On International Women’s Day Dr Angie Brown, Medical Director with the Irish Heart Foundation talks about the menopause and heart health.

While you may have heard about menopausal symptoms such as night sweats, hot flushes, vaginal dryness and low mood or anxiety, did you know that the menopause also affects your heart and in particular puts you at an increased risk of heart disease and stroke?

While the menopause itself doesn’t cause cardiovascular disease, lowering hormone levels coupled with the ageing process, increase your chances of developing risk factors for heart disease and stroke such as high blood pressure and high cholesterol.

In general women experience menopause between 45 and 55 years of age however, the average age for women to enter the menopause is 51. Some women experience what is known as early or premature menopause before the age of 40.

Why is it important for women to be aware of their heart health particularly around the time of the menopause?

As we age and particularly around the time of menopause, the level of cholesterol in our blood increases,  in particular the bad cholesterol or LDL , often triglycerides also increase and the good cholesterol or HDL decreases. This leads to an increased risk of cardiovascular disease – heart attack and stroke.

Lower oestrogen levels as a result of the menopause lead to a stiffening of the arteries of the heart which can increase blood pressure. Furthermore, as its easier to gain weight and harder to lose it as we age, and this can also lead to an increase in blood pressure- another risk factor for heart disease.

Why does your chances of a heart attack increase once you enter the menopause and what can you do about it?

Your chances of a heart attack increase in menopause as a result of lower oestrogen levels which adversely affect your cholesterol levels, arteries, and blood pressure all of which increasing the risk of a heart attack.

All of these risk factors can be treated therefore the best thing to do is to make an appointment with your GP to get your blood pressure, blood sugar and cholesterol checked.

What about HRT and heart health- does HRT protect your heart and are there any side effects of HRT I should be concerned about?

Hormone Replacement Therapy or HRT doesn’t protect against heart disease, particularly in late menopause. There are various forms of HRT available such as oral, transdermal, and pessaries, as well as different preparations of HRT, oestrogen alone or combined with progesterone. The risk and benefit of each varies from woman to woman according to their other risk factors such as heart disease or breast cancer and whether they have a womb or not.  Its therefore important to individualise these conversations and treatment decisions and talk to your doctor about the best option for you.

Heart palpitations are common in menopause, what causes them, and should I be concerned?

Changing hormone levels during the menopause can lead to palpitations – a feeling that your heart is beating faster than usual. Most often these are nothing to worry about, sometimes medication such as with a beta blocker can help settle the symptoms down.

However, if the palpitations are associated with other symptoms such as dizziness, breathlessness, chest pain, blackouts or they occur with increasing frequency or severity you should get these checked out. An assessment would involve an ECG, a 24-hour heart monitor, a blood test, and possibly other investigations as appropriate.

 What top tip would you give women who are entering the menopause to mind their cardiovascular health?

Look at your lifestyle and try to become more health aware. Stop smoking if you smoke, reduce alcohol intake, increase the amount of fresh food in your diet and keep to a healthy weight. Take regular exercise and try to reduce your stress levels. Lowering caffeine and alcohol may help reduce the number and intensity of hot flushes. Sleeping in a cold room may also help with night sweats.

And if you haven’t had a general check-up lately now is as good a time as any to get your heart health checked by your doctor.

For more information on ways to keep your heart healthy please see here