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Perimenopause may offer “window of opportunity” for heart disease prevention

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Perimenopause may offer a key window to spot heart disease risk earlier, with women in the transition twice as likely to have low heart health scores, new research suggests.

The findings suggest the transition to menopause could be an important time to reassess risk and prompt lifestyle changes.

Garima Arora is senior author of the study and professor of medicine in the division of cardiovascular disease at the University of Alabama at Birmingham.

Arora said: “Mid-life women should think of the perimenopausal period as a ‘window of opportunity.’

They should be proactive and not wait until they reach menopause to start checking their blood pressure, cholesterol and blood sugar levels.

“Women should talk with their health care team about their reproductive status and any changes they are experiencing. It may be the perfect time to get a baseline for their heart health.”

The analysis included 9,248 women aged 18 to 80 who took part in the National Health and Nutrition Examination Survey between 2007 and 2020.

Researchers used Life’s Essential 8, a heart health score developed by the American Heart Association. It measures diet, physical activity, tobacco use, sleep, blood pressure, cholesterol, body weight and blood sugar on a 100-point scale.

Median scores fell as women moved through reproductive stages, from 73.3 out of 100 in premenopausal women to 69.1 in perimenopausal women and 63.9 in postmenopausal women.

Among the individual Life’s Essential 8 measures, diet consistently had the lowest scores and continued to decline across all reproductive stages.

After accounting for age, perimenopausal women were twice as likely to have a low overall score as premenopausal women.

They were also 76 per cent more likely to have a low cholesterol score and 83 per cent more likely to have a low blood sugar score.

The researchers said fluctuations in oestrogen levels during perimenopause may contribute to lower cardiovascular health because they may affect cholesterol, insulin resistance, blood pressure and weight management.

Insulin resistance means the body does not respond properly to insulin, the hormone that helps control blood sugar.

Sleep duration scores remained high across all reproductive stages, despite perimenopausal women reporting difficulty sleeping, suggesting sleep quality may be more affected than sleep length.

Amrita Nayak, lead author of the study and research fellow in the division of cardiovascular disease at the University of Alabama at Birmingham, said the findings highlight a point where risk may begin to rise.

She said: “Our analysis highlights that perimenopause, women’s reproductive transition period to menopause, is the critical time when the increase in cardiovascular risk seems magnified.

“When we compared women’s LE8 scores to the premenopausal baseline, the perimenopausal group was the first to show a significant jump in the odds of having low heart health.”

Arora added that nutrition could be an important area for early intervention.

“Nutrition can be a central factor for early and proactive intervention.

“Focusing on heart-healthy habits early, especially getting regular exercise and following a healthy eating plan like the DASH diet with a focus on lowering salt can help improve cardiovascular health for perimenopausal women in the years to come.”

Stacey E. Rosen, volunteer president of the American Heart Association, who was not involved in the study, said the findings underline the need to consider women-specific risk factors across life stages.

“This research highlights yet another aspect of the unique factors that increase a woman’s risk of cardiovascular disease throughout the stages of her lifespan.

“Significant health changes during pregnancy, perimenopause and menopause make it particularly important to pay close attention to increases in health risk factors during those times.

“I encourage women to talk with their primary care and specialty health care teams to learn about early detection and modification of traditional and ‘female-specific’ risk factors.

“Women can take proven steps to improve their cardiovascular health at all ages.”

The researchers said the next step is to follow women over several years to track hormone levels and heart health, which may help clarify the long-term impact of perimenopause and how lifestyle changes could reduce risk.

Pregnancy

Pregnant women may reduce key health risk through more light exercise, study finds

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Light exercise and less sitting may reduce pregnant women’s risk of serious blood pressure complications, according to a new study.

Researchers have proposed a daily activity and sleep guide that they say was linked to a nearly 30 per cent lower risk of hypertensive disorders of pregnancy.

The suggested pattern includes fewer than eight hours of sedentary time, at least seven hours of light physical activity, around 22 minutes of more intense activity and nearly nine hours of sleep.

The University of Iowa-led study examined the daily behaviours of 470 pregnant women across all stages of pregnancy.

Participants wore monitors that measured physical activity over 24-hour periods and recorded how long they spent asleep.

Hypertensive disorders of pregnancy include chronic high blood pressure, gestational hypertension and pre-eclampsia.

Gestational hypertension is high blood pressure that develops during pregnancy, while pre-eclampsia is a potentially serious condition involving high blood pressure and signs that organs may be affected.

Sedentary behaviour means being mostly inactive, such as sitting or lying down.

Light physical activity can include casual walking, moving around the home or standing.

Moderate to vigorous activity includes movement such as brisk walking, where breathing and heart rate increase.

Kara Whitaker, associate professor in the department of health, sport, and human physiology at Iowa and corresponding author of the study, said: “We are identifying the optimal composition of movement behaviours across the day associated with the lowest risk of developing HDP and the most improved health outcomes.

“This blueprint holds for each and every trimester of pregnancy.”

Study participants were enrolled at sites in Iowa City, Pittsburgh and Morgantown, West Virginia.

The women wore activity and sleep monitors for at least one week during each trimester of pregnancy.

Four in five participants were non-Hispanic white and nearly a quarter lived in rural areas.

The data showed a steep rise in risk among pregnant women who were sedentary for more than 10 hours a day.

Women who increased light physical activity to at least four hours a day reduced their risk of hypertensive disorders of pregnancy to 15 per cent from 30 per cent.

Whitaker said: “Just moving around more seems to have significant health benefits.

“And I think it also may be a more feasible target for women who are pregnant who are not exercising regularly.”

The researchers said they were surprised that longer durations of moderate to vigorous physical activity did not appear to provide additional benefit.

