Menopause can bring increased cholesterol levels and other heart risks. Here’s why and what to do about it

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Menopause is a natural biological process that marks the end of a woman’s reproductive years, typically between 45 and 55. As women approach or experience menopause, common “change of life” concerns include hot flushes, sweats and mood swings, brain fog and fatigue.

But many women may not be aware of the long-term effects of menopause on the heart and blood vessels that make up the cardiovascular system. Heart disease accounts for 35% of deaths in women each year – more than all cancers combined.

What should women – and their doctors – know about these risks?

Hormones protect hearts – until they don’t

As early as 1976, the Framingham Heart Study reported more than twice the rates of cardiovascular events in postmenopausal than pre-menopausal women of the same age. Early menopause (younger than age 40) also increases heart risk.

Before menopause, women tend to be protected by their circulating hormones: oestrogen, to a lesser extent progesterone and low levels of testosterone.

These sex hormones help to relax and dilate blood vessels, reduce inflammation and improve lipid (cholesterol) levels. From the mid-40s, a decline in these hormone levels can contribute to unfavourable changes in cholesterol levels, blood pressure and weight gain – all risk factors for heart disease.

Speedkingz/Shutterstock

4 ways hormone changes impact heart risk

1. Dyslipidaemia– Menopause often involves atherogenic changes – an unhealthy imbalance of lipids in the blood, with higher levels of total cholesterol, triglycerides, and low-density lipoprotein (LDL-C), dubbed the “bad” cholesterol. There are also reduced levels of high-density lipoprotein (HDL-C) – the “good” cholesterol that helps remove LDL-C from blood. These changes are a major risk factor for heart attack or stroke.

2. Hypertension – Declines in oestrogen and progesterone levels during menopause contribute to narrowing of the large blood vessels on the heart’s surface, arterial stiffness and raise blood pressure.

3. Weight gain – Females are born with one to two million eggs, which develop in follicles. By the time they stop ovulating in midlife, fewer than 1,000 remain. This depletion progressively changes fat distribution and storage, from the hips to the waist and abdomen. Increased waist circumference (greater than 80–88 cm) has been reported to contribute to heart risk – though it is not the only factor to consider.

4. Comorbidities – Changes in body composition, sex hormone decline, increased food consumption, weight gain and sedentary lifestyles impair the body’s ability to effectively use insulin. This increases the risk of developing metabolic syndromes such as type 2 diabetes.

While risk factors apply to both genders, hypertension, smoking, obesity and type 2 diabetes confer a greater relative risk for heart disease in women.

So, what can women do?

Every woman has a different level of baseline cardiovascular and metabolic risk pre-menopause. This is based on their genetics and family history, diet, and lifestyle. But all women can reduce their post-menopause heart risk with:

  • regular moderate intensity exercise such as brisk walking, pushing a lawn mower, riding a bike or water aerobics for 30 minutes, four or five times every week
  • a healthy heart diet with smaller portion sizes (try using a smaller plate or bowl) and more low-calorie, nutrient-rich foods such as vegetables, fruit and whole grains
  • plant sterols (unrefined vegetable oil spreads, nuts, seeds and grains) each day. A review of 14 clinical trials found plant sterols, at doses of at least 2 grams a day, produced an average reduction in serum LDL-C (bad cholesterol) of about 9–14%. This could reduce the risk of heart disease by 25% in two years
  • less unhealthy (saturated or trans) fats and more low-fat protein sources (lean meat, poultry, fish – especially oily fish high in omega-3 fatty acids), legumes and low-fat dairy
  • less high-calorie, high-sodium foods such as processed or fast foods
  • a reduction or cessation of smoking (nicotine or cannabis) and alcohol
  • weight-gain management or prevention.
Women walking together outdoors with exercise clothes and equipment
Exercise can reduce post-menopause heart disease risk. Monkey Business Images/Shutterstock

What about hormone therapy medications?

Hormone therapy remains the most effective means of managing hot flushes and night sweats and is beneficial for slowing the loss of bone mineral density.

The decision to recommend oestrogen alone or a combination of oestrogen plus progesterone hormone therapy depends on whether a woman has had a hysterectomy or not. The choice also depends on whether the hormone therapy benefit outweighs the woman’s disease risks. Where symptoms are bothersome, hormone therapy has favourable or neutral effects on coronary heart disease risk and medication risks are low for healthy women younger than 60 or within ten years of menopause.

