Menopause is an inevitable occurrence marked by changes in hormone levels. These levels — and their daily fluctuations — vary from one woman to the next. Quality of sleep, diet, level of physical activity as well as stress and anxiety management are all factors that influence hormone levels and, therefore, the symptoms of menopause and the increased risk of diseases associated with it.

Cardiovascular disease (CVD) is the leading cause of death in women who have a notable increase for this disease after menopause. In December 2020, the American Heart Association issued a scientific statement about menopause and the risks of cardiovascular disease. The results emphasize that the menopause transition is a period of accelerated risk for CVD, demonstrating the importance of monitoring women’s health in their 40s, a critical period for the implementation of early interventional strategies to reduce this risk.

The average age of menopause (12 months without a period) in Western societies is 50 years old. Generally, however, it occurs between the ages of 42 and 56 (10% of women experience menopause before age 45; 1.9%, before the age of 40). Symptom onset and frequency or intensity, particularly vasomotor symptoms (hot flashes), are correlated with a higher disease risk, such as metabolic syndrome and cardiovascular disease. Unfortunately, the majority of women are unaware of this important aspect and the preventive approaches that can be considered. A recent meta-analysis that looked at 310,000 women across 32 studies reported that women under the age of 40 with menopausal symptoms would have a greater risk of heart disease, namely 50% and 23% higher for CVD and stroke, respectively.

In addition to hot flashes, disrupted sleep, and depression are often symptoms of menopause: the holy trinity, as it were. They, too, are correlated with an increased risk of cardiovascular disease. Even in women who experience symptoms later in life, after 50, for example, the risks of CVD increase and are correlated with symptom intensity.

To reduce the risks of CVD and menopausal symptoms, a healthy lifestyle is a top priority. Three weekly 30-minute sessions of intense physical activity (during which the activity would be at an intensity where speaking is difficult or even impossible) can help reduce the risk.

Aside from intense physical activity, diet is definitely a second important factor. The ingestion of isoflavones is particularly interesting. Three flavonoids help reduce the symptoms of menopause: genistein, glycitein and daidizein. For a long time, isoflavones were suspected of increasing the risk of hormonal cancers, however, the opposite appears to be true. The consumption of soy even has a preventive effect on hormone-dependent cancers and CVD risk.

Other natural treatments can also be considered. Black cohosh provides natural relief for hot flashes, night sweats, insomnia and other menopausal symptoms. Many clinical studies concerning this root are positive, yet the quality of the product is an important factor to consider.

Hormone therapy may be indicated in cases where other measures fail to provide relief from severe menopausal symptoms that interfere with daily activities. However, hormone use is not recommended in many instances, including in women who have a history of cardiovascular disease.

Menopause is a natural biological process, but is different for every woman. Many symptoms will go away over time, but if they are causing problems, there are several treatment options that can help you feel better. Be sure to talk to your doctor before starting any treatment.


From the Spring of 2021 issue of the MONTRÉAL enSANTÉ Magazine 




  • El Khoudary SR et al, 2020. American Heart Association Prevention Science Committee of the Council on Epidemiology and Prevention; and Council on Cardiovascular and Stroke Nursing. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association. Circulation. 2020 Dec 22;142(25):e506-e532
  • Mehrpooya et al, 2018. A comparative study on the effect of “black cohosh” and “evening primrose oil” on menopausal hot flashes. J Educ Health Promot. 2018 Mar 1;7:36
  • Taulant et al, 2016. Association of Age at Onset of Menopause and Time Since Onset of menopause With Cardiovascular Outcomes, Intermediate Vascular Traits, and All-Cause Mortality. JAMA Cardiology, 2016;1(7):767-776
  • Zhang et al, 2017. Dietary isoflavone intake and all-cause mortality in breast cancer survivors: The Breast Cancer Family Registry. Cancer. 2017 Jun 1;123(11):2070-2079.