Menopause is one of the major health milestones in a woman’s life, a significant transition. It involves a lot of hormonal fluctuation as periods stop, bringing symptoms like hot flashes and mood swings that many are familiar with. But these hormonal shifts also tend to pose a more fatal risk, too: a heart attack.
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To understand why menopausal women become vulnerable to heart attacks, HT Lifestyle spoke to Dr Anand R Shenoy, consultant- interventional cardiology, Manipal Hospital, Old Airport Road, who revealed that the sharp decrease in estrogen after menopause is one of the culprits. Estrogen is a vital hormone that helps support heart health.
Explaining more about how estrogen’s dip plays a role in surging the risks, the cardiologist said, ”Estrogen helps keep blood vessels relaxed, increases blood flow, and lowers bad cholesterol levels. As estrogen levels fall dramatically, blood pressure rises, cholesterol levels shift, and fat increases around the heart, all of which lead to a greater risk of heart attack. Menopause-related symptoms like hot flashes and night sweats have been associated with cardiac disease.”
To add to this, heart attacks in women are stealthy and tricky. According to Dr Shenoy, women have a ‘lower perception of the risks.’ This is alarming as it leads to underdiagnosis and delayed diagnosis. Primarily because the symptoms are not always traditional, they are a bit different and may even overlap with other health conditions.
The cardiologist further added how women can be more aware,
“To help avoid cardiovascular event possibilities, women should track their blood pressure weekly; participate in annual comprehensive cardiac screenings; recognise the signs and symptoms of a heart attack; and follow advice with proactive lifestyle changes. Tracking of signs and symptoms can provide early intervention and heart attack prevention during these vulnerable periods.”
So, as a menopausal woman, what should you do? Be aware of the red-flag signs and follow a healthy lifestyle.
Dr Shenoy shared a brief guide, covering 5 signs to help detect early and 5 prevention tips:
5 warning signs menopausal women should know

- Chest pain or discomfort: Instead of the regular crushing pain, females tend to experience more of a typical chest discomfort in addition to pain in the back, neck, jaw, or arms.
- Shortness of breath: Breathing difficulty while engaging in light physical activity.
- Palpitations: Irregular heartbeats or feeling skipped heartbeats.
- Dizziness or light-headedness: Feeling faint and unsteady.
- Fatigue: Unusual tiredness or weakness.
Prevention and management tips

1. Exercise:
- The aim is to be at the ideal body weight, BMI < 25, while also achieving at least 150 minutes of moderate intensity aerobic physical activity each week or 30-minute sessions, five days a week ideally, or 75 minutes of vigorous intensity aerobic physical activity each week.
2. Diet:
- Have a balanced diet containing fruits, vegetables, whole grains and lean protein.
- Minimise consumption of saturated fat, sugars and sodium.
3. Stress:
- Use stress-relieving techniques such as meditation, yoga, and deep breathing.
4. Sleep:
- Good quality sleep will help manage stress and cardiovascular health.
- It is essential to get good quality sleep (ideally 7-8 hours) each night.
5. Quit smoking
- Giving up smoking will decrease your chances of heart disease and improve your overall health.
This risk factor is applicable to both peri and post-menopausal women, as the cardiologist said, “To decrease the risk of heart disease during menopause, all peri and post-menopausal women should be assessed for risk factors and educated on heart-healthy lifestyle interventions to attempt to have optimum cardiovascular health.”
For the uninformed, post-menopause means when a woman hasn’t had any periods for 12 consecutive months, while perimenopause is the stage leading up to menopause, when typical symptoms like hot flashes and irregular periods start to show up. This phase can span the last few years of a woman’s menstruating years. So, the risk factors extend not only to women who have stopped menstruating and already reached menopause but also to those who are about to reach it.
As per the Cleveland Clinic’s report, the perimenopause stage begins 10 years prior to final menopause, narrowing down the age to around mid-forties, with the average period being from four to eight years. So for better precautions, women late 30s onwards need to embrace heart-healthy habits and also seek medical attention if they spot any worrisome signs.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.