Matters of the Heart: Understanding Heart Health During Hormonal Change

🚨 It Matters More Than You Think

If no one has ever talked to you about heart health in relation to perimenopause or menopause, that’s not your fault. But now is the time to tune in and become informed because knowledge is power. And knowledge can save lives.

For so long, menopause has been framed as a reproductive issue made up of hot flashes, missed periods, mood swings, and some other annoying symptoms. But the truth is, menopause is a whole-body transition, and one of the most important (and overlooked) systems affected is your heart.

🙋‍♀️ Why Women Need to Talk About Heart Health (More)

Heart disease is the number one cause of death in women. In the U.S., one woman dies from cardiovascular disease every 80 seconds. Even more concerning? Women are more likely than men to be misdiagnosed during a cardiac event, more likely to die in the year following one, and far more likely to have had no obvious warning signs at all.

That doesn’t mean heart disease is inevitable. It means women haven’t been given enough information especially during midlife and menopause, when risk starts to increase.

🩸 Menopause Is Not Just About Periods Ending

Here’s something most women are never told: estrogen doesn’t just affect your reproductive system. Estrogen receptors exist throughout your body – on every organ – in your heart, blood vessels, brain, muscles, bones, and metabolic system.

So when estrogen levels begin to fluctuate and decline during perimenopause and menopause, the effects aren’t isolated. They ripple through the entire body.

This is why menopause isn’t “just” a gynecologic issue. It’s cardiovascular, neurological, musculoskeletal, endocrine. All of it, all at once.

And because women now live, on average, into their early 80s, many of us will spend decades in a low-estrogen state. Up to 1/3 – 1/2 of our lives (if we’re that fortunate). Menopause isn’t something we get thru and leave behind. It’s something we continue to live with, and care for, long term.

❤️ What Hormonal Changes Mean for Your Heart

As estrogen declines, several changes tend to occur that impact heart health. Cholesterol patterns often shift, with LDL (“bad”) cholesterol rising and HDL (“good”) cholesterol falling. Insulin resistance can increase. Fat distribution changes, with more fat stored around the abdomen. Muscle mass naturally declines.

If you’ve ever said, “I’m doing the same things I always did, but my body feels different,” you’re not wrong. The rules really do change. And it’s not a failure of willpower – it’s biology!

🥵 Hot Flashes Aren’t Just “Annoying”

About 75% of women experience hot flashes and night sweats during perimenopause and menopause. These symptoms are often brushed off as something to tolerate, but they’re actually neurovascular events that originate in the brain and involve changes in blood vessel regulation.

Emerging research suggests that frequent or severe vasomotor symptoms may be associated with increased cardiovascular risk. That doesn’t mean hot flashes are dangerous – but it does mean they’re meaningful signals worth paying attention to and seeking treatment for. You don’t have to and should not just “deal” with them.

💊 A Word on Hormone Therapy

For healthy women without contraindications, estrogen-based hormone therapy is considered a first-line treatment for moderate to severe vasomotor symptoms and may offer cardiovascular benefits when started at the appropriate time. (Typically during perimenopause or within 10 years of hitting menopause)

Hormone therapy isn’t right for everyone, and it’s not a one-size-fits-all decision. Timing matters. Health history matters. Having a provider who understands menopause as a whole-body transition matters. I always refer clients to menopause.org to find an educated menopause-certified provider. In fact, that is where I found my own GYN.

💪 Why Strength and Lifestyle Matter for the Heart

As estrogen declines, muscle loss accelerates and visceral fat becomes more prominent, both of which directly affect heart health. Muscle plays an important role in blood sugar regulation, inflammation control, and metabolic health.

This is why heart health in midlife isn’t just about cardio or diet alone. It’s about strength training, nourishing food, quality sleep, stress management, and consistency over perfection. Supporting your heart means supporting your whole system.

🖼️ The Bigger Picture (and the Good News)

Every day, more than 6,000 women in the U.S. enter menopause. This isn’t a niche issue. It’s a massive life transition happening all around us.

The good news? Women are asking better questions. Conversations are changing. And when women understand what’s happening in their bodies, they can take proactive, empowered steps to protect their health, including their hearts.

💡 Bottom Line

Heart health isn’t something to worry about “later.” It’s a midlife issue, a menopause issue, and a lifelong issue.

Menopause doesn’t mean decline, but it does mean change. And change calls for awareness, education, and compassion toward ourselves. Your body isn’t betraying you. It’s communicating. And when you listen, learn, and take care of yourself — you give your heart (and yourself) the support it deserves.

💗 Join StrongHER Together

Ready for deeper support? StrongHER Together is my private community for women navigating perimenopause and menopause — a space for connection, expert coaching, wellness challenges, and real talk. Whether you’re seeking clarity, confidence, or just a circle of women who get it, you’ll find it here.

📬 Stay in the Know

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