Specialists at Quirónsalud Torrevieja Hospital explain how hormonal changes during perimenopause can affect cardiovascular health, emotional wellbeing and metabolism, and what women can do to reduce the associated health risks.
To mark World Menopause Day on 18 October, specialists at Quirónsalud Torrevieja Hospital are highlighting how the hormonal changes associated with menopause can begin several years before a woman’s final period, affecting far more than just gynaecological health.
From heart health and emotional wellbeing to metabolism, these changes can have a significant impact on women’s overall health. During perimenopause, many women begin experiencing irregular periods, hot flushes, sleep disturbances and physical and psychological changes, some of which may continue after menopause.
Perimenopause typically begins in a woman’s 40s, although it can start earlier or later and may last for several years. Menopause usually occurs between the ages of 45 and 55, with the average age in Spain being around 51. It is confirmed after 12 consecutive months without a menstrual period, provided there is no other medical explanation.
This marks the beginning of postmenopause, when cardiovascular prevention, bone health and maintaining muscle mass become particularly important.
How perimenopause and menopause affect heart health
Dr Silvia Silva, cardiologist at Quirónsalud Torrevieja Hospital, explains that oestrogen plays an important role in several processes linked to blood vessel function and metabolism. Fluctuating hormone levels during perimenopause, followed by a decline in oestrogen, can therefore influence cardiovascular health.
“During perimenopause, women may begin to experience changes in cholesterol levels, blood pressure and body fat distribution. This is why it is important to pay attention to cardiovascular health even while periods are still occurring, rather than waiting until menopause to start taking preventive measures,” Dr Silva explains.
During this transition, hormonal and age-related changes can contribute to increased abdominal fat, changes in blood lipid levels and a gradual rise in blood pressure, all of which may increase the risk of cardiovascular disease.
“Many women still associate cardiovascular disease primarily with men, when in fact it is also one of the leading causes of death among women. Perimenopause is an ideal time to check blood pressure, cholesterol, blood glucose levels and other cardiovascular risk factors,” she adds.
Dr Silva emphasises that following a balanced diet, exercising regularly, avoiding smoking and attending medical check-ups tailored to individual needs are essential steps towards protecting heart health.
Anxiety, irritability and insomnia: emotional changes can begin before menopause
Perimenopause can also affect emotional wellbeing. Hormonal fluctuations, disrupted sleep and other personal circumstances may contribute to irritability, anxiety, mood swings and difficulties with concentration.
Marine Bodin, psychologist at Quirónsalud Torrevieja Hospital, explains that many women begin experiencing symptoms during the menopausal transition while they are still having periods, meaning they do not always recognise the connection.
“During perimenopause, some women may experience changes in mood, increased irritability or difficulties sleeping and concentrating. However, these changes do not affect everyone in the same way. It is therefore important to consider not only physical symptoms, but also each woman’s personal, family and professional circumstances, stress levels and ability to cope with challenges,” Bodin explains.
Hot flushes and night sweats can disrupt sleep, leading to greater daytime fatigue and contributing to changes in mood.
Physical and sexual changes during this stage of life may also affect body image, self-esteem and sexual wellbeing, although their impact varies considerably from one woman to another.
“We should not assume that anxiety, insomnia or emotional distress are inevitable parts of menopause. When these symptoms persist or interfere with everyday life, it is important to explore their possible causes and seek professional support. Psychological care can help improve emotional wellbeing, develop effective coping strategies and address the challenges that may arise during this transition,” Bodin concludes.