How Menopause Impacts Your Heart

Menopause brings significant changes due to declining estrogen levels, which can adversely affect heart health. This decrease not only triggers symptoms such as hot flashes and sleep disturbances but also impacts blood vessels, cholesterol levels, heart rate, blood pressure, inflammation, and metabolism. These changes collectively increase the risk of cardiovascular issues.^{1, 2}

Estrogen typically protects the cardiovascular system, so its decline heightens vulnerability to heart disease. Cardiovascular disease (CVD), encompassing heart and blood vessel disorders, is the leading cause of death among women. In 2021, CVD was responsible for about 20% of female deaths. Despite this, only 56% of U.S. women acknowledge heart disease as their top health threat, with its risk exacerbated during menopause.³

The Connection Between Menopause and Heart Health

To grasp why the risk of heart disease rises during menopause, you need to consider the role of estrogen. Estrogen helps maintain flexible blood vessels, allowing them to expand and contract easily, which supports healthy blood flow and controls blood-pressure levels. It also has anti-inflammatory properties that prevent plaque buildup in the arteries, a key factor in heart disease.⁴

When estrogen levels drop during menopause, you lose these protective effects. Blood vessels may become stiffer, blood pressure can rise, and plaque buildup may accelerate—all contributing to a higher risk of heart disease. Additionally, menopause often leads to weight gain and increased abdominal fat, further exacerbating cardiovascular risks.^{5, 6}

Common Heart-Health Issues Around Menopause

High blood pressure: As estrogen levels decline during menopause, the hormone’s protective effects on blood vessels diminish. This results in stiffer blood vessels, making it more difficult for blood to flow smoothly and leading to increased blood pressure. Elevated blood pressure puts extra strain on the heart and arteries, raising the risk of cardiovascular issues over time.⁷
High cholesterol: During menopause, hormonal changes can lead to an increase in LDL (bad) cholesterol and a decrease in HDL (good) cholesterol. LDL cholesterol can contribute to plaque buildup in the arteries, while HDL cholesterol helps remove excess cholesterol from the body. As a result, total cholesterol levels may rise by 10-15% during menopause. Additionally, the decline in estrogen makes blood vessels stiffer and less flexible, exacerbating the problem. This combination of higher LDL, lower HDL, and stiffer blood vessels significantly raises the risk of heart disease, heart attacks, and strokes.^{8, 9}
Insulin resistance and diabetes: Menopause can increase the risk of insulin resistance, where the body’s cells become less responsive to insulin. This results in higher blood-sugar levels and a greater likelihood of developing type 2 diabetes.¹⁰
Weight gain: Weight gain, particularly around the abdomen, is common during menopause. This added weight further raises the risk of cardiovascular issues.¹¹
Heart palpitations: Hormonal fluctuations during menopause can disrupt the heart’s electrical pathways, causing palpitations or irregular heart rhythms. These irregularities may increase the risk of heart disease.¹²
Chronic inflammation: The decline in estrogen during menopause can worsen chronic inflammation, leading to blood-vessel damage and plaque buildup. Persistent inflammation is also linked to other health concerns, including diabetes, arthritis, and certain cancers, making it a significant overall health issue.^{13, 14}
Metabolic syndrome: Metabolic syndrome, more common during menopause, includes a cluster of risk factors such as abdominal obesity, high triglycerides, low HDL cholesterol, high blood pressure, and elevated blood sugar. These factors contribute to atherosclerosis, insulin resistance, and inflammation, all of which significantly increase the risk of heart disease.¹⁵

What Are the Symptoms of Heart Disease?

During and after menopause, it’s important to be aware of heart disease symptoms, as they can differ from the classic signs often associated with heart problems. While chest pain is a common indicator, women may experience more subtle or atypical symptoms, including:

Nausea or vomiting: These symptoms can occur instead of or alongside chest pain.
Back pain: Unexplained pain in the upper back can be a sign of heart issues.
Discomfort in the neck, jaw, or abdomen: Pain or discomfort in these areas can be indicative of heart problems rather than chest pain.
Fatigue: Persistent, unexplained fatigue can be a sign of heart disease.
Shortness of breath: This may occur with or without chest discomfort.
Dizziness or lightheadedness: Feeling dizzy or lightheaded can signal heart problems.^{16, 17}

Early recognition and prompt medical attention are crucial. If you experience any of these symptoms, seek medical help immediately, as early intervention can greatly enhance heart health management during and after menopause.

Factors That Impact Heart Health During Menopause

While menopause increases your risk of heart issues, you have plenty of ways to reduce your risk. One important aspect is maintaining a healthy weight. Weight gain, particularly around the abdomen, can increase your risk of heart disease. Abdominal fat is more metabolically active, leading to higher levels of inflammation and insulin resistance, which are key risk factors for heart disease.^{18, 19}

A well-balanced meal plan can help you achieve your ideal weight and support heart health. Eating protein first helps stabilize blood sugar, reduce cravings, and promote fullness. Combine protein with antioxidant-rich and fiber-filled plant foods. Antioxidants help protect blood vessels from damage, while fiber aids weight loss by promoting satiety and reducing excess hormones and cholesterol in the gut.^20-23

Incorporating regular resistance training can also keep your heart strong. Lifting heavy things helps maintain muscle mass, improve circulation, and support healthy blood pressure and cholesterol levels. Complement resistance training with an after-dinner walk to boost heart health by promoting digestion, lowering blood-sugar levels, and aiding in weight control.^24-26

Smoking and excessive alcohol consumption can severely damage your heart and heighten your risk of heart problems. Hormonal changes during menopause can also heighten stress, anxiety, and depression, which can negatively affect heart health.^27-29To manage these issues, practice relaxation techniques like meditation or deep breathing, and get professional help if needed.

