Every year, one million hearts are affected by menopause. (Technically one million, according to the National Institute on Aging, but you get what we're talking about.) If you haven't had a period for 12 months, you're considered to have gone through menopause. It is a time that usually comes with intense hormonal changes.
Here's what you need to know about the link between menopause and heart health. Keep reading for expert-backed heart health tips to help keep your ticker stronger for longer.
Menopause and Heart Health
“It’s really wrong to call estrogen, progesterone, and testosterone ‘sex hormones’ because they actually have effects throughout the body,” says Heather Hirsch, Ph.D., CEO and founder of Health by Heather Hirsch MD Collaborative.
During perimenopause (the premenopausal period), estrogen and progesterone levels begin to fluctuate, the NIA says. Consider estrogen, for example. “Estrogen is an anti-inflammatory and vasodilator,” says Dr. Hirsch. What it means: Containing estrogen helps open blood vessels and keep blood flowing easily. However, having less estrogen in your body during menopause means you lose this protective effect, which can put you at greater risk of plaque buildup in your arteries, which can lead to a heart attack. This is not a small change either. Heart disease is the leading cause of death among women in the United States, accounting for one in five deaths, according to the Centers for Disease Control and Prevention (CDC).
Plus, as estrogen falls, “bad” LDL cholesterol and triglycerides also increase, and “good” (heart-protective) HDL cholesterol decreases, adds cardiologist Dr. Karishma Patwa. Manhattan Cardiology in New York City. Additionally, studies have shown that there are additional metabolic changes, such as an increase in visceral (or abdominal) fat (which doubles or triples during this stage, according to studies), which may also put your heart at risk.
All these reasons contribute to the 2020 consensus published in the journal cycleThe American Heart Association lists menopause as an independent risk factor for heart disease.
“I hope people never enjoy life. Sometimes it’s okay to have a glass of wine or a steak.” Heather Hirsch, MD, Internal Medicine Specialist
How to care for your heart during menopause
It's all pretty disturbing. But you also need to know this: many There are things you can do to combat these risks and keep your heart healthy during menopause. Here are six good places to start:
Get a heart checkup
How is your heart health? “As women enter menopause, they need to monitor their cardiovascular health particularly diligently,” says Dr. Patwa.
Along with menopause itself, additional risk factors such as high blood pressure and cholesterol place additional strain on the heart. So here's what you need to do: Check your blood pressure at your annual checkup and request lab tests to check your lipid levels. Dr. Patwa also recommends considering getting a coronary calcium score. This is a scan that detects calcium buildup in the arteries and indicates how much the arteries are clogged by plaque. This test can give you a preview of your risk for a future heart attack or stroke.
Share your *entire* health history with Docs
One of the unfortunate myths that exist during pregnancy is that common conditions such as preeclampsia or gestational diabetes “go away” once the baby is born. Here's the truth: “What happens during pregnancy doesn’t continue during pregnancy,” says Dr. Hirsch. (Preeclampsia refers to abnormally high blood pressure, and gestational diabetes refers to abnormally high blood sugar levels during pregnancy.) Blood pressure or blood sugar levels may return to normal after giving birth, but the risk increases with age.
“Preeclampsia can have detrimental effects on cardiovascular health,” adds Kecia Gaither, MD, MPH, who is double board certified in obstetrics and gynecology and maternal fetal medicine. In fact, having preeclampsia is associated with a three times higher risk of having a stroke later in life, a 2021 study found. JAMA Network Open. Other studies published in 2022 Diabetes ManagementIt is associated with a two-fold higher risk of developing a heart attack compared to people without a history of gestational diabetes.
Of course, you cannot change your health records. But make sure both your doctor and your cardiologist know this information so they can help you make the best plan to protect your heart.
Take your sleep seriously
Peri-menopausal women are more likely than premenopausal women to say they have trouble sleeping, according to preliminary data from the 2023 American Heart Association Scientific Sessions. Unfortunately, the same study found that women who were poor sleepers also slept three times better. They are more likely to score low on measures of overall cardiovascular health, and especially on diet and BMI parameters. (What this means: Lack of sleep may be related to how you eat and whether you are overweight.)
One of the problems is that menopause can disrupt your sleep (for example, if you wake up in night sweats and with wet sheets). So we acknowledge that simply getting more or better sleep can be difficult. But some healthy sleep habits can help you hit better zzz's, including going to bed and waking up at the same time every day, exercising during the day, and adding regular relaxation activities before bed to cue you up. Trying to sleep, according to the North American Menopause Society.
If you've tried everything and are still struggling, it may be worth working with a sleep specialist to determine the cause of your sleep problems and find targeted strategies that can help.
Talk to your doctor about HRT
Hormone replacement therapy (HRT) is not FDA-approved for primary prevention of cardiovascular disease, says Dr. Hirsch. (It is used to treat menopause symptoms, such as hot flashes.) However, if started at the right time (for people under age 60 and in menopause or near menopause), HRT has been shown to reduce deaths from heart disease and deaths from menopause. It turns out. any The causes are also as follows: cancer journal The year 2022 is critical because HRT protects blood vessels and reduces atherosclerosis (plaque buildup in the arteries). But starting too late can speed things up and increase the risk to your heart.
The decision about when or if you should receive HRT varies from person to person, so talk to your doctor.
weight lifting
Both aerobic and resistance training are the cornerstones of a balanced exercise routine. But we've long thought of aerobic exercise as something that promotes heart health, and resistance training is good for your muscles and bones.
Newsflash: Resistance exercise (e.g., weight lifting) actually makes a difference in heart health by helping reduce total cholesterol, LDL cholesterol, and triglycerides, a 2023 review and meta-analysis concluded. European Journal of Obstetrics and Gynecology and Journal of Reproductive Biology. Strength training also helps build muscle and reduce excess body fat, which is linked to heart health issues.
Oh, and another benefit of weight training: It may also help lower blood pressure, other studies suggest.
Ditch the traditional Western diet
The first thing to be clear about is this: live a little During menopause. “I hope people never enjoy life. Sometimes it’s okay to have a glass of wine or a steak,” says Dr. Hirsch.
But there is data to suggest that moving away from a Westernized diet high in red and processed meats, fried foods and sugary drinks can help keep your blood vessels clear as you age. nutrition journal In 2020.
Although there are a variety of diets, such as the Mediterranean or DASH, that are specifically related to heart health, Dr. Hirsch says she doesn't necessarily recommend one diet. “Research what’s right for you and use your own health data to guide you in making the best choice,” she says. A registered dietitian can help you too. There are many people who specialize in menopause nutrition, so you don't have to go it alone.