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Menopause & Heart Health: Here's What You Need To Know About Staying Healthy

 

Hot flashes, weight gain, mood changes, insomnia—

many of us know to expect these well-known symptoms

of menopause. What we don’t commonly discuss or

prepare for, however, is how this time in our life puts us

at higher risk for certain illnesses, especially those that

involve our cardiovascular system. 

 

Many people are unaware that menopause can

increase your risk of common conditions like

osteoporosis, metabolic disorders, sexual dysfunction,

and urinary incontinence. When it comes to heart

disease, your risk increases substantially; and

considering the fact that cardiovascular disease is the

leading cause of death of men and women worldwide, this is something we should all have on our radar. 

The Facts On Heart Health At Menopause

Heart disease is a huge (and growing!) problem in the United States and all over the world, and many of us have lost a friend or family member to this growing epidemic. Heart disease is often thought of as a men’s health issue—since men tend to suffer heart attacks earlier in life—but ultimately, more women die from cardiovascular disease than men. 

 

This is partly because as women, our risk for cardiovascular disease increases after we go through menopause. In fact, studies have shown that heart disease rates are two to three times higher for postmenopausal women than for those of the same age who have not yet undergone this transition. According to Johns Hopkins Medicine, as women we should be particularly cognizant of our heart health if we go through menopause at an early age. Research studies that have followed women over long periods of time have found that women who enter menopause before age 45 have more cardiovascular issues than women who enter menopause around 50. 

The Heart Health-Menopause Connection Explained 

So what explains this connection between heart health and menopause? As with hot flashes, it’s thought that declining levels of estrogen are partly to blame. While famous for helping regulate our monthly hormone cycle during our reproductive years, estrogen actually plays a role in countless physiological functions, including having a protective effect on our artery walls, which helps keep our vessels flexible and our blood flowing smoothly. 

 

But estrogen isn’t the only player when it comes to heart disease and menopause. Research has shown that other known risk factors for heart disease—like blood pressure, LDL, and triglyceride levels—also increase at this time, making women even more vulnerable. It’s common for women to experience heart palpitations during menopause as well, but according to Leslie Cho, M.D., Director of Cleveland Clinic’s Women’s Cardiovascular Center, this is typically nothing to worry about. If heart palpitations are concerning you, she suggests cutting back on caffeine as a first step. You can try staying hydrated, leaning on mindfulness exercises like meditation or breathing, and exercising regularly. 

Treatment Approaches To Heart Health At Menopause 

 

Statistics show that about 70% of women will develop cardiovascular disease after menopause. This number is pretty shocking, but you can rest assured that menopause is not a sentence for heart disease. You can’t prevent the hormonal changes that make your heart more vulnerable, but there are so many lifestyle factors—ones that are totally under your control—that can drastically lower your risk of developing heart disease. 

 

So what can you do to protect your heart before, during, and after menopause? Your doctor will likely advise you to focus on decreasing or eliminating risk factors such as:  ​​

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  • High blood pressure

  • Diabetes and prediabetes

  • High cholesterol

  • Obesity

  • Tobacco use

  • An inactive lifestyle

  • An unhealthy diet

If you fall under the first four categories, you’ll want to work directly with your doctor. The following three factors you can tackle yourself—and the good news is that focusing on diet and lifestyle can decrease your risk for high blood pressure, diabetes, and high cholesterol. Win-win.

 

So what does a healthy heart diet and exercise routine look like? According to the American Heart Association (AHA), women should aim for at least 150 minutes of physical activity each week and focus on stocking the fridge and pantry with: 

 

  • fruits, vegetables,

  • whole grains,

  • low-fat dairy products,

  • poultry, fish, and nuts,

  • while limiting red meat and sugary foods and beverages.

If possible, it’s also a good idea to be aware of your family history so you can assess your individual risk for heart disease in the first place. For some of us, this can be as simple as asking our parents and grandparents about any heart disease in the family. For others among us, it could require genetic testing or further research to understand what your risk might be. You can’t avoid the increased risk for heart disease during menopause altogether, but you can arm yourself with knowledge and make sure you understand your individual risks. Then, it’s up to you to make the necessary lifestyle changes to mitigate them. 

