The Flipping 50 Show
If I Wanted to Reduce My Risk of Heart Disease Post Menopause
Published: 21 March 2025 at 09:00 Europe/London
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Episode notes
Women collectively “Catch Up” to men in their risk by age 60, largely because of the loss of estrogen. Based on studies from the American College of Cardiology’s Annual Scientific Session (April 2024) and the American Heart Association (2013, 2023).
Changes in blood pressure, cholesterol, and visceral belly fat all seem to be a part of the menopause transition for many women. Women spend 40% or more of their lives post-menopause, that’s a health risk if left unchecked. Women who have an early menopause, have even more time in their lives in post menopause.
Many women are advised or think about weight loss, stress reduction.
Very few women think about heart health risk and muscle loss. Yet, to define cardiovascular fitness is to talk about VO2 max.
VO2 max measures oxygen consumption capacity or liters of oxygen the body consumes during exercise, expressed in ml/kg/min. For every 1 liter of oxygen consumed roughly 5 kcals are burned.
Two components of VO2:
- The delivery of oxygen
- The extraction of oxygen from the tissues
Heart health CAN decline rapidly after menopause…
All statistics are based on historically what’s been true… and we sometimes forget that if we choose not to participate in the same habits of past generations we don’t have to get the same results.
If you lose muscle, you lose VO2.
If you lose VO2, you die tired, younger, sicker and fatter.
Replacing the overemphasis on cardiovascular exercise which seems to be the first go-to for women, trainers, and physicians alike, with an equal emphasis on muscle is the first step.
BUT.. that negates the fact that.. muscle-building exercise improves blood sugar levels, increase strength, stamina, power to inspire and motivate greater activity
Training Plan to Avoid Risk of Heart Disease Post Menopause
We also train wrong for women in midlife.
Highs and lows are best for women midlife.
Moderate-intensity exercise, a go-to for many women since the 80s, is actually an energy drain. Instead of reducing stress, it spikes cortisol, making fat loss and recovery harder.
High intensity to toleration during perimenopause, not all women tolerate when hormones are doing the greatest fluctuation. There’s a dance between the muscle, heart, bone benefits and the adrenals/cortisol response that has to be done.
Post menopause hormones have stabilized and a woman is likely to tolerate more high intensity- not longer but with greater frequency from say 2 times a week to up to 4. This will help overcome the loss of fast twitch muscle fibers lost more quickly with age and without fast or powerful movements. The significant boost of growth hormone and testosterone that occurs with true high intensity exercise provides mitigation of cortisol.
Let’s review this again. Moderate exercise can occur for 3 reasons:
- Intentionally you unknowingly are trying to hit moderate level exercise
- You attend boot camp type classes that never allow complete recovery. They feel hard and high intensity for long periods of time, but in actuality, you’re not reaching your peak capacity.
- You start out going at a low level but you either push it because you feel good or you go longer because it feels good, both result in a cardiac drift into the “no benefits zone” of moderate intensity exercise.
What’s the answer? Your midlife workout formula should look like this:
- 80% Low Intensity (walking, recovery movement)
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