The Age You Reach Menopause Could Play a Role in Your Future Heart Health, Study Finds
A new study suggests that late-onset menopause is linked to better heart health as you age—here's why
- People who start menopause later in life tend to have healthier blood vessels, new research found.
- Researchers are still investigating the link between late-onset menopause and better heart health, though estrogen, lipid levels, and oxidative stress may all play a role.
- While you can’t control menopause, experts said regular exercise, quality sleep, and a healthy diet can help protect your heart as you age.
Menopause can cause significant changes in the body—and according to new research, the age a person goes through this transition could be indicative of either better or worse heart health.
A study published on Jan. 31 in Circulation Research found that women who stopped menstruating later in life had healthier blood vessels and were much less likely to have heart attacks and strokes in their postmenopausal years as compared to those who went through menopause earlier.
The researchers also found that women who started menopause later had better lipid (fat) levels and fewer oxidative stress markers in their blood, which could explain this gap in heart health.
“Our paper identifies that there’s actually a physiological benefit to later-onset menopause and is one of the first to identify the specific mechanisms driving these benefits,” first author Sanna Darvish, a PhD candidate in the department of Integrative Physiology at the University of Colorado, Boulder, said in a press release.
Most people begin menopause between the ages of 45 and 55—the average age of menopause in the U.S. is 52. However, about 10% go through late-onset menopause, meaning they start the menopause process when they’re older than 55 years of age, Nidhi Mehta, MD, a cardiologist with the Lehigh Valley Health Network and assistant director of the Women’s Heart Program at Lehigh Valley Heart and Vascular Institute, told Health.
Here’s what to know about the study and the connection between menopause and heart health—including what you can do to protect your heart as you age.
Late-Onset Menopause and Risk of Heart Disease
For this study, researchers included 21 premenopausal women and 71 postmenopausal women in their analysis—this latter group was further split into a “normal-onset” or “late-onset” menopause group based on when they stopped menstruating.
To assess participants’ heart and blood vessel health, the researchers used a measure called brachial artery flow-mediated dilation, which provides a glimpse into how well the main blood vessel in the upper arm (the brachial artery) dilates as blood flow increases.
They then looked at the health and function of participants’ mitochondria—energy-producing organelles—in their blood vessel cells. Finally, the team also examined levels of hormones, lipids, and other molecules in the blood.
As researchers expected, all of the postmenopausal women had worse blood vessel function than their premenopausal counterparts. This can be explained by drops in estrogen and other normal changes in aging—blood vessels tend to become stiffer over time.
Additionally, as we age, mitochondria decline and often generate more damaging molecules called free radicals. Free radicals are normally balanced out by antioxidants. But when there are too many free radicals in the body, it can lead to oxidative stress, and subsequently, diseases such as diabetes and cardiovascular disease.
However, the researchers noticed that people in the late-onset menopause group appeared to have some protection against this age-related decline in vascular health.
The blood vessel function of participants with normal-onset menopause was 51% worse than the premenopausal group. It was only 24% worse, however, for the late-onset menopause group. This gap in blood vessel function held for at least five years after the participants completed menopause.
Women in the late-onset menopause group also had better mitochondria function, meaning fewer free radicals and less oxidative stress. They also had “more favorable” levels of certain lipids in their blood.
“Our data suggest that women who complete menopause at a later age have a kind of natural inherent protection from vascular dysfunction that can come from oxidative stress over time,” senior study author Matthew Rossman, PhD, assistant research professor in the department of Integrative Physiology at the University of Colorado, Boulder, said in a press release.
Why Does Menopause Have an Effect on Heart Health?
Though study participants who went through late-onset menopause had relatively better heart health, all women are at a greater risk for heart disease once they go through menopause.
This largely has to do with estrogen, experts agreed.
Estrogen is a known protector against heart disease. Once someone experiences a drop in estrogen levels during menopause, “they begin to lose that protective effect,” said Kimberly Skelding, MD, division chief of cardiovascular services for RWJBarnabas Health’s Jersey City Medical Center.
As a result, many women going through menopause will see increases in their blood pressure and cholesterol, even if their activity level and diet do not change, Skelding told Health.
So it’s not a shock that women who go through menopause later in life have better heart health, added Brittany Owen, MD, cardiologist at UTHealth Houston.
“The more time you are still producing estrogen, the more cardiac protection you get,” she told Health. “The function of the walls of the coronary arteries is [better] prior to menopause. So the longer you stay out of menopause, the more resilient the coronary arteries are against oxidative stress and heart attacks.”
Previous research has shown that estrogen may play some role in keeping mitochondria and blood vessels functioning properly. However, further research needs to be done on “the actual mechanisms behind estrogen being cardioprotective,” Owen said.
That means it’s also not clear whether estrogen-based hormone therapy might be a treatment for blood vessel dysfunction or oxidative stress associated with menopause, Mehta added.
However, further investigating this possible link between estrogen, oxidative stress, and blood vessel function could be key to protecting women’s heart health as they age.
“If we understand what exactly the protective mechanism of estrogen is in the premenopausal state, we could possibly utilize this to decrease the likelihood of having heart attacks and strokes,” said Skelding.
Protecting Your Heart During Menopause and As You Age
Though questions still remain, the American College of Cardiology and American Heart Association have recognized age at menopause as a risk-modifying factor for cardiovascular disease in postmenopausal people.
In most cases, when you start menopause is out of your control. However, protecting and maintaining your heart health during and after menopause is largely a matter of taking the usual steps to stay healthy.
That includes eating a healthy diet, increasing your intake of fruits and vegetables, and reducing your consumption of meat and cheese, Skelding said. It also means keeping an eye on your cholesterol numbers, Mehta said.
“It’s important to stay active,” Owen added. “Exercise at least 30 minutes [per] day most days of the week—both cardio and weight training—to maintain good cardiovascular health regardless of your menopause status.”
Along with exercise, getting enough sleep is also crucial for heart health. This can be easier said than done during menopause, thanks to insomnia, night sweats, and other symptoms. Still, it’s important to do whatever you can to get a restful night’s sleep and practice good sleep hygiene, including sticking with a regular sleep schedule and limiting use of electronic devices before bed.
Julia Landwehr
Julia is the associate news editor for Health, where she edits and publishes news articles on trending health and wellness topics. Her work has been featured in The Heights, an independent student newspaper at Boston College, and Minnesota Monthly.
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This story originally appeared on: Health News - Author:Elizabeth Yuko, PhD
