First things first, I am absolutely not trying to terrify you with this, but it is important so that you can advocate for yourself or your BFF should the worst happen.
Heart health is something we often associate with age, particularly as we move into our senior years, and normally old men. However, many may be surprised to know that menopause can increase our risk when it comes to coronary heart disease (CHD). For many midlife women, the menopausal journey brings about various changes, not just hormonally but also in terms of heart health. Let’s delve deeper into why CHD is a looming threat for menopausal women and how to tackle it.
The theme of this year’s World Menopause Day is cardiovascular health.
The Significance of Heart Disease in Midlife Women
The heart of the matter is this: cardiovascular diseases, including CHD, are the primary cause of death for women in the UK. Data from the British Heart Foundation reveals that over 28,000 women die from CHD annually in the UK (BHF, 2021). This is 77 women a day. A significant proportion of these deaths occur in women aged 50-64, highlighting the impact of menopause on heart health. But despite these sobering statistics, many women are unaware of the risk factors for heart disease or actively have lifestyle and nutrition interventions in place to combat their increased susceptibility to heart disease.
During menopause, the protective effects of oestrogen, a hormone that aids in maintaining the flexibility of the arterial walls begins to wane (Matthews et al., 2009). Oestrogen has many different uses in the body, including being anti-inflammatory. This drop in oestrogen levels is associated with increased heart disease risk factors, including higher levels of LDL (bad) cholesterol and increased blood pressure (Murphy and Kelly, 2011). It should be noted that many of our traditional Western medical approach doesn’t follow the path to the root cause or seek to understand what else is going on to cause inflammation in the body.
Why Heart Disease Often Goes Unnoticed in Women
One of the significant challenges is that heart disease in women often presents differently than in men (American Heart Association, 2019). While men may experience the classic, movie-portrayed chest clutching, women’s symptoms can be more subtle. These might include:
- Shortness of breath
- Fatigue
- Nausea or stomach pain
- Light-headedness
- Dizziness
- Burning sensation in the chest, much like heartburn
- Chest discomfort
- Pain in the neck, back, or jaw
Because these symptoms can be attributed to various other conditions, they often go unnoticed or are dismissed as “just a part of ageing”.
There are also some biological differences in the hearts of men and women (Kowalczyk, 2022):
- Women’s hearts and arteries are smaller than men’s. There are smaller arteries in women are more than a simple reflection of smaller body size. The difference is due, in part, to sex hormones: oestrogen, progesterone, and testosterone. This makes women’s arteries more prone to blood clots or plaque blockages, and more difficult to repair with angioplasty or bypass surgery.
- Plaques that cause heart disease are often different in women. While most heart attacks in men and women are caused by blockages in the arteries, the type of plaque and where it forms may be different in women. While men with heart disease often have hard (calcified) plaque affecting all three coronary arteries, women with heart disease may have less overall plaque, affecting only one or two arteries. But in women, plaque is more likely to be soft, making it more likely to dislodge—potentially causing a heart attack.
- Heart disease without blocked arteries happens more often in women. Their heart disease is thought to be caused by low blood flow to the heart which doctors have yet to fully understand but think may be due to problems with smaller arteries in the heart.
Furthermore, societal norms and biases can mean that women’s complaints aren’t always taken as seriously as they should be. This means diagnosis can be delayed, leading to advanced stages of the disease before intervention. Women are traditionally juggling running and organising a home alongside a career, so often put their own care needs at the bottom of the never-ending jobs list.
Symptoms that you never ever ignore as a midlife women
- Palpitations: Don’t assume heart palpitations are natural flutters. It could be a sign of atrial fibrillation, so it’s important to get this checked out to rule out anything more sinister.
- Shortness of breath: If you were able to go up the stairs fine, and now you find you are short of breath, talk to your healthcare provider, it could be an early sign of coronary artery disease.
- Pressure in the chest: A feeling of fullness, squeezing or dull pressure in the chest that doesn’t go away or that goes away and comes back could be a sign of a heart attack in women. Some women think that unless they have crushing chest pain it’s not a heart attack.
- Jaw ache: This could be a sign of an unhealthy heart and is a warning sign of a heart attack in women.
Lifestyle Tips for Heart-Healthy Menopause
Taking care of your heart during menopause isn’t just about recognising the risks. It’s about adopting a proactive approach. Here are some steps to help maintain a heart-healthy lifestyle:
- Diet Matters: Opt for a balanced diet rich in fruits, vegetables, whole grains, lean protein, and healthy fats. Reducing caffeine, alcohol, saturated fats and sugar, can also play a pivotal role in heart health.
