“Stressors that are relevant to the life-experiences of mid-life women (age 40 – 65 yrs) include job stress, caregiving, marital quality and discrimination. The articles we reviewed support the hypothesis that life stress and stressful events that occur in mid-life can impact women’s later-life risk for Cardiovascular (CVD) events.” (Stewart, Kathawalla et al, 2018, p.13).
The emails find me from all corners of the world. Most contain descriptions of women leading busy, stressful lives. Some describe caring for ageing parents or the loss of their parents. Other emails describe stressful life events such as the loss of a loved one, including animals. Many describe the impact this is having on their sleep, anxiety, sore muscles, palpitations and other health concerns such as weight gain and high cholesterol. Most tell me that their Doctors ‘can’t find anything wrong’ and they are wondering if their insomnia, hot flushes, sore joints, high cholesterol and/or weight gain, might be related to menopause. I always answer these emails – women trying to make sense of their lives and changing health in mid-life – and almost always, I say ‘yes’ this may be menopause … but it’s deeper than that. It’s also the result of how your modern, stressful lifestyle, may be clashing with your ancient physiology.
The impact that the accumulation of stress (past and present) has on our heart and blood vessels as we age is what I mention in my Masterclass on Menopause. They are the ‘invisible’ symptoms that we can’t see – higher cholesterol, changing blood pressure, increased heart rate and other changes to cardiac function that may appear in blood work but are dismissed as not being relevant to menopause. But they are.
General life stress, including perceived stress and life events, in mid-life was significantly related to later-life CVD risk and mid-life subclinical CVD in the majority of studies published in the past six years and this is why I’m pleased that a relatively new study examining the relationship between stress and cardiovascular changes in mid-life women has emerged from the scientific research. It confirms what many of us feel as we age – and that is, that our day-to-day stress (and stress exposure over our lifetime) impacts cardiovascular disease in mid-life women. Two-thirds of the hundreds of studies reviewed showed a positive relation between stress and sub-clinical cardiovascular health measures and that the connection between stress and cardiovascular changes occurs through multiple pathways, with the main ones being:
- Inflammation and thickening of the inside of the blood vessels – (intima-media thickness)
- Stiffness of the blood vessels leading to higher blood pressure (I often write about this condition, called ‘vascular stiffness’).
- Plaque development in arteries.
Women in mid-life experience unique stressors, including transitions within their family roles, informal caregiving, job stress, and perceived discrimination. Hence, of interest to all of us from this study was the connection between the types of stress and the cardiovascular changes. This is one of the first studies that has looked at this connection – thank you to the researchers because here’s what we need to be aware of:
- General day to day stress was related to inflammation and thickening of the inside of blood vessels.
- An acute stressful event (such as the loss of a loved one) related to arterial stiffness and changes in blood pressure.
- Stress over the lifetime was related to plaque development in arteries leading to CVD in older age.
Menopause is a time of change – in more ways than just the physiological. In our changing hormonal environment, there are also organ changes occurring and this includes to our blood vessels. Getting our stress under control is an important factor for managing our symptoms and I’m often referring to how to do this in my private coaching community.
Perceptions of feeling stressed and over-whelmed influences so much of our daily behaviours, many of which we do unconsciously. From grabbing an extra cookie for the much-needed sugar-rush when we feel under the pump, to smoking, to drinking more alcohol to yelling at the kids, partner dog, or work colleagues – it’s a tough time getting through the day, without worrying about menopause symptoms. But herein lies the catch-22. Many of our symptoms are related to the invisible changes that occur inside our blood vessels when we both feel stressed, or we are carrying stressful emotions into our mid-life years. If we don’t do anything about managing or removing our stress, then this is the time of life when we become vulnerable to metabolic dysfunction (thyroid problems, weight gain or Type 2 diabetes) and blood pressure dysregulation.
How do we improve our resilience to cardiovascular changes caused by stress?
There is ample evidence in the literature that positive psychological states and social factors such as optimism, life engagement and psychological wellbeing may be protective against the development of cardiovascular disease, but in the day-to-day grind, it’s hard to stay optimistic and/or engage with life. But as I’m always saying to women in the MyMT™ community – small changes turn into larger changes when they become routine habits, so making one small change in behaviour to build our resilience every day can have impact over the longer term.
