The heart. Pre-menopausal women in general have a lower risk of heart attack than men of a comparable age. After menopause the rate at which women suffer heart attacks increases dramatically. There appears to be an increase in the levels of certain types of cholesterol and triglyceride (blood fats, or lipids) associated with the decreasing levels of oestrogen. This has an effect on the blood vessels of the heart (as well as the brain, and all other vessels in the body, for that matter). We tend to notice the changes in the heart and brain vessels more because when they get clogged, the result is a heart attack (a coronary occlusion, or an acute myocardial infarct), and a clogged vessel in the brain gives rise to a stroke (a cerebrovascular accident).

Unfortunately a very large risk factor, family history, is impossible to change. Having your name changed by deed-poll does not take away the fact that your father, an aunt and your sister have all had bypass surgery.

Another important factor in cardiovascular (heart and blood vessel) disease is smoking. Overall, women who do not smoke have a lower risk than women who do. Not a lot of surprises in that.

So the menopausal woman may have the added burden of an increased risk of vascular disease as a result of her oestrogen deficiency. This is not to say that everyone will be affected, but statistically there is a significant increase in the population, particularly in women who have an early menopause.

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