Early menopause occurs before the age of 45, and can be due to a decline in ovarian function or medically induced from a hysterectomy. One of the most significant but less talked about concerns of menopause is the heightened risk of cardiovascular disease women experience. If you have or are experiencing early menopause, this risk starts earlier. While this might feel scary for you, understanding this phase of life, changes you experience and how to protect your cardiovascular system will help allay the fear and help you to feel empowered during this time in your life.
Understandably, women are most concerned with the symptoms of menopause: hot flashes, night sweats, mood and cognitive changes, and weight gain which prompt women to see their health care provider. Unfortunately, the silent changes get ignored resulting in a missed opportunity to educate and empower women to take a proactive approach to their heart health.
After menopause, women experience a significant increase in their risk of developing cardiovascular disease. Prior to this stage, women are generally better shielded against cardiovascular disease compared to men, thanks to the protective effects of estrogen. However, with the onset of menopause, the once-advantageous influence of estrogen diminishes, leaving women more vulnerable to cardiovascular health issues.
Estrogen, a hormone that declines during menopause, plays a protective role in cardiovascular health. The decline in estrogen after menopause causes a heightened risk for cardiovascular disease in a number of ways:
- Reduced estrogen levels can lead to unfavorable changes in lipid profiles, including increased levels of total cholesterol, low-density lipoprotein (LDL), triglycerides, and Lp(a), and decreased levels of high-density lipoprotein (HDL) cholesterol. These changes can contribute to the development of plaque build up in the artery walls and increase the risk of heart attack or stroke.
- Endothelial dysfunction: Estrogen helps maintain the health and function of the endothelium, the inner lining of blood vessels. Endothelial dysfunction, characterized by impaired dilation and increased inflammation, is an early event in the development of atherosclerosis. Decreased estrogen levels can contribute to endothelial dysfunction, thereby increasing the risk of CVD.
- Weight gain and abdominal fat: Hormonal changes during menopause can lead to an increase in body fat, particularly around the waistline and organs (called visceral fat). Abdominal fat is strongly associated with a higher risk of heart disease, type 2 diabetes, and other metabolic disorders.
- Elevated blood pressure: Menopause may cause an increase in blood pressure levels, further straining the cardiovascular system.
- Reduced insulin sensitivity: Menopausal hormonal changes can affect insulin sensitivity, potentially leading to insulin resistance and an increased risk of developing diabetes, which is a significant risk factor for heart disease.
Given the increased risk of heart disease associated with menopause, it's important for women who experience early menopause to be proactive about cardiovascular health. This includes adopting a heart-healthy lifestyle and Mediterranean eating pattern, engaging in regular physical activity, not smoking, managing stress, and monitoring blood pressure and cholesterol levels. For many women, hormone replacement therapy is an important part a treatment plan and should also be included in the discussion for management of early menopause. Early screening is paramount for women in early menopause to prevent future cardiac events.
Disclaimer: The information presented on this site does not constitute medical advice and does not replace the advice from your doctor. Always consult a qualified health care professional when changing or beginning a new health plan.
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