Ms. Nguyen Thi Thanh (57 years old, Dong Nai province) has been in the pre-menopausal period for 3 years now. During a periodic health check-up, Ms. Thanh was diagnosed with a heart disease by the doctor, which surprised her.
"I have a history of high blood pressure, but I don't think about heart disease anymore because I think shortness of breath or the feeling of a heartbeat is just because I'm getting older. The doctor instructed me to treat and have a follow-up examination to control my heart disease," said Ms. Thanh.
According to Associate Professor. Dr. Ho Thuong Dung, Deputy Director of Thong Nhat Hospital, Ho Chi Minh City, premenopause, with irregular menstrual cycles and related symptoms, lasts nearly half of a woman's life when life expectancy increases.
Estrogen protects the cardiovascular system in young women, but when premenopause arrives, this "shield" weakens, pushing the risk of cardiovascular disease in middle age up.
Worryingly, reputable scientific recommendations (AHA 2012, 2020) still state a lack of interest and clinical data for this group of patients. Statistics in the US show that unhealthy lifestyles are common in middle-aged women, aggravating the risk.
According to Dr. Dung, early menopause (under 45 years old) is a major risk factor, increasing the frequency of cardiovascular disease compared to menopause at the right age (50-55).
Menopause due to ovarian surgery is similar, especially dangerous for young women. Symptoms of severe and persistent burns are also a "call" warning of cardiovascular disease.
Women experience "double aging": ovarian aging (hormonal content) and aging over time (age). Ovarian aging causes belly fat accumulation, blood lipid disorders (increased LDL, HDL loss of protective function), while aging is associated with weight gain and high blood pressure.
Notably, high blood pressure is more related to age, but arteriosclerosis increases during the period around menopause due to hormonal effects.
An worrying "gender gap" exists in treatment. Women with severe cardiovascular disease are often not given active intervention like men (higher mortality rate, lower cardiovascular intervention - US data 2021).
Associate Professor, Dr. Ho Thuong Dung added that medicine often only focuses on the reproductive organs but forgets the cardiovascular system of women. The history of biomedical research also shows a lack of women in studies due to concerns about drug safety, leading to a lack of treatment data.
Prevention needs to focus on both traditional risk factors (insensitivity, smoking, blood fat, diabetes, obesity) and specific factors in women (social factors, psychology, hormones, pregnancy history).
Currently, there are many shortcomings in premenopausal women's care. They often see an obstetrician and gynecologist (focusing on treating menopausal symptoms rather than cardiovascular disease) or come to the department of medicine too late. Premenopause is unclear and lacks evidence-based treatment instructions.
To narrow this "space", it is necessary to coordinate between specialties, raise awareness of cardiovascular risks in premenopausal women, screen early and change their lifestyle to protect their "second heart".