Working With Your Functional-Medicine Doctor

Working with a functional-medicine doctor or other healthcare practitioner is critical for maintaining heart health during and after menopause. Regular check-ups enable monitoring of key factors like blood pressure and cholesterol levels. Together, you can develop strategies to keep these numbers within a healthy range. Your doctor can also recommend specific supplements, such as berberine, which support heart health during menopause.

Menopause introduces many changes to your health, and your functional-medicine doctor can help you navigate them. They can monitor your hormone levels, assist with weight management, and address mental health concerns. Your doctor may also discuss hormone replacement therapy (HRT) with you. Since HRT has both potential risks and benefits for heart health, it’s important to have an open discussion to determine if it’s the right choice for you.

Master Your Mindset to Manage Heart Health

Your mindset is your most powerful tool as you navigate the changes and challenges of each new phase of life, including menopause. It can transform the stress, anxiety, and negativity that impact your heart and overall health into opportunities for growth and empowerment.

Mastering your mindset means taking control of your mental landscape, enabling you to live a more balanced and fulfilling life. Think of it as a mental fitness routine that strengthens your ability to be your most authentic, powerful self.

A positive mindset during life’s transitions can help you manage stress, improve sleep, and lead a happier, more fulfilling life. In Mindset Mastery: 20 Practices for Power and Purpose, you’ll find 20 carefully selected mindfulness practices to immediately shift your mindset and enrich your daily routine.

Get your FREE Mindset Mastery: 20 Practices for Power and Purpose here.

References:

Ryczkowska K, Adach W, Janikowski K, Banach M, Bielecka-Dabrowa A. Menopause and women’s cardiovascular health: is it really an obvious relationship? Arch Med Sci. 2022 Dec 10;19(2):458-466. doi: 10.5114/aoms/157308. PMID: 37034510; PMCID: PMC10074318.
American Heart Association Journals: Menopause Transition and Cardiovascular Disease Risk
Centers for Disease Control and Prevention: About Women and Heart Disease
Cleveland Clinic Health Essentials: Estrogen: What It Does and 5 Benefits
Raj A, Chakole S, Agrawal S, Gupta A, Khekade H, Prasad R, Lohakare T, Wanjari M. The Impact of Menopause on Cardiovascular Aging: A Comprehensive Review of Androgen Influences. Cureus. 2023 Aug 16;15(8):e43569. doi: 10.7759/cureus.43569. PMID: 37719547; PMCID: PMC10503403.
Mayo Clinic: The reality of menopause weight gain
Mayo Clinic: Menopause and high blood pressure: What’s the connection?
Time Magazine: How Menopause Affects Cholesterol—And How to Manage It
Cleveland Clinic Health Essentials: How Estrogen Supports Heart Health
Diabetes UK: Menopause and diabetes
Mayo Clinic: The reality of menopause weight gain
balance menopause: Heart palpitations and menopause: what you need to know
Harvard Health: Beyond hot flashes
Henein MY, Vancheri S, Longo G, Vancheri F. The Role of Inflammation in Cardiovascular Disease. Int J Mol Sci. 2022 Oct 26;23(21):12906. doi: 10.3390/ijms232112906. PMID: 36361701; PMCID: PMC9658900.
Patni R, Mahajan A. The Metabolic Syndrome and Menopause. J Midlife Health. 2018 Jul-Sep;9(3):111-112. doi: 10.4103/0976-7800.241951. PMID: 30294180; PMCID: PMC6166423.
Mayo Clinic: Heart disease in women: Understand symptoms and risk factors
American Heart Association: Heart Attack Symptoms in Women
British Heart Foundation: Menopause and heart and circulatory conditions
UPMC: Abdominal Fat Gain Tied to Heart Disease Risk in Menopause
Science Direct: Protein, weight management, and satiety
Healthline: How Protein Can Help You Lose Weight Naturally
Leopold JA. Antioxidants and coronary artery disease: from pathophysiology to preventive therapy. Coron Artery Dis. 2015 Mar;26(2):176-83. doi: 10.1097/MCA.0000000000000187. PMID: 25369999; PMCID: PMC4315737.
Mayo Clinic: Dietary fiber: Essential for a healthy diet
John Hopkins Medicine: Exercise and the Heart
Mayo Clinic: Strength training: Get stronger, leaner, healthier
Healthline: Walking After Eating: Benefits and Downsides
Piano MR. Alcohol’s Effects on the Cardiovascular System. Alcohol Res. 2017;38(2):219-241. PMID: 28988575; PMCID: PMC5513687.
Mukamal KJ. The effects of smoking and drinking on cardiovascular disease and risk factors. Alcohol Res Health. 2006;29(3):199-202. PMID: 17373409; PMCID: PMC6527044.
Alblooshi S, Taylor M, Gill N. Does menopause elevate the risk for developing depression and anxiety? Results from a systematic review. Australas Psychiatry. 2023 Apr;31(2):165-173. doi: 10.1177/10398562231165439. Epub 2023 Mar 24. PMID: 36961547; PMCID: PMC10088347.

*These statements have not been evaluated by the Food & Drug Administration. Products mentioned are not intended to diagnose, treat, cure, or prevent any disease. The views in this blog by JJ Virgin should never be used as a substitute for professional medical advice. Please work with a healthcare practitioner concerning any medical problem or concern.