Having Multiple Severe Menopause Symptoms Linked to Increased Risk for Heart Disease Everyday Health MenuNewslettersSearch Menopause Having Multiple Severe Menopause Symptoms Linked to Increased Risk for Heart Disease Experiencing extreme hot flashes and other symptoms isn’t just uncomfortable, it’s also a warning sign. By Kaitlin SullivanReviewed: October 13, 2020Fact-CheckedDizziness, a racing heart, exhaustion, and forgetfulness are some of the symptoms most closely linked to future heart disease risk.iStockGoing through menopause is uncomfortable, to say the least. Hot flashes can make you feel like you’re in the tropics despite there being snow on the ground, and brain fog can make it hard to focus on work. It’s easy to dismiss these symptoms as just something that women go through, but having multiple intense menopause symptoms may not be as harmless as it seems. That’s because severe menopause symptoms may be an indication of increased risk for heart disease, according to new research presented during the 2020 Virtual Annual Meeting of the North American Menopause Society (NAMS) on September 28, 2020. The study included more than 20,000 women between the ages of 50 and 79, whose health was followed for an average of seven years. A team of researchers looked at the women’s vasomotor symptoms (VMS) — or menopause symptoms — including hot flashes, night sweats, dizziness, heart racing or skipping beats, tremors, feeling restless or fidgety, feeling tired, difficulty concentrating, forgetfulness, mood swings, vaginal dryness, breast tenderness, headache or migraine, and waking up multiple times during the night. They then determined whether or not the severity of a woman’s menopause symptoms puts her at a higher risk for heart disease or stroke. What the researchers found was that symptom severity did not increase a woman’s risk of cardiovascular disease (CVD) if she had just one moderate or severe symptom. However, having two or more moderate or severe menopause symptoms increased a woman’s risk for CVD and stroke by about 40 percent compared with women who had none. In addition, feeling dizzy, a racing heart or skipping heartbeats, forgetfulness, or feeling tired were most strongly correlated with increased risk for heart disease and stroke. According to Stephanie S. Faubion, MD, director of the Mayo Clinic Center for Women’s Health and medical director of the North American Menopause Society, who was not involved with the study, this new research adds to a growing body of studies that suggest menopause symptoms are more than just an uncomfortable side effect. “Women and their providers have tended to blow off menopause symptoms as benign, and this is one more indicator that we need to take them seriously,” says Dr. Faubion. While common menopause symptoms such as hot flashes likely do not cause heart disease, the uncomfortable hallmarks may be a good warning sign. “Paying attention to these symptoms could help doctors identify those women who are at risk for CVD earlier,” says Faubion. According to Matthew Nudy, MD, a cardiology fellow at Penn State Hershey Medical Center, who coauthored the new study, past research has hypothesized that the link between CVD and menopause could be due to risk factors that come with menopause, including a drop in heart-protecting estrogen, elevated lipid levels, age, and elevated blood pressure. And this new research shows there’s an opportunity to see who is at a higher risk and possibly catch the disease early. Dr. Nudy is careful to point out that the current body of research does not prove cause and effect (that is, it doesn’t show that having multiple severe menopause symptoms causes heart disease). “Given the association that we were able to find and given that patients who have more severe symptoms are more likely to see a doctor, menopause may be an ideal time to assess patients’ CVD risk,” says Nudy. This new study gets added to existing research that connects certain menopause factors with CVD risk. For example, women who have hormone imbalances that cause them to have lower estrogen levels before age 55 are already at a higher risk for heart disease once they reach menopause, says Fabion. The same is true for women who reach menopause at an early age. A study published in 2017 in the journal Circulation showed that women who went through menopause before the age of 43 had a nearly 15 percent increased risk for cardiovascular disease compared with women who experienced menopause at ages 48 to 50. The new study also found that supplementation with vitamin D and calcium, which are sometimes recommended to menopausal women to curb symptoms, does not appear to have any effect on mitigating risk. But the researchers didn’t look at other treatments. “We don’t know if hormone therapy could play a role. If we make the symptoms better, does that lower cardiovascular disease risk? We need more research there,” says Fabion. 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