Women with a family history of heart disease may find themselves buffeted by conflicting information about hormone replacement therapy and heart protection. I want to emphasize here that when it comes to protecting your heart, HRT needs to be weighed as one of a range of options you have. A family history of heart disease is one factor to consider in evaluating the benefits of HRT, evidence shows that HRT can reduce the incidence of heart disease by as much as 30 to 50 percent. But in our forties the tools at our disposal to strengthen and protect our hearts certainly aren’t limited to medication. I prefer to aim for the overall goal of good health and resilience and do what we can do now, on our own, to achieve it without medical intervention.

Perimenopause is a time to begin anew, to make a strong commitment to taking better care of ourselves than we ever have before. A very important aspect of your self-care is paying attention to what your heart is telling you. It’s true that men and women who report cardiac symptoms are often treated very differently by the health care system, but it’s also true that women themselves often dismiss signals of heart trouble. If you have any concern about a possible cardiac symptom, you owe it to yourself to be sure that this symptom is fully explored. And you may have to be assertive in insisting that it be checked out, if your health care provider seems reluctant to do so or if he or she wants to attribute it to anxiety without any futher exploration. In other words, you may have to take the lead in educating your health care provider about the risks of heart disease in women.

The American Heart Association lists these warning signs of a heart attack:

- Uncomfortable pressure, fullness, squeezing, or pain is felt in the center of the chest, lasting more than a few minutes.

- The pain may spread to the shoulders, neck, or arms.

- Chest discomfort with lightheadedness, fainting, sweating, nausea, or shortness of breath may also occur.

If you have pain in your chest radiating into your left arm; tightness in your chest accompanied by shortness of breath; or palpitations, contact your health care provider right away. Note that palpitations can also be a symptom of perimenopause. Some perimenopausal women say their heart pounds abnormally hard or fast when they are having a hot flash, while others have palpitations that are not connected to hot flashes. Again, I want to underscore the importance of not making any assumptions about these symptoms. Talk them over with your health care provider and ask to have the appropriate investigation to rule out a heart problem.

Women who are affected by cardiovascular disease have a less favorable prognosis than men, for a host of reasons. In the past, the medical community tended to interpret danger signs differently for men and women, although this is slowly changing. Still, palpitations in women are frequently attributed to anxiety, while in men they are viewed as a more serious sign of potential heart disease. A more complete diagnostic workup will usually be done on a man who reports chest pain than on a comparable woman. The medical community is beginning to pay closer attention to signs of heart disease in women, a long overdue change mat women in our age group can take credit for because we have insisted upon being heard.

If a woman is incorrectly diagnosed as having anxiety, however, when heart disease is the real culprit, her treatment will be delayed or inappropriate. By the time the problem is correctly identified, she will probably have more advanced coronary disease than her male counterpart. Delaying treatment for coronary disease lessens the opportunity for effective intervention. Again, if you experience the warning signs of a heart attack, there are two rules to heed: get medical help immediately, and insist that a heart attack be ruled out. Honoring and respecting yourself means listening to your body when it is talking to you.

The Female Heart cites sobering statistics on women who have heart attacks:

- Thirty-nine percent of all women heart attack victims will die within the first year of the attack, versus 31 percent of all men.

- A woman is twice as likely as a man to die within the first sixty days of a heart attack.

- After a first heart attack, a woman is twice as likely as a man to have a second heart attack.

These statistics can be alarming; especially for those of us whose mothers or fathers have had heart attacks. But you don’t have to feel like you may suddenly be blindsided by a heart attack, there is a lot you can do to keep your heart healthy so you don’t find yourself facing those post-heart attack odds. For example, smoking not only causes lung cancer and emphysema but also increases the risk of heart attack. You can cut your risk of heart disease by stopping smoking, exercising regularly (women who exercise regularly are three times less likely to have hearts disease than those who don’t), minimizing your stress level, and paying attention to your diet.

Related posts:

1. The Basics of Perimenopause – Planning Ahead for Healthy Heart, Bones, and Breasts

2. The Basics of Perimenopause – Relationship Between Estrogen and the Healthy Heart

3. The Basics of Perimenopause – Risks and Benefits Hormone Replacement Therapy

4. The Basics of Mood Swings During Perimenopause – Anxiety

5. The Basics of HRT alternative perimenopause treatment – black cohosh

6. The basics of heart disease – what angina feels like

7. The Skinnies on Women and Heart Surgery

8. The Basics of Perimenopause – The Arc Bends toward Maturity

9. The Basics of Perimenopause – Working with Your Health Care Provider

10. The Basics of Hormone Replacement Therapy For Perimenopause – Facts about Your Choices