Treatments, Wellness
Understanding Heart Health for Women: The Impact of Menopause
It’s no secret that heart disease is the leading cause of death for women.
While it tends to show up about a decade later in women than in men, it can often be more severe. Studies reveal that women are more likely than men to experience complications like stroke or heart failure within five years of a heart attack.
But why are women at a higher risk for heart issues, especially as they age? Many experts point to menopause as a key factor.
How Menopause Affects the Heart Menopause triggers significant changes in a woman’s body, especially when it comes to hormones. A major player is estradiol (E2), a hormone that helps keep many body systems in balance. As E2 levels drop during menopause, the body undergoes noticeable changes. Muscle mass begins to decrease, and fat often starts to gather around the midsection—or even around the heart, known as pericardial fat. This can lead to increased risks for heart-related issues.
These changes set the stage for metabolic syndrome, a group of conditions that include insulin resistance and unhealthy cholesterol levels, both of which can raise the risk of heart disease. The age at which menopause begins also matters. Research shows that for every year earlier menopause starts, the risk of heart problems increases by 3%. This means women who experience menopause at a younger age are at a higher risk for future heart complications.
Why Estradiol Is Important: Estradiol plays a crucial role in protecting the heart. During a woman’s reproductive years, this hormone helps regulate energy production for the heart and supports processes that reduce inflammation, oxidative stress, and damage to blood vessels. Without enough estradiol, the heart becomes more vulnerable to conditions like heart failure.
Dr. Felice L. Gersh, a leading expert, explains that the idea of estradiol turning harmful after menopause doesn’t hold up scientifically. Instead, estradiol remains important for heart health, even though the body produces much less of it after menopause.
Can Hormone Therapy Help? For some women, hormone therapy may be a helpful option to support heart health. Research suggests that starting hormone therapy within 10 years of menopause—especially for women under 60—can improve cardiovascular outcomes. However, this is not a one-size-fits-all solution. Each woman’s health journey is unique, and any decision about hormone therapy should be made with the guidance of a medical professional.
A Heartfelt Conclusion: As women approach and move through menopause, understanding the changes happening in their bodies is vital. Hormones like estradiol may play a bigger role in heart health than many realize. While the heart wants what it wants, staying informed and seeking personalized care can make all the difference in keeping it healthy.
Adapted from “Give Your Patients’ Heart a Break” by Rachel Noonan, PHarmD
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