Depending on the level of stroke or heart risk and the response to lifestyle strategies, some women may also require medication management to control high blood pressure or elevated cholesterol levels. Up until the early 2000s, women were underrepresented in most outcome trials with lipid-lowering medicines.

The Cholesterol Treatment Trialists’ Collaboration analysed 27 clinical trials of statins (medications commonly prescribed to lower cholesterol) with a total of 174,000 participants, of whom 27% were women. Statins were about as effective in women and men who had similar risk of heart disease in preventing events such as stroke and heart attack.

Every woman approaching menopause should ask their GP for a 20-minute Heart Health Check to help better understand their risk of a heart attack or stroke and get tailored strategies to reduce it.

Treasure McGuire, Assistant Director of Pharmacy, Mater Health SEQ in conjoint appointment as Associate Professor of Pharmacology, Bond University and as Associate Professor (Clinical), The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Apple vs Blackberries – Which is Healthier?
    Our Verdict When comparing apple to blackberries, we picked the blackberries. Why? It wasn’t close today: In terms of macros, apples have slightly more carbs while blackberries have 2x the fiber, so that’s an easy win for blackberries in this category. In the category of vitamins, apples have slightly more vitamin B6, while blackberries have…

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  • Tired, Heavy Legs After Just A Few Minutes? Try This

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Alyssa Kuhn, physio, weighs in with professional tips:

    It’s about efficiency

    Feeling like your legs are heavy, sluggish, or tiring easily is often not just a normal part of aging; it can indicate that your leg muscles are not working efficiently, making movement feel more difficult.

    Making things worse, when these muscles are inactive or weak, blood can pool in your lower legs, contributing to a heavy sensation. However, when moving (even without great exertion), your leg muscles act as a pump, helping return blood from your lower legs back to the rest of your body.

    This, in turn, improves circulation, stamina, and ease of movement.

    So, how to do it? Here are four good ways:

    1. Alternating heel lift with a weight shift: shift your weight onto one leg while lifting the opposite heel, keeping your toes on the floor, then alternate sides.
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    For more on all of this plus visual demonstrations, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like:

    Can’t Squat? Try This Instead For Stronger Legs

    Take care!

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  • Pajama Pilates – by Maria Mankin

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    If The Science Of Pilates was a bit more information than you wanted to get up and running with Pilates at home, then this book offers a much easier way in.

    As the name suggests, it’s all about convenience, and making things as easy as possible while enjoying the gradual cumulative gains that come when one practises even just a little every day instead of thinking “well I would, but I have to read all this technical stuff and get changed and clear a space and…”, and thus results in meaningful improvements to mobility and strength over time.

    The 40 exercises promised by the subtitle are demonstrate via cute illustrations, of which the cover art is a good representative example. There’s nothing unduly technical here, and yet everything is quite clear. There are also simple practical explanations for each, as well as an initial overview of Pilates as a whole, its principles and necessary knowledge and so forth.

    Bottom line: if you’d like to get into Pilates but it has seemed sufficiently taxing that you’ve never quite got started, or if you did then it didn’t stick, then this book can make things easier.

    Click here to check out Pajama Pilates, and get ready to pajama Pilates party!

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  • The Longevity Formula – by James Smart

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This book is, notwithstanding the title, less a formula and more a long list of actionable things one can do to improve one’s healthy longevity, which list is then summarized at the end in a chapter entitled “101 science-backed methods for increasing your lifespan and achieving long-term wellness”.

    We see the usual items of understanding what causes/promotes aging, and thus how to fight that with diet, exercise, rest, and healthy habits in general (e.g. fasting, hot/cold therapy, vagus nerve stimulation, breathing exercises, etc), as well as medical practices (e.g. allergy testing, stem cell injection, blood glucose monitoring, etc), plus complementary therapies that have at least some scientific backing.

    The style is a little “salesy” despite not actually selling anything beyond ideas, but it’s all sound advice. There are short-form in-line citations, there’s a full bibliography at the back.

    Bottom line: if you’d like a lot of healthy longevity tips packed into a 200-page book, this is it.

    Click here to check out The Longevity Formula, and optimize your healthy lifespan!

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  • Cordyceps: Friend Or Foe?

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    Cordyceps: friend or foe?

    Cordyceps is a famously frightening fungus. It’s the one responsible for “zombie ants” and other zombie creatures, and it’s the basis for the existential threat to humanity in the TV show The Last of Us.

    It’s a parasitic fungus that controls the central and peripheral nervous systems of its host, slowly replacing the host’s body, as well as growing distinctive spines that erupt out of the host’s body. Taking over motor functions, it compels the host to do two main things, which are to eat more food, and climb to a position that will be good to release spores from.

