The Entailed Relationship Between Menopause and Heart Disease

Menopause is a natural phase in a woman’s life, which marks the end of her menstrual cycle and reproductive years. While it brings several hormonal and physiological changes, one of the most significant health concerns associated with menopause is the increased risk of heart disease.

According to the American Heart Association, heart disease is the leading cause of death for women in the United States, who typically develop heart disease several years later than men. Understanding how menopause can affect heart health can help women take proactive steps to protect themselves while also distinguishing normal menopausal symptoms from those that could indicate heart issues.

Menopause is officially diagnosed after a woman has not had her period in over 12 months. While the average age for menopause in the United States is around 52, it can occur anytime between the ages of 45 and 55. As well as early menopause under the age of 45, or premature menopause that affects women under the age of 40, which is rare and is usually a result of premature ovarian insufficiency. When a woman begins menopause, there are a variety of symptoms that come along with this new chapter.

What Happens During Menopause?

During menopause, estrogen levels decline significantly, which can influence various aspects of cardiovascular health. Estrogen is known to have a protective effect on the arteries, helping to maintain their flexibility and promoting good circulation. When this hormone decreases, blood vessels may become stiffer, leading to higher blood pressure and can increase the chances of high cholesterol.

Menopause can have a significant change in cholesterol levels, with LDL (bad cholesterol) increasing and HDL (good cholesterol) decreasing. These shifts make it easier for fatty deposits to accumulate in the arteries, increasing the likelihood of blockages that can lead to heart attacks or strokes.

Weight gain is another common concern during menopause, particularly around the abdomen. Excess abdominal fat is linked to higher levels of inflammation and insulin resistance, both of which can strain the cardiovascular system. When combined with unhealthy lifestyle choices, these changes can increase the risk of heart disease development.

When Menopause & Heart Disease Symptoms Collide

Some menopausal symptoms can mimic those of heart disease, which may cause unnecessary worry. However, understanding the differences can help women identify when they should seek medical attention:

• Hot Flashes and Night Sweats vs. Heart Attack Signs: Hot flashes and night sweats are hallmark symptoms of menopause. They cause sudden feelings of warmth, flushing of the skin, and excessive sweating, particularly at night. While they can be uncomfortable, they are not typical signs of heart disease. However, if these episodes are accompanied by chest pain, dizziness, nausea, or shortness of breath, it may be a warning sign of a heart attack and should not be ignored. 
• Palpitations vs. Irregular Heartbeat: Many women experience heart palpitations during menopause, feeling as if their heart is racing or skipping beats. This is often due to the fluctuating hormone levels and is usually harmless. However, if the palpitations are persistent, occur with chest discomfort, or are accompanied by fainting, they could indicate an underlying heart condition such as atrial fibrillation. A good way to assess symptoms is by taking a heart risk assessment and discussing it with your health care provider. 
• Fatigue vs. Heart Disease: Fatigue is common during menopause due to sleep disturbances, hormonal shifts, and emotional stress. However, fatigue that is severe, sudden, or accompanied by other symptoms such as chest pain or shortness of breath may be a sign of heart disease. Women should listen to their bodies and consult a health care provider if they experience unusual, or extreme fatigue.

As we age, we become increasingly at risk for heart disease. But menopause can accelerate certain conditions that contribute to cardiovascular issues such as:

• High Blood Pressure: Estrogen helps keep blood vessels relaxed and open, allowing for smooth circulation. When estrogen levels drop, blood pressure may rise, increasing strain on the heart. 
• High Cholesterol Levels: Many women experience an increase in LDL cholesterol and a decrease in HDL cholesterol after menopause, raising the risk of artery blockages. 
• Diabetes: Women who develop diabetes before or after menopause face a higher risk of heart disease than men with the same condition. Managing blood sugar levels is essential for heart health. 
• Obesity: Weight gain, particularly around the midsection, contributes to inflammation and metabolic imbalances that strain the cardiovascular system.
• Decrease in Exercise: Reduced physical activity can lead to weight gain, high blood pressure, and decreased cardiovascular fitness. 
• Smoking: Women who smoke have an increased risk of early menopause and a significantly higher chance of developing heart disease. Quitting smoking can greatly improve heart health. 

