Menopause transition can lead to increased risk of developing heart disease for women, as per American Heart Association, "Menopause Transition and Cardiovascular Disease Risk: Implications for Timing for Early Prevention," published in the journal, Circulation.
Perimenopause or menopause transition is the period where a woman starts to develop menopausal changes due to the fluctuating levels of hormones produced by the aging ovaries. This leads to irregular menstrual patterns commonly between the ages 45 and 55 — the change from the reproductive to the non-reproductive phase of life.
"We have accumulated data consistently pointing to the menopause transition as a time of change in cardiovascular health. Importantly, the latest American Heart Association guidelines that are specific to women, which were published in 2011, did not include the data that is now available on menopause as a time of increased risk for women's heart health. As such, there is a compelling need to discuss the implications of this accumulating body of literature on this topic", said Samar R. El Khoudary, Ph.D., M.P.H., FAHA, chair of the statement writing committee and associate professor of epidemiology at the University of Pittsburgh's Graduate School of Public Health and the Clinical and Translational Science Institute.
Estrogen, the female sex hormone, secreted by ovaries are said to have cardio-protective effects. As the menopause transition begins, the hormonal levels along with contributing factors diminish, thereby posing a greater risk for heart problems. Several studies have shown the implications of menopause transition on heart problems. Similar changes may also occur when ovaries or uterus are surgically removed (partial or full oophorectomy or hysterectomy) due to other problems.
The evidence thereby led to various studies involving hormonal therapy to treat heart diseases and potential benefits were observed when certain combinations of hormone therapy were initiated in early but not late menopause. The therapy also demonstrated a decreased risk of type 2 diabetes and protection from bone loss. Further studies are however needed to conclude the long-term benefits.
"As such, it emphasizes the importance of monitoring women's health during midlife and targeting this stage as a critical window for applying early intervention strategies that aim to maintain a healthy heart and reduce the risk of heart disease. Thus, health care professionals may consider an aggressive, prevention-based approach for women during this stage in their lives to decrease the probability of a future cardiovascular disease occurrence, such as heart attack or stroke", said Samar R. El Khoudary.
Takeaway facts on menopause:
Risk factors contributing to cardiovascular diseases include:
- Common symptoms like hot flashes and night sweats
- Depression and sleep disturbances
- Physiological changes during menopause, such as increased abdominal fat and visceral fat (body fat around the organs)
- Menopause at an earlier age
- Cholesterol levels, metabolic syndrome risk and vascular vulnerability increase with menopause beyond the effects of normal aging. Metabolic syndrome is diagnosed when a person has three or more of the following measurements: abdominal obesity, high triglycerides, low HDL cholesterol (the good cholesterol), high blood pressure and/or high blood glucose levels (blood sugar).
- Higher good cholesterol levels may not consistently reflect good heart health in all stages of life in women.
- Use of cholesterol-lowering medications remains limited for women during menopause transition
- Physical activity and nutrition may play a role in the timing of menopause for all women.
- Women who drink little to moderate amounts of alcohol may have later onset of menopause, and those who smoke cigarettes are likely to start menopause about a year earlier than non-smokers.
- Data indicates that only 7.2% of women in menopause meet physical activity guidelines, and fewer than 20% of those women consistently maintain a healthy diet.