The Overlooked Risk: Cardiovascular Disease in Perimenopause and Menopause

The Overlooked Risk: Cardiovascular Disease in Perimenopause and Menopause

When we talk about perimenopause and menopause, the focus is often on hot flashes, mood swings, and sleep disturbances. But there’s a far more serious health concern that often gets overlooked: cardiovascular disease (CVD). Heart disease is the leading cause of death in women, and the risk skyrockets during and after menopause. Why? Because estrogen, which has a protective effect on the heart, starts to decline, leaving women more vulnerable to heart-related issues.

Why Does the Risk Increase?

Estrogen plays a crucial role in keeping blood vessels flexible and promoting good cholesterol levels. As estrogen declines during perimenopause and menopause, several changes increase the risk of cardiovascular disease:

  • Higher Blood Pressure: Loss of estrogen can lead to stiffer blood vessels, making it harder for the heart to pump efficiently.

  • Increased LDL (Bad) Cholesterol & Decreased HDL (Good) Cholesterol: The balance shifts unfavorably, contributing to plaque buildup in arteries.

  • Weight Gain & Fat Redistribution: Many women notice an increase in belly fat, which is linked to higher cardiovascular risk.

  • Insulin Resistance: Menopause-related metabolic changes make it harder to regulate blood sugar, increasing the likelihood of type 2 diabetes—a significant risk factor for heart disease.

  • Increased Inflammation: Chronic, low-level inflammation becomes more common with aging and can contribute to cardiovascular problems.

Know the Symptoms—They’re Different for Women!

Most people associate heart attacks with crushing chest pain, but for women, the symptoms can be much more subtle. Many women dismiss these signs as stress or exhaustion. Key symptoms include:

  • Shortness of breath

  • Unexplained fatigue

  • Nausea or indigestion

  • Dizziness or lightheadedness

  • Pain or discomfort in the neck, jaw, back, or stomach

  • Cold sweats

  • Chest pain (although this may be less common in women than in men)

If you experience any of these symptoms, especially in combination, don’t ignore them—seek medical attention immediately.

Testing & Prevention: What You Need to Know

Prevention is key when it comes to heart disease. Regular screenings and lifestyle adjustments can make a big difference. Here’s what you should monitor:

  • Blood Pressure: High blood pressure is a major risk factor; aim for readings below 120/80 mmHg.

  • Cholesterol Levels: Get a full lipid panel to check LDL, HDL, and triglycerides.

  • Blood Sugar & A1C: Keep an eye on glucose levels to catch early signs of insulin resistance.

  • Weight & Waist Circumference: Excess abdominal fat is a red flag for cardiovascular issues.

  • Inflammation Markers: Tests like C-reactive protein (CRP) can indicate inflammation linked to heart disease.

  • Coronary Calcium Scan: This test can assess plaque buildup in your arteries and help determine your overall risk.

When to Seek Help

Don’t wait until a major issue arises. Talk to your doctor if you:

  • Have a family history of heart disease

  • Experience any of the symptoms mentioned above

  • Have risk factors like high blood pressure, diabetes, or high cholesterol

  • Notice a rapid change in weight, energy levels, or endurance

Steps to Protect Your Heart

You can’t stop menopause, but you can take action to lower your cardiovascular risk:

  • Eat a Heart-Healthy Diet: Focus on whole foods, healthy fats, and lean proteins.

  • Exercise Regularly: Aim for at least 150 minutes of moderate exercise per week.

  • Manage Stress: Chronic stress contributes to heart disease, so find ways to relax.

  • Quit Smoking: If you smoke, quitting is one of the best things you can do for your heart.

  • Consider HRT (Hormone Replacement Therapy): For some women, HRT can help manage symptoms and potentially protect heart health—but it’s not for everyone, so discuss it with your doctor.

Final Thoughts

Menopause may be inevitable, but heart disease doesn’t have to be. Understanding your risks, recognizing symptoms, and making proactive lifestyle changes can help you maintain heart health well into your later years. Don’t wait until it’s too late—start protecting your heart today!

Back to blog