How menopause affects heart health—and what women can do to stay healthy

As women around the world celebrate International Women’s Day, it’s crucial to shed light on an often-overlooked aspect of women’s health: the impact of menopause on heart health. Menopause, a natural biological transition, brings hormonal changes in women that can increase the risk of cardiovascular diseases, according to experts.

With heart disease being a leading cause of mortality among women, understanding how menopause affects heart health and adopting preventive measures is more important than ever. Experts emphasise that a proactive approach—through diet, exercise and regular health check-ups—can help women deal with it.

Dr Neha Gupta, Additional Director, Obstetrics & Gynecology at Fortis Hospital (Noida) cited studies saying that in India more women die of heart disease than of breast cancer and other cancers combined.

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“During menopause, declining estrogen levels increase cardiovascular disease risk. Estrogen protects the cardiovascular system by helping blood vessels relax and dilate, improving blood flow. It also lowers LDL (bad cholesterol) and raises HDL (good cholesterol). The drop in estrogen leads to higher blood pressure, worsened lipid profiles, and inflammation in blood vessels,” said Dr Neha.

What women can do

To reduce the risk of cardiovascular disease during menopause, women can:

2. Maintain a healthy weight: A body mass index (BMI) between 18.5 and 24.9 is desirable. To calculate your body mass index (BMI), you can divide your weight in kilograms by your height in meters squared.

3. Exercise regularly: Regular exercise can help lower blood pressure and cholesterol levels. At least 150 minutes of moderate-intensity exercise per week, which can be broken down into 30 minutes of exercise five days a week, ideally including a mix of both cardiovascular activity and strength training exercises at least twice a week to maintain muscle mass and bone density.

4. Eat a heart-healthy diet: Focus on whole, unprocessed foods like fruits, vegetables, whole grains, and lean proteins.

5. Avoid smoking

6. Manage stress: Chronic stress and depression can increase the risk of cardiovascular disease; try techniques like meditation or yoga.

7. Regular health check-ups: Regular health check-ups can help identify cardiovascular risk factors like diabetes early.

According to Dr Archana Dhawan Bajaj, Gynecologist, Obstetrician and IVF expert, Nurture IVF clinic (New Delhi) said “Most people’s risk of heart disease grows with age, but this is especially true for women. During menopause, women are more vulnerable to heart disease and stroke than at any other stage of life. It’s crucial to address these risks early.”

Dr Bajaj said that menopause, typically occurring in women in their 40s or 50s and being heart-healthy before menopause can reduce later risks. Studies show that maintaining heart health during menopause lowers the risk of irregular heart rhythms (atrial fibrillation) later in life.

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“Stressful life events, insomnia, and obesity—especially in women experiencing late menopause at 55 or older—increase heart failure risks. Women who enter menopause by 40 have a 40% higher lifetime risk of coronary heart disease compared to those who don’t,” she said.

“Heart attack symptoms in women often differ, including chest tightness, exhaustion, shortness of breath, or pain in the back, neck, arm, or jaw. To defend against heart disease, adopt a nutritious diet, exercise regularly, maintain a healthy weight and avoid smoking. Postmenopausal women should stay active, eat well and manage risk factors to reduce future heart problems," she added.

Talking about key issues post-menopause, Dr Astha Dayal, Director - Obstetrics and Gynaecology, CK Birla Hospital (Gurugram) said “It includes increased blood pressure, arterial stiffness, metabolic changes leading to insulin resistance (a risk factor for diabetes), and greater abdominal fat deposition, further raising cardiovascular risks,”.

Dr Dayal emphasised that women can take proactive steps to protect their heart health during and after menopause: eating a heart-healthy diet rich in fruits, vegetables, whole grains, and healthy fats and engaging in at least 150 minutes of moderate exercise weekly, such as walking, yoga or strength training.

Dr Parinita Kaur, Principal Consultant and Unit Head - Internal Medicine, Max Super Speciality Hospital (Dwarka) said that women undergo hormonal changes during their lifetime, particularly during menarche and menopause.

To prevent heart ailments, Dr. Kaur emphasised maintaining a healthy lifestyle: eating a balanced diet rich in omega fatty acids (flaxseeds, salmon, almonds, walnuts) and calcium (skimmed or toned milk), exercising 45 minutes daily (cardio, brisk walking, yoga, or strength training), and avoiding smoking and alcohol.”

“Women are more likely than men to develop heart disease later in life, largely due to the hormone estrogen, which also plays a key role in reproduction. After menopause, estrogen levels drop and subsequently increase heart disease risk. Menopause affects heart health in several ways: adverse changes in cholesterol levels, elevated blood pressure, weight gain (especially abdominal obesity), increased risk of type 2 diabetes, altered blood vessel function, higher risk of metabolic syndrome and a greater likelihood of spontaneous coronary artery dissection (SCAD). Poor sleep during peri-menopause, linked to estrogen depletion also raises heart disease risk," said Dr. Rajendra Patil, Consultant - Cardiology, Jupiter Hospital, Baner (Pune).