What Menopause Has to Do With Your Heart — And Why the Timing Matters

Most women are surprised to learn that heart disease risk starts to rise during the menopause transition—not years later. According to the American Heart Association, the changes in hormones around perimenopause cause real shifts in cholesterol, blood sugar, blood pressure, and the way your body stores fat, especially around the abdomen. These shifts aren’t just “getting older.” They’re directly tied to dropping estrogen levels.

Researchers found that the steepest changes happen in the years leading up to the final menstrual period and the early years after it. This is when blood lipids rise, insulin resistance increases, and arteries begin to stiffen more quickly. It’s also when many women start noticing symptoms like hot flashes, sleep issues, and mood changes—symptoms that can be linked to higher cardiometabolic stress.

The good news: your body is highly responsive to prevention during this window. Lifestyle habits—nutrition, movement, stress support, sleep—have an even bigger payoff when started around perimenopause. And for some women, menopausal hormone therapy may offer cardiovascular benefits when begun before age 60 or within 10 years of their final period.

Understanding what’s happening physiologically removes the mystery—and gives you a clearer path forward. The menopause transition isn’t just an ending. It’s a powerful turning point for long-term heart health.

Citation: AHA Scientific Statement—Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention