The heart of the matter

September is widely recognised as a Heart Health Awareness Month because it leads up to World Heart Day on September 29. Heart disease remains the leading cause of death among women, yet awareness of the risks facing women, particularly during perimenopause and menopause, remains alarmingly low.

That is the warning from Carrickmacross-based functional medicine practitioner Brianán Dolan, who believes many women are unaware that cardiovascular disease kills more women than all cancers combined and that crucial opportunities for prevention are being missed.

“Cardiovascular disease accounts for approximately 35% of all female deaths globally, exceeding mortality from all cancers combined,” Ms Dolan explained. “In Ireland, cardiovascular disease accounts for almost one third of all deaths annually, yet there is nowhere near the level of awareness that exists for conditions such as breast cancer.”

According to the practitioner, one reason for this gap is the long-held perception that heart disease is primarily a male condition.

“We tend to think of heart attacks as a man clutching his chest and collapsing, but women often experience very different symptoms,” she said. “They can include unusual fatigue, shortness of breath, nausea, jaw pain, neck and shoulder pain, anxiety and even a sense of impending doom. Many women simply don’t realise these are possible signs of a heart attack.”

She believes the transition from perimenopause into menopause is a particularly critical period for women’s heart health.

“Up until menopause, women benefit from the protective effects of oestrogen,” she explained. “Once that protection declines, a woman’s risk of heart attack becomes similar to that of a man. At the same time, women become more prone to insulin resistance, inflammation and weight gain around the abdomen, all of which increase cardiovascular risk.”

Hot Flushes

and High Heels

Ms Dolan will join the Confidence and Style CEO Deirdre Treanor for a talk on menopause and women’s health and confidence as we age at the Íontas Centre, Castleblayney, on Thursday, October 8 from 7-9pm, at an event called Hot Flushes and High Heels.

Speaking to the Celt ahead of the event, the functional health practitioner is of the opinion that many women attribute symptoms such as poor sleep, anxiety, brain fog and fatigue to the natural ageing process and simply try to endure them.

“Menopause is not a brief event. It can affect a third of a woman’s life,” she said. “Women often put on a brave face and think they have to get through it because previous generations did. But these symptoms can have significant effects on overall health and should not be ignored.”

She also highlighted several female-specific risk factors that should prompt closer monitoring of cardiovascular health, including polycystic ovary syndrome, gestational diabetes, pre-eclampsia, early or surgical menopause and hormonal changes associated with menopause. “These factors are often overlooked, but they can signal increased cardiometabolic risk later in life,” she said.

The functional health practitioner is particularly passionate about empowering women to advocate for themselves when attending medical appointments. “I want women to know what questions to ask and what markers to discuss with their GP,” she said. “Things like blood sugar control, inflammation markers and family history can provide important clues about future cardiovascular risk.”

She believes women should also pay more attention to lifestyle factors during midlife. “Weight training, walking, prioritising sleep and eating enough protein become increasingly important as we age,” she said. “Women need protein at every meal. It helps maintain muscle mass, supports metabolic health and contributes to healthy ageing.”

As well as increasing protein intake, Brianán recommends a Mediterranean-style approach to eating, with plenty of vegetables, pulses, healthy fats and minimally processed foods.

“There is no such thing as being healthy simply because you are slim,” she said. “Waist-to-hip ratio is often a better indicator than body mass index alone.”

Urging women not to overlook symptoms such as persistent hot flushes, night sweats or sleep disruption, she warned: “Sleep is essential for brain and cardiovascular health. If you’re sleeping only three or four hours a night because of menopausal symptoms, that will eventually affect every aspect of your wellbeing.”

While hormone replacement therapy (HRT) is not suitable for everyone, Brianán believes many women have unnecessarily avoided treatment because of outdated fears.

“A lot of women were told HRT was dangerous, but the research has evolved significantly,” she said. “The most important thing is that women have access to accurate information and can make informed choices with their healthcare provider.”

Ultimately, Ms Dolan believes awareness is the key to prevention. “There are so many things women can do to protect their heart health, but first they need to know the risks,” she said. “Women are very good at looking after everyone else. They now need to start putting the same energy into looking after themselves.”

Brianán Dolan is a certified functional medicine practitioner and founder of Natural Medic.

More information is available at www.naturalmedic.ie