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Heart health
6 mins

Five things you should know about cardiovascular disease and menopause

byDr. Lucy Wilkinson

Cardiovascular disease is responsible for just over a third of women’s deaths each year, but sadly, it’s not given the attention it deserves. Cardiovascular disease in women is “understudied, under-recognised, under-diagnosed and under-treated”, according to The Lancet. We want to help change that! Read on for five facts about cardiovascular disease and menopause that can help you live a long and healthy life.

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What is cardiovascular disease?

Cardiovascular disease is a phrase that doctors use a lot, but many people don’t actually know what it means. Put simply, cardiovascular disease is an umbrella term used to describe all illnesses affecting the heart and circulation. This includes:

Some of these illnesses have negative, knock-on consequences too. For example, having long-term high blood pressure can cause problems with your eyes, kidneys and nerves.

Fortunately, there are ways that you can take control of your cardiovascular health and reduce your risk of developing these conditions. Read on to find out what the science says can work.

Fact 1: Your risk of cardiovascular disease increases after menopause

For those who go through premature or early menopause (before age 40 or 45 respectively), this is thought to be directly related to menopause. 

The relationship is less clear for those who go through menopause at a more typical age – around 50. Researchers now believe that it comes down to the combined effects of getting older and hormonal changes during menopause, which both increase your risk. Read on to learn why.

Fact 2: Menopause can make it more difficult to control your risk factors

Risk factors are things that increase your chance of developing an illness or disease. Some you can change, but others you can’t.

Risk factors for cardiovascular disease include:

  • Whether or not you smoke 
  • Weight
  • Exercise levels
  • Blood pressure
  • Cholesterol levels
  • Family history and genetics

Menopause can make it harder to control these risk factors. Some of this is because of reduced oestrogen levels. This can lead to higher levels of ‘bad cholesterol’ and – if you go through early menopause, before age 45 – increased risk of high blood pressure. We tend to gain fat around the middle after menopause, which can increase your risk of cardiovascular disease.

There are also less obvious ways in which menopause impacts these risk factors. Those struggling to manage their menopause symptoms may find that their motivation to exercise and eat healthily is very low. If this sounds familiar, it might be time to ask your doctor whether hormone replacement therapy (HRT) would help. They’ll help you weigh up your personal risks and benefits.

Fact 3: HRT can prevent cardiovascular disease for some people

Most people who go through premature menopause – by the time they are 40 – are advised to take HRT. This is because premature menopause increases your risk of cardiovascular disease. HRT reduces this risk and is generally taken until at least the age of 50 – or longer if it’s still needed to control menopause symptoms.

Fact 4: …but HRT can also increase your risk of some kinds of cardiovascular disease

This is where things get a little murkier. While HRT decreases the risk of cardiovascular disease for younger people, the picture is more complicated for those who go through menopause at a more typical age, which is around 50. 

Research seems to show that HRT can prevent heart disease in some cases, but it can also sometimes increase your risk of other types of cardiovascular disease including stroke and blood clots.

Because of this mixed evidence, HRT is not prescribed solely to reduce your cardiovascular risk for those who go through menopause aged over 45, but it is a safe treatment for menopause symptoms in most cases.

Your risk of developing blood clots or having a stroke can be minimised by choosing the right kind of HRT. Your doctor will likely recommend oestrogen that is applied to and absorbed through the skin, such as a patch, gel or spray.

Fact 5: A healthy lifestyle is key

Take things into your own hands! Regardless of your menopause status or HRT use, a healthy lifestyle is the best way to reduce your risk of cardiovascular disease. While the effects of menopause and HRT on your heart and circulation are still being debated by researchers, healthy habits are consistently proven to help.

These include:

Achieving any of the above can also help to improve menopause symptoms, so they’re well worth thinking about! Lots of small changes are often more effective than making big changes to your routine, as they are easier to stick to.

Final word

Menopause can have an impact on your cardiovascular health but there are plenty of positive steps you can take to reduce your risk.

Speak to your doctor for personalised advice if you have any concerns about your cardiovascular health or risk.
You can find out more about menopause on our blog or in our symptoms library.

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Our author

Dr. Lucy Wilkinson

Dr. Lucy Wilkinson is a general practitioner with special interests in women’s health and digital health. She trained at the universities of St Andrews, Manchester, and the Autonoma University of Madrid, and holds postgraduate qualifications in obstetrics, gynecology and sexual health. She is a member of the British Menopause Society and clinical advisor at Stella.