Menopause and Your Heart

One fact: Heart disease increases after menopause. 

Another fact: Heart disease increases with age. 

And this is because.…?

While menopause doesn't cause heart disease per se, there are certain risk factors that occur during menopause that raise the risk for heart disease. 

And as we get older, our risk for many diseases—heart disease among them—climbs. 

To make it worse, if, prior to menopause, you've led a life of indulgence or had one too many unhealthy habits, such as eating a high-fat diet, smoking, drinking, stressing or sitting too much, those can pave the way for heart disease. Learn more about 6 Scary Side Effects of Sitting.

So, what are the facts, exactly?

A bit concerning, considering heart disease is the leading killer of women: More than one in three women have some sort of cardiovascular disease, according to the American Heart Association. And about 10 years after menopause, there's an overall increase in heart attacks among women. 

Let's get estrogen out in the open first. What's its role in heart disease?

It's complicated—and controversial—especially when it comes to replacing missing estrogen with hormone replacement therapy.

It used to be believed that hormone replacement therapy could protect women against heart disease. That's because it was thought that the drop in estrogen levels around menopause was the culprit behind the increase in women's heart disease risk. Waning estrogen levels increases levels of low-density lipoprotein cholesterol ("bad" cholesterol) and lead to decreases in the "good" type (high-density lipoprotein cholesterol), contributing to a buildup of fat and cholesterol in the arteries. 

But after many years of studies, showing that taking hormone therapy yielded opposite effects (the risk of heart attack, stroke and blood clots increased), recommendations were changed, and both the American Heart Association and the U.S. Food and Drug Administration developed new guidelines for the use of hormone replacement therapy, recommending against it for the prevention of heart attack and stroke.

The American Heart Association says that although the loss of natural estrogen as women age may contribute to the higher risk of heart disease after menopause, they do not advise the use of hormone replacement therapy to reduce that risk.

I'm confused. Is heart disease connected to menopause and estrogen?  

A lot of us are confused. Yes, heart disease is related to menopause. That's because estrogen changes the walls of your blood vessels, which then make it easier for plaque and blood clots to form. Estrogen also changes the level of fats (lipids) in your blood. And it increases something called fibrinogen, which is a substance that helps your blood clot. Increased levels of fibrinogen are related to heart disease and stroke, say experts at Cleveland Clinic. 

So, if the loss of estrogen is related to heart disease risk, and I'm advised against replacing that estrogen, what's left to do?

Plenty. Start by taking a look at your lifestyle and all the things you could improve upon. Everyone should do this anyway, but it becomes especially important as we age.

Do you smoke? Are you overweight? Do you get enough exercise? Do you eat a diet low in saturated and trans fats? Does your diet include plenty of fiber, whole grains, legumes, fruits, veggies and fish? Are you paying attention to, and treating, high blood pressure, diabetes, and/or high cholesterol? Read about The Most Important Thing You Can Do for Your Heart.

So, it seems there's a higher risk of heart disease as we pass through menopause and age, but that doesn't mean that risk can't be dealt with.

Yes! Turning unhealthy behaviors into healthy ones pays off big-time for your ticker. Data proves it, and if you're skeptical about the impact of lifestyle on your health, read about the top five habits that harm the heart.

Show me the money!

Here's proof: A study by Johns Hopkins that tracked more than 6,000 people between 44 and 84 for over seven years found that those who made healthy changes decreased their risk of death by 80—yes, 80!—percent. 

Even if you've neglected your health up to now, or haven't been stellar or consistent with healthy habits, it's never too late. Setting goals, tracking your progress, garnering support from friends and family and making yourself accountable can help—a lot. So can realizing that small changes add up over time into big improvements.