- Managing constipation: In both Ayurvedic and Chinese medicine there is the belief that constipation may cause serious diseases (Choe, et al., 2006). Lack of bowel movements AKA constipation can be considered as a marker for cardiovascular disease (Salmoirago-Blotcher, et al., 2011). Never has staying hydrated, eating fibrous foods such as whole grains, seeds, fruits and veggies sounded so great.
- Stay Active: The NHS recommends at least 150 minutes of moderate-intensity exercise a week (NHS, 2021). This can include brisk walking, cycling, or even dancing. Weight-bearing or body-weight exercise is phenomenal for mid-life health. Exercise helps maintain healthy blood pressure, cholesterol levels, and weight – it’s also a great way to help calm away some of the stress in your life.
- Limit Alcohol and Quit Smoking: Alcohol, when consumed in excess, can raise blood pressure. And smoking? It’s a major risk factor for CHD. Ditching cigarettes and vapes can dramatically reduce the risk.
- Know your numbers: Monitoring blood pressure, cholesterol, and blood sugar levels can provide early warnings and pave the way for timely interventions.
- Manage Stress: This is huge in managing our mid-life health. Modern life is way too stressful for our bodies to handle. Stress can directly affect health, including heart health. Much of my work here in clinic, is about successfully helping you manage your stress. There are so many benefits beyond heart health for finding healthy coping mechanisms like meditation, yoga, or simple deep breathing exercises.
- Hormone Replacement Therapy (HRT): I love a great conversation about HRT vs non-HRT, helping you recognise when that time might have come for you, and supporting you in getting ready to talk to your GP about it. I can help you manage menopausal symptoms, it’s essential to discuss its pros and cons with your doctor when it comes to your heart health.
In summary – just in case you’re having a meno moment
The journey through menopause is a significant phase in every woman’s life, marking a time of transition and growth. As we embrace this change, it’s essential to understand the potential risks associated with it, especially those concerning heart health.
While menopause does usher in increased risks of CHD, knowledge, awareness, and a proactive approach to a healthy lifestyle can make all the difference. Remember, taking care of your heart is not just about adding years to your life but life to your years.
A bit about me & my background
Claire is a Women’s Health Specialist at Restoring Balance; a Sports Scientist and a Women’s Health Coach who is also a multi-disciplined therapist specialising in person-centred care. Claire is also a carer, juggling her time between her clinic and looking after her Mum.
Claire’s work is very different to many therapists – working with you as a whole person using a unique combination of mind, nutrition and movement to overcome both physical and emotional blocks; not just where you feel pain or have dysfunction, allowing you to live life again. Claire can help you with:
- Balancing your hormones
- Understanding your cycle and how to work with it and not it against it
- Peri-menopause and menopause coaching
- Post-operative rehabilitation
- Post-operative scar care
- Improving your pelvic floor function
- Calming your stress & anxiety
- Improving your digestive health
- Changing your mind-set
- Improving your emotional health
- Relieving pain
- Increasing mobility, balance, stability, co-ordination
I work both online and in person from my home-based clinic on Hayling Island, Hampshire.
Ready to make a change? Book in for a Let’s Talk.
References
American Heart Association. (2019). Symptoms of Heart Attack in Women.
British Heart Foundation. (2021). Women and heart disease. [link]
Choe J, Tu S, Lim J, et al. “Heat in their intestine”: colorectal cancer prevention beliefs among older Chinese Americans. Ethnicity & Disease. 2006;16(1):248–254.
Kowalczyk, J. Women’s vs Men’s Hearts, 2022, Share Care. https://www.sharecare.com/heart-health/heart-disease/womens-heart-vs-mens-hearts
Matthews KA, Crawford SL, Chae CU, et al. (2009). Are changes in cardiovascular disease risk factors in midlife women due to chronological aging or to the menopausal transition? Journal of the American College of Cardiology ;54(25):2366-2373.
Murphy, E., Kelly, D. (2011) Estrogen Signally and Cardio Vascular Disease. Circulation Research: 109: 687-696.
NHS. (2021). Physical activity guidelines for adults.
Salmoirago-Blotcher, E., Crawford, S., Jackson, E., Ockene, J., & Ockene, I. (2011). Constipation and risk of cardiovascular disease among postmenopausal women. The American journal of medicine, 124(8), 714–723. https://doi.org/10.1016/j.amjmed.2011.03.026
