The Grandmother Hypothesis & Heart Health

When it comes to menopause, scientists have formed many theories as to why humans, unlike all other primates and nearly all other species, live so far beyond our reproductive years. The most commonly accepted is the "Grandmother Hypothesis."

The grandmother hypothesis suggests that women undergo menopause because it is more beneficial to cease their own reproduction and aid in the rearing of grandchildren. Their daughters' risk of health and birth defects is lower, and menopause allows for increases in quality over quantity. Makes sense from an evolutionary standpoint, but how does that affect the health and wellness of the menopausal woman?

In 1901, the life expectancy was between 47 and 50 years. In 2019, life expectancy for women is 85, and the average age of menopause is 51. For the first time in history, we are living just as much of our lives in menopause as we did in our fertile years, around 35 years in each

Not only has our life expectancy changed in the past 100 or so years, so have the causes of death. In the early 1900s, most adults died of infections. With the advent of antibiotics, infections rank 8th on the causes of death in today's world, behind even accidents and Alzheimer's Disease.

I’ve heard many times that heart disease is the leading cause of death for women, but I didn’t realize just how much higher the stats were. Women die of heart-related issues 10x more often than from breast cancer. Once thought to be a “male” problem, cardiovascular disease causes a larger number of deaths in older women than in older men. Nearly a million more in a 2004 study!

While menopause does not cause cardiovascular disease, our long postmenopausal lifespans are definitely a factor in the rise of heart disease as the number one killer of women.

A decline in the natural hormone estrogen may be a factor in heart disease increase among postmenopausal women. Estrogen is believed to have a positive effect on the inner layer of the artery wall, helping to keep blood vessels flexible. That means they can relax and expand to accommodate blood flow. When estrogen drops in menopause, so do the protective effects.

Other assorted changes in the body that occur with menopause also contribute to heart disease. Blood pressure starts to go up. LDL cholesterol, or “bad” cholesterol, tends to increase while HDL or “good” cholesterol declines or remains the same. Triglycerides, certain types of fats in the blood, also increase.

Other common risk factors also contribute, including high blood pressure, high LDL cholesterol, smoking, diabetes, overweight or obesity, unhealthy diet, physical inactivity, drinking too much alcohol, and of course, family history.

Most women don't have any symptoms of heart disease, but some have reported angina (dull and heavy or sharp chest pain or discomfort), pain in the neck, jaw or throat, and pain in the upper abdomen or back.

Heart attack symptoms can include chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, and shortness of breath.

Despite the common knowledge that cardiovascular disease is the number one cause of death in females, women have different ways of having a heart attack than men, so when traditional tests — based on men’s bodies — show everything is “normal," female heart patients are often told it must be reflux or anxiety. It’s not misogyny, but a traditional sex and gender bias in medicine that’s leading female patients to be misdiagnosed, neglected, dismissed as complainers, accused of being overanxious, mislabeled as depressed or told their symptoms are "just menopause."

If you feel you may be experiencing the symptoms of heart disease, or want to have a thorough screening for heart disease, be persistent with your doctor! Don't let them convince you that it's anxiety or hormones. Trust yourself, and if you're feeling like it could be more serious, tell your doctor you want to be screened or find another doctor.

If you show signs that make you think you are having a heart attack, call 9-1-1 immediately. Don't wait to see if it passes, or dismiss the symptoms as no big deal.

And talk to your spouse, children, and friends about the symptoms of heart attack in a woman as well, so they can call 9-1-1 if you're unable to.

Make the most of your long postmenopausal life by making heart health a priority!

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