The Silent Shift: Why Perimenopause Is a Crucial Time for Your Heart

March 9, 2025

Perimenopause marks a significant hormonal transition that can affect multiple bodily systems, especially cardiovascular health. Oestrogen plays a vital role in protecting your heart and blood vessels, but as oestrogen levels decline during perimenopause, your cardiovascular system faces new challenges. Taking proactive steps to support heart health during this time is crucial, as heart disease often develops silently over time. Understanding how perimenopause impacts the cardiovascular system and making informed decisions about your health can help ensure a healthier future.

The cardiovascular system is akin to a highway for your body, delivering oxygen and nutrients through blood vessels powered by the heart. To function optimally, it requires strong blood vessels, balanced cholesterol, proper clotting, and minimal inflammation. This blog explores four key changes in cardiovascular health during perimenopause and actionable steps you can take to manage your heart health.

How Falling Oestrogen Affects Heart Health

Elevated LDL Cholesterol Levels

Oestrogen plays a protective role in lipid metabolism, and as it declines during perimenopause, LDL cholesterol levels often rise. Elevated LDL can lead to plaque buildup in the arteries, increasing the risk of heart disease.

How a Naturopath Can Help:
- Incorporate high-fiber foods such as oats, legumes (lentils and beans), and leafy greens to improve lipid profiles and promote regular bowel movements.
- Add omega-3-rich foods like flaxseeds, chia seeds, walnuts, and fatty fish (e.g., salmon, sardines) to reduce inflammation and lower LDL cholesterol.
- Consider supplementing with high-quality fish oil (EPA/DHA) under professional guidance.
- Engage in regular aerobic exercise to improve cholesterol profiles and reduce cardiovascular risk.
- Consult a healthcare professional before considering red rice yeast extract, which may help lower cholesterol.
Diminished Vascular Function

Oestrogen influences blood vessel function, particularly in promoting vasodilation (relaxation of blood vessels). As oestrogen levels decline, blood vessels may lose their ability to dilate efficiently, leading to higher blood pressure and increased strain on the cardiovascular system.

How a Naturopath Can Help:
- Increase physical activity, especially resistance and aerobic exercise, to improve blood vessel function and lower blood pressure.
- Potassium-rich foods such as bananas, leafy greens, avocados, and sweet potatoes can help manage blood pressure. (Always consult a professional before increasing potassium intake, as it may be contraindicated in certain conditions.)
- Incorporate nitric oxide-boosting foods such as beetroot and pomegranate to improve vascular health.
- Your naturopath may recommend amino acids like L-arginine and citrulline to support healthy vascular function.
Increased Inflammation

Oestrogen has anti-inflammatory properties, so when oestrogen levels decline, systemic inflammation can increase. Chronic inflammation contributes to conditions like atherosclerosis and other cardiovascular diseases.

How a Naturopath Can Help:
- Add anti-inflammatory foods to your diet, such as turmeric (curcumin), oily fish, and flaxseed oils.
- Curcumin supplements may be beneficial; however, consult with a healthcare professional, as curcumin can interfere with some cardiovascular medications.
- Reduce processed food intake and focus on whole foods to lower inflammatory markers.
- Incorporate nuts and seeds (especially walnuts and flaxseeds) for their anti-inflammatory omega-3 content.
- Stress management is key. Techniques such as yoga, meditation, time with loved ones, nature walks, journaling, massage, or professional therapy can help manage inflammation and stress levels.
Altered Blood Coagulation

Oestrogen is involved in regulating blood clotting mechanisms. As oestrogen declines, the risk of abnormal blood clot formation increases, raising the risk of heart attacks and strokes.

How a Naturopath Can Help:
- Stay active to improve circulation and prevent blood stagnation.
- Stay hydrated and monitor your salt intake for optimal blood pressure.
- Maintain a healthy weight through balanced nutrition and regular exercise to reduce cardiovascular risk factors.
- Include natural anticoagulants like garlic, turmeric, and fish oil in your diet to support healthy blood clotting.
- Supplements like CoQ10, vitamin C, and ginkgo biloba may also help thin the blood, but always consult a professional before adding them.
- Regularly monitor blood clotting factors with your GP, especially if you are undergoing hormone replacement therapy (HRT).

Take Action Today for Heart Health Tomorrow

As oestrogen levels drop during perimenopause, several cardiovascular risks emerge, including higher LDL cholesterol, diminished vascular function, increased inflammation, and altered blood coagulation. It’s essential to take action now by evaluating your diet and alcohol intake—could they be improved?

Visit your GP for updated cardiovascular tests and consider working with a naturopath to create a personalized plan. This plan may include dietary adjustments, lifestyle changes, and herbal medicine where appropriate, ensuring you are proactively managing your heart health. Taking the reins today will help you stay well tomorrow.

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