Our cardiovascular system carries out several essential functions within the body and a healthy heart is crucial for our overall health and wellbeing – but menopause can increase the risk of a woman developing cardiovascular disease (CVD). Let’s dig a little deeper and see why this is the case, and how women can support heart health at menopause.

CVD is a general term for a variety of conditions that affect the heart and circulation, which can include heart disease, atrial fibrillation, heart attack and stroke, vascular dementia etc. Although CVD is often associated with men, the risk for females increases greatly at, and after menopause.^[1]

Menopause transition (or perimenopause) is a natural progression in a woman’s life when her reproductive system gradually slows until she hits “menopause”; when she has had an absence of periods for 12 months. It marks a critical stage, characterised by remarkable changes in hormonal and menstruation patterns, as well as both physiological and psychosocial symptoms.^[2]

Hormonal changes during menopause are thought to contribute to the increased risk of CVD. Menopause is accompanied by a drop in female hormone production, particularly oestrogen. Oestrogen supports blood vessel health and flexibility, blood lipid balance and modulates oxidative stress and inflammation. After menopause, the protective effects of oestrogen are lost, and the incidence of a number of CVD risk factors increases:1

Hypertension –

High blood pressure occurs twice as often in post-menopausal women as those before menopause.

High Cholesterol -

A decrease in HDL levels and an increase in triglycerides and LDL cholesterol by about 10–15% has been observed in postmenopausal women, leaving them at an increased risk of CVD.

Blood glucose imbalance -

Oestrogen deficiency during menopause affects insulin sensitivity and glucose metabolism, increasing the risk for insulin resistance and cardiovascular disease.^[3]

Sleep disturbance –

Insomnia and poor sleep quality are a major complaint of women transitioning through menopause and can have a far-reaching impact on quality of life, mood, and physical health. Poor sleep is an emerging risk factor for cardiovascular disease.^[4]

Stress -

Menopause transition is characterised by biological, hormonal, social, and psychologic changes that make women vulnerable to psychologic distress, and increased levels of stress and mood imbalances. Psychosocial stress can negatively affect cardiovascular health through multiple pathways.^[5]

How can I protect my heart health after menopause? 

Eat a healthy diet –

The Mediterranean diet, abundant in natural plant-based foods (fruits, vegetables, nuts, and legumes) and oily fish, along with a reduction in processed meats, red meats, and ultra processed products has a wealth of supportive evidence for cardiovascular health.

Phytoestrogens –

Phytochemicals such as isoflavones can have a mild oestrogenic effect and may be supportive for women after during menopause transition as well as a protective function for cardiovascular health.^[6] Dietary phytoestrogens include soybeans and soy products such as tofu and tempeh, flaxseeds and cruciferous veggies.

Regular exercise –

The advice for physical activity in the UK is that adults do at least 150 minutes moderate intensity activity, 75 minutes’ vigorous activity, or a mixture of both strengthening activities on two days
reducing extended periods of sitting

It is estimated that, in the UK 42% of women are not active enough for good health. Regular physical activity can reduce the risk of developing cardiovascular disease by up to 35%. Regular exercise can also support mood balance and sleep.

Stress relief -

Being more active, prioritising restful sleep, practicing mindfulness, deep-breathing, yoga and being outside in nature are all great ways to relieve stress, which can beneficially affect your cardiovascular health.

Sleep -

Data continues to demonstrate the importance of sleep quality and duration for cardiovascular health. Please see our recent “ask the expert” question on how to support refreshing sleep.

 
^{[1] https://pubmed.ncbi.nlm.nih.gov/37034510/
[2] https://pubmed.ncbi.nlm.nih.gov/33251828/
[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC10503403/
[4] https://pubmed.ncbi.nlm.nih.gov/31302068/
[5] https://pubmed.ncbi.nlm.nih.gov/38986672/
[6] https://pubmed.ncbi.nlm.nih.gov/31356541/}