Specialized Heart Care Just for Women

At MemorialCare Medical Group, we offer specialized care tailored to each patient, including focused OBGYN services and women’s heart care. As women enter menopause, their susceptibility to heart disease increases. Fortunately, those who visit MemorialCare Medical Group can take advantage of having access to a dedicated women's heart program at the Women's Heart Center with the MemorialCare Medical Group -- Long Beach (Douglas Park), filling a major gap in women's cardiac care in the South Los Angeles and North Orange County communities.

At the Women’s Heart Center, my colleague, Dr. Nissi Suppogu, is a fellowship-trained doctor with two additional years of training and education exclusively on women’s heart health, providing comprehensive services such as education, prevention, early diagnosis, specialized testing, and timely management of women-specific cardiac issues across their lifespan. This includes care during pre-conception planning, pregnancy, early menopause, and beyond.

If a woman requires further testing and care, she can trust that she will be connected to the MemorialCare Heart & Vascular Institute at Long Beach Medical Center, a leading acute care hospital that specializes in women’s heart procedures. Long Beach Medical Center has received recognition from national organizations like U.S. News & World Report and Healthgrades for exceptional care provided to cardiac patients.

Managing Menopause: Tips & Tricks

Maintaining overall health after menopause requires a proactive approach. Fortunately, many lifestyle changes can help women enhance their well-being and reduce the risk of various health issues, including cardiovascular disease. Here are some effective strategies to consider:

• Adopt a Healthy Heart Diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help manage cholesterol levels and reduce inflammation. Foods rich in omega-3 fatty acids, such as salmon, walnuts, and flaxseeds, are particularly beneficial for heart health. It is also important to reduce the intake of processed foods, added sugars, and trans fats as they can further affect cardiovascular function.
• Stay Physically Active: Regular physical activity helps strengthen the heart, improve circulation, and maintain a healthy weight. The American Heart Association recommends at least 150 minutes of moderate-intensity exercise per week, such as a brisk walk, water aerobics, or cycling. Strength training exercises can also help maintain muscle mass and support metabolic health, such as squats, wall push-ups, toe stands, side hip raise, and finger marching.
• Monitor Blood Pressure and Cholesterol Levels: Routine health screenings can help detect changes in blood pressure and cholesterol early, allowing for timely intervention. Women should work with their healthcare providers to manage any abnormalities through lifestyle adjustments or medications if necessary. 
• Manage Stress and Mental Well-Being: Stress and anxiety can negatively impact heart health, particularly during menopause. Practicing relaxation techniques such as yoga, meditation, and deep breathing can help regulate stress levels. Staying socially connected and seeking support from friends, family, or a therapist can also improve emotional well-being. 
• Quit Smoking and Limit Alcohol Intake: Smoking is one of the most significant risk factors for heart disease, and quitting can lead to immediate and long-term health benefits. Additionally, limiting alcohol consumption can help maintain a healthy heart, as excessive drinking can raise blood pressure and contribute to weight gain. 

Menopause is a significant transition, but it does not have to mean a decline in health. By understanding the changes that occur and taking proactive steps to maintain a healthy, cardiovascular well-being, women can embrace this stage of life with confidence.

At MemorialCare Medical Group - Long Beach (East Spring St.), me and my colleagues partner with our patients who are entering into menopause or are already menopausal to provide them with the best health care plan possible – ensuring that they live healthier lives and have a better quality of life. Should a patient have questions about her menopause journey, we are here to provide her with the guidance she needs. By partnering with our patients and connecting with them, we can get them the dedicated and specialized care that they need in a timely manner.

If you’re interested to learn more about what we have to offer for specialized care, please call (657) 241-8041 to schedule an appointment.