Heart disease is the number one killer in America. One in three women dies from heart disease – more than all cancers combined. Women’s bodies change dramatically as they age, and more risk factors seem to pop up everywhere. A big contributor to heart disease in women seems to be menopause, and those who experience early onset of menopause may be at higher risk for coronary issues.
Early Menopause and the Link to Heart Disease
Menopause, well-known for hot flashes, weight gain, irritability, and a host of other inconveniences, may also be responsible for even more serious health issues. A new study has linked the early onset of menopause to a higher risk of lifetime cardiovascular events. The research, published in JAMA Cardiology, found that women who start natural menopause before the age of 40 have about a 40% higher likelihood of developing coronary heart disease throughout their lives compared to those who begin at a later age.
Earlier studies have linked menopause with heart health issues and an increased risk of short-term coronary heart disease. The American College of Cardiology/American Heart Association Primary Prevention guidelines in 2019 recognized that early menopause established the risk factor, but this newer study is the first to look at that link over a lifetime. Priya Freaney, the study’s lead author and an assistant professor of medicine in the division of cardiology at Northwestern University Feinberg School of Medicine, said the findings “reinforce that menopause timing isn’t just a reproductive issue—it’s also a heart health issue.” “By looking at lifetime risk, we hoped to better capture the long-term impact of premature menopause on heart health and help inform prevention earlier," Freaney said.
The Study
Researchers analyzed data from more than 10,000 women ages 55-69 in the post-menopausal stage who participated in various studies from 1964 through 2018. Participants consisted of black and white women who had no coronary heart disease and had natural menopause, not surgical. The women self-reported their data, and researchers didn’t account for hormone therapy or certain cardiovascular risks that could influence the likelihood of heart disease.
During the study timeframe, 260 black women and 748 white women experienced coronary heart disease events. Premature menopause was more common (15%) among black respondents than whites (5%). Early menopause accounted for a 41% higher lifetime risk of heart disease for black women and 39% for white women.
It’s important to note that the women in the study with premature menopause didn’t develop heart disease earlier than others - they were just at a higher risk of doing so.
Stages
The average age to begin menopause is 52.
Perimenopause is the first stage that can begin up to ten years before actual menopause. This usually starts in your 40s and is characterized by hot flashes, mood swings, and irregular periods. The Department of Health and Human Services’ Office on Women’s Health says it is not uncommon for women to have high blood pressure as they transition from this stage to menopause.
Menopause happens when women no longer have their periods and haven’t had one for 12 consecutive months. The body has stopped producing the female reproductive hormone estrogen, which many associate with adding to the risk of heart disease.
Postmenopause transitions right after menopause and it is referred to as the stage a woman stays in for the rest of her life. Irritating symptoms start to disappear, but this is the stage where heart disease, stroke, osteoporosis, and other illnesses become more of a risk. About 41% of women develop hypertension after menopause.
The cycle of menopause comes with heart risks, but premature menopause may increase those dangers. Rhym Radjef, director of the Henry Ford Health Women’s Heart and Cardio-Obstetric Program, told Health that the loss of estrogen may be part of the problem since it helps to protect the heart and blood vessels. “Early menopause might also reflect [underlying] inflammation or metabolic changes that can lead to heart disease. In that sense, menopause may be both a cause and a marker that a woman is at higher risk and may benefit from earlier cardiovascular prevention.”
To help reduce the chance of heart disease and cardiovascular incidents, experts say to incorporate a heart-healthy diet, get plenty of exercise, regular doctor’s checkups, and stay away from unhealthy habits such as smoking and drinking.
