How to look after your heart health during menopause

Mature woman, 50-something, in a swimming pool, exercising, doing water aerobics with dumbbells..  She is smiling, having fun.  There is plenty of copyspace.
Exercises like swimming can help keep your heart healthy, before, during, and after menopause. (Getty Images)

Menopause brings on an avalanche of changes in women’s bodies. Hot flushes, vaginal dryness and skin changes are all the usual suspects when it comes to menopause symptoms. But a new study has found that the process can be far harsher on women’s health than previously thought.

After menopause, which is the natural end to a woman’s fertile years, women’s risk of suffering heart problems like heart attacks and strokes increases significantly, rising to similar risk levels as men, the research suggests.

According to US scientists, who presented their findings at a conference held at the American College of Cardiology, the steep drop in oestrogen during menopause leads to the risk of heart disease in women accelerating.

This is because oestrogen has a protective effect on heart health, helping to control cholesterol levels and reducing the risk of artery blockages due to fat build-up.

The study examined 579 women who were post-menopausal and were receiving treatment to lower their cholesterol. The researchers compared the data with 579 men of the same age and health levels, and assessed the levels of plaque in the arteries of the participants.

Heart attack, panic attack,. An elderly woman sits on the sofa at home and holds her hand to her chest. It is difficult to breathe, feels severe pain.
When oestrogen levels drop in perimenopause and menopause, the risk of heart disease rises, according to new research. (Getty Images)

They found that plaque accumulated in the arteries of the post-menopausal women twice as fast as it did in the men who participated over the course of a year.

Dr Ella Ishaaya, the study’s lead author, was quoted by The Times as saying: "This is a unique study cohort of only post-menopausal statin users that signals that post-menopausal women may have risk of heart disease that is on par with males.

"Women are under-screened and under-treated, especially post-menopausal women, who have a barrage of new risk factors that many are not aware of.

"After menopause, women have much less oestrogen and shift to a more testosterone-heavy profile. This affects the way your body stores fat, where it stores fat, and the way it processes fat; it even affects the way your blood clots. And all of those [changes] increase your risk for developing heart disease."

What is the role of oestrogen in heart health?

Renowned menopause specialist Dr Louise Newson, who founded the balance app for menopausal women, The Menopause Charity and Newson Health Research and Education, tells Yahoo UK that cardiovascular disease is the leading cause of death in post-menopausal women - despite it often being thought as a men’s health issue.

"This is thought to be because oestrogen, the hormone which fluctuates and falls in the perimenopause and menopause, has an improtant protective role for your heart," she explains.

"When oestrogen falls, the cholesterol in your blood often rises, which can lead to fatty deposits building up inside the large blood vessels. This narrowing of the arteries can increase the risk of heart attacks and strokes.

"Oestrogen also has an anti-inflammatory effect on the lining of the blood vessels and increases the levels of chemicals that protect your heart and the blood vessels."

The hormone can also "lower blood pressure, which then also reduces the risk of cardiovascular disease", Dr Newson adds.

What can women do to protect heart health?

Taking steps to protect your heart health before and during menopause will go a long way in keeping you healthy and living long after you’ve gone through it.

Dr Newson recommends "combining a healthy diet with regular exercise is the best way of maintaining a healthy weight, which is key as a healthy weight reduces your chances of developing high blood pressure".

"Regular exercise will make your heart and blood circulatory system more efficient, lower your cholesterol level, and also keep your blood pressure at a healthy level."

Getting your heart rate up when exercising helps keep it healthy and strong. (Getty Images)
Getting your heart rate up when exercising helps keep it healthy and strong. (Getty Images)

Hormone health and intimate health expert Dr Shirin Lakhani recommends: "Exercises that get the heart pumping will be beneficial, such as walking, swimming and cycling. Low-impact exercises are gentler on the joints and may be more suitable for women experiencing joint pain or other musculoskeletal issues.