Knowing how stress impacts our blood vessels is the starting point to changing our behaviour to reduce cardiovascular risk in mid-life. Here are the ‘heavy-hitters’ which help:
- Change your diet to an anti-inflammatory one and increase your intake of foods which help to dilate blood vessels. I talk about the role of nitrates in foods in all of my programmes.
- You must focus on turning around your sleep and your circadian rhythm. Finding ways to get natural light into your eyes in the morning is an important part of regulating our blood pressure. The MyMT™ ‘Sleep All Night’ module is the first module you receive in the MyMT™ programmes – it’s that important to our cardiovascular health, especially for those of you not sleeping now that you are in post-menopause. At 72 yrs, Iris from Australia said she hadn’t slept for 30 years until she did the programme!
- Wholegrains are a necessary part of a heart-healthy diet. So, yes, find an organic, wheat-free bread if you can, or start having oats for breakfast, not bacon and eggs. Oats contain beta-glucans which help with your heart health and I’ve written about this HERE.
- Ditch the emphasis on high-intensity exercise and heavy weight training (until you sleep all night) and give your arteries the love they need, with aerobic exercise. This is a huge challenge for a generation of women who are addicted to their high-intensity exercise and resistance training however, the work of Professor Hirofumi Takana has been revolutionary in understanding the role that aerobic exercise has on our arterial function in mid-life. As he mentions, “In sedentary humans, arterial stiffness in the central (cardiothoracic) circulation increases with advancing age even in healthy men and women. Daily brisk walking for ≈3 months improves carotid artery compliance in previously sedentary but healthy middle-aged and older men, as well as in apparently healthy, postmenopausal women to levels seen in age-matched endurance-trained adults.” (Tanaka, 2019, p. 237).
- Get some regular massage if you can – especially the type of massage that helps to release the myofascial sheath (the outer sheath surrounding the muscles). Understanding that over our life-time, our exposure to stressful events and chronic stress can increase inflammation in our fascia is an important aspect of helping you to manage stress and cardiovascular health. Both our nervous system and muscles are changing as oestrogen declines, hence, our muscles become tighter and our fascia acquires inflammation (Castro-Sanchez et al, 2011). Seeking a trained professional who can help with a little myofascial love during menopause can be an influential part of your menopause symptom-management toolkit.
Sometimes we feel that we can’t do anything about the circumstances in our life – and yes, for many women of our generation this is hard and I used to feel that way at times too. But when we understand the factors that matter to our health as we move through menopause, then we can make small changes that matter and take back some control of our day to day habits. It’s what I help women achieve on my 12 week programmes. It’s a privilege to educate them on what they can do at a time of life whereby the stressors that build up daily, become a ‘perfect storm’ for changing cardiovascular health as we move through menopause.
When my own cardiac health changed as I moved through menopause, I was blind-sided as to why. I kept fit and ate well and tried to follow all the relevant lifestyle information. But I now reflect on how nobody was making the connection between our day-to-day stress levels, cardiac health and of course, our changing hormonal environment. It’s my privilege to connect-the-dots and do this for you. If you would like to learn a little bit about me and how I got to setting up MyMT™ , then have a listen to the ‘Meet Wendy‘ video below.
Dr Wendy Sweet (PhD)/ Founder of MyMT™/ Member: Australasian Society of Lifestyle Medicine.
Castro-Sánchez, A. M., Matarán-Peñarrocha, G. A., Granero-Molina, J., Aguilera-Manrique, G., Quesada-Rubio, J. M., & Moreno-Lorenzo, C. (2011). Benefits of massage-myofascial release therapy on pain, anxiety, quality of sleep, depression, and quality of life in patients with fibromyalgia. Evidence-based complementary and alternative medicine : eCAM, 2011, 561753.
Stewart, A.L., Kathawalla, UK., Wolfe, A.G. et al. (2018). Women’s heart health at mid-life: what is the role of psychosocial stress?. Womens Midlife Health 4, 11. https://doi.org/10.1186/s40695-018-0041-2
Tanaka H. (2019). Antiaging Effects of Aerobic Exercise on Systemic Arteries. Hypertensio, AHA doi: 10.1161/HYPERTENSIONAHA.119.13179.