At Forty Fifty, we couldn’t be happier that the conversation around menopause has awoken. After living/suffering in silence, a topic considered unimportant is finally having a moment. A study found that 58% of medical textbooks worldwide did not reference menopause, and 12% dedicated less than a paragraph to the topic. Additionally, a survey of OB/GYN program directors found that 83.8% agreed or strongly agreed that their programs needed more menopause educational resources as they are rarely longer than 10 hours spent.
While we marinate on that, the systemic issue is hard to ignore: the lack of representation of women in the data and the distraction from the issues that affect our health and well-being the most. Menopause tends to be a blanket term for many symptoms that may or may not be associated with it. However, what is most important is that recognition is beginning to be seen and shared. Caroline Criado Perez has been advocating for this data inclusion and articulates it best in her book “Invisible Women.”
Invisible Women shows us how, in a world largely built for and by men, we are systematically ignoring half the population. It exposes the gender data gap – a gap in our knowledge that is at the root of perpetual, systemic discrimination against women, and that has created a pervasive but invisible bias with a profound effect on women’s lives
If you’re like most women, heart health probably hasn’t been your main focus over the years. There’s always something else grabbing your attention—kids, work, relationships, aging parents, pets. And then suddenly, you find yourself in your 40s or 50s, feeling the tug of fatigue and wondering if it’s just stress or something more. But here’s the thing: heart disease doesn’t show up with a dramatic entrance. It’s subtle, gradual, and often silent until it’s not.
Heart health for women in midlife is often overshadowed by more visible issues like breast cancer or the challenges of menopause. Yet, heart disease is the leading cause of death for women. Romanticism tells us the heart is the center of our emotions, the core of our passions. But the heart’s health often becomes an afterthought in the daily grind. For many of us, the wake-up call comes too late. Melissa, 54, assumed her fatigue and shortness of breath were just part of menopause. She didn’t realize her heart was crying out for attention until her doctor gave her a stark warning: high blood pressure, high cholesterol, and real danger. It wasn’t just the stress of life—it was heart disease taking root.
In menopause, hormonal shifts—particularly the loss of estrogen—leave us vulnerable. Estrogen once protected our blood vessels, keeping them flexible and healthy. High blood pressure, cholesterol, and heart disease risk rises sharply as it fades. Yet, we often brush off signs like weight gain, fatigue, and stress as “just menopause.”
But it’s more than that. The build-up of risk factors—like weight gain around the belly, sleep disturbances, and chronic stress—add up. Many women assume the emotional and physical tolls are part of aging, but often, it’s our hearts under strain. But paying attention now means we don’t have to face a devastating wake-up call later. Caring for your heart doesn’t have to be a dramatic overhaul. Listen to your body’s clues, check in with your doctor, and recognize that self-care goes beyond managing menopause.
For more information, we encourage you to read our Cardiology Guide, an introduction to preventative heart health. Your heart isn’t just the romantic core of who you are—it’s the central instrument in the orchestra of your life. And now, in midlife, it needs you to care for it as much as it’s cared for you.
In solidarity,
Ali, Forty Fifty
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👏❤️ YES to heart health checks and advocating for ourselves in following up new symptoms and changes we might not think could be associated with cardio health. (Trackers on wearables like watches and rings do, I find, make a difference in helping me notice trends in heart rate etc but nothing takes the place of medical consultation and just asking the questions.) So so good. Xxxx