As women move through menopause, heart health becomes an increasingly important focus. Shifts in hormones like oestrogen can influence cholesterol, blood pressure, and even how your blood vessels function. Understanding these changes — and how to support your body naturally — is key to protecting long-term cardiovascular wellbeing.
Now, there are some things in life that we want to pass through us quickly. Those uncomfortable feelings of grief or loss, that traumatic event that left us feeling shaken, or that dodgy kebab we ate on the weekend. Prescribing strategies in conventional medicine tend to focus on relieving pain and suffering as quickly as possible, and we have ample pharmaceutical medications to alleviate pain promptly. And while many of us have become accustomed to dampening our pain as quickly as possible. I’m here to tell you (and I’m sorry to be the bearer of bad news), that perimenopause is something that you DON’T want to go through rapidly.
I know there is a great deal of media attention on the negative effects of perimenopause and declining oestrogen levels post-menopause. This doom and gloom and push for a quick fix (with MHT or other hormone therapy) seems to overlook some of the pertinent issues with menopause.
But why does speed matter in perimenopause?
Surely, the quicker you transition through menopause, the better, right?
You might think: Let’s alleviate this discomfort as quickly and simply as possible.
However, this may not be the healthiest approach from a long-term cardiovascular perspective.
In 2020, a longitudinal study was performed to observe the link between the cardiovascular risk of women post-menopause and the timing of the menopausal transition. Distinct patterns were observed between the duration of perimenopause and the risk of CVD (cardiovascular disease)1.
Unsurprisingly, the rapidity of the menopausal transition correlates with a faster decline in oestrogen levels. This quick decline has kick-on effects as the cardiovascular system struggles to keep up with these rapid hormone changes.
This study found that a quick menopausal transition was the most significant factor in increasing the risk of CVD, rather than the ‘usual’ assumed factors such as the age of menopause, BMI (body mass index), or WHR (waist-to-hip ratio).
A rapid decline in oestrogen and a correspondingly fast increase in FSH (follicle-stimulating hormone) significantly influenced markers for increased CVD risk, including alterations to body composition (weight gain), changes to cholesterol levels, and arterial markers for cardiovascular risk2.
This puts a spanner in the works for those hoping to transition through menopause in the seemingly desirable three-year period rather than the somewhat daunting 12-year period.
How does menopause influence my cardiovascular risk?
I like to think of oestrogen as a robust dam wall that holds strong to keep many inflammatory conditions under control. As our oestrogen levels begin to decline through our menopausal transition, this dam wall begins to give way to the weight of many of our preexisting medical conditions.
Our once resilient liver can become sluggish with the mere thought of processing cholesterol, the epithelial cells lining our blood vessel walls become rigid and stiffened. Our cells become more resistant to insulin, and then we begin to put weight on around our midline, our blood pressure has increased, and our LDL cholesterol has popped out of the ‘acceptable range’.
This common trifecta of changes to the cardiovascular system can lay the foundations for future health problems and potential cardiovascular disease.
But what would happen if we ease our way through menopause rather than trying to rush the process?
In my experience, some of the most beneficial events in my life were accompanied by intense negative emotional sensations.
That relationship that I so wanted to hang on to caused me intense emotional discomfort. But in the end, the dissolution of the relationship was a door-opening experience for a better life.
That car/house/dress that I wanted but couldn’t afford and had a little meltdown about was almost instantly replaced with something that served me on a deeper and more spiritual level.
And so many times, I see women desperately wrestling with the discomfort of perimenopause, not fully seeing the blessing behind the transition.
“But, more from a medical perspective, slowing down the decline of oestrogen during the menopausal transition gives your body time to adjust.”
Your brain has time to adjust to the reduction of oestrogen, enabling you to maintain neural networks and process your thoughts, feelings and emotions with greater ease.
Your skeletal system has time to adjust to the decline in oestrogen, and you have time to address nutritional deficiencies and improve your bone porosity rather than having to cope with a rapid decline.
Your cardiovascular system has time to become more supple and fluid with gradual decreases in oestrogen to accommodate changes in liver function (essential for healthy cholesterol levels) and potentially reduce the risk of cardiovascular events post-menopause.
Not only does a smoother and slower menopausal transition help your physical body adjust to lower oestrogen levels, but it also enables you to emotionally process the feelings associated with moving into your Wise Woman years. Time to deal with grief, loss, and anxiety, as well as adequate time to embrace the freedom, expansive awareness, and empowering wisdom that comes from this transformative time.
Learning to enjoy the ride
So, I’m not suggesting we drag out the discomfort, grit our teeth, and hold on for dear life. Perimenopause is an opportunity to gain a deeper awareness of ourselves, re-discover our passions, re-visit our interests, and become more in touch with an authentic, wise, and powerful woman.
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