When my mom underwent menopause, my understanding of the impacts was limited to hormones and periods. I did not look deeper into the long-term effects of menopause on brain, bone, and heart health. On top of this, we both had wrong notions that heart attacks mostly happened to men due to media portrayals.
Women typically develop heart-related conditions several years later than men. Despite this, heart diseases lead to the most deaths in women in the U.S., more than all forms of cancer combined [1]. Women also have different symptoms of heart conditions compared to men which result in underdiagnosis and low awareness. Real gaps exist in research and education about gender differences in heart health risks that lead to late diagnosis and treatment.
So if you’re reading this as you are navigating menopause transition or are in menopause and wondering why nobody prepared to take care of your heart, you are not alone. This blog post would provide you with a primer on what changes happen to women’s body during menopause that relate to heart health and ways you can protect your heart.
So, what changes the heart after menopause?
When it comes to ageing, women undergo ovarian ageing, along with chronological ageing. Unlike men, who only age chronologically, women have a complex interplay with hormones along with ageing. Big changes happen around menopause as Estrogen (your heart’s bodyguard) is slowly signing out during menopause transition.
Estrogen keeps your blood vessels flexible, supports healthy cholesterol levels, and ensures a healthy blood flow throughout your body. One of the largest cohort studies on women’s health in midlife showed strong changes in total cholesterol, Low Density Cholesterol (LDL), within a short span of time around menopause [4]. Combined with weight gain around midlife, these risk factors lead to an increase in heart risk.
Women who experience premature menopause (before age 40), surgical menopause (ovary removal), or chemotherapy-induced menopause face significantly higher cardiovascular risk due to a sudden estrogen loss at younger ages. Research shows these women have up to 50% higher risk of heart disease compared to those experiencing natural menopause, as their bodies lose estrogen’s protective effects decades earlier than expected [5].
What can you do?
This is a short article and we want to make it actionable, so let’s talk action!
Start with educating yourself (you have taken step 1 by reading this article, kudos!) because knowing what is coming will enable you to take action. Next, gather all the reports from the last couple of months, and note your numbers down: blood sugar, blood pressure, cholesterol levels, etc. If you haven’t seen your PCP in a while, make that appointment.
Once you have your numbers, check if you have developing metabolic syndrome, which is characterized if you have three or more of the following [2]:
- Abdominal Obesity
- High Triglycerides
- Low HDL (the good cholesterol)
- High Blood Pressure
- High Blood Sugar
Additionally, use ASCVD risk calculator [3] to get a baseline of your heart health and what risks to look out for in the coming years. Discuss all of these with your provider and read more about them. They will recommend personalized strategies for you and medication (if necessary).
Once you have an understanding, it’s time to start by making small changes in your life. Start with walking more, make small tweaks in your diet, make a plan to reduce smoking, and set up your health monitor or watch.
We have a guide written for you: 3 Heart Healthy Actions You Can Take Today
Menopause is a new health chapter
Menopause is a new chapter in your life where your life, career, health and relationships are changing. You get to be the author of the new chapter. This phase of life gives you an opportunity to prioritize your health and set the tone for a healthier ageing. Investing time and resources to understand your risks empower you to take action. We, at Middlescence, are your companion in this journey. Let us know if you have questions and how we can support you in the best way.
References:
- https://www.cdc.gov/womens-health/lcod/index.html (Accessed on 06/21/2025)
- https://www.nhlbi.nih.gov/health/metabolic-syndrome (Accessed on 06/21/2025)
- https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/ (Accessed on 06/21/2025)
- https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000001078 (Accessed on 06/21/2025)
- https://jamanetwork.com/journals/jama/fullarticle/2755841 (Accessed on 06/22/2025)