Why women's hearts beat differently: Cardiovascular health during perimenopause

During perimenopause, the risk of cardiovascular diseases increases. This is due to declining estrogen levels, which can negatively affect cholesterol levels and blood vessels. But why is this the case? Aren't the menopause years just a natural phase? And what can women do to protect their hearts?

Heart disease is one of the leading causes of death in older age. One might think that this area has been extensively researched, but gender-specific differences have only been studied more intensively in recent years. The campaign "Women's Hearts Beat Differently" draws attention to this research gap.

Particularly, women with severe menopause symptoms should take them seriously. Studies show that these symptoms are associated with an increased risk of cardiovascular diseases. A healthy lifestyle pays off in more ways than one!

The influence of hormones

Estrogen protects blood vessels and fat metabolism. When estrogen levels decline, this can have the following effects:

• Changes in blood vessels:
  • The vessels become stiffer, which can raise blood pressure.
  • The risk of arteriosclerosis (hardening of the arteries) increases.
• Increased cholesterol levels:
  • The ratio of "good" HDL cholesterol to "bad" LDL cholesterol shifts.
• Changes in sugar metabolism:
  • Insulin sensitivity may decrease, increasing the risk of type 2 diabetes.
• Higher risk of high blood pressure:
  • Blood pressure rises in many women.
• Changes in heart rate:
  • Palpitations or rapid heartbeat can occur.

Women’s hearts beat differently

There is an urgent need for more education and gender-specific research, including in medical training. These differences are still insufficiently considered in medicine, which can lead to misdiagnoses.

• Women's hearts are smaller and beat faster.
• The coronary arteries are finer.
• Women’s hearts become stiffer with age, while men’s hearts tend to grow larger.
• The symptoms of heart disease differ between men and women.

Recognizing and taking symptoms seriously

Common symptoms in women include:

• Palpitations
• Rapid heartbeat
• Heart skips or irregular beats
• High blood pressure
• Dizziness
• Nausea
• Panic attacks
• Chest tightness

Take these symptoms seriously and consult a doctor if they persist or are severe.

Differences between women’s and men’s hearts

Men often experience the classic chest pain during a heart attack. However, women more frequently experience symptoms such as:

• Palpitations, racing heart, irregular heartbeat
• Chest tightness, nervousness, panic attacks
• Lower abdominal pain
• Chest pain
• Sore throat
• Nausea
• Dizziness
• Persistent fatigue
• Shortness of breath
• High blood pressure

Additionally, women tend to wait longer than men before calling for emergency help (in Germany, this averages around 2 hours). Also, heart attacks in younger women are still often detected later and less accurately.
Heart issues such as palpitations, chest tightness, and racing heart are typically short-lived and disappear as suddenly as they arrive. However, if these symptoms persist unusually long or occur very frequently, it’s advisable to consult a doctor.

Further possible causes to investigate

It is important to also consider other potential causes for the symptoms. Symptoms like fatigue or palpitations can not only indicate heart issues but may also be triggered by other factors, such as:

• Thyroid dysfunction: An overactive or underactive thyroid can cause symptoms similar to heart problems.
• Anxiety disorders: Psychological stress and anxiety can manifest physically, leading to symptoms such as palpitations, racing heart, or shortness of breath.
• Anemia: A lack of red blood cells can lead to fatigue, weakness, and shortness of breath.

This is why it can be difficult for general practitioners to correctly interpret symptoms in women. The diverse and often nonspecific signs women exhibit during heart conditions can easily be mistaken for other health problems or psychological stress.

To address this challenge, specialized heart centers in some cities offer dedicated women's consultation hours. These centers provide targeted diagnostics and therapies tailored to the unique aspects of the female cardiovascular system. Experts work here who focus on gender-specific differences, ensuring optimal care and treatment.

Why stress reduction is so Important: when heart pain really comes from the heart

The "Broken-Heart Syndrome", also known as Takotsubo Cardiomyopathy, is a heart condition that can actually be triggered by emotional stress. Typically, it occurs after a traumatic event such as the loss of a loved one, a breakup, a serious illness, or even after extreme joy.

The symptoms are similar to those of a heart attack:

• Sudden, intense chest pain
• Shortness of breath
• Heart palpitations

However, unlike a heart attack, the coronary arteries are not narrowed or blocked in Broken-Heart Syndrome. Instead, there is a temporary dysfunction of the heart muscle, particularly the left ventricle, which balloons outward.

Proactive action: Prevention is key

Instead of staying passive, women should actively protect their heart health. A healthy lifestyle and regular health check-ups are essential to counteract risk factors such as high cholesterol, diabetes, or high blood pressure and to prevent heart attacks or strokes.

Healthy Lifestyle:

• Regular Exercise: At least 150 minutes of moderate exercise per week.
• Heart-Healthy Diet: Eat plenty of fruits, vegetables, whole grains, and healthy fats.
• Adequate Sleep: 7-9 hours per night.
• Stress Reduction: Relaxation techniques such as yoga or meditation.
• Avoid Smoking and Limit Alcohol Consumption.
• Potassium and Magnesium-Rich Foods: Bananas, potatoes, nuts, dark chocolate.

Regular Health Check-ups: Early Detection is Crucial

• Blood Tests: Check cholesterol and blood sugar levels.
• ECG (Electrocardiogram): monitors heart rhythm.
• Imaging Procedures: For example, coronary calcium score to assess artery health.
• Blood Pressure Measurements: Regular monitoring.

When is High Blood Pressure Diagnosed?

The following guidelines apply for measurement:

• 120/80: Optimal blood pressure
• 130/90: Normal blood pressure
• 140/90: High-normal blood pressure
• 160/100: Mild hypertension
• 180/110: Moderate hypertension
• 180/110: Severe hypertension

Medical Support

In some cases, hormone therapy or the use of medication to lower cholesterol or regulate blood pressure may be beneficial. Discuss this with your doctor

The Role of Fitness Trackers

Fitness trackers, smartwatches, and AI-powered programs can help keep track of heart health. They allow for long-term monitoring of changes.

Conclusion

Maintaining heart health through lifestyle changes, regular check-ups, and the use of modern technology can significantly reduce the risks of heart disease.