Study Finds Increased Cardiovascular Health Risks Among Perimenopausal Women

The years leading up to menopause may quietly become one of the most important turning points for a woman's heart health.

A new study published in the Journal of the American Heart Association found that women going through perimenopause were twice as likely to have poor cardiovascular health compared to women with regular menstrual cycles.

Perimenopause is the stage before menopause when hormone levels — especially estrogen and progesterone — begin to fluctuate. During this time, many women experience irregular periods, sleep problems, mood changes, and hot flashes. Scientists now say these hormonal changes may also significantly affect cardiovascular health.

The study analyzed health data from 9,248 women aged 18 to 80 who participated in the U.S. National Health and Nutrition Examination Survey between 2007 and 2020. Researchers used the American Heart Association’s Life’s Essential 8 scoring system, which evaluates blood pressure, cholesterol, blood sugar, body weight, sleep, diet, physical activity, and smoking habits.

The results showed cardiovascular health steadily declined across reproductive stages. Premenopausal women had a median score of 73.3 out of 100, while perimenopausal women scored 69.1, and postmenopausal women dropped further to 63.9.

After adjusting for age, researchers found that perimenopausal women were twice as likely to have low overall heart health scores compared to premenopausal women. They were also 76% more likely to have poor cholesterol scores and 83% more likely to show unhealthy blood sugar levels.

Researchers believe fluctuating estrogen levels may negatively influence cholesterol metabolism, insulin resistance, weight control, and blood pressure regulation during this stage.

Diet emerged as one of the weakest areas across all groups, with researchers emphasizing that healthier eating habits, regular physical activity, and early screening could help reduce future cardiovascular risk.

The team now plans to follow women over several years to better understand how hormone changes influence long-term heart health and whether lifestyle interventions during perimenopause can reduce disease risk later in life.

REFERENCE: Nayak, A., et al. (2026). Cardiovascular Health Characterization Using Life’s Essential 8 Score in Perimenopausal Women: An Analysis of the National Health and Nutritional Examination Survey. Journal of the American Heart Association. DOI: 10.1161/JAHA.125.046898. https://www.ahajournals.org/doi/10.1161/JAHA.125.046898