Do You Know What to Do When a Menopausal Female Has a Heart Attack?

Sep 13, 2023

Take a moment to imagine that you’re relaxing and having coffee with a good friend from many years ago, Julie. You’ve been in fits of giggles, reminiscing about your ‘adventures’ at secondary school and having a fantastic time together.

Then suddenly, an uncomfortable look spreads over Julie’s face and she shifts position, trying to focus on the discussion.

You ask her if everything is OK and she meekly smiles and jokes that maybe the lentil salad wasn’t the best choice for lunch because it definitely doesn’t agree with her stomach. She also feels a bit queasy and sweaty so it makes sense- it must be indigestion or a touch of food poisoning.

Everything seems to be OK and you continue having fun for the rest of your lunch date, thinking that everything is OK.

But when she stands to visit the bathroom, she collapses at your feet and although calm, seems unable to move. Clearly, you’re concerned so call the ambulance, only to find out that it wasn’t just indigestion. It was a heart attack!

Despite what you might have heard or watched in Hollywood movies, heart attacks in women are far more common than you’d think.

In fact, heart attacks and CHD are the biggest killers of women worldwide, claiming the lives of 42,000 women in 2022 alone (double the number of male deaths.) It kills twice as many women as breast cancer and is more likely to happen when they reach menopause.

The symptoms of heart attacks in women make it even more likely that they will die immediately or within five years of their first attack.

This is partly because they may not experience the ‘classic signs’ of a heart attack such as a gripping vice-like pain in the chest. Yes, they feel uncomfortable or even in pain, but they often believe they have an upset stomach so don’t immediately seek the urgent medical help they need.

That’s why, for this year’s International Menopause Day (Weds 18th Oct 2023), the theme is Cardiovascular Disease (CVD)- the disease that affects the heart and blood vessels and can lead to postmenopausal heart attacks.

If we can raise awareness of heart attacks in menopausal women, know what they look like and, most importantly, what we can do if the worst happens, we can protect the health of those women we love and cherish and potentially prevent their untimely death. Today I’d like to explain exactly how you can do this.

What is Cardiovascular Disease (CVD)?

Cardiovascular Disease is an umbrella term for all diseases of the heart and circulation. It includes various conditions such as Coronary Heart Disease (CHD), heart attacks, strokes, heart failure, peripheral arterial disease, aortic disease and many more. More than four out of five CVD deaths are caused by heart attacks and strokes.

If a woman has high blood pressure, high cholesterol, smokes, has diabetes, doesn’t exercise, is overweight or has a family history of heart disease, they are more likely to experience CHD or a heart attack.

Of course, social factors also play a role in heart attacks in women. Those who lack education, have a low income, lack access to healthcare, have experienced sexual violence or are not Caucasian are also more at risk.

Other less common causes can include:

Starting their periods early (before age 11)
Premature menopause (before age 40)
Polycystic Ovarian Syndrome (PCOS)
Hypothalamic Amenorrhea
Hypertensive disorders of pregnancy
Gestational diabetes
Preterm delivery (low– or high–birth weight)
Oral contraceptive/HRT
Endometriosis

Why does CVD affect women more after menopause?

It’s a common misconception that heart attacks and CVD kill men more than women. But as you saw earlier, this is far from the truth. More women are killed by heart attacks each year than men.

But why is this? It all comes down to hormones, mainly one of the key female sex hormones called oestrogen.

This hormone plays a role in puberty, ovulation and pregnancy and also plays a protective role on the bones and heart. Normal levels of this hormone help to keep the blood vessels relaxed and open, help control cholesterol levels and reduce the chances that those fatty plaques will build up inside the arteries.

When the perimenopause and menopause approach, levels of oestrogen start to decline so this protective effect is reduced. This increases the risk of narrowing of the arteries, build-up of plaque, and circulation problems and could potentially lead to heart attack, stroke and other types of CVD.

If you want to protect the health of those women you love and ensure they can continue to thrive postmenopause, you need to learn how to spot a heart attack, treat it and prevent it.

How to spot the signs of a heart attack in women?

Forget what you’ve seen in the movies- heart attacks usually don’t involve clutching the chest, gasping for breath or collapsing on the floor and most certainly don’t only affect men.

Here are the most common signs of a heart attack in women:

Uncomfortable pressure, squeezing, fullness or pain in the centre of the chest that lasts for more than a few minutes.
Pain or discomfort that spreads to one or both arms, the back, neck, jaw or stomach.
Shortness of breath with or without chest discomfort
Sweating
Nausea and/or vomiting
Lightheadedness
A sudden feeling of anxiety, like a panic attack
Excessive coughing or wheezing

What should you do if you think someone is suffering from a heart attack?

If you believe someone is having a heart attack, call 999 immediately.

They may protest, saying that they are fine and don’t want a fuss but you must insist on medical assistance.

By doing this, you’ll help them access the essential medical attention and treatment they need and increase their chance of survival. Better to be safe than sorry, even if it turns out to be a panic attack or a severe case of indigestion.

While you wait for the ambulance to arrive, follow the first-aid guidelines for treating heart attacks. Move them into a comfortable position then give them one aspirin tablet (300mg) and ask them to chew it slowly. (Don’t do this if they are under 16 or allergic to aspirin!). If they have their own angina medication, encourage them to take it.

Stay there until help arrives, checking how the patient is and providing CPR if they become unresponsive.

What can women do to reduce their risk of heart attack post-menopause?

If you want to reduce their risk of heart attack, you should focus on reducing inflammation and calming the nervous system. The following five tips can help:

Boost your blood flow

Gentle exercise can help ensure your heart works effectively, blood flows where it needs to go and you stay feeling healthy for longer. Downtraining like walking, mindfulness, yoga, breathwork and inversions like this are all great ways to do this.

Eat nutrient-dense food (and make sure you’re absorbing it properly)

You need to absorb as much of the vitamins, minerals and amino acids from your food as you can so you can feel energetic, protect your heart, regulate the rhythm of your heart and protect against oxidative damage. Eat a balanced diet and ensure you’re having at least one bowel movement daily.

Get your polyphenols

Polyphenols are powerful antioxidants found in plant-based foods and contain anti-inflammatory properties, support heart health and improve insulin sensitivity. You can find these polyphenols in berries, cocoa, coffee, tea, spices, nuts, and seeds- the richest sources are those berries, nuts, flaxseeds and veggies. Other sources include apples, red wine (but not for everyone), chocolate, olive oil, turmeric, olives, tea, coffee, soya products, and beans. These all contribute to a healthy heart.

Relax

Practice relaxation activities such as slow breathing, mindful eating, yoga, Chi gong, meditation, hypnotherapy and guided visualisation to help calm your body, relax and open the blood vessels, reduce inflammation and help you avoid heart problems. Most importantly, make sure you’re getting a good night’s sleep.

Be mindful of cold exposure therapies

Although Wim Hoff-style cold therapy can be very beneficial to your health, it’s a good idea to be careful if you’re a woman in her perimenopause journey. Yes, this therapy can cause heart attacks in women, even if they have no history of heart disease.

Summary

Heart disease is the biggest killer of women worldwide- 42,000 women in the UK died from a heart attack in 2022 alone.
The signs of a heart attack in women are different from men. Make sure you learn what they are and what you should do if someone you know has one.
International Menopause Day (Weds 18th Oct 2023) focuses on Cardiovascular Disease (CVD) this year. Check out their resources for extra help.
You can reduce their risk by eating a nutrient-dense diet (including plenty of polyphenols), getting plenty of relaxation time, exercising and practising activities like mindfulness and yoga.