Sleep beyond a certain duration also did not appear to bring major further benefits.

Whitaker said: “Through this study, we are providing evidence that reducing sedentary behaviour and engaging in light physical activity are important, and maybe more important, when it comes to pregnancy and health.”

The findings may be relevant beyond pregnancy because clinical research has shown that women who develop hypertensive disorders of pregnancy are more than twice as likely to develop heart disease later in life.

Cardiovascular disease includes conditions affecting the heart and blood vessels, such as heart disease and stroke.

Whitaker said: “We know that cardiovascular disease is the number one killer of women, and if we can intervene in pregnancy and prevent women from developing a hypertensive disorder of pregnancy, we are putting them on a better trajectory, away from cardiovascular disease and toward more optimal cardiovascular health.”

The study was published online on June 10.

A second study, published online on May 27, looked more closely at the ratio and type of sedentary behaviour and light physical activity linked to a lower risk of hypertensive disorders of pregnancy.

Whitaker is a lead co-author on that study.

Co-authors in the June 10 study include Alex Crisp, Jaemyung Kim, Karina Smith, Donna Santillan, Mark Santillan and Bridget Zimmerman, from Iowa; Jacob Gallagher, from Iowa State University; Melissa Jones, from Oakland University in Michigan; Bethany Barone Gibbs, Katrina Wilhite, Alexis Thrower and Iqra Sheikh, from West Virginia University; and Sabera Rahman, Janet Catov, Christopher Kline and Maisa Feghali, from the University of Pittsburgh.

The National Institutes of Health, the University of Iowa Institute for Clinical and Translational Science, the University of Pittsburgh Clinical and Translational Science Institute and the West Virginia Clinical and Translational Science Institute funded the research.

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News

Femtech World Awards 2026: Winners revealed

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We are excited to reveal the winners of the third annual Femtech World Awards.

The winners were announced at a virtual event this afternoon attended by shortlisted companies, along with sponsors and judges.

The event welcomed guests from the UK, Europe, Asia, Africa and North America.

Thank you to all 174 entries, as well as the sponsors for making the event possible.

See you in 2027!

Femtech World Awards 2026 Winners

Winner:

Shortlisted:

IVI RMA x Juno Genetics

Natural Cycles

Winner:

Highly commended:

U-Ploid

Shortlisted:

Hello Inside

Winner:

WISE HF, led by Prof. Mary Ryder

Highly commended:

Cardiac College for Women

Shortlisted:

Hyvelle Ferguson-Davis

CognitiveCare

Winner:

Highly commended:

Youterus

Shortlisted:

ŌURA

Winner:

Shortlisted:

LeanShield by ParrotPal Group

Perigen

Winner:

Shortlisted:

Body Moody

Looop

Winner:

Shortlisted:

Owning Your Menopause

Womeno

Winner:

Shortlisted:

The Blue Box

Celbrea

Winner:

Shortlisted:

HealCycle

Mor

Winner:

Shortlisted:

HRC Fertility

Mira

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Motherhood

Expectations about sleep affect postpartum sleep quality, study finds

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Pregnant women’s expectations about postpartum sleep may predict sleep quality after birth, outweighing prior sleep and psychiatric history, a study suggests.

The findings suggest attitudes and beliefs about sleep during pregnancy could be a modifiable risk factor for postpartum sleep concerns.

They also indicate that, among women expecting the poorest sleep, higher postpartum anxiety may further worsen sleep quality.

Sammy Dhaliwal, lead author is clinical health psychologist and research fellow in the department of obstetrics and gynaecology at the Perelman School of Medicine at the University of Pennsylvania.

Dhaliwal said: “Most pregnant women in our sample anticipated poor postpartum sleep before it occurred, and it was striking that those expectations predicted worse sleep outcomes even after accounting for factors such as prior sleep disorders, psychiatric history, and number of previous births.

“This suggests that attitudes and beliefs about sleep during pregnancy may represent a modifiable target for early intervention before postpartum sleep problems emerge.”

Sleep disturbance affects an estimated 60 to 80 per cent of postpartum women and is linked to a higher risk of depression and anxiety.

Researchers said it is often regarded as an expected part of life after childbirth rather than a health issue that may be addressed earlier.

The study enrolled 432 pregnant women at about 24 weeks of gestation, meaning around 24 weeks into pregnancy.

Participants completed measures of their expectations about postpartum sleep, current sleep quality using the Pittsburgh Sleep Quality Index, and mood using validated depression and anxiety scales.

Assessments were repeated at six, 12 and 24 weeks postpartum.

A subset of 49 women also wore wrist actigraphy devices at six to eight weeks postpartum.

Actigraphy uses a wearable device, similar to a watch, to estimate sleep and wake patterns based on movement.

The results showed that 70 per cent of pregnant women, or 301 of 432 participants, expected poor sleep in the postpartum period.

Researchers found that predicted sleep disruption during pregnancy was a significant predictor of postpartum sleep concerns.

Among first-time pregnant women without prior health concerns, those who expected greater sleep disturbance had significantly more disrupted sleep after birth, measured by both actigraphy and self-report.

Among women who expected the worst sleep quality, higher postpartum anxiety significantly worsened both measured sleep and self-reported sleep, independent of anxiety levels during pregnancy.

Dhaliwal said the findings point to two possible areas for intervention: addressing sleep-related beliefs during pregnancy and treating postpartum anxiety.

Dhaliwal said: “Postpartum sleep disruption is often treated only after problems develop, but our findings suggest there may be an opportunity to intervene earlier during pregnancy.

“Addressing sleep-related beliefs and postpartum anxiety during prenatal and postpartum care may help improve sleep and emotional well-being in new mothers.”

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