Why women should pay attention to their heart health, especially during menopause

Cardiovascular problems can manifest in several different ways depending on sex, and for women, the signs are often more subtle or mistaken for other issues. Symptoms like fatigue, chest discomfort, or shortness of breath may be wrongly attributed to hormonal changes rather than underlying heart disease. The common misconception is that women are less susceptible to cardiovascular disease than men are. And, while it’s true that women tend to have lower rates of heart disease before age of 55, their advantage falls short when menopause comes around.

One key reason for this shift is the decline in estrogen levels. Estrogen holds cardioprotective properties, helping women maintain healthy cholesterol levels, promote flexibility in blood vessels, and reduce inflammation. When estrogen levels drop after menopause, women lose this natural protection and become more vulnerable to cardiovascular disease—putting their risk on par with, or even higher than, that of men.

Risk Factors After Menopause

There are several key risk factors that become more prevalent in women post-menopause, including:

• High Blood Pressure: Also known as hypertension, blood pressure tends to rise after menopause, increasing the risk of heart disease and stroke.
• Atherosclerosis: The buildup of fats, cholesterol, and other substances in and on artery walls can restrict blood flow and lead to serious complications such as heart attacks or strokes.
• Heart Disease: Often the result of high blood pressure, high cholesterol, obesity, physical inactivity, smoking, and diabetes.
• Insulin Resistance: When cells don’t respond normally to insulin, it makes it harder for glucose (sugar) to enter your cells for energy. This can lead to high blood sugar levels and an increased risk of type 2 diabetes.

What Can Women Do

Fortunately, there are proactive steps women can take to protect their heart health at every stage—before, during, and after menopause:

• Know Your Family History: Understanding your family’s health background, especially if it has a strong line of heart disease, can help you and your doctor make informed decisions early.
• Monitor Blood Pressure and Cholesterol: Track your blood pressure and cholesterol levels, as these are key indicators of heart health.
• Maintain a Healthy Diet: Avoid processed foods and eat meals high in fiber and rich in protein. You can also follow a Mediterranean diet, which is centered around plant-based foods, healthy fats, and moderate amounts of fish, poultry, dairy, and eggs.
• Exercise regularly: Incorporate cardiovascular workouts like walking, swimming, or cycling into your weekly routine.
• Manage Stress and Prioritize Sleep: Practices such as journaling, meditation, movement, and limiting screen time can reduce stress. A consistent sleep schedule with 7–9 hours of rest per night also helps the body recover and lowers heart risks.
• Avoid Smoking and Limit Alcohol: If you’re a long-time smoker, take steps to quit the habit to reduce your risk of cardiovascular problems. Also, try to limit excessive alcohol consumption.

The Bottom Line

Heart health is not just a men’s issue, it’s an issue for all genders and ethnicities. Women, especially after menopause, should be mindful of the unique risks they face. By raising awareness, regular screenings, and lifestyle changes, women can take control of their cardiovascular health and live longer, healthier lives.

Schedule an appointment today with one of Mount Sinai’s cardiologists by calling 305.674.CARE.