Hello and welcome to Making Sense of Women's Health. I'm Roberta Bass, a women's health physiotherapist, menopause mentor, and founder of Thrive and Shine Women's Wellness. Today, we're diving into a really important topic—women's heart health. February is National Heart Month here in the UK, and I want to use this opportunity to highlight an issue that affects far more women than many of us realise.

Cardiovascular disease is the leading cause of death for women in the UK. Over 3.6 million women are living with heart and circulatory diseases. Each year, 30,000 women are admitted to hospital with a heart attack. This isn’t just an issue for older women. I recently saw a patient who had a heart attack in her late 30s, reminding us that we need to think about heart health at every stage of life.

Hormones play a huge role in how our cardiovascular system functions, yet this isn’t talked about enough. Oestrogen acts as a protective shield for our hearts. It keeps blood vessels flexible, allowing arteries to expand and contract easily. It encourages high levels of HDL, which is good cholesterol, helping to clear LDL, or bad cholesterol, from the bloodstream. It also reduces inflammation, particularly in blood vessels, which is crucial because chronic inflammation is a major contributor to heart disease.

After menopause, as oestrogen levels decline, we see a range of changes that increase heart disease risk. There’s a tendency for higher blood pressure as arteries become stiffer. LDL cholesterol levels can rise, while HDL levels drop, increasing the risk of atherosclerosis. Insulin resistance can develop, making it easier to gain weight, especially around the middle, which is another risk factor. Reduced heart rate variability can also increase the risk of arrhythmias like atrial fibrillation.

Heart attack symptoms in women can be different from the classic crushing chest pain often depicted. Women may experience chest discomfort, pressure, tightness, or a squeezing sensation rather than sharp pain. Pain can also occur in the jaw, neck, or upper back. Other symptoms include nausea, dizziness, fainting, extreme fatigue, and shortness of breath. Because these symptoms aren’t always dramatic, women often delay seeking help or are misdiagnosed. Trust your instincts. If something feels wrong, get checked out.

But heart health isn’t just about heart attacks. There are other conditions that affect women at higher rates, especially as we get older. High blood pressure is often symptomless but can significantly increase the risk of heart disease and stroke. Atrial fibrillation is an irregular heartbeat that raises the risk of stroke, and women with AF are more likely than men to experience serious complications. Heart failure affects more women than men, often developing after years of high blood pressure or undiagnosed heart disease.

Many women experience heart palpitations during perimenopause and menopause. This can be due to fluctuating oestrogen levels affecting the autonomic nervous system, making the heart more sensitive to adrenaline. Stress, anxiety, caffeine, alcohol, dehydration, and electrolyte imbalances can also trigger palpitations. While most are harmless, you should seek medical advice if they are frequent, prolonged, or accompanied by dizziness, chest pain, or shortness of breath.

So, how can we protect our heart health? First, move more. Regular physical activity reduces the risk of heart disease. Aim for at least 150 minutes of moderate-intensity exercise per week, like brisk walking, swimming, or cycling. Include strength training twice a week to improve blood pressure, cholesterol, and insulin sensitivity. Activities like yoga or Pilates can help with stress management and flexibility.

Next, eat a heart-healthy diet. Focus on healthy fats from olive oil, avocados, nuts, and seeds. Include omega-3s from oily fish, flaxseeds, and walnuts. Eat plenty of fibre from whole grains, beans, fruits, and vegetables. Aim for a colourful diet to get a variety of antioxidants. Limit processed foods, sugar, and salt, and stay hydrated.

Managing stress is crucial. Chronic stress contributes to high blood pressure and inflammation. Find stress-reducing activities that work for you, like deep breathing exercises, mindfulness, spending time in nature, or creative hobbies. Social connections also play a big role in heart health.

Prioritise sleep. Poor sleep increases the risk of heart disease, high blood pressure, and obesity. Aim for 7-9 hours of quality sleep per night. Maintain a consistent sleep schedule, create a relaxing bedtime routine, and limit screen time before bed. Avoid heavy meals, caffeine, and alcohol close to bedtime.

Regular health checks are essential. Know your numbers—blood pressure, cholesterol, and blood sugar levels. Don’t wait for symptoms to appear. Prevention is key.

So, what can you do today? Take one small step towards better heart health. Go for a walk, prepare a healthy meal, practice a few minutes of deep breathing, or book a health check. Your heart works hard for you every day. Show it some love.

If you’re struggling with menopause symptoms, joint pain, fatigue, pelvic health issues, or stress that’s holding you back from making changes, visit my website for support. All the details are in the show notes.

Thanks for listening to Making Sense of Women's Health. Until next time, take care.