Menopause and your heart: what every woman should know

Menopause is a natural transition, but its impact on heart health is often underestimated. The declining estrogen levels that accompany menopause can significantly affect the cardiovascular system, increasing the risk of heart disease. While this might sound alarming, understanding the risks and taking proactive steps can empower women to protect their hearts and maintain their health and vitality during this phase of life.

Estrogen, a key hormone in a woman’s reproductive system, also plays a crucial role in maintaining heart health. It helps keep blood vessels flexible, reduces inflammation, and balances cholesterol levels. However, as estrogen levels drop during menopause, these protective effects diminish. This hormonal change can lead to higher cholesterol levels, increased blood pressure, and a greater likelihood of developing cardiovascular disease.

Many women are unaware that cardiovascular disease is the leading cause of death among women worldwide, surpassing even cancer. The risk of heart disease accelerates after menopause, with studies showing a clear link between lower estrogen levels and a decline in cardiovascular health. This makes menopause a critical time for women to focus on heart health and adopt measures that support long-term well-being.

Regular health check-ups are a cornerstone of good heart health, especially during menopause. Key diagnostic tools include blood tests to assess cholesterol and glucose levels, electrocardiograms (ECGs) to monitor heart rhythms, and imaging techniques like coronary calcium scoring to evaluate arterial health. These assessments help identify risk factors early, allowing for personalised prevention or treatment strategies.

It’s also crucial to consider potential differential diagnoses. For instance, symptoms such as fatigue or palpitations might be linked to thyroid dysfunction, anxiety, or anaemia rather than the heart itself. Collaborating with a healthcare professional ensures that the correct cause is identified and addressed.

Adopting healthy habits during menopause can significantly improve heart health and overall well-being.

• Physical activity: Engage in at least 150 minutes of moderate exercise per week, such as brisk walking or swimming. Incorporate strength training twice weekly to maintain muscle mass and boost metabolism. Activities like yoga or tai chi can also help manage stress and lower cortisol levels.

• Nutrition: Follow a heart-friendly diet that includes plenty of fruits, vegetables, whole grains, lean proteins, and healthy fats. Limit sodium, sugar, and processed foods. Ensure proper hydration by drinking plenty of water daily.

• Sleep: Prioritise high-quality sleep by maintaining a regular sleep schedule and creating a restful environment. Aim for 7–9 hours of sleep each night, as poor sleep can impact cardiovascular health.

Quitting smoking and moderating alcohol consumption are also crucial. Smoking significantly raises the risk of cardiovascular disease, while excess alcohol can contribute to high blood pressure and cholesterol issues.

For women at higher risk for cardiovascular disease, specific medical interventions might be necessary. These may include the use of statins to lower cholesterol levels, management of hypertension through antihypertensive medications, and optimized control of diabetes, if present. Such interventions can significantly reduce the risk of cardiovascular events. Additionally, addressing lifestyle factors, such as weight management and smoking cessation, can complement medical therapies to maximize cardiovascular protection.

In contrast, Menopausal Hormone Therapy (MHT) has shown promise in certain scenarios. Emerging evidence suggests that MHT, when initiated within 5–10 years of menopause, may offer protective effects against heart disease by improving cholesterol profiles, reducing arterial stiffness, and mitigating other cardiovascular risks. However, MHT is not routinely prescribed for the prevention of cardiovascular disease due to ongoing debates about its safety and long-term outcomes. The decision to use MHT must be individualized, involving a thorough discussion with the patient about the risks and benefits, her overall health status, and personal preferences.

Prevention is the best approach to cardiovascular health, and technology is making this easier than ever. Wearables such as fitness trackers and smartwatches can monitor heart rate, physical activity, and sleep patterns, providing valuable insights into overall health. These devices can alert women to potential issues early, allowing for timely medical evaluation.

Predictive tools powered by artificial intelligence are also transforming how cardiovascular risk is assessed. By analysing data from wearables and other health metrics, these tools can identify women at higher risk and recommend personalised strategies for prevention and care.

Heart health during menopause isn’t just about managing risks—it’s about embracing a proactive approach to well-being. By understanding the changes happening in your body and taking advantage of modern tools and treatments, you can protect your heart and enjoy a healthy, vibrant life through menopause and beyond.