Women's Health

Your heart on menopause

A woman going through menopause, holding her hand over her chest,


By Carol Gemayel-Barra, MD

Menopause is a significant phase in a woman’s life, marking the end of her reproductive years. While it is a natural biological process, menopause brings about various physiological changes, some of which can impact cardiovascular health. Understanding this connection is crucial for promoting better health outcomes for women in their post-menopausal years.


The physiological changes during menopause

typically occurs between the ages of 45 and 55, though it can vary. It is characterized by the cessation of menstruation and a decline in the production of estrogen and progesterone. These hormonal changes are responsible for many of the symptoms associated with menopause, such as hot flashes, night sweats and mood swings.


However, the decline in estrogen levels also has significant implications for cardiovascular health. Estrogen is known to have a protective effect on the cardiovascular system. It helps maintain the flexibility of blood vessels and supports healthy cholesterol levels. As estrogen levels drop, these protective effects diminish, increasing the risk of cardiovascular issues.


Related Content: Navigating menopause

Cardiovascular risks associated with menopause

  1. Increased cholesterol levels: Post-menopausal women often experience an increase in LDL (low-density lipoprotein) cholesterol, known as “bad” cholesterol, and a decrease in HDL (high-density lipoprotein) cholesterol, or “good” cholesterol. High LDL levels can lead to the build-up of plaque in the arteries, a condition known as atherosclerosis, which increases the risk of heart attacks and strokes.
  2. Hypertension: Blood pressure tends to rise after menopause. The exact mechanisms are not entirely understood, but the hormonal changes are believed to play a role. Higher blood pressure is a major risk factor for cardiovascular disease.
  3. Weight gain and metabolic changes: Many women gain weight during menopause, particularly around the abdomen. This central obesity is closely linked to metabolic syndrome, a cluster of conditions that includes high blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels. Metabolic syndrome significantly increases the risk of heart disease, stroke and type 2 diabetes.
  4. Changes in blood vessel function: Estrogen helps to keep blood vessels flexible and responsive. With lower estrogen levels, the blood vessels can become stiffer and less responsive, contributing to increased blood pressure and cardiovascular strain.
  5. Insulin resistance: Menopause can also lead to insulin resistance, where the body’s cells become less effective at using insulin. This can lead to higher blood sugar levels and increase the risk of developing type 2 diabetes, another risk factor for cardiovascular disease.

Related Content:
Know your numbers for heart health: A guide for people 50 and older

Managing cardiovascular health post-menopause

Given these increased risks, it is essential for post-menopausal women to take proactive steps to maintain cardiovascular health. Here are some strategies:

  1. Regular physical activity: Engaging in regular physical exercise can help manage weight, lower blood pressure, and improve cholesterol levels. Activities such as walking, swimming, cycling, and strength training are beneficial.
  2. Healthy diet: A diet rich in fruits, vegetables, whole grains, and lean proteins, and low in saturated fats and sugars, can help manage cholesterol levels and reduce cardiovascular risk. Foods high in omega-3 fatty acids, like fish, flaxseeds, and walnuts, are particularly heart-healthy.
  3. Regular health screenings: Regular checkups with a healthcare provider to monitor blood pressure, cholesterol levels and blood sugar can help detect and manage potential issues early.
  4. Medications: In some cases, medications may be necessary to manage high blood pressure, high cholesterol or other conditions. Hormone replacement therapy (HRT) is sometimes considered to relieve menopausal symptoms and may have some cardiovascular benefits, but it is not suitable for everyone and should be discussed thoroughly with a healthcare provider.
  5. Lifestyle changes: Avoiding smoking, reducing alcohol intake, and managing stress through mindfulness practices, such as yoga or meditation, can also support cardiovascular health.
  6. Maintaining a healthy weight: Achieving and maintaining a healthy weight through diet and exercise is critical for reducing the risk of cardiovascular disease.

Related Content: Heart disease in women: Uncovering the silent killer

Learn more about preventive cardiology at Nuvance Health.

The bottom line: Menopause is a natural part of aging, but it brings about changes that can increase the risk of cardiovascular disease. By understanding these risks and adopting a proactive approach to health, women can significantly reduce their chances of developing cardiovascular issues. Regular physical activity, a healthy diet, routine health screenings and lifestyle modifications are key components in maintaining cardiovascular health post-menopause. Empowering women with knowledge and resources to manage their health during this transitional phase is essential for promoting long-term well-being.

Learn more about women’s health at Nuvance Health.

Dr. Gemayel-Barra is the director of the women’s cardiac and heart failure programs at The Danbury Hospital, part of Nuvance Health.