The Heart and The Menopause

Menopause happens when a woman stops getting her monthly menstrual period. It is a natural process that most women go through, usually around age 51 years, but it can happen earlier. The risk of developing heart disease increases in everyone as we get older, however in women the risk increases significantly about 10 years after the menopause. Studies that have followed women over a period of time have found that women who have an early menopause, under the age of 45 years, are most at risk of developing heart disease. It is thought that about 1 in 3 postmenopausal women have cardiovascular disease.


heart disease in women




Oestrogen, the female sex hormone, is protective against the development of heart disease as it relaxes the arteries and helps control cholesterol levels. It is associated with higher levels of HDL or “good” cholesterol and lower levels of LDL or “bad” cholesterol. The presence of oestrogen is probably the reason why women tend to have a lower risk of cardiovascular disease than men up until the menopause. After the menopause, however, oestrogen levels fall and your heart and blood vessels become more stiff and less elastic, causing blood pressure to rise. A fall in oestrogen also results in a rise in LDL cholesterol  and a fall in protective HDL cholesterol levels. 

In premenopausal women oestrogen influences where we store fat and our metabolism. After the menopause the decline in oestrogen causes our metabolism to slow down which contributes to weight gain. It also makes us store fat around our middle, so we become more resistant to insulin, increasing our risk of type 2 diabetes and other metabolic diseases. 

The good news is that a lot of this is either reversible or preventable. Your overall risk of heart disease is determined by a set of risk factors. While you cannot control your family history or your age, you can control your lifestyle and habits. Adopting a heart-healthy lifestyle can reduce your risk of developing heart disease.


6 habits to reduce your risk of heart disease

1. Eat a healthy diet

Eat a diet rich in whole grains, nuts and seeds, beans, fruits and vegetables daily. Try to eat fish, particularly oily fish, twice a week. Minimise the intake of processed foods, sugar sweetened drinks and saturated fats.

2. Exercise regularly

Many studies have shown that exercise reduces the risk of heart attack and stroke. It helps lower high blood pressure and cholesterol, reduces stress, helps keep weight off and improves blood glucose levels. Try to aim for 150 minutes of physical activity a week.

3. Maintain a healthy weight.

Carrying excess weight, particularly around your middle, is a strong predictor for heart disease, especially in women. If you are overweight you can reduce your health risks greatly by losing just 10% of your body weight.

4. Reduce stress.

Severe prolonged stress can contribute to heart disease. Because it is impossible to avoid all stress it is important for us to learn how to handle it to lessen its impact on our heart and body. 

5. Stop smoking.

Smokers have twice the risk of heart attack than nonsmokers. The good news is that no matter how long or how much someone has smoked, you can immediately reduce your risk of heart attack by quitting.

6 Regular health screens.

High blood pressure, diabetes and high cholesterol levels all increase the risk of heart disease if left untreated. You can’t manage what you don’t know about.  It is recommended that you have your blood pressure, blood glucose and cholesterol levels checked regularly to monitor your health risks. Early treatment of any of these conditions will reduce the risk of heart disease and other complications. 

Whether hormone replacement therapy (HRT) is protective against heart disease is still being debated. The studies show that oestrogen replacement probably protects against heart disease in women who have experienced an early menopause and may be protective in women starting HRT within a few years of the menopause. Have a chat with your doctor about whether HRT is right for you but it is not usually prescribed solely to prevent heart disease.