If you ask women what they’re most likely to die from, they’ll say breast cancer. But actually, cardiovascular disease is the leading cause of death for women. Yes, you read that right. It kills more women than all forms of cancer combined. 

You might be thinking, “Great, another thing to worry about as I age.” Not exactly. But, understanding how perimenopause affects your heart is important so that you can start taking proactive measures.  

In a recent This Is Perimenopause podcast with Dr. Amy Louis-Bayliss of Lume Women’s Health, we learned some important information about heart health that every woman needs to know.

The Estrogen Connection

Estrogen isn’t just about keeping your skin plump and your moods (somewhat) stable. It’s also been quietly protecting your heart all these years. As you enter perimenopause and your estrogen levels start to fluctuate, these fluctuations can impact your cardiovascular system.

Dr. Amy puts it this way, “Estrogen has a protective effect on quite a few of the diseases that impact women. So when you go through the menopause transition, that loss in estrogen adds to that risk that’s accumulating over time.”

In other words, as your estrogen declines, it leaves your heart more vulnerable.

Heart Attacks in Women

Another concerning fact is that women are seven times more likely to be misdiagnosed and sent home from Emergency during a heart attack compared to men. Why? Because women don’t always present with the ‘classic’ symptoms.

Symptoms of Heart Attack in Women

So, what should you be looking out for? Dr. Amy explains that women can have typical symptoms like shortness of breath, nausea, pain or a pressure in the chest radiating down the left arm, and sweating.

But many women present with what doctors call atypical chest pain (though we think we should call this ‘the female presentation of chest pain’ because, hello, we’re half the population!). Women can also present with symptoms that are a lot more subtle. These symptoms can include:

• Back pain
• Jaw pain
• Pain on the right side
• Nausea on its own
• Flu-like symptoms
• General malaise and weakness
• Fatigue
• Dizziness
• Shortness of breath
• Vomiting
• Cold sweats

So if you’re experiencing any of these symptoms, or just feeling off and can’t explain why, don’t ignore it. Take an active role in your health. Talk to your doctor right away. Especially if you have any of the risk factors listed below.

Reproductive Risk Factors

Most people know about the usual suspects when it comes to heart disease: smoking, high blood pressure, high cholesterol, diabetes, sedentary lifestyle, and obesity. 

What you might not know is that your reproductive history can also play a role. Some risk factors that might surprise you include:

1. Severe hot flashes 
2. High blood pressure or diabetes during pregnancy
3. Recurrent miscarriages
4. Early menopause
5. Breast cancer

If any of these apply to you, it might be time to have a chat with your doctor. Taking preventive action today could be the key to safeguarding your future heart health.

Taking Charge Of Your Health 

The reality is that no one is coming to explain perimenopause to you or the increased risks that come with menopause. No one is going to hand you a manual. You’ve got to take charge of your own health. Dr. Amy puts it perfectly: “Having health literacy is really important so that you can gather the information to know, ‘Am I good?’ ‘Do I need to be doing any more?’” 

So, what can you do to keep your heart healthy during perimenopause?

1. Get Moving (But Not How You Think)

Think cardiovascular exercise is the only way to a healthy heart? Think again. Strength or resistance training is now advocated by the American Heart Association as an intervention for heart disease, even once you’ve had a heart attack.

Dr. Amy encourages including strength or resistance training into your exercise routine. Dr. Amy explains, “As you age, you lose muscle mass. And muscle has multiple benefits. It doesn’t just benefit your heart, your brain, your bones. It also improves your mood. It lengthens your life and improves your quality of life.” So lifting weights even for 15 minutes, two to three times a week, can make a big difference.

2. Protein is Your New Best Friend

Speaking of muscle, let’s talk protein. Dr. Amy recommends aiming for 100 to 120 grams of protein a day. That might sound like a lot, but it’s essential for maintaining muscle mass.

3. Rethink That Glass of Wine

This one might hurt. But the truth is that alcohol isn’t great for us. In fact, it’s a bigger risk factor for breast cancer than hormone therapy. Dr. Amy advises limiting alcohol to one or two drinks a week. Your heart (and your waistline) will thank you.

4. Sleep Like Your Life Depends On It (Because It Kind of Does)

Getting enough quality sleep isn’t just about avoiding ‘under eye bags’. It’s really important for your heart health. Aim for 6-9 hours a night, and if you’re having trouble sleeping, talk to your doctor. Sleep apnea becomes more common during perimenopause, and it can increase your risk of heart disease.

5. Become Your Own Advocate

The reality is that many women are dismissed when they approach their doctors about perimenopause symptoms. So, you need to become your own advocate. Don’t be afraid to speak up, ask questions, and push for the care you need and deserve.

If you’re concerned about your heart health, book a specific appointment to discuss it – don’t just  tack it on at the end of another appointment. And if your doctor dismisses your concerns? Find a new one. Your health is too important to settle for subpar care.

Informed Steps Forward

Knowledge is power. And you’re clearly tapping into that power right now. By educating yourself about these risks and taking steps to protect your heart, you can enter this new phase of life stronger and healthier than ever before.

A great place to continue this education is the National Menopause Show on October 26 at the Metro Toronto Convention Centre. You’ll find evidence-based solutions and practical strategies to support you in perimenopause, menopause, to postmenopause. We can’t wait to meet you there. 

xo 

Mikelle & Michelle