The Scary Menopause Side Effect No One's Talking About

Menopause  is a pain, literally and figuratively. It can cause hot flashes, mood swings,  brain fog , trouble sleeping and even  heart palpitations . The list goes on…and includes an under-discussed and seemingly random side effect: an increased risk of heart disease, the  number one cause of death in American women .

🩺 SIGN UP for tips to stay healthy & fit with the top moves, clean eats, health trends & more delivered right to your inbox twice a week 💊

"While many women associate menopause with physical symptoms, like  hot flashes  and night sweats caused by hormonal changes, they may be less familiar with the more subtle changes in cholesterol metabolism, body fat distribution and blood pressure regulation that can increase the risk for heart disease if left unchecked," explains  Dr. Hannah Rosenblum, MD,  a cardiologist and an assistant professor of cardiology at Columbia University Irving Medical Center.

Ahead, she and a couple of other doctors explain the connection and how you can protect your  heart health .

Related:  3 Weird Menopause Signs No One's Talking About

How Menopause Affects Heart Health

The first thing to know is that  estrogen  and cholesterol are connected.

Wait, what? "Estrogen has a protective effect on the heart and blood vessels," Dr. Rosenblum confirms. "As estrogen levels decrease during menopause, LDL (or 'bad' cholesterol) increases and HDL ('good' cholesterol) decreases."

That combination can  lead to a heart attack .

Further,  Dr. Asima Ahmad, MD, OB/GYN , the chief medical officer and co-founder of Carrot Fertility, explains that LDL clogs the arteries while HDL protects them. This can cause the arteries to become less elastic, leading to an increase in blood pressure. Hot flashes can also contribute to a higher risk of elevated blood pressure, she adds.

High blood pressure  starts with the systolic pressure (the upper number) at 130 mm HG and/or the diastolic pressure (the lower number) at 80 mm HG. This condition can contribute to a stroke, vision loss, heart or kidney failure, sexual dysfunction and more.

Collectively, these changes can increase the risk of atherosclerotic disease, Dr. Rosenblum says, and can even lead to a heart attack or stroke down the road. People who experience menopause before age 45 are especially at risk because they've had low estrogen levels for a longer period.

There's one more related condition to discuss. "Women in menopause are also more prone to a condition called 'metabolic syndrome,'" says  Dr. Amy Ahnert, MD ,a cardiologist and the director of the women's heart program at Morrisville Medical Center in the Atlantic Health System.

Metabolic syndrome is a combination of three of these five conditions: high triglycerides, low HDL, high sugar, high blood pressure and increased waist circumference. "Any of these conditions alone or in combination increases the risk of heart disease," she adds.

Related:  'I'm a Cardiologist—Here's How Women Can Cut Their Heart Disease Risk in Half'

6 Heart Health Tips for People Experiencing Menopause

To protect yourself from those dangers, doctors share how to keep your heart and body in tip-top shape.

1. Add nutrient-rich foods to your diet

Fresh vegetables, lean proteins and whole grains are all great for your heart and overall well-being, Dr. Ahmed says. Specific  heart-healthy foods  include oranges, tuna, green tea, berries, spinach, almonds and more.

2. Get enough (and the right kind of) exercise

Dr. Ahmad encourages moving your body daily, incorporating both strength training and weight-bearing exercises. To combine those, she encourages walking on an incline with a weighted vest.

As far as time and frequency, Dr. Rosenblum (and the U.S. Department of Health and Human Services) advise  150 minutes of moderate-intensity aerobic exercise a week or 75 minutes of high-intensity aerobic exercise a week  to "significantly lower the risk of heart disease."

If that sounds like a lot of something you don't enjoy, Dr. Ahnert wants to remind you that the gym isn't your only option—walking, swimming, dancing and  pickleball  are just a few other ways to move that may be more fun, especially when done with a friend.

3. Avoid smoking

According to the CDC , smoking is a major cause of cardiovascular disease (CVD); in fact, it's responsible for 25 percent of CVD deaths.

4. Monitor your risk factors

How are your  cholesterol levels ? What's your  blood pressure ? Are you at risk for diabetes? What's your A1c level? Discuss this ASAP and regularly with your healthcare provider.

"It's better to catch and address things earlier," Dr. Ahmad says.

5. Create a menopause management plan

Menopause symptoms may make you feel like crap, to put it bluntly. Rather than suffering through, make an appointment with a health professional. You two can think through how to manage your symptoms long-term and plan follow-ups for working through any kinks.

"For example, those with vasomotor symptoms or hot flashes have been shown to have a higher risk of high blood pressure and heart disease," Dr. Ahmad says. "Hormone therapy can be one way to manage vasomotor symptoms, while for some, it may also be protective for cardiovascular health."

Dr. Ahnert adds that research about whether hormone replacement therapy (HRT) can prevent heart disease—and the details about who, what and when—are ongoing.

Related:  The One Thing an OB/GYN is Begging Anyone with Unbalanced Hormones to Stop Doing ASAP

An important consideration regarding HRT is that it may cause harm. It's generally safe for women who have a low cardiovascular risk and start it within 10 years of starting menopause, Dr. Rosenblum says. However, it may be harmful when people start it at an older age or with a greater amount of time since the start of menopause. In those folks, it can increase the risk of blood clots and stroke. "You should always consult with a physician or medical provider before starting HRT," she concludes.

6. Treat related conditions

Menopause can also contribute to sleep disturbances and  depression , according to Dr. Ahnert. Treating these concerns, whether through medication, therapy or lifestyle changes may decrease cardiovascular risk too.

But again, every person's body is different, so don't ignore the importance of individualized treatment. Dr. Ahmad encourages talking to your provider about your current state of health, lifestyle, family history and goals.

Taking those steps can have a pretty significant impact. "It is estimated that  80 percent of heart disease is preventable ," Dr. Ahnert says. "Information is power."

Up Next:

Related: Menopause Hot Flashes Ruining Summer? Doctors Share What Actually Helps

Sources

• Dr. Hannah Rosenblum, MD,  a cardiologist

• Dr. Asima Ahmad, MD , an OB/GYN

• Dr. Amy Ahnert, MD , a cardiologist

• About Heart Disease in Women , American Heart Association

• LDL and HDL Cholesterol and Triglycerides , CDC

• What is High Blood Pressure? , American Heart Association

• Physical Activity Guidelines for Americans , U.S. Department of Health and Human Services

• Health Effects of Cigarettes: Cardiovascular Disease , CDC

• Prevention , World Heart Federation

The Scary Menopause Side Effect No One's Talking About first appeared on Parade on May 26, 2025