Women’s bodies undergo significant changes around the age of 40 and beyond, especially as they transition through menopause and perimenopause. These natural stages mark the end of the reproductive years and involve a gradual decline in the production of key hormones, particularly estrogen and progesterone. Though a normal part of aging, the reduction in these hormones can lead to notable shifts in physical health, especially regarding cardiovascular well-being.
Estrogen, for instance, has a protective role in heart health, so its decline increases risks for conditions such as high blood pressure, elevated cholesterol, and weight gain, which collectively heighten the chance of heart disease. Heart disease is the leading cause of death among women, and the risk grows with age. That’s why staying aware of certain health changes—and acting on instinct when something feels off—can be crucial for long-term health.
According to Dr. Stacey Rosen, executive director of Northwell’s Katz Institute for Women’s Health, being aware of one’s health patterns is essential: “Knowing what you’re capable of in your daily activities allows you to recognize when something feels different. Don’t ignore changes in your chest, abdomen, or back movement, as they could be signals for more serious issues.”
Additionally, knowing your family health history can provide further insight, as women with a family history of heart disease, especially if it affected close relatives under age 65, may be at greater risk. Armed with knowledge, here are five symptoms every woman over 40 should take seriously.
1. Chronic Fatigue
Fatigue is common, particularly for women balancing multiple roles, from careers to caregiving. However, it’s essential to distinguish normal tiredness from exhaustion that might signal a severe health issue. Studies show that unusual fatigue is often a precursor to heart attacks in women. Research indicates that up to 70% of women experience this profound tiredness in the weeks leading up to a heart attack.
According to Dr. Rosen, the fatigue associated with heart issues “feels different from normal end-of-day tiredness.” If persistent exhaustion doesn’t resolve with adequate rest, it’s wise to consult a healthcare provider for further evaluation. Ignoring unexplained fatigue may mean overlooking an early warning of a heart problem.
2. Intense Hot Flashes
Hot flashes—those sudden episodes of intense flushing and sweating, particularly in the upper body—are familiar symptoms for women transitioning through menopause. However, when these episodes are severe and frequent, they might indicate more than just hormonal changes.
Studies suggest that women with moderate to severe hot flashes and night sweats may have a higher risk of heart disease and nonalcoholic fatty liver disease. According to Dr. JoAnn Pinkerton, an obstetrics and gynecology professor, “Moderate hot flashes involve sweating, while severe hot flashes can disrupt activities, like causing pauses during a speech or waking you up at night due to overheating.”
If you experience several episodes daily, consider talking to your doctor about possible treatments. Keeping track of your symptoms can help you determine if they might be pointing toward a more serious health condition.
3. Depression and Mood Shifts
Mental health and physical health are deeply intertwined, with depression known to increase cardiovascular risks, especially for women. A study analyzing over 4 million medical records found that women with depression had a higher incidence of heart attacks, strokes, and chest pain compared to men.
Dr. Pinkerton emphasizes the importance of addressing depression as a health issue. “If depression is present, it’s essential to seek appropriate treatment, which could involve counseling, medication, or other therapies based on one’s menopausal stage.” Women of all ages should consult a healthcare professional if they experience mood swings, ongoing sadness, or thoughts of self-harm.
Early intervention is key. Starting with a depression screening through a primary care physician can pave the way for further support if needed. Don’t wait to address these feelings, as emotional health plays a critical role in maintaining overall physical well-being.
4. Persistent Shortness of Breath
The image of a heart attack often brings to mind the dramatic Hollywood portrayal of sudden chest pain and collapse. However, in women, heart attacks frequently present differently and may not involve such intense symptoms. Shortness of breath, for example, is one of the most common indicators of an impending heart issue in women. Unfortunately, this sign is often ignored or mistaken for fatigue or a minor illness.
As Dr. Rosen advises, “Be mindful of how you typically feel when going up stairs or taking a walk around the block. Any noticeable change in breathing or unexplained breathlessness should prompt a visit to the doctor, especially for women with heart disease risk factors.”
In fact, shortness of breath is the second most common heart attack symptom among women after fatigue. In one study, over 40% of women who had experienced heart attacks reported breathlessness as a warning sign. When in doubt, seeking medical advice can help address potential heart risks early.
5. Severe Migraines
Migraines are another symptom more common in women than men, affecting them at a rate nearly three times higher. For many middle-aged women, migraines become more prevalent due to hormonal fluctuations in perimenopause and menopause. These migraines can be triggered by stress, sleep disturbances, diet, or anxiety and are often exacerbated by the decline in estrogen levels.
Unfortunately, migraines can sometimes be mistaken for or overlap with stroke symptoms, as both can cause vision changes, numbness, dizziness, or tingling. Studies have shown that migraines may double a woman’s risk of stroke, particularly if they are severe or frequent.
If you’re experiencing migraines for the first time or notice new neurological symptoms, don’t ignore them. Even if they’re unrelated to a more severe issue, effective treatments are available to manage and alleviate migraine pain. Speaking with a healthcare provider can help differentiate migraines from more critical neurological conditions and offer relief.