How Menopause Affects Your Heart.

What is menopause?

Menopause is when your periods stop, and you are no longer able to conceive naturally and is diagnosed after you have not had a menstrual period for 12 months. It predominately affects women between the ages of 45 and 55, although it is possible for it to begin earlier, this is known as early, or premature menopause, depending on your age. Premature menopause occurs before the age of 40 years old, whilst early menopause occurs between the ages of 40 and 45. Women tend to have a lower risk of coronary heart disease, however, after menopause, your risk increases.

As you age, your ovaries gradually stop producing the primary form of oestrogen, oestradiol, and stop releasing an egg every month. This drop in oestrogen, alongside other hormones such as testosterone and progesterone, and the cessation of ovulation result in the stopping of your period. The drop in your hormone levels can also cause symptoms such as:

• Emotional changes. You may experience low mood, anxiety, mood swings and low self-esteem.
• Cognitive challenges. Issues with memory or concentration, including brain fog.
• Hot flushes. A sudden feeling of hot or cold in your face, neck and chest, which can make you feel dizzy.
• Difficulty sleeping. This may be due to night sweats, causing irritability and tiredness throughout the day.
•  Headaches and migraines. These may feel worse than usual.
• Muscle aches and joint pains.
• Changed body weight. This may be due to weight gain.
• Skin changes. This may be mean dry and itchy skin.
• Heart palpitations. An increased awareness of your heartbeat.

Please see the NHS website for more information about menopause symptoms.

How does menopause affect the heart?

Oestrogen is cardioprotective, it plays a crucial role in heart health by regulating cholesterol levels and preserving the health of your blood vessels. However, with menopause, the dropping in oestrogen levels can lead to a negative effect on your heart health. With less oestrogen to help protect your heart and blood vessels, fat can begin to build-up in your arteries, potentially narrowing them, therefore, elevating your chances of developing coronary heart disease, experiencing heart attacks, or suffering cardiac arrest, if you do not know the difference between a heart attack and cardiac arrest, please check out our blog).

The decrease of oestrogen can also prompt other changes in your body that can impact your heart health:

• High cholesterol. Oestrogen helps to control your cholesterol levels. As there is less oestrogen in your body after menopause, your cholesterol levels will rise.
• Elevated blood pressure. Your blood vessels may not respond well to the decrease in hormones, becoming narrower, increasing your blood pressure.
• An increased risk of diabetes. After menopause, your body cannot control sugar levels (glucose) as well as before, which can increase your risk of diabetes.
• Increased pericardial fat. The reduction in oestrogen may result in heightened deposits of pericardial fat.

Another factor that could increase your cardiovascular risk is the age that you begin menopause. Early menopause, occurring before the age of 45, whilst premature occurs before the age of 40. Both can happen naturally or as a result of treatments like chemotherapy, oophorectomy (ovary removal surgery), or hysterectomy (uterus removal surgery).

Experiencing early or premature menopause leads to an earlier drop in oestrogen levels, heightening the risk of coronary heart disease and heart failure. Research from the European Society of Cardiology indicates that women with early menopause face a 23% greater risk of heart failure compared to women aged 50 years and above, whilst women with premature menopause face a 39% greater risk of heart failure compared to women aged 50 years and above. The authors of the study found that the association between menopausal age and heart failure was due to the drop in oestrogen levels and changes in body fat distribution.

How can you improve your heart health and your symptoms?

Reducing the risk of coronary heart disease involves proactive steps. A crucial approach is adopting a healthier lifestyle to regulate blood pressure and cholesterol levels. These improvements not only contribute to improving your cardiovascular health but will also aid in managing your symptoms.

Whilst lifestyle changes may seem daunting, especially when you are navigating the changes of menopause. Initiating even the smallest of adjustments can have a significant impact. The following tips can make the process more manageable and promote overall well-being:

• Maintaining a healthy weight. Consider food swaps like replacing biscuits with plain popcorn or rice cakes and white rice and bread with brown rice and bread. Additionally find small ways to fit exercise into your daily routine, e.g. taking the stairs instead of a lift, or getting off the bus a stop or two earlier.
• Eating a healthy, balanced diet. Maintaining a healthy, balanced diet is crucial in decreasing your cardiovascular risk and aiding your symptoms. It involves consuming a variety of foods in appropriate portions to provide essential nutrients. Reducing your salt and saturated fat intake is particularly important during this stage to manage higher cholesterol and blood pressure levels. Prioritising fruits and vegetables whilst minimising high sugar, salt and saturated fat foods can help decrease your risk of coronary heart disease.
• Increasing your activity levels. Boosting activity levels offers numerous advantages, including weight maintenance, alleviation of anxiety and low mood, and improvement of heart health. Exercise has proven beneficial in addressing menopausal symptoms like difficulty sleeping and mood swings.
• Reducing the amount of alcohol you drink. Cutting back on alcohol intake, ideally to less than 14 units weekly as advised by experts, can alleviate menopausal symptoms like hot flushes and heart palpations.
• Not smoking. During stressful periods like menopause, smokers may notice an increase in smoking frequency, which can hinder efforts to cut down or quit. Nonetheless, smoking exacerbates menopausal symptoms like hot flushes and heart palpations, making quitting imperative.

For more information about how your heart health can be affected by menopause, go to the British Heart Foundation website.

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