Menopause and Blood Pressure: What You Need to Know

As people navigate perimenopause, they start to become familiar with those common menopausal experiences. Hot flashes. Irregular periods. Heavy periods. Light periods. Night sweats. Vaginal dryness. Mood changes. So on and so forth.


What is often a surprise is being told that their cholesterol or blood pressure has changed as well. This unexpected news may come during a routine check-up and folks may be left feeling like they’ve done something wrong. This can be particularly true if they’ve been previously congratulated about their “excellent” numbers.


Estrogen is the Major Player!


A blood pressure increase can always be attributed to a combination of factors, but at this time, we see changes largely induced by our shifting hormones.


The eventual decline in estrogen levels during the menopausal transition makes us more sodium sensitive (it’s a kidney thing). Put another way, less estrogen means we retain more sodium. Where sodium goes, water follows. More water retention increases blood volume which translates to elevated blood pressure.


What Else?


Changes to Nutrition and Movement


It isn’t unusual for people to not feel their best when dealing with changes to mood, vasomotor symptoms, poor sleep and more. As a result, we may be less likely to keep to our regular exercise routines and more likely to reach for convenience foods. The decreased activity and increased sodium may intensify the hormonal blood pressure increases.




Stress further complicates things. Midlife brings its own set of challenges – balancing family responsibilities, career pressures, and reassessing relationships – all of which can significantly impact blood pressure.


So, what can you do?


Firstly, if you haven’t checked your blood pressure recently, it’s time to start. At-home monitoring allows you to track your levels regularly, offering a more accurate reflection than sporadic doctor visits. Look for validated machines (see below for resources) and replace older models. Pro tip? When measuring, take three readings, discarding the first and averaging the second two for a more reliable result.

Concerned about your numbers? Check in with your healthcare provider, armed with your at-home readings. They can provide insights and guidance on the next steps.


Watch your salt intake and prioritize movement. Even if you haven’t made any recent dietary changes to cause your increased pressure, reducing sodium can mitigate the effects of estrogen-induced salt sensitivity. Additionally, incorporating regular exercise, such as walking, can help manage stress and lower blood pressure. I always say, some is better than none and that continues to be true here.




Managing blood pressure fluctuations during menopause benefits from a holistic approach. By staying informed, making lifestyle adjustments, and monitoring proactively, you can navigate this transition with greater ease. Remember, these changes are largely driven by hormones—not personal shortcomings—but that doesn’t mean we can’t take action to address them.

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