Estrogen levels have a direct effect on three risk factors for heart disease: blood pressure, cholesterol, and insulin levels. When estrogen levels fall, blood vessels and heart muscle can become less elastic and stiffen.
This can lead to an increase in blood pressure which, if left unchecked, can result in hypertension. Lack of estrogen can also wreak havoc on your cholesterol levels, causing your HDL (“good” cholesterol) levels to go down and your LDL (“bad” cholesterol) levels to rise. Some women also can become resistant to insulin during menopause. This leaves their bodies unable to effectively convert blood sugar and starch to cellular energy and causes them to become diabetic.
One of the universal truths about women’s health is that your risk for heart disease goes up once you reach menopause.
“Cardiovascular disease is the leading cause of death among women in the United States,” says Dr. Patrycja Galazka, cardiologist at Aurora Health Care. “Every woman should be aware of not only the traditional cardiovascular risk factors such as smoking, diabetes, and high blood pressure, but the risk factors that are sex specific such as premature menopause and menopause.”
Why? Simply put, during perimenopause and menopause, estrogen levels drop significantly. This causes a flurry of physical responses that effect a woman’s heart.
Menopausal hormone changes can also be the culprit behind two other issues that affect heart health: atrial fibrillation (AFib) and weight gain. With AFib, the fluctuation of hormones women experience during menopause can cause a faster heart rate or other abnormal heart rhythms. Lack of estrogen is also behind a woman’s metabolism slowing down which can cause weight gain. That weight gain will be more likely to occur around the stomach area thanks to the fact that estrogen regulates where a person normally stores excess fat. Having less estrogen means the weight is no longer being pointed in the right direction and is stored in the mid-section.
All of this makes menopause, and the unpleasant symptoms it may bring, sound scary and beyond your control. However, women are in control some of their menopause destiny—at least in terms of heart health.
If you aren’t someone who already lives a heart-healthy lifestyle, the years before perimenopause and menopause are the time to start. Eating a heart-healthy diet rich in fruits and vegetables, getting enough exercise, and learning your blood pressure, cholesterol and blood sugar numbers is a great place to start. If you are already experiencing perimenopause or menopause, there are things you can do as well. Make time for exercise and healthy foods each day, monitor your weight, and whatever you do, don’t smoke. If you do, quit.
“It is so important that each woman discuss her own individual cardiovascular risk with her physician as part of shared decision-making for treatment and lifestyle changes,” says Dr. Galazka. Having these open conversations with your provider can put you on the path to good heart health as you make the transition through perimenopause, menopause, and beyond.