Before menopause, coronary heart disease is less common in women than in men of a similar age. After menopause, risk rises, alongside changes in factors such as blood pressure, cholesterol, body weight and glucose control. Your individual risk depends on more than menopause alone.[2]
Risk factors worth discussing
An assessment can consider blood pressure, cholesterol, diabetes risk, smoking, activity, family history, symptoms and the age at which menopause occurred. Early menopause may be relevant to this conversation. A clinician can decide which checks are useful rather than applying the same test list to everyone.[1][2]
Blood pressure
High blood pressure often has no symptoms, so measurement matters.
Cholesterol
Results need interpretation alongside overall cardiovascular risk.
Symptoms
New symptoms can need a different route from a routine risk review.
Health history
Medicines, conditions and family history can change the discussion.
Menopause symptoms and heart symptoms
Hot flushes, sleep disruption and palpitations may occur around menopause. They are not a diagnosis. Do not assume that chest pain, pressure, breathlessness, sweating, nausea, sudden weakness or a rapid worsening of symptoms is due to menopause. Those symptoms can need urgent assessment.[2][3]
Call 999 if you think you may be having a heart attack or another life-threatening emergency. Use NHS 111 or seek urgent clinical advice for concerning symptoms when you are unsure what to do.
HRT and cardiovascular health
NICE recommends an individual discussion of the benefits and risks of each management option for menopause-associated symptoms. That discussion includes the type, route, dose and duration of HRT where relevant, alongside your age, circumstances and risk factors. This article cannot determine whether HRT is suitable for you or prescribe it.[1]
Frequently asked questions
Does menopause cause heart disease?
Cardiovascular risk changes with age and other factors such as blood pressure, cholesterol, diabetes, smoking, weight, activity, family history and menopause timing. A clinician can put these factors together for you.
Are palpitations always caused by menopause?
No. Palpitations can occur around menopause, but symptoms alone cannot show their cause. Seek assessment for new, persistent or troubling palpitations, particularly if they occur with chest pain, breathlessness, dizziness or fainting.
Does HRT protect the heart?
HRT is prescribed for menopause-associated symptoms after an individual discussion. It should not be started or changed from this page for cardiovascular prevention. A prescriber should discuss the relevant benefits, risks and alternatives in your circumstances.
Which heart tests should I have?
Tests are selected after an assessment. Blood pressure, cholesterol and diabetes-risk checks may be relevant for some people; an ECG, echocardiogram or other investigations may be considered for specific symptoms. Tests do not replace an urgent assessment when symptoms could be serious.