    Fortunately, none of that matters to humans. Cordyceps does not (unlike in the TV show) affect humans that way.

    What does Cordyceps do in humans?

    Cordyceps (in various strains) is enjoyed as a health supplement, based on a long history of use in Traditional Chinese Medicine, and nowadays it’s coming under a scientific spotlight too.

    The main health claims for it are:

    • Against inflammation
    • Against aging
    • Against cancer
    • For blood sugar management
    • For heart health
    • For exercise performance

    Sounds great! What does the science say?

    There’s a lot more science for the first three (which are all closely related to each other, and often overlapping in mechanism and effect).

    So let’s take a look:

    Against inflammation

    The science looks promising for this, but studies so far have either been in vitro (cell cultures in petri dishes), or else murine in vivo (mouse studies), for example:

    In summary: we can see that it has anti-inflammatory properties for mice and in the lab; we’d love to see the results of studies done on humans, though. Also, while it has anti-inflammatory properties, it performed less well than commonly-prescribed anti-inflammatory drugs, for example:

    ❝C. militaris can modulate airway inflammation in asthma, but it is less effective than prednisolone or montelukast.❞

    Source: Effects of the immunomodulatory agent Cordyceps militaris on airway inflammation in a mouse asthma model

    Against aging

    Because examining the anti-aging effects of a substance requires measuring lifespans and repeating the experiment, anti-aging studies do not tend to be done on humans, because they would take lifetimes to perform. To this end, it’s inconvenient, but not a criticism of Cordyceps, that studies have been either mouse studies (short lifespan, mammals like us) or fruit fly studies (very short lifespan, genetically surprisingly similar to us).

    The studies have had positive results, with typical lifespan extensions of 15–20%:

    Against cancer

    Once again, the studies here have been in vitro, or murine in vivo. They do look good though:

    In vitro (human cell cultures in a lab):

    In vivo (mouse studies):

    Summary of these is: Cordyceps quite reliably inhibits tumor growth in vitro (human cell cultures) and in vivo (mouse studies). However, trials in human cancer patients are so far conspicuous by their absence.

    For blood sugar management

    Cordyceps appears to mimic the action of insulin, without triggering insulin sensitivity. For example:

    The anti-hyperglycemic activity of the fruiting body of Cordyceps in diabetic rats

    There were some other rat/mouse studies with similar results. No studies in humans yet.

    For heart health

    Cordyceps contains adenosine. You may remember that caffeine owes part of its stimulant effect to blocking adenosine, the hormone that makes us feel sleepy. So in this way, Cordyceps partially does the opposite of what caffeine does, and may be useful against arrhythmia:

    Cardiovascular protection of Cordyceps sinensis act partially via adenosine receptors

    For exercise performance

    A small (30 elderly participants) study found that Cordyceps supplementation improved VO2 max by 7% over the course of six weeks:

    Randomized double-blind placebo-controlled clinical trial and assessment of fermentation product of Cordyceps sinensis in enhancing aerobic capacity and respiratory function of the healthy elderly volunteers

    However, another small study (22 young athletes) failed to reproduce those results:

    Cordyceps Sinensis supplementation does not improve endurance exercise performance

    In summary…

    Cordyceps almost certainly has anti-inflammation, anti-aging, and anti-cancer benefits.

    Cordyceps may have other benefits too, but the evidence is thinner on the ground for those, so far.

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  • 5 ways climate change is making us all sick

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    What you need to know

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    • The health effects of climate change can harm everything from our heart and immune system to our mental health and ability to sleep. 
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    Our environment influences our health—especially the climate. Climate change fuels extreme temperatures, severe weather, poor air and water quality, and carriers of infectious diseases, all of which have negative impacts on our overall health.

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    “In the United States, an estimated 1,600 deaths due to cardiovascular disease

    occurred annually [from 2008 to 2019] due to extreme heat exposure,” said Dr. Sameed Khatana, a cardiologist at Penn Medicine and the study’s lead author, in a University of Pennsylvania video

    Khatana found that the number of deaths could double or even triple in the coming decades if greenhouse gas emissions increase.

    Mental health

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    Many people experience stress and anxiety about the global climate crisis. A May American Psychiatric Association poll revealed that more than half of adults in the U.S. report climate anxiety, a persistent fear or stress about the climate. This anxiety is often worse for individuals with existing mental health conditions, about one in five U.S. adults.