"As well as this, weight training can be beneficial for menopausal women due to muscle mass decreasing throughout menopause. It's essential to choose activities that you enjoy and that fit your fitness level and any existing health conditions. Remember to start slowly, listen to your body, and gradually increase the intensity and duration of your workouts over time."

In terms of your diet, Dr Newson encourages you to think about striking a balance to ensure you’re getting the right nutrition.

"Think colourful, fresh ingredients and avoid processed foods, which tend to be higher in salt and other additives, wherever possible. The menopause can be a period of upheaval, so try to see food as an anchor during these times - I’m often short on time during the working day, and find that prepping food at weekends helps me stay on track during the week and less likely to reach for quick convenience foods."

Dr Lakhani adds that a diet rich in healthy fats, good quality proteins, and fresh fruits and vegetables is essential to support cardiovascular health during perimenopause.

Close up of woman's hand holding a bowl of fresh beef cobb salad, serving on the dining table. Ready to enjoy her healthy and nutritious lunch with coffee. Maintaining a healthy and well-balanced diet. Healthy eating lifestyle
Eating a heart-healthy diet is crucial for maintaining good heart health. (Getty Images)

"Some examples of foods that are beneficial for heart health during perimenopause are fatty fish due to their source of omega-3 fatty acids, leafy green vegetables which are high in vitamins and minerals, as well as nuts, avocados, olive oil and seeds for a source of healthy fats.

"In addition to incorporating these heart-healthy foods into your diet, it's essential to limit processed foods, refined carbohydrates, added sugars, and unhealthy fats, as these can contribute to inflammation, weight gain, and an increased risk of heart disease. Eating a varied and balanced diet, along with maintaining a healthy weight and active lifestyle, can help support heart health during perimenopause."

Prioritise heart health before menopause

Dr Lakhani emphasises the importance of being aware of how your body will change during perimenopause and menopause, as this will help you better prepare yourself for the changes.

"During perimenopause and menopause, women undergo significant hormonal changes that can affect their heart health." In order to maintain a healthy heart before menopause, she recommends:

Maintaining healthy weight: Excess weight, especially around the abdomen, can increase the risk of heart disease. Strive to achieve and maintain a healthy weight through a combination of diet and exercise.

Quit smoking: Smoking is a significant risk factor for heart disease.

Drink less alcohol: Excessive alcohol consumption can increase blood pressure and contribute to weight gain.

Reduce stress: Chronic stress can negatively impact heart health. Practice stress-reduction techniques such as mindfulness, meditation, deep breathing exercises, yoga, or hobbies that promote relaxation.

Get enough sleep: Poor sleep can contribute to weight gain, high blood pressure, and other risk factors for heart disease.

Keep an eye on your blood pressure and cholesterol: Monitor your blood pressure and cholesterol levels regularly as high blood pressure and high cholesterol are significant risk factors for heart disease.

Use HRT: HRT is extremely beneficial for heart health and bone protection, so anyone going through symptoms of menopause at any age should be offered HRT.


How HRT can help heart health

Hormone replacement therapy (HRT) can play an important role in replenishing the body’s oestrogen levels during perimenopause and menopause.

It not only helps manage menopause symptoms, but can also help protect heart health, Dr Newson says. She points to a growing body of research that suggests this is the case.

"Reviews of evidence have shown that the risk of being diagnosed with heart disease is reduced by around 50% and the risk of dying from heart disease in women taking HRT is reduced by about 30%," she says.

"By replacing the missing oestrogen, there is less furring and clogging of the lining of the arteries, which reduces the risk of heart disease. HRT can also lower blood pressure, reduce the risk of heart failure, and reduce the numbers of people who experience an irregular heartbeat."

Starting HRT earlier, such as during menopause of within 10 years of the menopause starting, can also set your heart up for a better future, Dr Newson says.

"However, the natural body identical hormones we now usually prescribe are safe for older women to start too," she adds. "HRT is usually taken for ever."

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