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  • Writer's pictureJanet O'Neill

Five ways to reduce heart risks to women this world menopause day

With World Menopause Day shining a light on the link between heart health and hormones, here are five ways to help female employees reduce the risks.

Even though twice as many women die of heart disease than breast cancer in the UK, women are twice as likely as men to get the wrong diagnosis after a heart attack. With almost one in two women (47%) experiencing heart failure, stroke or death five years after a heart attack.

Perimenopause – the time leading up to menopause, which starts to affect women in their late 30s and early 40s – can increase the risk of heart problems. This is due to reduced production of Oestrogen, a heart-protective hormone.

Fortunately, there are several things employers can do to help women reduce heart health risks, starting by raising awareness of the issue as part of this year’s World Menopause Day (18 October). Janet O’Neill, our head of occupational health training, shares her top five tips.

1. Encourage women to check their heart health

Most women are now aware of the importance of actively checking themselves for breast lumps and have regular eye and dental checks. Very few are aware of the importance of checking their heart health.

Encourage those over the age of 40 to take up their free NHS health check, which includes a heart health assessment or offer free health checks at work. These can be done on a voluntary basis, as part of a wellbeing day, or offered as part of an employee benefits package.

Those who have a history of heart issues within their family, have gone through early menopause or are considered at risk due to high cholesterol, should also be encouraged to get a home blood pressure testing kit, so they can regularly keep an eye on their blood pressure.

2. Explain the symptoms of heart disease

Most people are aware of the symptoms of cardiac arrest (when the heart stops beating and the person loses consciousness). However, far fewer people are aware of the symptoms of heart disease (when the arteries become furred up with fatty deposits) or a heart attack (when blockages reduce oxygen to parts of the heart).

This is particularly for women who can experience a heart attack with much milder symptoms than the widely advertised chest pressure and pain radiating up the arm. For example, women might just experience shortness of breath, light-headedness, feelings of nausea or indigestion and sweating in what’s often dubbed a ‘silent heart attack’.

We often come across women, referred to our occupational health services, who were tempted to dismiss these symptoms as not being severe enough to trouble the NHS, when they were actually having a heart attack. By making sure both men and women know all the possible symptoms of a heart attack, you can give them the confidence to go straight to A&E.

Symptoms of a heart attack can include:

  • Feeling lightheaded or dizzy

  • Shortness of breath

  • Sweating

  • Feeling sick (nausea) or being sick

  • Overwhelming feeling of anxiety (like a panic attack)

  • Chest pain – a feeling of pressure, heaviness, tightness or squeezing across your chest

  • Pain in other parts of the body – it can feel as if the pain is spreading from your chest to your arms (usually the left arm, but it can affect both arms), jaw, neck, back or stomach

  • Coughing or wheezing

3. Promote positive lifestyle changes

Simple lifestyle changes, such as quitting smoking, taking more exercise and eating more healthily can help to reduce the risk of heart disease. As can reducing stress levels, with research by the World Health Organisation showing that working 55 hours or more a week increases the risk of developing heart disease by 17%.

Employers can help by making it possible for all employees to make healthy choices both in and outside of work. Initiatives as simple as encouraging everyone to disconnect from work in the evening and take fresh-air-breaks during the day can make a big difference.

Healthy eating is also essential to sustaining good heart health, but many women entering menopause are also juggling looking after teenagers and older relatives, so struggle to cook healthy food from scratch every night. Encouraging them to get other family members to help out and use frozen vegetables, tinned beans and bulk cooking can go a long way towards motivating them to eat well, for less, instead of reaching for cholesterol rich fast food.

4. Don’t underestimate the impact of menopause

The reduction in oestrogen associated with menopause not only increases the risk of heart disease, but also causes a range of symptoms that can put women under incredible strain. As well as experiencing the more well-known side effects, such as hot flushes, menopause can also lead to fatigue and significant cognitive difficulties.

Many women suddenly find they suddenly can’t do basic things, such as remembering words or giving presentations, that they used to excel at. The anxiety and stress associated with this is not only very bad for heart health, but has also contributed to one in ten women deciding to quit work due to menopause symptoms.

Although treatment, such as hormone replacement therapy (HRT) can help, it takes time to take effect, so you might also want to consider reasonable adjustments. This should be tailored to individuals but could include a stress risk assessment to review particular difficulties in the workplace and/or access to occupational health to look at bespoke adjustments depending on symptoms. For example, new ways of working and use of memory aids to reduce errors caused by forgetfulness.

5. Train managers to signpost to support

Although menopause takes place when women are aged 51 on average, perimenopause can start 15 years before, meaning women in their late 30s and early 40s often have no idea why they’re struggling with fatigue, memory loss and anxiety. It also means they also have no idea they need to start taking extra care of their hearts.

Managers are often one of the first to notice when an employee is struggling, so should be encouraged to offer kind enquiry and take employees aside to observe how they’ve seen them struggling and let them know about any appropriate support services in place.

Having these conversations can be daunting for some managers, so it can also be helpful to create a menopause policy and offer training on how to open up a conversation about menopause (see our free guide on how to write a menopause policy ). Published case studies on how other women have been supported and employee support groups and workshops, can also help to create an open culture where people feel safe asking for support.


Free Quick Guide: How to support heart health at work

Download our free guide for managers and employees on spotting the signs of a heart attack and ways to reduce the risk of this happening.


How we can help…

At PAM OH, we are committed to helping you to prevent sickness absence by putting in place education and support services. Our menopause support services include:

Menopause self-assessment – a free self-assessment questionnaire that women who aren’t feeling themselves can complete to see if they are entering the menopause.

Occupational health assessment – to identify how the menopause is impacting an individual at work and suggest coping strategies and recommended adjustments to work.

Employee Assistance Programme (EAP) – confidential telephone access to mental health counsellors providing emotional support and practice advice on tackling memory issues.

Menopause workshops – to educate employees about the symptoms of menopause, what to expect and how best to support themselves through the transition.

Manager workshops – practical sessions to educate managers about the menopause and how it can impact on people at work and their role in signposting towards appropriate support.

Heart health workshops – to educate employees about the symptoms of a heart attack, what to do and how best to get the support and treatment needed to help reduce risks.


To set up a free consultation to discuss ways of managing cardiovascular disease at your organisation, please contact your PAM Account Manager or email


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