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Heart health: What's Menopause got to with it?

Dr. Safiya McCarter

A pair of hands holding a heart-shaped object.
A pair of hands holding a heart-shaped object.

The transition into perimenopause and menopause marks a significant shift in a woman’s health, particularly when it comes to cardiovascular health. While menopause is commonly associated with symptoms like hot flashes, mood changes, and sleep disturbances, one of the most critical—yet often overlooked—concerns is heart health. Cardiovascular disease (CVD) is the leading cause of death in postmenopausal women, making proactive heart care essential. Black women, in particular are at increased risk of cardiovascular disease (heart attack, stroke etc) and also have increased incidents of associated risk factors such as elevated blood pressure, diabetes, and higher rates of stress associated with racial discrimination.


Why should you pay particular attention during the perimenopausal/postmenopausal stage? As estrogen levels decline during perimenopause and menopause, the protective effects this hormone has on the cardiovascular system begin to wane. Estrogen helps maintain healthy blood vessel function, supports optimal cholesterol levels, and reduces inflammation. Without it, women face an increased risk of hypertension, atherosclerosis (clogged arteries), and metabolic changes that contribute to heart disease. More specifically, here are some of the changes that occur:


  • Increased Cholesterol Levels: LDL (“bad” cholesterol) tends to rise, while HDL (“good” cholesterol) often declines.

  • Higher Blood Pressure: Loss of estrogen can lead to stiffer arteries and elevated blood pressure.

  • Weight Gain & Insulin Resistance: Many women experience shifts in metabolism, leading to increased fat storage around the abdomen, a risk factor for CVD.

  • Inflammation & Oxidative Stress: A pro-inflammatory state can contribute to plaque buildup in arteries.


What can you do? Firstly, know your numbers! If you don't know your cholesterol levels, blood pressure or blood sugar levels, this is the perfect time to schedule an appointment to get these labs done, including those markers of inflammation. With regard to treatment, integrative medicine offers an approach that is specific to you based on your overall health profile. Remember, that what may have worked for someone else, may not work for you. Diet and nutrition are of course cornerstones of optimal health. In addition, sleep is critical (see my February 2021 blog post) and supplementation may have a place in your personalized plan.


Women’s cardiovascular health during perimenopause and menopause is an often-overlooked yet crucial component of overall well-being. By taking a proactive, integrative approach—balancing nutrition, exercise, stress management, and hormonal health—women can optimize heart health and thrive during this transformative stage of life. If you’re experiencing perimenopausal or menopausal changes and want a personalized strategy for cardiovascular wellness, schedule an appointment with me today! You deserve to have a tailored plan that meets your unique needs.


In health,

Dr. Safiya




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