Pregnancy
Pregnancy causes profound changes in a woman's body, including her cardiovascular system. To support the growing fetus, the mother's blood volume and the work her heart does increases by up to 50%. As a result, her heart rate increases and her blood pressure decreases. Along with these changes, labour presents additional challenges to the heart and cardiovascular system. Heart disease is a complication in up to four of every 100 pregnancies.
Because these changes are so dramatic, it is not uncommon for pregnant women to experience symptoms associated with heart disease. The most common of these symptoms include heart murmurs, blood pressure problems and arrhythmias, which are changes in the speed or pattern of the heartbeat. If you are pregnant, it is important that you report unusual symptoms to your doctor immediately.
Pre-existing Heart Conditions
Women who have a heart condition or who have had an event such as a heart attack, heart failure or stroke should talk to their doctor before deciding to become pregnant.
Pre-existing Heart Disease Risk Factors
Women who have risk factors for heart disease prior to becoming pregnant are at increased risk for complications during pregnancy. These risk factors include:
Congenital Heart Defects and Inherited Conditions
Women with congenital heart defects or other inherited cardiovascular conditions such as arrhythmias have additional factors to consider before deciding to become pregnant. For example:
- The their own health and the nature of their heart condition
- The need to take medications that could impact the fetus
- The possibility of passing on an inherited condition to the baby
Individual situations vary based on the mother's specific condition. Many women have safe and successful pregnancies. However, in some situations, pregnancy may not be advisable. If you have a congenital or inherited condition, you should consult your doctor before deciding to become pregnant.
Menopause and Hormone Replacement
Menopause
Menopause is the end of a woman's monthly menstrual periods. This usually occurs between the ages of 40 and 55. Common symptoms of menopause include hot flashes, night sweats, mood changes, and vaginal dryness.
These symptoms are a result of a drop in levels of the hormones estrogen and progesterone. The type, intensity, and length of menopause symptoms differ among women. If these symptoms are severe, they can affect your quality of life.
Your risk for heart disease increases with age and with the onset of menopause. Estrogen is believed to protect younger women from developing heart disease, but as you age, your estrogen levels begin to decrease.
Hormone Replacement Therapy
Hormone Replacement Therapy (HRT) is a supplement of the hormone estrogen, with or without progesterone depending on whether a woman has had surgery to remove her uterus or not (hysterectomy). HRT can be prescribed as a pill, a patch or a gel. HRT has been shown to reduce the severity of menopausal symptoms.
HRT and Heart Disease
For some time, it was believed that HRT could help reduce the risk of heart disease in older women. But results from the most recent studies tell us that, for some women, taking hormones can actually increase the risk of heart attack, stroke, blood clots, and breast cancer.
HRT can help with some symptoms of menopause including hot flashes, vaginal dryness, mood swings, and bone loss. If hormone replacement is used, it is recommended that hormones be used at the lowest dose for the shortest time needed.
The decision to take hormone replacement therapy should be based on each woman's individual needs, risks and health. Talk with your doctor about your own potential risks and benefits
Resources
- Women@Heart
A peer support program led by women with heart disease, for women with heart disease that aims to create a caring environment for women to learn from each other. - For more information on women and heart disease, please visit the Canadian Women's Heart Health Centre.