Starting Menopause Later Linked to Lower Stroke, Heart Attack Risks

• Cardiovascular risk goes up after menopause due to declining estrogen levels.
• However, females who enter menopause later have less risk of heart attack and stroke.
• A study found that later-onset menopause is linked to lower oxidative stress and improved endothelial function.
• Experts say it’s important to manage blood pressure, cholesterol, and blood sugar as you age.
• Stress reduction, good sleep, a healthy diet, and regular exercise can also help maintain heart health.

Could the age of menopause onset affect heart health?

According to a new study, females who started menopause at ages 55 and older had healthier cardiovascular systems than those who stopped menstruating earlier.

The authors explained that reduced levels of certain triglyceride-derived lipid metabolites contributed to lower oxidative stress, which leads to improved endothelial function.

When there is endothelial dysfunction, blood flow to the heart is restricted, which may lead to heart attacks in females.

The authors of the new study say that understanding these factors could help physicians personalize female patients’ care throughout their lifetimes, reducing their risk of heart disease.

The authors explained it’s already known that females’ risk of early heart attack and stroke risk is lower than males. However, after females reach menopause, the risk rises to the same level as males.

Additionally, a female’s age at menopause makes a difference. If she starts menopause at 55 or older, her likelihood of developing heart disease is 20% lower than someone who stops having their menstrual cycle at a younger age.

The authors of the recent study wanted to find out why.

To do this, the researchers measured the brachial artery flow-mediated dilation of 92 females to see how the artery in their upper arms could dilate when blood flow increased. They also measured their mitochondrial health and ran hormone tests to confirm menopause.

Finally, they conducted analyses to determine what factors contributed to differences in mitochondrial reactive oxygen species bioactivity and endothelial function.

However, there was a difference between the late-onset menopause group and those who stopped menstruating earlier. The late-onset group had 24% worse vascular function than premenopausal females, while the normal-onset group had 51% worse vascular function than premenopausal females.

It was also noted that these differences lasted for five years or more beyond menopause.

This led the authors to speculate that women who go through later menopause are protected from the vascular dysfunction that can arise from oxidative stress.

Noor Dastgir, MD, a cardiologist with Oladoc, said estrogen helps protect the cardiovascular system.

“It helps maintain blood vessel flexibility and regulates cholesterol levels,” he told Healthline.

According to Dastgir, this is why later menopause can benefit females.

“Traditional risk factors for the development of cardiovascular disease include smoking, high blood pressure, diabetes, high cholesterol, and obesity,” she told Healthline.

Menopause accelerates this risk, Trivedi explained, especially if females begin menopause before the age of 40.

Trivedi added that the typical menopause symptoms — such as sleep and mood disturbances, weight gain, and decreased energy — can make females less active, which also increases these traditional risk factors.

Michelle Routhenstein, a preventive cardiology dietitian and certified diabetes educator at EntirelyNourished.com, said the study’s findings are important since they help us understand how the timing of menopause affects heart health.

“It also opens the door for further studies and conversations with healthcare providers about whether hormone replacement therapy (HRT) could be a helpful option for those who go through menopause early,” she told Healthline.

Routhenstein added there are also other proactive steps females can take to improve their cardiovascular health.

“To reduce the risk of heart attacks and strokes as we age, women should monitor and optimize all their cardiometabolic risk factors — such as blood pressure, cholesterol, and blood sugar,” she said.

Additionally, females can work to prioritize their heart health and endothelial function through:

“A nutrient-adequate diet is focused on improving endothelial health, addressing oxidative stress, inflammation, and insulin resistance that may arise during the menopausal transition,” Routhenstein said.

A new study reports that later-onset menopause is associated with a reduced risk of cardiovascular compared to those who stop menstruation at an earlier age.

The study’s authors reported starting menopause later is linked to less oxidative stress and, therefore, healthier blood vessels.

Experts say hormone replacement therapy could potentially help women who go through early menopause.

Additionally, it is important to manage risk factors for heart disease, such as maintaining healthy blood pressure, cholesterol, and blood sugar levels.