Understanding Heart Disease

February 23, 2026

Tags: Heart Health, Cardiology, Women's Health

What Every Woman Should Know

Hot flashes, mood swings, and disrupted sleep are common topics of concern when a woman hits her midlife years, and hormonal changes take center stage. But there's another critical talking point that deserves just as much attention during this stage in life: heart health.

Hormonal shifts during perimenopause and menopause can significantly influence cardiovascular risk. Understanding that connection helps give women the knowledge they need to take proactive steps to protect their heart health.

“Hormonal changes in midlife can affect cholesterol, blood pressure and how the body stores fat, making them an important and often overlooked part of women’s heart health," said the Witham Cardiology Team (Zulfiqar A. Mirza, M.D., Bethany E. Reynolds, FNP-BC, and Carlyanne Wenzel, N.P.). "Understanding these changes helps women take proactive steps to protect their hearts.”

How Does Estrogen Protect Your Heart?

Estrogen plays a key role in how a woman’s cardiovascular system functions. This protection is one of the reasons they tend to develop heart disease later in life than men.

Estrogen:

Helps keep your blood vessels flexible
Supports healthy cholesterol levels
Reduces inflammation within artery walls

As estrogen levels fluctuate and eventually decline during perimenopause and menopause, their protective benefits begin to drop. Blood vessels may become stiffer, LDL ("bad") cholesterol may rise, and HDL ("good") cholesterol may drop. Inflammation throughout your body may increase. Any of these issues can increase a woman's risk of heart disease and heart attack.

“By supporting healthy blood vessels and cholesterol balance, estrogen offers important protection for cardiovascular health," said Witham Cardiology.

What are the Warning Signs of Heart Disease for Women?

Cardiovascular disease is the leading cause of death for women, causing 1 in 3 deaths every year, according to the American Heart Association. And yet, the warning signs are routinely overlooked, dismissed or ignored – often with life-changing consequences.

Heart disease red flags are distinctly different for women than they are for men. Men often describe the pain as “an elephant sitting on their chest,” while women may feel it as a dull, heavy chest discomfort or ache.

Other common heart disease symptoms for women include:

Pain in the jaw, neck, or throat
Upper abdomen or back pain
Nausea
Vomiting
Extreme fatigue that won’t go away or feels excessive

For some women, a heart attack is the first sign they have heart disease. Call 9-1-1 if you experience:

Severe chest pain
Upper back or neck pain
Severe indigestion and heartburn
Dizziness
Shortness of breath

“Never ignore symptoms like unusual fatigue, chest discomfort, or shortness of breath — trusting your instincts and getting checked matters," said Witham Cardiology.

How Do Perimenopause and Menopause Affect Heart Health?

Hormonal changes during perimenopause and menopause affect several heart-related risk factors. Although heart disease can occur before menopause, studies show the risk goes up dramatically as estrogen declines in the decade after menopause.

The transition into and through menopause significantly impacts heart health in several ways, including:

Cholesterol levels may change, with reduced “good” cholesterol (LDL) levels and higher “bad” cholesterol (HDL)
Blood pressure may go up
Metabolic changes affect weight distribution, leading to increased abdominal fat in midlife
Vascular inflammation increases with some hormone changes

Should Women be Screened for Heart Disease Differently than Men?

Because heart disease can present differently in women, there is no one-size-fits-all screening schedule. Talk to your doctor to determine the screenings and schedule that’s best for you.

Most guidelines recommend checking your blood pressure at least once a year and having cholesterol screening every 4 to 6 years. For women with risk factors such as a family history of heart disease or early menopause, a Heart Score CT Scan is one of the most advanced methods available to detect heart disease in its earliest stages.

“Heart disease risk isn’t the same for every woman; screenings should be personalized based on your health history, family history, and individual risk factors to ensure you get the right care at the right time," said Witham Cardiology.

How Does My Lifestyle Support Hormonal and Heart Health?

A healthy lifestyle is one of the most powerful tools for controlling cardiovascular risk.

To protect your heart health:

Don’t smoke
Get regular checkups and health screenings
Exercise regularly
Nurture your mental and emotional well-being
Eat a healthy diet consisting mainly of low-fat proteins, fresh fruit and vegetables, and whole grains
Maintain a healthy weight
Consume alcohol in moderation or not at all

“Consistent, sustainable habits like balanced nutrition, regular movement, good sleep, and stress management help support hormonal balance and protect your heart for the long term," said Witham Cardiology.

Expertise You Can Trust

The team of cardiology experts at Witham offers comprehensive heart care for women of all ages. We offer comprehensive, compassionate care, including preventive screenings, diagnostic testing and advanced treatments, interventional procedures, and cardiac rehabilitation. Whether you’re looking to better understand your heart health, manage symptoms or create a long-term plan, Witham Cardiology is here to support you every step of your health journey.

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