You could spend roughly 30 years of your life — or more — living with menopause. That’s why it’s important to take hold of your heart health, says Shufelt. Here’s what you can do.
See your doctor regularly. “After 50, every woman should have an annual checkup,” Shufelt says. Yearly appointments can help you keep track of health markers like your cholesterol, weight, blood pressure, and blood sugar, and help keep those numbers within a healthy range to reduce your heart disease risk.
If you’re at high risk for heart disease because of high cholesterol or weight gain, or if heart disease runs in your family, your doctor may recommend more screening tests. “People with a family history of heart disease are at a higher than average risk of heart disease,” Shufelt says. “For those people, we might use tools to assess their risk, such as a coronary calcium scan.”
For women with a family history of heart disease, the coronary artery calcium (CAC) test offers a precise assessment to help guide treatment and medication options. The CAC test — an X-ray that takes images of your heart — can help detect and measure calcium-containing plaque in your arteries.
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“The scan is a good tool to virtually look at your heart,” Shufelt says.
Consider hormone replacement therapy. “We don’t use estrogen replacement to prevent heart disease, but we do use it in low doses for bothersome menopausal symptoms, such as having night sweats that prevent you from sleeping,” Shufelt says.
Previously, the Menopause Society recommended the lowest dose of supplemental hormones for the shortest time for menopause relief. “The guidelines now state ‘the appropriate amount of time,’” Shufelt (a coauthor on the new guidelines) says, which varies per person.
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“There’s a certain percentage of women who will have troublesome menopausal symptoms for years — every woman is different,” Shufelt says.
If you enter menopause before age 45 (because of chemotherapy, hysterectomy, or premature ovarian insufficiency, a type of early menopause in younger women), hormone replacement therapy is also recommended.
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Premature menopause (before age 40) or early menopause (before age 45) without hormone replacement therapy can accelerate your risk of heart disease, Shufelt says.
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“When you enter menopause at an earlier age, it’s important to get a dose of estrogen in an amount your body would otherwise naturally produce at this time,” Shufelt says. “These are women who should have estrogen naturally in their bodies.”
If you’re in premature or early menopause and you’re eligible, Shufelt recommends using a dose of estrogen and progesterone through the time of natural menopause, at age 52, to replace what your body would naturally produce.
Get daily physical activity. Exercise can lower your risk of heart disease as you age. One study that followed participants for more than 20 years found that women who regularly exercise had a 36 percent reduced risk of a fatal heart attack or stroke, and were 24 percent less likely to experience death from any cause compared with those who didn’t exercise.
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In general, experts recommend 150 minutes of moderate exercise per week that includes a combination of strength and cardiovascular training.
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Additionally, lifestyle habits like not smoking, eating a balanced diet, losing weight if recommended by your doctor, and managing your blood pressure, cholesterol, and blood sugar can help maintain health during menopause.
“Menopause is an opportunity to know your numbers and look at your lifestyle because exercise and diet are the backbone and the cornerstone of cardiovascular disease prevention,” Shufelt says.
