You could just call this post “how being a woman affects heart health in many ways,” but I’ll try to keep it a little more focused. February is American Heart Month. That’s important because heart disease is still the number one killer of women, according to the American Heart Association.

Women’s heart health is a big deal and you’ve probably seen posts about it all over. What you may not know is that having fertility challenges, whether due to PCOS, endometriosis, or premature ovarian failure/insufficiency, can increase your risk of heart disease. So your fertility struggles come with heartbreak and, potentially, a compromised heart. Let’s take a look at exactly how infertility—and other women’s issues—and heart health are related.

PCOS

Polycystic ovary syndrome is a very common cause of fertility challenges. Characterized by irregular periods, a high number of “stunted” follicles in the ovaries, high levels of androgenic hormones and/or possibly some signs/symptoms we see in metabolic syndrome. That would be high blood sugar, high blood pressure or cholesterol, excess weight (although not always) and more. These are risks for heart disease. People with PCOS are more likely to develop type 2 diabetes and high blood pressure than people without it.

Endometriosis

In endometriosis, endometrial tissue (typically found only in the uterus) grows outside the uterus, glomming onto the outside of the uterus, fallopian tubes, ovaries, intestines, bladder and even the diaphragm. Endometriosis is a very complicated picture and experts aren’t sure what causes it yet. But various studies have found that people with endometriosis have a higher risk of heart attack and heart disease. In Chinese medicine, this makes total sense since part of the picture we see in endometriosis is what we call blood stagnation, blood not moving. Often, this isn’t just in the reproductive organs, it’s a systemic (whole body) issue. (And yes, we have treatments to help with this picture.)

Diminished ovarian reserve

If you’ve been told that your antral follicle count is low, your estrogen is low or your FSH is high, or you’re not responding to IVF stimulation medications, you may have diminished ovarian reserve (DOR) or premature ovarian insufficiency (POI). Some research has suggested that women with low AMH (antimullerian hormone, which is released by follicles in the ovaries—low number of follicles equals low AMH), may have a higher risk for cardiovascular disease. More research is needed, but this isn’t super surprising because…see the next one….

Perimenopause/Menopause

The hormonal changes that start happening in perimenopause (the seven to 10 years leading up to cessation of menstruation) can start setting the stage for increased risk of heart disease in menopause. At first estrogen and progesterone start fluctuating wildly and then they head down, down, down. Estrogen plays key roles throughout the body, including keeping blood vessels more pliable and less stiff. Rates of high blood pressure and cardiovascular disease increase significantly in menopause, when estrogen and progesterone are super low. (Check out one of my recent posts to hear the good news about menopause treatments.)

Pregnancy Complications

If you were able to conceive but experienced complications like high blood pressure, gestational diabetes, pre-term birth, placental abruption or preeclampsia, then you have a higher risk of developing heart disease down the road, per the American Heart Association. (Having a stillbirth also significantly increases risk.) Always tell your doctor about any pregnancy complications you experienced, even if it was more than a decade ago. They affect your risk later on.

So what does this all mean, except that women’s heart health is complicated and being a woman seems to provide many opportunities to develop heart disease? Mainly, it means that you need to prioritize your heart health if you have any of these conditions that may be affecting fertility or if you’re heading into your 40s and beyond. (If you’re already into menopause it’s never too late to start prioritizing your heart health.)

Obviously, you can’t turn off your PCOS, endometriosis or DOR. You certainly can’t change the fact that your periods will end and your hormones will shift. But there are things you can do.

So stay tuned for my next blog post when we’ll go into exactly how you can make your heart happier every day…and improve your longevity.