insulin resistance, inflammation, and weight control struggles, PCOS is a strong risk factor for heart disease, especially after menopause. 

Severe menopause symptoms 

Experts are also beginning to understand that certain menopause symptoms can indicate an elevated risk of future heart disease, including an increased risk of heart attack. 

Red-flag symptoms associated with higher cardiovascular risk levels include severe or frequent hot flashes or night sweats, recurrent heart palpitations, and insomnia. 

Keeping your heart healthy at every age

Luckily, there’s a lot you can do to keep your heart healthy as you age, including after menopause. If you smoke or vape, quitting is the single most effective protective step you can take. We can connect you to smoking cessation resources. 

If you don’t already lead a heart-healthy life, use perimenopause (the transition into menopause) as a call to action to manage modifiable risks: 

Move and eat well

Work to maintain a healthy weight: Get at least 30-60 minutes of moderately intense exercise most days, don’t sit too much, eat nutrient-dense whole foods, and limit your intake of highly processed foods, sodium, saturated fats, added sugars, and alcohol. 

Sleep and destress 

Get enough sleep each night, seeking help if you struggle with a chronic sleep-disrupting condition like insomnia or sleep apnea. Manage stress through exercise, talk therapy, time outdoors, meditation, or connection with loved ones. 

Know your risk level

Monitor your blood pressure, cholesterol, and blood sugar levels. Talk with your doctor about all your personal heart disease risk factors, and work together to create a preventive plan tailored to your needs. 

Ready to take charge of your heart health? We can help. Call 806-359-5468 to schedule an appointment at Panhandle Obstetrics and Gynecology today.