Menopause, A call for action by Yaduna
17 March 2022
Menopause is a natural phase
of a woman’s life cycle. The hormonal changes that occur during
menopause carry increased cardiovascular risks linked to inevitable
physiologic and metabolic alterations including higher blood pressure and
AS a custodian of women’s Heart Health, we in YADUNA
endeavor to stress the importance of this phase of women’s Health and call for
special attention to prevention and early diagnosis and intervention for
mitigating the changes that could impact their health.
Menopause is the
time that marks the end of a woman’s menstrual cycles. It's diagnosed after a
woman has gone 12 months without a menstrual period. The mean onset of
menopause is 50 years, however, there is an inter-individual variation, ranging
between 40 and 60 years. It is known that heart disease is more common in men
but, following the menopause, the risk increases in women with a significant
catch up. Studies have found that women with early menopause (45 and younger)
have excessive cardiovascular health issues later on than those who have menopause
closer to the normal age; this risk is higher among Women with family history
of heart diseases. If cardiovascular disease runs strongly in the family, the
risk is even higher. An overall rise in
heart attacks among women is seen about 10 years after menopause.
With onset of menopause, the ovaries gradually stop
producing estrogen. Estrogen, a hormone that regulates important protective cardiovascular functions and maintains
the wellbeing of the vessels and the heart. Hence lower hormonal levels can
bring an increased cardiovascular risk.
These hormonal changes can trigger increased
appetite, change in diet and can lead to obesity. Obesity may then cause
depression, which in turn enhances further food intake and sleep deprivation
and reduces physical activity.
Menopause results in lipid profile changes, with a 10–15% higher LDL-cholesterol and triglyceride levels and slightly lower HDL cholesterol levels. Sodium sensitivity frequently increases, as well, leading to intermittent fluid retention usually presenting as oedema of the legs, hands, and eyelids.
Gynecologists might prescribe hormone replacement
therapy (HRT) as a way to give some of the estrogen back and help regulate
common menopausal symptoms such as hot flashes, as well as prevent
osteoporosis. HRT however may have controversial benefit on the described
These developments call for the primacy of monitoring
women’s health during midlife, a critical window for implementing early
intervention strategies to reduce cardiovascular risk.
Adherence to a healthy lifestyle and diet with
regular exercise are important factors that can prevent weight gain while
reducing lipids, blood pressures, as well as blood glucose, insulin, and
subclinical carotid atherosclerosis, among women going through menopause.
At the Women Health Heart Center at Yaduna, a
personalized approach is offered to women in this transitory period. Making use
of the laboratory tests, imaging facilities, and medical staff expertise to screen
and guide women in this critical stage of their life is a unique opportunity to
fight Heart Disease and Stroke.
Samir Alam MD, FACC, FRCP
Professor of Medicine, Cardiology
Associate VP for Health, Chief of Staff
American University of Beirut Faculty of Medicine and Medical center
YADUNA-WHHC Board of Trustees and Directors
Wissam Harb MD
Associate AUBMC, Yaduna – WHHC