Before the menopause, women in general have a lower risk of being affected by coronary heart disease. But after the menopause, your risk increases.

Why does the menopause affect your heart?

Oestrogen is a hormone naturally produced in a woman’s body which forms a vital part of regulating her menstrual cycle. It can offer some protection against coronary artery disease therefore reducing the risk of a heart attack. It helps to control your cholesterol levels and so reduces the risk of fatty plaques building up inside the artery walls. 

As we get older the blood vessels can become stiffer, caused by high blood pressure. This is a risk factor associated with heart attacks and stroke

During the perimenopause and after the menopause, a woman’s body gradually produces less oestrogen than it used to. This increases the risk of the coronary arteries narrowing whereas it previously protected the lining of the artery walls reducing the build-up of plaque. This increases your risk of developing coronary heart diesase, or a circulatory condition such as stroke. 

Does hormone replacement therapy (HRT) affect your risk of heart and circulatory disease?

HRT can be very effective for relieving symptoms of the menopause but can also help to reduce the long-term risk of  heart disease  and stroke. 

Taking HRT in tablet form could possibly increase the risk of cardiovascular disease but we need to remember that lifestyle choices such as diet, exercise and smoking are much more important when we consider our overall risk ,this risk can be reduced by having HRT through the skin, as a patch or gel This is called transdermal HRT and is increasingly being advocated in women. 

Recent evidence shows that menopausal women taking HRT have no higher risk of dying from a heart attack than women who don’t take HRT.

Early menopause (POI) and the heart

If you have an early menopause or suffer from premature ovarian insufficiency  you are at higher risk of premature coronary heart disease, so treatment is very important. Common treatments include HRT and the combined contraceptive pill – you can speak to your GP about whether these are suitable for you.