What you probably already know: Cardiovascular disease is the leading cause of death in women, claiming more than 400,000 lives in the U.S. each year. Heart attacks in women are also the most commonly misdiagnosed disease in the U.S., with about 50% of heart attacks being treated as milder conditions like anxiety or indigestion. Current health models do not take female biological transitions like periods, pregnancy, perimenopause, menopause, and all of their hormonal changes into account. A new health framework built by the American Heart Association, American Academy for Pediatrics, American College of Obstetricians and Gynecologists, and the Society for Maternal-Fetal Medicine hope to address these differences and build new guidelines for how health care professionals treat their female patients.
Why it matters: New studies have begun to emerge that examine how changing estrogen levels during perimenopause and menopause can affect heart health. But even lesser known research shows that cardiovascular risk factors can begin to emerge around the time girls get their first period. To address the overwhelming risk of cardiovascular disease in women, these four health agencies have put together a connective framework for doctors treating women and girls of any age in order to help lower the risk of late-stage heart issues.
What it means: The Female Life Stage framework is structured into five stages, offering unique health guidance in each. Stage one, perimenarche, represents early menstrual cycles and addresses girls between the ages of 8 and 15; stage two acknowledges the ovaries’ cycle during the time period when it is fertile and when pregnancy is most likely to occur; stage 3 addresses perimenopause; stage four relates to postmenopause; and a fifth stage addresses pregnancy in any life stage. Within each stage, the framework offers a holistic approach to women’s heart health and acknowledges that looking at the heart alone does not fully treat underlying causes or risks like hormonal changes. For example, the first signs of endometriosis and PMOS can emerge in early adolescence, but both are rarely diagnosed until later stages of a woman’s life and can bring major impacts to hormonal, psychological, and cardiovascular health if you wait too long to treat them.
What happens now? The four health societies are calling for a national infrastructure to be built upon its findings and suggest four main pillars: interdisciplinary clinical care, professional education and training, and research and community engagement. They also suggest more research be conducted to address gaps in evidence specific to women by prioritizing the inclusion of women in new studies, funding into related health initiatives, and the translation of evidence into action.