An Integrative Approach To Heart Disease At Menopause 

 

Unfortunately, there’s no herb, supplement, or natural remedy that will take heart disease off the table. In fact, the dietary and lifestyle recommendations from the AHA are similar to those that a more holistic medical provider might suggest, with one major exception: Low-fat dairy products.

 

We’ve long been told to blame fat—especially saturated fats, which are found mostly in animal products—for increasing cholesterol and therefore causing heart disease. But recent research suggests saturated fat might not be as bad as we thought, and that eliminating fat from our diets in such a drastic way has actually had negative consequences for our heart health. This is, in part, because when we made everything low-fat, we replaced that fat with carbs and sugar. As Dr. Anna M. Barbieri, M.D., an OB/GYN at Mount Sinai School of Medicine put it: “Basically, for decades we were frankly wrong by promoting a low-fat, high-carb approach and are still seeing its effects in our rising rates of obesity, diabetes, and cardiovascular disease.” If you’re a big fan of butter and full-fat Greek yogurt, you’ll be happy to know that most nutrition experts now consider them to be part of a healthy diet. (Yogurt parfait, anyone?) If this just leaves you even more confused about what to eat, that’s understandable. Keep reading to answer exactly that question.

 

Inflammation And Heart Disease: An Important Connection 

So then, what does cause heart disease? Leading nutrition and heart health experts are now describing heart disease as a chronic inflammatory condition—an idea that has been gaining ground. In fact, pharmaceutical companies are running clinical trials to see whether anti-inflammatory drugs can help prevent heart disease. It appears that one drug, called Canakinumab, can—and it does so without affecting cholesterol levels, according to a study published in the New England Journal of Medicine

 

So is cholesterol out and inflammation in? As with many things in life, the true cause of heart

disease is multifactorial and not so cut and dried. There are still certain types of fat we should eat in moderation or avoid completely (we’re looking at you, trans fats, which are found in vegetable oils, margarine, and many packaged and processed foods). But there’s also enough evidence to conclude that fat is not public enemy number one and that focusing on decreasing inflammation—with an anti-inflammatory diet and plenty of exercise and stress relief—could very well protect your heart. 

 

So what should you eat? Dr. Barbieri says that “As a general rule, I always recommend a whole food, plant-based, low-carbohydrate diet; one that eliminates processed food, refined carbohydrates, and added sugars as much as possible and incorporates a healthy amount of fats, especially those from cold water fish, avocados, nuts, and olive oil.” 

 

Ready for one last important piece of knowledge to take home with you? The symptoms we normally associate with a heart attack (ahem, chest pain) do not always occur in women. This causes many of us to delay treatment or be misdiagnosed. Get familiar with the top symptoms of a heart attack in women, which include shortness of breath, weakness, unusual fatigue, and cold sweats.

Helpful Links: 

Menopause and Heart Disease — The American Heart Association 

Why Your Heart Needs Extra Love After Menopause — Cleveland Clinic 

Keeping Your Heart Healthy At Menopause — North American Menopause Society 

Gender Matters: Heart Disease Risk In Women — Harvard Health Publishing 

Contributors & Reviewers:

Dr-Anna-Barbieri-MD-275689-circle_large_

Dr. Anna Barbieri

Assistant Clinical Professor,

Mt. Sinai 

Anna Barbieri MD FACOG completed her undergraduate studies at Colgate University, her medical degree from SUNY Syracuse and completed residency training in obstetrics and gynecology at Mount Sinai Medical Center, where she currently serves as Assistant Clinical Professor. Dr. Barbieri is a Fellow at the Andrew Weil Center for Integrative Medicine, University of Arizona, and a Certified Practitioner at the North American Menopause Society. She specializes in menstrual and hormonal problems and perimenopausal and menopausal transition. 

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