Menopause occurs when menstrual cycles stop. In the years before and after menopause, the body goes through many changes, leading to symptoms that may include hot flashes, emotional changes, and trouble sleeping. But its impact on the body could be even more profound. Medical news today studies why menopause might impact cardiovascular health and how women can maintain a healthy heart as they age.

Doctors generally believe that cardiovascular disease affects men more than women, but American Heart Association (AHA) recently pointed out that heart disease kills more women than all forms of cancer.

In addition, the risk for a woman of heart disease can increase significantly in the years before and after menopausethe stage of life after the end of menstrual cycles.

The periods before, during and after the cessation of menstrual cycles are called:

• perimenopausewhich can start several years before the last period and end 12 months after the last period.

• menopause, which occurs 12 months after the last period at an average age of 52 or after surgery, such as removal of the ovaries, that stops menstruation

• And postmenopausethe years following menopause.

For some people, perimenopause and menopause can go almost unnoticed, other than the cessation of periods. But for most, the weather can bring a whole host of symptoms, which may include:

Many of these symptoms are caused by a decrease in reproductive hormones, estrogen And progesteronewhich accompanies menopause.

Although progesterone is thought to have little influence on heart health, the decline in estrogen is likely to contribute to a increased risk of cardiovascular disease.

How estrogen protects the heart

Deborah Matthew, MDchief medical advisor at BHRT Training Academy and founder of Exclusive well-beingsaid Medical news today that:

Estrogen protects the cardiovascular system in several ways. Robin Noble, MDboard-certified obstetrician-gynecologist and chief medical advisor for Let’s talk about menopauseexplained some of them to MNT.

“We don’t see a lot of cardiovascular disease in women before menopause – probably because estrogen has a vasodilatory effect on the vascular (system). Additionally, estrogen has anti-inflammatory effects, and inflammation and oxidative stress appear to be the primary mechanisms for the development of cardiovascular plaques,” Noble told us.

Once estrogen declines, these cardioprotective effects disappear, increasing the risk of heart disease.

What other pathologies does menopause increase the risk of?

“With the decline in estrogen levels at menopause, there may be increased cholesterol levels, higher blood pressure and increased visceral fat, leading to plaque buildup and hardening of the arteries,” a note Jennifer Wong, MDboard-certified cardiologist and medical director of non-invasive cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California.

“There may also be an increase in inflammation which has been associated with an increase atherosclerotic plaqueparticularly unstable plate. Autonomous Changes in menopause can lead to an increase in heart rate and a decrease in heart rate variability,” she added.

According to the AHASome of the common symptoms of menopause—hot flashes, night sweats, depression, trouble sleeping, and increased fat around the abdomen—are associated with a higher risk of cardiovascular disease.

Furthermore, a 2023 study linked stress and insomnia after menopause to a higher risk of atrial fibrillation (AFib).

And the risk of cardiovascular diseases is higher in those who experience early menopause, before the age of 40, than in those whose menopause occurs later.

Matthew outlined a range of cardiovascular risks that can increase after menopause. These include:

• coronary artery disease — estrogen deficiency can promote atherosclerosis, the buildup of plaque in the arteries, increasing the risk of heart attack

• high blood pressure (hypertension) — estrogen maintains tissue elasticity and promotes vasodilation, so loss of estrogen can lead to high blood pressure

• arrhythmias — hormonal fluctuations can influence heart rate, potentially leading to palpitations or atrial fibrillation

• stroke — the risk of stroke is increased due to higher blood pressure and arterial stiffness

• heart failure — a decrease in cardiac efficiency due to weakening of the heart muscle may develop, often as a result of untreated high blood pressure or coronary artery disease

• high cholesterol — Estrogen is actually made up of cholesterol, and estrogen deficiency after menopause can lead to higher levels of LDL (bad) cholesterol and HDL (good) cholesterol.

• insulin resistance or prediabetes – after menopause, women become more resistant to insulin, increasing the risk of prediabetes and diabetes, which, in turn, are important risk factors for heart disease and stroke .

How Menopause Can Affect Pre-Existing Heart Disease

Some pre-existing heart conditions can make menopausal symptoms worse, and hormonal changes during menopause can impact pre-existing conditions, as Matthew explains.

“Women with cardiovascular disease may experience more severe menopausal symptoms, such as hot flashes, anxiety and fatigue. The decline in estrogen with menopause can worsen existing cardiovascular diseases like atherosclerosis, high cholesterol and high blood pressure, increasing the risk of heart attacks and strokes, she told us.

Noble shared a similar comment:

“Pre-existing cardiovascular disease and other health conditions may hinder a person’s ability to follow some of the healthy lifestyle interventions recommended to alleviate symptoms,” she added.

3 Ways to Minimize Your Risk of Heart Disease

During the years surrounding menopause, people should follow general healthy living advice to maintain heart health. Noble advised “lifestyle modifications that include increased physical activity, stress management, healthy eating – with an increase in plant-based foods and whole grains.” »

“A green Mediterranean diet, incorporating fish, is probably the healthiest diet: less animal fats and animal proteins, eliminating ultra-processed foods. Intermittent fasting can also be a healthy strategy,” she said. MNT.

In addition to a healthy lifestyle, hormone replacement therapy (HRT) can be an effective way to reduce the risk of heart disease at this time of life.

A studynot yet published in a peer-reviewed journal, suggests that estrogen therapy may have long-term beneficial effects in reducing the risk of heart disease.

In this study, women taking conjugated equine estrogens (CEE), the most commonly used estrogen formulation, and those who take CEE more medroxyprogesterone acetate (MPA) showed improvements in all cardiovascular biomarkers except triglycerides.

They had increased levels of HDL-C (the “good” cholesterol), lower levels of LDL-C (“bad” cholesterol), decreased insulin resistance and decreased lipoproteins – all factors which could be beneficial for heart health.

“Estrogen replacement, if initiated within 10 years of menopause, is associated with a reduction in the progression of atherosclerosis and a reduction in the risk of death from heart disease (and a reduction in mortality all causes combined). The discussion about hormone therapy should be individualized with the woman’s doctor,” Matthew advised.

A goodbye also suggests that transdermal estrogens (such as gels and patches) may have a greater cardioprotective effect than oral estrogens or estrogens combined with progesterone. However, estrogen alone can increase the risk for endometrial (uterine) cancer, so it is usually only given after a hysterectomy.

The timing of starting estrogen therapy may also be important. A 2016 study showed that there were more cardiovascular benefits when HRT was started within 6 years of menopause than when it was started later.

The main things to know about menopause and heart health

Although the risk of cardiovascular disease increases in women around the time of menopause, there are several steps a person can take to minimize this risk.

Experts advise following a healthy lifestyle, including a healthy diet and regular physical activity, not smoking and moderating alcohol consumption.

For many women, hormone therapy will not only help manage menopausal symptoms, but may also reduce cardiovascular risk.

However, experts advise that any hormonal treatment should be discussed with a clinician to ensure the most appropriate type is prescribed.

So, although cardiovascular risk increases with the onset of menopause, there are many ways to help maintain a healthy heart later in life.

See the original article on Medical news today