Menopause and the heart

Menopause is part of the aging process that happens when a woman's body begins to produce fewer reproductive hormones and the ovaries no longer release eggs. Most women may associate menopause with common symptoms, such as hot flashes, vaginal dryness and trouble sleeping. But menopause can also have a significant impact on a woman’s heart.

Menopause occurs 12 months after a woman’s last period. The time leading up to menopause is called perimenopause, or menopausal transition. Changes in the body during this time have been linked to cardiovascular disease risk.

“Menopause and the transition leading up to it are completely natural phases,” says Dr. Seemal Mumtaz, a cardiothoracic surgeon affiliated with Sharp Grossmont Hospital. “But the hormonal shifts that occur during this stage can influence how the heart functions and how the body manages cardiovascular risk.”

Heart disease risk factors

According to the American Heart Association, the following symptoms and bodily changes that occur during perimenopause have been associated with an increased risk for cardiovascular disease:

• Hot flashes and night sweats

• Depression and trouble sleeping

• Fat around the abdomen, known as belly fat or visceral fat

• Metabolic syndrome, a group of five conditions that affect heart health

• Decline in estrogen levels

Moreover, the type and timing of menopause may influence a woman’s risk for heart disease. Menopause typically occurs between the ages 45 and 55, with the median age being 50 years old. Menopause between ages 40 and 45 is considered early menopause.

Researchers have found that early menopause is a marker for increased risk of cardiovascular disease. Early menopause is associated with women who are Black or Hispanic, smoke, have short menstrual cycles, or have poor heart health in their reproductive years.

Menopause caused by surgery, such as the removal of the ovaries, has also been associated with higher cardiovascular disease risk. However, a hysterectomy (removal of the uterus) did not appear to affect cardiovascular risk.

Keeping your heart healthy

Although there is ample research on women’s heart health, there is limited data to help answer the question of what women of perimenopausal or menopausal age can do to prevent heart disease.

However, doctors and researchers advise that all women — no matter their age — can still reduce their risk for cardiovascular disease by practicing a healthy lifestyle aimed toward reducing risk factors. The American Heart Association recommends practicing “Life’s Simple 7”:

• Manage blood pressure

• Lose weight

• Control cholesterol

• Reduce blood sugar

• Stop smoking

• Get active — at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity per week

• Eat a healthy diet consisting mostly of fruits, vegetables, whole grains, poultry and fish; and limit foods that are high in salt and sugar

“Building healthy habits early in adulthood is ideal,” Dr. Mumtaz says. “But even if you’re already in perimenopause or menopause, there’s a lot you can do. Partner with your doctor to create a plan that supports your heart — small, consistent steps can add up to a longer, healthier life.”

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