ELI5 how peri/menopause and cardiovascular disease interact?

March 9, 2025 9:00 AM

And how HRT plays into things? Estrogen is protective right? How and why? ELI5 level sources would be appreciated.

(I am just extremely burned out on having to stay on top of multiple people’s multiple medical conditions, and this is more complicated than I have the bandwidth for. Plus, people are very vocal on both sides of the question of HRT for peri/menopause and gaaaah please just tell me how it basically is haha.)

Ok bonus question, pros and cons of HRT for peri/menopause in general. And, ok: what actually is peri/menopause in general and what consequences does it have for health. (Can affect MSK system too?? How and why?)

Thanks, hugely, in advance!

posted by cotton dress sock to Health & Fitness (5 answers total)

Response by poster: Bonus bonus if you know how prolactinomas affect things. I have an endo for that but they “don’t do menopause” and my appointment is far away.
posted by cotton dress sock at 9:05 AM on March 9

The NHS has some good information about this. Some of it may not apply, but it's in clear and easy to understand language.

Here's some more info from the Menopause Centre.
posted by fight or flight at 9:45 AM on March 9 [3 favorites]

Having been through this issue in the last decade, I really think it's something every woman needs to discuss with her doctor because there are personal risk factors that impact the decision. One risk factor has to do with breast cancer risk.
In many cases, HRT is protective of cardiovascular health until age 60 when some risks begin to outweight some benefits. In some cases it is protective after 60, but that also has to be discussed with a doctor.
The New Yorker has a story on lots of peri / menopause info this week!
https://www.newyorker.com/magazine/2025/03/10/menopause-is-having-a-moment
posted by ojocaliente at 10:15 AM on March 9 [2 favorites]

Another resources to look at is menopause.org, which is the homepage for the North American menopause society. In addition to patient education, you can look up doctors who specialize in menopause medicine.

To answer one of your questions Perimenopause is the period during which your body is in the process of stopping menstruation altogether. During this time you may experience irregular periods, shorter/longer periods, hot flashes, brain fog, and other symptoms. You are considered in menopause when you have not had a period for at least 6 months.

One thing that my primary care doctor said to me, which I really appreciated is that you can think of going through menopause as a return to normal. She didn't mean that all those other years I was somehow "abnormal," just that women will generally, spend more of our lives not menstruating than menstruating.

As you talk to your doctor about what you may experience, you'll want to focus on heart health, cancer risks, and sexual health primarily. You might also want to talk about diet and exercise, brain/memory health. Your hormones fluctuate a lot during peri-menopause - literally day-to-day. Prior to your doctor's appointment you might want to get blood work to test your hormones, so you at least have some kind of baseline to discuss.

HRT is not the only treatment you may want to consider in addressing any thing you're experiencing. You may want to ask about gaba-pentin to control hot-flashes/insomnia/night-sweats. You may want to ask about vaginal estrogen to help maintain sexual health and pleasure.

Whatever you do don't accept any treatment other than 100% supportive of your health and what you want to experience going forward.
posted by brookeb at 10:49 AM on March 9 [3 favorites]

I'm surprised not to have seen The Menopause Manifesto among the recs yet. I can't personally endorse it -- I've absolutely glided through this (to make up for the abject misery I went through in my teens and early twenties, I'm certain!) -- but have seen it highly praised elsewhere and trust Dr. Gunter.
posted by kate4914 at 1:33 PM on March 9 [2 favorites]