Menopause and Heart Health

Menopause is a profound time in women’s lives that often fails to get the attention that it deserves. Aside from the telltale signs of night sweats and hot flashes, fluctuating hormone levels and changes in menstrual patterns, women going through menopause are also at a significantly increased risk for heart disease.¹ In fact, postmenopausal women have up to a 2.6 times higher risk of cardiovascular events, including heart attack, than premenopausal women of the same age.² Considering that heart disease is the leading cause of death for women in the U.S., that makes menopause a crucial time to focus on women’s heart health.³

‍

The same way women who turn 40 take steps to lower their risk of breast cancer by getting regular mammograms,⁴ women going through menopause can take steps to lower their risk of heart disease by tracking their blood pressure and cholesterol, and using this data to get the right treatment

Resources About Menopause

TIP SHEET

Managing Heart Health Through Menopause

Learn how to break menopause stigma and empower women in your workforce to advocate for themselves with critical heart health information using digital health.

View

TIP SHEET

How to Support Menopausal Women in Your Workforce

Women in menopause have almost 3 times a higher risk of cardiovascular issues, including heart attacks, than premenopausal women of the same age. Implement these ideas to help support the women in your workforce.

View

Menopause and Perimenopause

‍

Perimenopause, or menopause transition, refers to the time before menopause when women experience changes in their pattern of menstruation and changes in hormone levels.⁵ This usually begins between ages 45 and 55, but can start as early as the mid-30s.⁶ Menopause is diagnosed after a woman has gone 12 months without a menstrual period,⁶ and the average age for menopause in the US is 52.⁷ After menopause, estrogen levels drop significantly.⁷

‍

The changes in hormone levels mean that women in perimenopause and menopause commonly experience symptoms like hot flashes, night sweats, mood and cognitive changes, genitourinary symptoms, and irregular periods. In fact, three-quarters of women going through menopause have symptoms, with a quarter of women having severe symptoms.⁸

‍

Estrogen’s Impact on Heart Disease Risk

‍

Lower levels of estrogen mean that postmenopausal women are at an increased risk for heart disease. Estrogen is protective in younger women, and keeps the cardiovascular system healthy by stabilizing blood pressure, lowering LDL (“bad”) cholesterol, lowering triglycerides (a type of fat in the blood), and increasing HDL (“good”) cholesterol.⁹ When estrogen levels drop after menopause, women have worsening risk factors for heart disease, including increased blood pressure, increased total cholesterol, increased LDL cholesterol, increased triglycerides, and decreased HDL cholesterol.⁵ Symptoms and heart risk are related, as hot flashes and trouble sleeping are associated with worse heart risk.⁵

‍

Mitigating Heart Risk

‍

There is a general lack of awareness of the importance of heart risk in women, even among women themselves.¹⁰ The healthcare system also provides inadequate treatment for women with heart disease, best seen by looking at the way we treat women with heart attacks. And women going through menopause must also deal with stigma,⁸ embarrassment, and a lack of clear and high-quality information.¹¹

‍

The good news is that most cardiac and stroke events can be prevented through education, controlling risk factors like high blood pressure, and with healthy lifestyle changes like moving more and eating better.¹

‍

Menopause is a crucial time to focus on women’s heart health given the accelerating risk for heart disease and worsening heart risk factors.¹ Women going through menopause can take steps to lower their risk of heart disease by tracking their blood pressure and cholesterol, the same way women take steps to lower their risk of breast cancer by getting mammograms.⁴

Footnotes

The Facts about Women and Heart Disease. Go Red for Women Web Site. https://www.goredforwomen.org/en/about-heart-disease-in-women/facts. Accessed May 15, 2023.
Prabakaran S, et al. Cardiovascular risk in menopausal women and our evolving understanding of menopausal hormone therapy: risks, benefits, and current guidelines for use. Ther Adv Endocrinol Metab. 2021; 12: 20420188211013917. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111523. Accessed May 15, 2023.
Women and Heart Disease. CDC Web Site. https://www.cdc.gov/heartdisease/women.htm. Published February 21, 2023. Accessed May 15, 2023.
What Is Breast Cancer Screening? CDC Web Site. https://www.cdc.gov/cancer/breast/basic_info/screening.htm. Published September 26, 2022. Accessed May 15, 2023.
El Khoudary SR., at al. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020;142:e506–e532. https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000912. Accessed May 15, 2023.
What Is Menopause? National Institute on Aging Web Site. https://www.nia.nih.gov/health/what-menopause#transition. Published September 30, 2021. Accessed May 15, 2023.
Menopause basics. Office on Women’s Health Web Site. https://www.womenshealth.gov/menopause/menopause-basics. Published January 6, 2023. Accessed May 15, 2023.
Ryder, J. and Schaedel, Z. Attitudes towards menopause: time for change. The Lancet. https://doi.org/10.1016/S0140-6736(22)01099-6. Published June 18, 2022. Accessed May 15, 2023.
Estrogen: What It Does and 5 Benefits. Cleveland Clinic Web Site. https://health.clevelandclinic.org/what-does-estrogen-do. Published January 5, 2022. Accessed May 15, 2023.
Cushman M., et al. Ten-Year Differences in Women’s Awareness Related to Coronary Heart Disease: Results of the 2019 American Heart Association National Survey: A Special Report From the American Heart Association. Circulation. 2021;143:e239–e248. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000907. Accessed May 15, 2023.
Edwards, AL., et al. “It just makes me feel a little less alone”: a qualitative exploration of the podcast Menopause: Unmuted on women's perceptions of menopause. Menopause. 28(12):p 1374-1384. https://journals.lww.com/menopausejournal/Fulltext/2021/12000/_It_just_makes_me_feel_a_little_less_alone___a.9.aspx. Accessed May 15, 2023.

Menopause