Heart Health in Perimenopause: What You Need to Know

Over the weekend, I attended the Her Heart Conference 2025, a full day of science, stories, and inspiration focused on women’s heart health.

It was a powerful reminder that perimenopause is one of the most important times in a woman’s life to protect her long-term wellbeing. Hormonal shifts during this stage influence everything from blood pressure and metabolism to sleep, stress, and mood - all of which affect heart health.

The good news? There’s so much within our control. Here are the key takeaways for women in perimenopause.

Perimenopause Is a Critical Window for Prevention

As Professor Patricia Davidson shared, women’s health doesn’t start or end with menopause -  it’s shaped across our whole lives. But perimenopause is a turning point. The habits, stress levels, and health conditions you have now set the tone for how your body transitions into menopause and beyond.

Many women enter this stage already juggling stress, poor sleep, weight gain or rising blood pressure, and these all impact heart health. The empowering part is that it’s not too late to change course. Focusing on healthy lifestyle foundations now can dramatically reduce future risk.

Hormones and Heart Health Are Connected

One of the clearest messages from the conference was how hormonal changes influence the cardiovascular system.

As oestrogen levels fluctuate and eventually decline, this affects blood vessel flexibility, cholesterol, metabolism, and blood pressure regulation.

Professor Caryl Nowson explained that these changes begin during perimenopause and accelerate in the decade after menopause. That’s why it’s so important to check your blood pressure, cholesterol, and glucose levels during this stage.

Even small lifestyle adjustments now can make a big difference to your long-term heart health.

Movement Really Is Medicine

Almost every expert echoed the same message: exercise is essential - not optional.

Movement protects your heart, balances mood, supports hormones, strengthens bones, and helps regulate weight and insulin.

Professor Erin Howden shared research showing women can gain the same heart-protective benefits as men from slightly less exercise - meaning you may not have to push harder, just move intentionally and regularly.

The best combination includes: • Aerobic activity • Strength training (at least twice a week) • Short bursts of higher-intensity movement

Movement improves heart health at every size. Even if you’re carrying extra weight, being active dramatically reduces your risk compared to being inactive.

Strength Matters – Not Just Appearance

Dr Julee McDonagh spoke about frailty - the gradual loss of strength, resilience and capacity that can creep up over time.It’s more common in women, and it doesn’t start in our 70s. It starts earlier if we’re not actively protecting our muscle and bone health. That’s why building strength in perimenopause is one of the best investments you can make.

If you’ve focused on being “skinny” up until now, it’s time for a rethink. Focus instead on becoming stronger to support healthy ageing. In fact, it’s not just being overweight that impacts mortality - a BMI below 19 increases mortality risk as well.

Whole-Woman Health Needs to Be the Standard

A strong theme throughout the conference was the need for healthcare that sees the whole woman – not just her hormones, heart, or symptoms in isolation

.Integrated, person-centred care - physical, mental, and emotional - gives women the best chance to thrive through perimenopause and beyond.

At Midlife Women’s Clinic, this is exactly what we believe in: providing evidence-based care from practitioners passionate about supporting women through midlife, so you can take charge of your wellbeing with confidence.

What Stood Out for Me Most

Perimenopause doesn’t have to be the beginning of decline. Instead, it is an opportunity to refocus.

This is the time to get curious about your body, become informed, pay attention to early changes and make empowered choices.

You don’t need to do everything perfectly. Just start - one small step, one new habit, one conversation at a time.

If you’d like support understanding your perimenopause health and how to protect your heart long-term, our team at Midlife Women’s Clinic is here to help. We offer evidence-based assessments and practical, empowering advice to help you take charge of your health through this pivotal stage.

Better is possible.