Women’s Equality Day: Why We’re Still Missing the Mark on Menopause and Heart Health
Menopause, Heart Health & the Gaps We Can’t Ignore
This Women’s Equality Day, we’re turning our attention to a quiet but serious gap in care: how menopause affects heart health—and why so many women miss out on the screenings and conversations they deserve.
We talk a lot about women’s equality in terms of opportunity and rights, and that matters. But the quiet truth is that many of the most damaging inequalities still show up in places we don’t always see, like the exam room.
This Women’s Equality Day, we want to talk about one of the most overlooked health gaps affecting midlife women in Cincinnati and across the country: the connection between menopause and heart health.
Most women know that menopause brings hot flashes, sleep issues, mood swings, and hormonal shifts. But fewer are told that it also increases their risk for heart disease. And even fewer are offered real solutions to reduce that risk.
That’s not just a personal issue. That’s a systemic one.
The Numbers Tell a Clear Story
Heart disease is the leading cause of death for women in the United States. But too often, it’s still seen as a “men’s issue.” Most of the early research in cardiology focused on male patients. That bias shaped our understanding of symptoms, risk factors, and treatments. As a result, many women don’t get diagnosed until later, and don’t receive the same level of preventive care.
This gap becomes even more serious around menopause. Why? Because estrogen plays a protective role in cardiovascular health. As estrogen declines in midlife, women lose that layer of protection, and their risk for high blood pressure, high cholesterol, insulin resistance, and inflammation all go up.
But instead of being screened more closely, many women in their 40s and 50s are told their symptoms are “just stress” or “just aging.” Shortness of breath, fatigue, or chest discomfort might be brushed off. Preventive labs might be delayed. And conversations about hormone therapy often come late, or not at all.
This isn’t just a clinical oversight. It’s a reflection of whose experience has been centered in medicine, and whose hasn’t.
Why Estrogen Loss Isn’t Just About Hot Flashes
When estrogen declines in midlife, so does a woman’s natural cardiovascular protection. The result? Higher risk for high blood pressure, cholesterol, and inflammation. Learn why tracking these changes early can protect your heart for decades.
Menopause Isn’t the End of Health, It’s a Turning Point
The idea that menopause is something women have to push through is outdated. We don’t treat puberty or pregnancy that way. We shouldn’t do it with menopause, either.
This is a transition that touches nearly every part of a woman’s life, physically, emotionally, and metabolically. Hormonal changes affect your brain, bones, sleep, mood, and cardiovascular system. If we ignore those shifts, we miss the opportunity to intervene early and meaningfully.
At Concierge Medicine of Cincinnati, we approach menopause as a turning point, not a decline. That means looking closely at your cardiovascular risk. It means asking the right questions, ordering the right labs, and helping you understand what’s changing and why.
We also talk honestly about hormone therapy. Not every woman needs it, and it’s not the right choice for everyone. But for many women, hormone therapy can help with more than just hot flashes. It can improve sleep, support cognition, ease joint pain, and yes, help protect the heart when started around the time of menopause.
The key is personalized, evidence-based care. Not one-size-fits-all guidance pulled from decades-old studies. Not vague warnings about risk without context. And certainly not silence.
What Real Prevention Should Look Like
Here’s what we wish more women knew:
Heart disease often looks different in women than in men. Chest pain might not be the first symptom. Fatigue, dizziness, jaw discomfort, or anxiety can all signal cardiovascular issues in women.
Your risk increases after menopause, even if you feel healthy. You can have normal blood pressure and still be at risk for arterial stiffness or plaque formation. That’s why tracking lipid markers, insulin sensitivity, inflammation, and vascular health matters.
Hormone therapy has come a long way. The fear that all estrogen causes heart attacks is based on outdated interpretations of old studies. Newer data shows that when hormone therapy is started early in the menopause transition, it can support heart health in the right patient.
Lifestyle matters, but it’s not everything. Eating well, exercising, and managing stress all support cardiovascular wellness. But some women still need medication, hormone support, or more frequent screenings to truly address their risk. That’s not failure. That’s individualized care.
This kind of prevention takes time, and time is something many women don’t get in a standard primary care visit.
Why Concierge Care Changes the Conversation
When you work with a concierge provider, you don’t get rushed through your annual. You get time to talk. Time to ask questions. Time to connect the dots between your symptoms, your labs, and your goals.
We see many women in their 40s and 50s who are taking care of everyone else but haven’t had their own risk factors fully evaluated. They’re sleeping poorly, gaining weight despite exercising, feeling foggy, and writing it off as “just midlife.” But when we dig deeper, we often find underlying shifts in cardiovascular markers that deserve attention.
And once we have that information, we can act on it early, not reactively.
Our team sees patients at all three of our locations: Mariemont, Kenwood, and Mason, and we support women throughout Greater Cincinnati who are ready to take a proactive, personalized approach to their health.
