Could I be in
perimenopause?

Why this matters beyond your periods

What does perimenopause have to do with your heart?

Perimenopause is the time leading up to menopause, when hormone levels shift.

Estrogen helps influence blood vessels and how your body handles cholesterol. As hormones change around menopause, LDL—the cholesterol that can build up in artery walls—may rise. More fat may collect around your middle, too. Age, blood pressure, smoking, diabetes and family history also shape your risk.

Having hot flashes does not mean you have heart disease. But this stage is a useful time to check in on your heart health, even if you feel well. The American Heart Association’s 2020 scientific statement identifies the menopause transition as an opportunity for earlier prevention.

Remember to tell your heart doctor about your periods, too.

If your periods have become heavier, less predictable or have stopped, mention it at your heart appointment. Bring your quiz note and a list of any hormone medicines you take. These details can help your doctor understand your symptoms and decide what needs checking.

The 2026 cholesterol guidelines say doctors should consider whether you reached menopause before age 45 or had certain pregnancy complications when deciding how to help protect your heart. Something that happened years ago may still matter today. Read the American Heart Association’s guidance on women’s health history.

Ask: “Does any of this change what we should do for my heart?”

You do not need to know how everything connects before you bring it up.

What do the new guidelines say?

The 2026 ACC/AHA cholesterol guideline emphasizes looking at risk earlier and over a lifetime. It recommends checking lipoprotein(a), or Lp(a), at least once in adulthood. This blood-fat particle can add to heart risk. Its level is mostly inherited, and it is not included in a standard cholesterol panel.

At your next visit, ask: “Can we review my blood pressure, cholesterol and whether blood sugar testing is due? Have I had an Lp(a) test?” Mention heart disease in close relatives, too. Your history helps decide what needs attention.

What is the “window of opportunity”?

For heart health, think of it as a chance to act early: find changes, choose a manageable plan and follow up. If you are already past menopause, prevention still matters. You have not missed your chance to care for your heart.

You may also hear this phrase about hormone therapy. That is a separate treatment discussion. The Menopause Society’s 2022 position statement says the balance of benefits and risks is generally more favorable for treating bothersome hot flashes in healthy women under 60 or within 10 years of menopause, when there is no medical reason to avoid treatment. Your own age, timing and health history still matter.

Hormone therapy is not recommended solely to prevent heart disease. Hormonal and nonhormonal treatments can help with symptoms; ask which options fit you.