Heart health after menopause

Blood pressure and cholesterol can be raised even when you feel well. Around menopause, it’s worth discussing heart-health checks. You can ask about everyday support as well as treatment for hot flushes.

Risk changes through midlife

The Office on Women’s Health explains that lower oestrogen and changes related to ageing can raise the risk of heart disease and stroke. This evidence is about women and reflects both menopause and ageing.

Your own risk also depends on factors such as smoking, blood pressure, cholesterol and family history. Some factors can be changed; others cannot. A review looks beyond whether your periods have ended to work out what support could help you.

Checks to discuss with your clinician

In England, the NHS Health Check is offered to eligible adults aged 40 to 74 every 5 years. Some existing health conditions mean you are not eligible. If you already have a condition such as heart disease, diabetes or high blood pressure, your care team can explain your regular reviews instead.

The check usually includes blood pressure and cholesterol measurements, and may include a blood sugar test. Expect questions about close relatives’ health, smoking, alcohol and physical activity. If you think you are eligible but have not been invited, contact your GP practice.

The US does not use this NHS invitation pathway. The Office on Women’s Health recommends blood pressure and cholesterol checks, with other tests according to your health. Ask your clinician which checks you need and when to repeat them. Elsewhere in the UK or internationally, ask about the local service.

Make prevention practical

Physical activity supports heart health, and stopping smoking reduces harm to your health. The Office on Women’s Health suggests activities such as brisk walking and getting support to quit smoking. Choose a starting point that fits your circumstances, and ask about help if making a change feels difficult.

A health review can also include eating habits, salt and alcohol, and support for managing cholesterol. After a check, the NHS may refer you to local activity or stop-smoking services. Ask for an agreed follow-up plan so you know what you are working towards.

HRT treatment is a separate decision

NICE recommends HRT as an option for hot flushes and sweats, but says not to offer it solely to prevent cardiovascular disease. Your age, circumstances and risk factors all matter when choosing treatment for symptoms. Ask how the proposed treatment is likely to help you.

In the US, the USPSTF recommends against systemic hormone therapy for the primary prevention of chronic conditions in people after menopause. That recommendation is for people without symptoms who are considering treatment for prevention. It does not cover treatment of menopause symptoms, or people with premature or surgical menopause.

Advice has changed recently. The FDA approved changes to HRT labels in February 2026, including removal of cardiovascular risk statements from the boxed warning on an initial group of products. That label change and the prevention guidance address different questions. Discuss the current information for your particular treatment with your prescriber.

When symptoms need help

Call 999 now in the UK, 911 in the US, or your local emergency number if you have chest pain that feels tight or squeezing, or spreads to your arms, neck or jaw. Do not drive yourself to hospital. US guidance says to call even if you are not sure it is a heart attack.

Heart attack symptoms can also include breathlessness, nausea, back or jaw pain and extreme tiredness. If you think you are having a heart attack, call emergency services now. Do not wait for a menopause appointment or a routine health check.

For a routine prevention discussion, book with your GP in the UK or your doctor in the US or elsewhere. Bring any previous results, your medicine list and the questions you want answered about heart checks or HRT.