heart disease

When a woman reaches her natural menopause (usually around the age of 50) the risk of heart disease increases dramatically. This is due to the fact that the levels of oestrogen in a women’s body drop significantly. In younger women who have undergone early menopause or had to have surgical menopause, who do not take oestrogen, their risk for heart disease is also higher.

During childbearing years oestrogen works to protect your heart by controlling the amount of fat (lipids) in your body. Lipids make up the cholesterol in the bloodstream and the oestrogen helps to fight the build up of unhealthy cholesterol stored in the body. It does this by increasing the amount of good cholesterol (HDL) in the bloodstream and reducing the amount of bad cholesterol (LDL). This in turn prevents the arteries from building up fatty deposits and allows the blood to flow more easily through the heart.

During and after the menopause however, the body stops producing oestrogen and therefore the amount of bad cholesterol (LDL) in the bloodstream increases, preventing the good cholesterol (HDL) from doing its job. As cholesterol and heart disease are linked, a high amount of LDL can result in the thickening of the arteries and an increase in blood pressure thereby increasing the risk of heart disease.

As the oestrogen levels decrease slowly in women experiencing a natural menopause, the risk of heart disease increases slowly. However, women who go through the menopause due to surgery tend to increase their risk of heart disease much more quickly. This is predominantly due to the fact that the oestrogen levels decrease rapidly.

In addition to a drop in oestrogen levels weight gain can also play a role in the postmenopausal risk of heart disease. As the body experiences a change in hormone levels during the menopause, maintaining a healthy weight can often become difficult. This extra weight can impact the body by causing physical inactivity, high blood pressure, diabetes and high cholesterol which are all risk factors that can lead to a heart attack or stroke.

Symptoms of cardiac disease in women are different to those in men and some of them can be mistaken for normal aging or ‘feeling under the weather’. Symptoms to be aware of include:

• Crushing chest pain
• Pain down the left arm
• Profound fatigue
• Difficulty breathing
• Feeling faint or dizzy
• Nausea and vomiting
• Being anxious
• Profuse sweating
• Neck/shoulder blade/upper back pain or discomfort
• Burning abdominal pain

Although there is no cure for heart disease, the risks can be reduced significantly by:

• Keeping on top of your health – having a yearly checkup that includes a blood pressure and cholesterol check. Both of these can be monitored and reduced by medication if necessary if it’s felt they are too high.
• Stopping smoking – women who smoke have a high risk of heart disease much earlier than those that don’t.
• Managing stress – stress and depression can be hard on the heart.
• Checking your family history - there is a higher risk of heart disease in women where there is a history of it in the family.
• Maintaining a healthy diet – eating a diet that is low in fat can help prevent the arteries from clogging.
• Taking exercise – moderate exercise of 30 minutes, three times a week, can greatly reduce the risk of heart disease

Information written by the talkhealth medical panel

Last Reviewed: 15 February 2011
Next Review Date: 15 February 2013