Hot flashes, insomnia, and night sweats probably come to mind when you think of menopause. Heart disease may not be high on your list of related health concerns, but perhaps it should be.
Heart disease is the top killer of women, and a woman’s risk for heart disease increases dramatically around the time she goes through menopause — typically between ages 50 and 54.
During menopause, levels of the female hormoneestrogen drop significantly, explains Nicole Weinberg, MD, a cardiologist at the Pacific Heart Institute in Santa Monica, California.
Estrogen Drops, and Your Body Responds
High blood presure When estrogen levels drop, your heart and blood vessels become stiff and less elastic. Because of these changes, your blood pressure tends to rise, causing hypertension. Elevated blood pressure can place added strain on the heart, says JoAnne Foody, MD, medical director of the cardiovascular wellness program at Brigham and Women’s Hospital and an associate professor of medicine at Harvard Medical School in Boston.
High cholesterol Lack of estrogen can also cause detrimental changes in yourcholesterol and blood fats: Your good cholesterol (HDL) may go down, and your bad cholesterol (LDL) may go up, which increases your risks of heart attack and dying from heart disease, says Dr. Foody. Triglycerides, another kind of fat in the blood, also increase becasue of the drop in estrogen.
Diabetes When women go through menopause, they can also become more resistant to insulin, the hormone needed to convert blood sugar and starches into energy for cells to use. As a result, “women are more likely to become prediabetic and diabetic as they transition from premenopause to menopause,” explains Foody. Having diabetes puts you at a higher risk for heart disease and stroke.
Atrial fibrillation Women may see an increase in abnormal heart rhythms like atrial fibrillation (afib) around the time they go through menopause. “Sometimes hormonal changes can cause a slowing of the heart and heart blockages that can cause symptoms, including dizziness,” notes Foody. More commonly, the change in hormones causes faster heart rates. Atrial fibrillation can also be brought on by high blood pressure, which is more common after menopause.
Weight gain Estrogen affects where women store fat and how it is burned, says Stacey E. Rosen, MD, a cardiologist and vice president of women’s health at Northwell Health’s Katz Institute for Women’s Health in New Hyde Park, New York. Menopause can cause the metabolism to slow, which contributes to weight gain. And this can put stress on your heart and increase your risk of heart disease, says Dr. Rosen.
Symptoms of Heart Disease
With menopause, factors conspire to change a woman’s risk for heart disease, Foody says. “It’s important for women to understand that while menopause transition is natural, some of the symptoms associated with it, such as heart palpitations or increases in blood pressure, can have significant consequences.”
Women should check with their doctor to be sure what they’re experiencing is still within a range of normal, Foody notes.
Symptoms you should never ignore include:
1. Palpitations “Don’t assume heart palpitations are natural flutters,” says Rosen. “It’s important to identify atrial fibrillation, because this heart condition increases therisk of stroke,” adds Foody.
2. Shortness of breath “If you were able to go up the stairs fine, and now you find you are short of breath, talk to your healthcare provider,” says Foody. It could be a sign of congestive heart failure or coronary artery disease. Shortness of breath is also one of the most common symptoms of atrial fibrillation.
3. Pressure in the chest It could be an indication of heart disease. “Some women think that unless they have crushing chest pain, it’s not a heart attack,” Foody reports. A feeling of fullness, squeezing or dull pressure in the chest that doesn’t go away or that goes away and comes back could be a sign of a heart attack in women.
4. Headaches They might be a sign of high blood pressure, so get any symptoms checked out.
5. Lightheadedness or dizziness This could be caused by a number of disorders, including diabetes, heart failure, or a heart arrhythmia like atrial fibrillation.
6. Jaw ache This could be a sign of an unhealthy heart and is a warning sign of a heart attack in women.
7. Swelling of the feet Fluid could be accumulating in your legs as a result of congestive heart failure.
8. Difficulty lying flat This could be a symptom of fluid pooling in your lungs as a result of congestive heart failure, Dr. Weinberg says.
Heart Disease in Menopause Is Preventable
“On the good side, a lot of this is reversible or preventable,” Foody says. Menopause is an important time to take good care of yourself and your heart.
Women who exercise, don’t smoke (or quit), monitor themselves for weight gain, and eat a healthy, nutritious diet rich in fruits and vegetables can lower their risk of heart disease as they age.
“We know that women who exercise tend not to get high blood pressure as much. And exercise can also prevent your heart from stiffening as you age,” Foody says.