How Menopause Impacts Heart Health—and What You Can Do About It

When is a heart palpitation a normal part of perimenopause, and when is it a warning sign of something more serious? For Dr. Jayne Morgan, this question isn’t just clinical, it’s urgent. A noted cardiologist, media health expert, and Vice President of Medical Affairs at Hello Heart, Dr. Morgan has made it her mission to close the knowledge gap around women’s heart health, especially during and after menopause.

“Estrogen protects the heart,” Dr. Morgan explains. “That’s why, prior to menopause, women only have about 50% of the risk of heart disease as men. But after menopause, that risk not only equals—it eventually surpasses—the risk men face by our late sixties.”

Given that heart disease is the leading cause of death among women, understanding the hormonal connection is essential for prevention, and especially critical for women of color, who often face additional risk factors.

The Heart-Hormone Connection

“Estrogen receptors are not just in the breast and ovaries,” Dr. Morgan says. “They’re also in the heart.” This hormone plays a vital role in regulating cholesterol, raising HDL (the good kind), and lowering LDL (the bad kind) while keeping blood vessels supple and reducing inflammation throughout the arteries. But as estrogen levels begin to decline during perimenopause, so too does that cardiovascular protection.

It’s not just menopause that matters. Dr. Morgan notes that complications during pregnancy—like hypertension or gestational diabetes—can significantly increase a woman’s long-term risk of heart disease. “The obstetricians are not handing off these patients with pregnancy complications to cardiologists,” she says. “And that’s a missed opportunity for early intervention.”

If you’re between 35 and 55 and experiencing heart palpitations, it may well be hormonally driven, but it’s also worth seeing a cardiologist to rule out more serious concerns.

The Weathering Effect

Black women often enter menopause earlier than their white counterparts—a disparity Dr. Morgan attributes in part to what researchers call the Weathering Effect. She describes it as the toll of “high-effort coping,” a phenomenon shaped by both racial and gender-based stress.

“It’s a double whammy,” she says. “The constancy of looking over your shoulder, the need to navigate corporate spaces through code-switching, the weight of raising Black sons in a world that views them with suspicion—it’s all incredibly stressful.”

That persistent stress accelerates biological aging, making the body older than the birth certificate suggests. “Black women are more likely to enter menopause earlier,” Dr. Morgan notes. “And that means their risk for heart disease begins climbing sooner, too.”

What You Can Do to Protect Your Heart

Hormone Therapy

Hormone therapy can play a protective role when timed properly. “The sooner you start to lose that estrogen, the sooner your risk of heart disease begins to rise,” Dr. Morgan says. Replenishing estrogen can help rebalance the body and reduce inflammation, a key driver of cardiovascular disease. Her advice? Start the conversation with your doctor early to assess whether hormone therapy is right for you.

Nutritional Shifts

Even without hormone therapy, daily habits matter. Dr. Morgan recommends cutting back on processed foods and focusing on a nutrient-dense, protein-rich diet. “It’s not about pushing meat,” she clarifies. “Beans and plant proteins work well, too.” Prioritizing quality protein supports muscle mass, which is especially important during menopause and contributes to cardiovascular resilience.

Restorative Sleep

Sleep isn’t just for beauty—it’s for survival. Insomnia during menopause is linked to higher heart disease risk. “Sleep impacts blood pressure, inflammation, and overall cardiovascular function,” Dr. Morgan says. Hormone therapy may also help restore better sleep, adding another layer of protection.

Resistance Training

Muscle isn’t just aesthetic—it’s metabolic. As estrogen drops, the likelihood of weight gain and muscle loss increases. Resistance training, including weightlifting or resistance bands, becomes essential. “It helps regulate blood pressure, improves circulation, and builds strength,” says Dr. Morgan, who herself holds 17 Pilates certifications. Movement, she adds, is one of the best ways to strengthen your literal and metaphorical heart.

Check In with Your Cardiologist

Understanding your heart health now can help prevent complications later. Dr. Morgan recommends a coronary artery calcium (CAC) scan—a test that detects calcified plaque in the arteries—as well as a baseline EKG for future comparisons. And if you’ve experienced complications during pregnancy like preeclampsia or gestational hypertension, don’t wait. “Your risk of heart disease is higher than any of your friends who haven’t had those complications,” she warns. “It’s a good time to check in with your cardiologist.”

The Heart of the Matter

Menopause doesn’t just close a hormonal chapter—it begins a new conversation with the body. One that requires awareness, curiosity, and care. “We can’t afford to treat menopause as an afterthought,” says Dr. Morgan. “It’s the beginning of a new cardiovascular reality.”

Rather than waiting for symptoms to surface, this is the time to lean in. Pay attention. Ask the questions that haven’t been asked. Take the steps that feel overdue. Because when you move with intention, you’re not just protecting your heart—you’re honoring the strength it’s carried you with all along.

“Your heart has carried you this far,” Dr. Morgan reminds us. “Now it’s time to start caring for it like it’s carried you through everything—because it has.”