Because the risk of coronary heart disease increases with age, women will have increased risk once they reach menopause. Therefore, it is important to take good care of your heart to keep it strong.

Menopausal Women

Menopausal women or the golden girls will no longer have their period permanently for at least one year. The average age of menopause is 50 years old or between 45 to 55 years old. There are two types:

1. Natural menopause is when the ovaries stop working naturally in women who are over 40 years old; and
2. Surgical menopause is when both ovaries are removed and can happen in women younger than 40 years old.

Symptoms of Menopause

The ovaries are responsible for producing the female hormone estrogen for various organs in the body. Once women reach menopause, the ovaries will stop working and the production of female hormones will decrease, leading to menopausal symptoms due to lack of female hormones, such as:

• Hot flashes
• Bodily aches and pains
• Sleeplessness
• Mood swings
• Depression

These symptoms will start showing up about 3 – 4 years prior to and after menopause. The period and severity will differ for each woman. Some may not experience any symptom at all. Other symptoms due to insufficient female hormones include osteoporosis, dry vagina, difficulty urinating.

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Menopause and the Risk of Heart Disease

Menopausal women are at increased risk of coronary heart disease because the female hormones help reduce bad lipids and increase the good lipids in the blood. They also prevent cholesterol from attaching to the arterial walls and keep them flexible. Once these hormones decrease, there is an increased risk of atherosclerosis or clogged arteries as well as the vessels feeding the heart and brain.

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Signs of Arterial Disease

Arterial disease can occur anywhere in the body. Symptoms depend on the severity of the condition and the organs it affects. For example:

• • Coronary artery can lead to ischemic heart disease and manifests as chest pain from the center radiating down the left arm, mandible, or shoulder. Patients may experience fatigue and difficulty breathing.
  • Cerebral artery which feeds the brain can manifest as limb weakness on one side, drooping mouth, and slurred speech.
  • Femoral artery will cause aches and pain while walking.

If they condition is not severe, there may not be any symptoms. In any case, coronary heart disease can lead to sudden cardiac arrest even if the occlusion is minor and there are no symptoms, especially if other factors are involved, such as stress, sleeplessness or other conditions that cause bodily stress. These will induce rupture of the plaque in the coronary artery.

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Check for Arterial Disease

Atherosclerosis or clogged arteries in various organs can be diagnosed as follows:

• Coronary artery, even when asymptomatic, can be viewed by a technique called coronary artery calcium scan or CAC. When symptomatic, a CT angiography coronary artery including cardiac output by other methods can be performed based on the indication and the doctor’s discretion.
• Cerebral artery can be examined using carotid duplex ultrasound.
• Peripheral arteries to the legs and arms can be examined by checking blood flow via ankle brachial index or ABI.

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Treatment for Arterial Disease

If symptoms are not too severe, treatment with medication, such as anti-cholesterol, can be given to reduce or prevent more atherosclerotic lesions. These anti-cholesterol medications, including blood thinners and other condition-related medications, can also prevent acute ischemic heart disease. If the symptoms are severe, a balloon or a stent can be inserted. Alternatively, a heart bypass surgery can also be performed. All of these will reduce the risk of paralysis and death, while decreasing symptoms and increasing the quality of life. Each person will receive individualized treatment plan based on the cardiologist’s assessment.

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Prevention of Arterial Disease

• Annual physical exam as indicated
• Cardiac assessment if there is any indication
• Eat healthy meals with reduced sugar, salt, and fat
• Exercise regularly, with moderate to high cardio exercise at least 150 minutes per week.
• Get enough rest
• Decrease stress
• Control weight within the BMI limit
• Stop smoking
• In case of other health conditions, such as diabetes, hypertension, or hypercholesterolemia, try to keep them under control.

Women who are entering menopause should take note of some of the above-mentioned conditions. Self-observe for any signs and symptoms that may be out of place. Take good care of your health. Get an annual checkup to prevent and take care of chronic conditions, including your heart.