    The mental health impact is even greater for people who have survived extreme climate events, which are increasingly common.

    “After [Hurricane] Katrina, we saw…rises in conditions like trauma-related disorders, anxiety, or depression,” said Dr. Jacob Lee, a psychiatrist and the chair of APA’s Committee on Climate Change and Mental Health, in an August interview.

    He added, “That’s kind of a pattern we see across a variety of other disasters that are becoming more frequent.”

    Additionally, people with existing mental health conditions are especially vulnerable to extreme heat, which can worsen symptoms. Difficulty regulating body heat is also a side effect of certain anti-psychotic and anti-depressant medications, making people taking them more susceptible to heat exhaustion and heat stroke. 

    Immune disease

    Climate change also takes a toll on the immune system, our body’s primary defense against disease. A 2024 review reported that climate stressors can damage the immune system. This leads to an increase in immune conditions, including allergies, asthma, and autoimmune diseases, which occur when the immune system mistakenly attacks healthy cells. 

    “Climate change derails the human immune system in two [key] ways: it breaks down the body’s defenses and also prevents the body from rebuilding them,” wrote Dr. Kari Nadeau, one of the study’s authors and professor of climate and population studies at Harvard University, in a STAT News opinion piece.

    “All these exposures damage the structures that have evolved to protect humans from infection, including the skin and the mucous membranes of the gut and lungs.”

    Similarly, a 2023 report suggests that a climate-related rise in pollutants, allergens, and disease-carrying organisms could lead to allergic and autoimmune conditions. Like previous studies, the paper emphasized that lower-income and marginalized communities “bear a disproportionate burden of climate change.”

    Sleep 

    Sleep is one of the most important—and most frequently neglected—components of health. Consistently getting enough sleep is linked to better overall health and lower risks of a host of chronic diseases. Unfortunately, climate change is also diminishing our ability to get a good night’s sleep.

    A June study found that warming temperatures increased rates of sleep apnea, a condition in which breathing pauses during sleep. The condition, which affects around 1 billion people worldwide, can lead to poor sleep quality, chronic sleepiness, and headaches during waking hours. 

    “If temperature keeps rising the way they project it to, the burden and prevalence of sleep apnea may double,” said Bastien Lechat, the study’s lead author and a senior research fellow at Flinders University in Australia, in an ABC News interview.

    An earlier study projected that rising global temperatures could result in people losing up to 58 hours—seven to eight nights—of sleep per year by the end of the century. The researchers emphasized that women, older adults, and individuals living in lower-income countries are most affected by climate-related sleep loss. 

    Infectious disease

    Climate change also creates ideal environments for organisms that cause and carry human diseases. Research suggests that climate change is accelerating the spread of a staggering number of infectious diseases. 

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    “The reality is that with the changes we’re seeing in climate, we have to be more prepared and more aware of the infections and the pathogens that we can be exposed to by being outside,” Dr. Manisha Juthani, the Connecticut Department of Public Health commissioner, told NBC News.

    This article first appeared on Public Good News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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  • Ageless Aging – by Maddy Dychtwald

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    Maddy Dychtwald, herself 73, has spent her career working in the field of aging. She’s not a gerontologist or even a doctor, but she’s nevertheless been up-to-the-ears in the industry for decades, mostly as an organizer, strategist, facilitator, and so forth. As such, she’s had her finger on the pulse of the healthy longevity movement for a long time.

    This book was written to address a problem, and the problem is: lifespan is increasing (especially for women), but healthspan has not been keeping up the pace.

    In other words: people (especially women) are living longer, but often with more health problems along the way than before.

    And mostly, it’s for lack of information (or sometimes: too much competing incorrect information).

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    The book answers a lot of important questions beyond the obvious “what diet/exercise/sleep/supplements/etc are best for healthy aging” (spoiler: it’s quite consistent with the things we recommend here, because guess what, science is science), questions like how best to prepare for this that or the other, how to get a head start on preventative healthcare for some things, how to avoid being a burden to our families (one can argue that families are supposed to look after each other, but still, it’s a legitimate worry for many, and understandably so), and even how to balance the sometimes conflicting worlds of health and finances.

    Unlike many authors, she also talks about the different kinds of aging, and tackles each of them separately and together. We love to see it!

    Bottom line: this book is a very good one-stop-shop for all things healthy aging. It’s aimed squarely at women, but most advice goes for men the same too, aside from the section on hormones and such.

    Click here to check out Ageless Aging, and plan your future!

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