Menopause is a natural life stage
Menopause is a natural biological process that every woman experiences. While symptoms and timing vary, menopause is not an illness and, for most women, it can be managed well with the right information, support and care.
Understanding what is happening in your body allows you to take positive steps to protect your health and wellbeing during midlife and beyond.
What are perimenopause and menopause?
Perimenopause is the transition phase leading up to menopause. It can start in a woman’s 40s (sometimes earlier) and may last several years. During this time, hormone levels - particularly oestrogen - rise and fall unpredictably. It can begin several years before periods finally stop.
Menopause is reached when periods have stopped for 12 months. After this point, oestrogen levels remain lower and more stable.
Both stages are part of normal ageing, but the hormonal changes affect more than periods and hot flushes - they also influence heart and blood vessel health.
Why does menopause matter for heart health?
Oestrogen plays an important protective role in women’s cardiovascular health. It helps keep blood vessels flexible, supports healthy cholesterol levels, and assists with blood sugar regulation.
During perimenopause and menopause, oestrogen levels fluctuate and then decline. This change does not cause heart disease on its own, but it can influence how other risk factors develop over time. As oestrogen levels decline and fall:
- Blood vessels may become stiffer
- Blood pressure can rise
- Cholesterol levels may change
- Blood sugar regulation can worsen
- Body fat may be redistributed, particularly around the waist
These changes often occur gradually and without symptoms, which is why regular heart health checks are important. They also help explain why a woman’s risk of heart disease increases during midlife and after menopause.
Common symptoms during perimenopause and menopause
Symptoms vary widely and can come and go. Common experiences include:
- Hot flushes and night sweats
- Sleep disturbance and fatigue
- Mood changes, anxiety or low mood
- Weight gain, especially around the abdomen
- Brain fog or difficulty concentrating
- Palpitations or increased awareness of heartbeats
Some symptoms overlap with heart conditions, so new or concerning symptoms should always be checked.
How menopause affects heart disease risk
During and after menopause, women are more likely to develop key heart disease risk factors, including:
- High blood pressure
- High cholesterol
- Type 2 diabetes
- Weight gain around the waist
- Reduced physical activity due to fatigue or joint pain
These changes often happen silently, making regular health checks important.
Palpitations and heart rhythm changes
Palpitations are common during perimenopause and menopause and are often linked to hormonal fluctuations, stress or sleep disruption. They can feel unsettling but are frequently benign.
However, persistent palpitations or those accompanied by dizziness, chest discomfort or shortness of breath should be assessed by a health professional.
Protecting your heart during perimenopause and menopause
- Heart Health Check
If you have not had a Heart Health Check, this is an important first step. These checks look at blood pressure, cholesterol, blood sugar, lifestyle factors and family history.
Regular checks help identify changes early, allowing you and your doctor to take action before problems develop.
- Stay physically active
Regular movement supports blood pressure, cholesterol, blood sugar and mental wellbeing. Activity does not need to be intense to be beneficial.
Walking, swimming, strength training or gentle exercise can all support heart health and help manage menopausal symptoms.
- Healthy eating
A balanced diet rich in vegetables, fruits, whole grains, legumes, lean proteins and healthy fats supports cardiovascular health.
The Mediterranean diet is ideal during this transition, as eating well during midlife can help manage weight changes, cholesterol levels and blood sugar, all of which influence heart disease risk.
- Sleep
Sleep disruption is common during perimenopause and menopause, often due to night sweats or anxiety. Poor sleep can increase inflammation in the body, raise blood pressure and affect blood sugar control. It can also make healthy habits more difficult to maintain due to sleep deprivation.
Prioritising sleep routines and discussing persistent sleep problems with a health professional is an important part of heart protection.
- Stress and emotional wellbeing
Chronic stress and ongoing anxiety can affect the heart by increasing inflammation and blood pressure. Menopause can be a time of multiple life pressures, not just hormonal change.
Managing stress through support, counselling, relaxation techniques or lifestyle changes benefits both mental and heart health. Looking after your mental health is a critical part of emotional wellbeing and an important part of protecting the heart.
- Menopausal hormone therapy and heart health
Menopausal Hormone Therapy can be helpful for some women in managing symptoms. Its role in heart health depends on individual factors such as age and time since menopause, type and dose of hormones and existing cardiovascular risk factors. It is important to keep track of your symptoms and listen to changes to your body and seek support early.
It is not a “one size fits all” decision and decisions about hormone therapy should be made with a knowledgeable health professional and tailored to your personal health profile.
When to seek medical advice
See your doctor if you experience:
- New or worsening discomfort with lack of sleep
- Shortness of breath
- Ongoing or severe palpitations
- Unexplained fatigue
- Symptoms that feel different or concerning
If something does not feel right, it is important to have it checked.
Summary
Perimenopause and menopause are natural stages of life and also an important opportunity to focus on heart health. With regular checks, supportive care and practical lifestyle strategies, women can take positive steps to protect their hearts now and into the future.