PERIODS, PREGNANCY AND MENOPAUSE: THE NEW RULES FOR WOMEN'S HEART HEALTH
Four of America's leading medical groups have joined forces to rethink women's heart health, and their message is one every woman should hear.
They say a woman's periods, pregnancies and menopause can offer early warning signs about her heart, and doctors should be paying attention at every stage.
The guidance was published on 26 October in three linked papers in the journal Circulation.
A new way to look at heart health
The American Heart Association, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine worked together on the framework.
The American Heart Association describes it as the first multi-society framework of its kind for heart disease in girls and women.
It divides a woman's life into four stages, each with its own risks and opportunities.
The first is perimenarche, around ages 8 to 15, when periods begin.
The second is the ovarian cycling years, roughly 15 to 44.
The third is perimenopause, around 45 to 51.
The fourth is postmenopause, from about 51 onwards.
Pregnancy is treated as a kind of stress test that can happen at any point and reveal hidden risk.
Your period as a vital sign
One of the most striking recommendations is that menstrual patterns should be treated as a vital sign.
Heavy or irregular bleeding, including the condition long known as PCOS, should prompt a check of heart risk.
As vice-chair Dr Amanda Marma Perak put it: "Heart health begins long before adulthood".
What pregnancy can reveal
The framework names several pregnancy complications linked to higher heart risk later in life.
These include high blood pressure, preeclampsia, gestational diabetes, preterm birth, having a small baby and stillbirth.
It recommends a blood pressure check within six months of giving birth.
Many women never connect these experiences with their heart, so it's well worth mentioning them to your GP, even years later.
The menopause years
Cholesterol and metabolic changes during perimenopause are flagged as important risk factors.
Hot flushes and other symptoms affect about 50 to 80 per cent of women in perimenopause, Medical News Today reported.
About a third have frequent, severe or long-lasting symptoms, which have been linked to higher heart risk.
Anxiety, depression and eating disorders are also recognised as factors that can affect the heart.
The years after menopause can make up as much as 40 per cent of a woman's life, and that is when most heart attacks and strokes happen.
The good news is that the AHA says more than 80 per cent of these events are preventable with early action.
Why it matters
In the US, heart disease kills more than 400,000 women a year, more than breast cancer, lung cancer and chronic lung disease combined.
Yet only about 41 per cent of American women see it as their greatest health threat.
Many women in Australia may underestimate their risk too, so the message is a useful one closer to home.
Questions to ask your doctor
This is general information, so speak to your GP about your own situation.
You might like to ask whether your period history or any pregnancy complications affect your heart risk.
Ask when you last had your blood pressure, cholesterol and blood sugar checked, and how often they should be tested.
If you're going through perimenopause, mention any symptoms, including hot flushes, poor sleep or changes in mood.
Small steps that help
Moving your body most days, eating plenty of vegetables, wholegrains and legumes, and limiting alcohol are all good for your heart.
Not smoking, getting enough sleep and finding ways to manage stress make a difference too.
In Australia, the Heart Foundation has helpful information on heart health checks and women's heart risk.
Your heart has been with you through every stage of life, so it deserves a little attention at every stage too.
