What changes
The harmful type of cholesterol rises. Blood pressure climbs. Fat shifts to the waist. Blood sugar control weakens. Blood vessels stiffen.
Higher risk groups
Women whose menopause came before 45. Women with frequent, severe hot flushes. Women who had preeclampsia, high blood pressure in pregnancy, gestational diabetes or premature birth. Women with polycystic ovary syndrome, autoimmune conditions like lupus and rheumatoid arthritis, or a family history of early heart disease.
Know your numbers
Blood pressure every year. Cholesterol and blood sugar at least every few years from 45, more often if raised. Ask for a formal heart risk assessment. Tell your practitioner about any pregnancy complications, because they are rarely recorded as heart risk factors.
What protects your heart
150 minutes of moderate activity a week plus two strength sessions. Stop smoking. Keep alcohol under ten standard drinks a week. Eat mostly plants, fish, whole grains and olive oil. Sleep well. Treat raised blood pressure and cholesterol.
Hormone therapy and the heart
Hormone therapy is not prescribed to prevent heart disease. Started before 60 or within ten years of menopause, it does not appear to raise heart attack risk and may lower it. Started later, risk is higher.
See a practitioner if
- Chest pain or pressure
- Sudden breathlessness
- Pain in the jaw, neck, back or arm
- Nausea, sweating, dizziness or unusual tiredness with any of the above. Call emergency services. Do not drive yourself.
Common questions
Are women's heart attack symptoms different?
Chest pain is still the most common symptom. Women more often also have breathlessness, nausea, back or jaw pain and fatigue, and are more likely to delay seeking help.
Are palpitations a heart problem?
Palpitations are common in perimenopause and usually harmless. Get them checked if they come with chest pain, fainting or breathlessness.
Does menopause itself cause heart disease?
It removes some protection and speeds up changes in cholesterol and blood pressure. Lifestyle and treatment of risk factors make the biggest difference.
Sources
- American Heart Association, scientific statement on menopause and cardiovascular risk, 2020
- Heart Foundation Australia, women and heart disease
- The Menopause Society, 2022 Hormone Therapy Position Statement
This page is education, not medical advice. Talk to your doctor or menopause practitioner about your own care. In an emergency, call your local emergency number.