What Your Pregnancy or Menopause May Be Telling You About Your Heart

By Nina Williams, M.D. & Sarah Shaw-Dressler, D.O.

When most women think about heart health, they think about the awareness campaigns — the red dresses, the statistics, the general reminders to know your numbers. And those efforts matter. But in our practice, we see something consistently: women recognize the traditional risk factors — family history, high blood pressure, obesity — but they often miss the ones that are unique to them. The ones that showed up during pregnancy. The ones that are quietly shifting during perimenopause. The ones they've been told are unrelated to their heart.

We're here to change that conversation.
 

What a Complicated Pregnancy Is Really Telling You

If you experienced gestational diabetes, gestational hypertension or preeclampsia, you may have been told those conditions resolved when your baby was born. In one sense, that's true. 

But those diagnoses are also early warning signs of cardiovascular risk that don't disappear with delivery — they follow you.

Preeclampsia in particular is a cardiovascular risk factor specific to women. Women who have experienced it are significantly more likely to develop chronic high blood pressure, and their lifetime risk of type 2 diabetes rises sharply. Both of those conditions are powerful accelerators of heart disease.

That doesn't mean a cardiac event is inevitable. It means you deserve to know your risk — and to have a care team helping you manage it proactively, long after your last postpartum appointment.
If you've had a complicated pregnancy, these are the conversations worth having with your doctor:

• Blood pressure monitoring and what your numbers mean long-term
• How weight, physical activity and family history fit into your personal risk profile
• When a cardiology consultation makes sense
   

What Menopause Is Doing to Your Heart

As estrogen levels decline during perimenopause and menopause, the body changes in ways that directly affect cardiovascular risk — blood pressure, metabolism, cholesterol and weight can all shift, sometimes significantly.

Women also have biological differences that make their heart disease look different from men's: smaller coronary vessels, a greater tendency toward a particular type of plaque behavior, and a higher prevalence of autoimmune disease, which carries its own cardiovascular implications.

Chronic inflammation, depression and anxiety also tend to carry greater cardiovascular weight in women than in men — and these are factors that don't always make it into the standard risk calculation.

The picture is more complex for women. Which means the care needs to be more attuned.
 

The Symptom You Talked Yourself Out Of

We meet women regularly who have been to the emergency room for a cardiac event and tell us, in retrospect, that their symptoms had been present for weeks. Unusual fatigue. Atypical chest discomfort. Something that felt off but didn't feel dramatic enough to act on.

Women tend to power through. They put themselves second. They don't want to make a fuss or seem paranoid. We understand — and we also know that those instincts, however understandable, can delay care that matters.

If something feels different in your body, it's worth saying out loud. You are not being dramatic. You are paying attention, and that is exactly what we want you to do.
 

Care From Women Who Understand

At Saint Francis Heart and Vascular Institute, we are fortunate to have four women cardiologists — each at a different stage of career and with different areas of focus. That's a rarity in most cardiology practices, and it's something we're proud of.

We are passionate about reaching women early — especially those in childbearing years and those navigating the transition into menopause — because that's when we have the greatest opportunity to change the trajectory.
If any of the following apply to you, we'd love to connect:

• A history of preeclampsia, gestational diabetes or gestational hypertension
• Perimenopausal or menopausal changes that feel like more than normal aging
• A diagnosis of an autoimmune condition
• A family history of early heart disease
• Symptoms — however subtle — that don't feel quite right

You don't have to wait for a crisis to talk to a cardiologist. In fact, the best time to have that conversation is long before one. Ask your primary care provider about a referral to Saint Francis Heart and Vascular Institute — or reach out to us directly at (918) 494-8500. We're here, and we're listening.