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Affairs of the heart

Cardiovascular problems can conspire to put a damper on sexual enjoyment. Talking to your doctor and your partner can help.

A physical connection with your romantic partner is often an important part of a fulfilling relationship. But when it comes to matters of the heart, the health of your heart matters.

"A satisfying sex life depends on physical health, psychological well-being, and the quality of the relationship," says Dr. Jan Shifren, who directs the Massachusetts General Hospital Midlife Women's Health Center. Heart disease and related conditions can influence all three of those factors in both men and women. Here's a look at the range of those effects and some possible solutions.

Belly fat may pose more danger for women than for men

Whittle your waist for better health.

You've probably heard that extra pounds around your middle are bad for your heart. But a new study has found that excess weight in your belly — a body shape doctors refer to as central adiposity — may be even worse for women's heart health than men's.

The study, in the March 6 issue of the Journal of the American Heart Association, involved about 500,000 people (55% of them women), ages 40 to 69, in the United Kingdom. The researchers took body measurements of the participants and then kept track of who had heart attacks over the next seven years. During that period, the women who carried more weight around their middles (measured by waist circumference, waist-to-hip ratio, or waist-to-height ratio) had a 10% to 20% greater risk of heart attack than women who were just heavier over all (measured by body mass index, or BMI, a calculation of weight in relation to height).

Baby’s early arrival may hint at future heart problems for mom

Preterm birth joins other pregnancy-related conditions as potential heart risk factors.


 Image: © metinkiyak/Getty Images

Preterm birth has long been known to bring health risks for the baby, but it may also bring risks for the mother. A study in the June issue of Hypertension shows that women who gave birth to a baby before 37 weeks of pregnancy were more likely to experience rising blood pressures later on compared to women who delivered closer to term. If they had this pattern, they were also more likely to show signs of coronary artery disease, which is associated with an increased risk of heart attack and stroke.

Because of the unique demands that pregnancy places on a woman's body, it may serve as a stress test for the female heart, says Dr. JoAnn E. Manson, the Michael and Lee Bell Professor of Women's Health at Harvard Medical School. In the May issue, we talked about how other pregnancy-related conditions — gestational diabetes, pre-eclampsia (a type of pregnancy-induced high blood pressure), and other pregnancy-related hypertensive disorders — can raise a woman's risk of developing cardiovascular disease. Preterm birth should now join that list, says Dr. Manson.

5 myths about endometriosis

While as many as one in 10 American women is affected by endometriosis, it can take years to get a correct diagnosis because the symptoms may mimic other common conditions. And myths about this condition may keep some women from seeking help.

Improving PET scans are good news for doctors and patients alike

A recent blog post discussed a newly approved imaging agent with an unwieldy name: gallium-68 PMA-11. Delivered in small amounts by injection, this minimally radioactive tracer sticks to prostate cancer cells, which subsequently glow and reveal themselves on a positron emission tomography (PET) scan. Offered to men with rising PSA levels after initial prostate cancer […]

Is it just midlife, or is your thyroid slowing down?

Maybe you're feeling tired and having trouble concentrating — or perhaps you've noticed changes in your hair or weight, or just feel blah. You might easily attribute these issues to other health problems, or to simply getting older. But these symptoms can be signs of a sluggish thyroid.

The thyroid is a butterfly-shaped gland in the neck. It produces the hormones that regulate metabolism. Low levels of thyroid hormone can cause a range of symptoms, including fatigue, constipation, dry skin, brittle nails, hair changes, aches and pains, and feeling down. Untreated, an underactive thyroid (hypothyroidism) can increase the chances of developing high cholesterol, high blood pressure, and heart disease.

Can taking aspirin regularly help prevent breast cancer?

Experts say there's little evidence that low-dose aspirin therapy brings benefits, and there are some risks.

In recent years, there's been a lot of talk about the potential benefits, and risks, of a regular regimen of low-dose aspirin. While much of the discussion has centered on whether taking low-dose aspirin can head off cardiovascular disease, some of the focus has also been on breast cancer. Can regular doses of this over-the-counter pain reliever reduce your risk of this common cancer?

For a while there were hints that the evidence was leaning that way. Back in 2017, this area of research, while still inconclusive, was somewhat promising. For example, a 2017 study published in Breast Cancer Research found that among some 57,000 women, those who reported taking low-dose aspirin (81 mg) at least three times a week had a 16% lower risk of breast cancer over all and a 20% lower risk of a specific type of hormonally driven breast cancer.

Women sit more after retirement

Research we're watching

If you're looking forward to having some extra downtime after retirement, just make sure it doesn't bring more sitting-down time. A study published online Nov. 17, 2020, by the journal Occupational and Environmental Medicine found that on average, women saw a sharp increase in sedentary time — more than an additional 20 minutes each day — after they retired compared with when they were working. This is an unhealthy pattern that can lead to a higher risk for cardiovascular disease.

Researchers identified this trend by looking at data on nearly 700 people (nearly 85% of them women) from a Finnish study. Most of the participants worked in administrative roles or held professional positions before retiring at an average age of 63. To provide objective measurements of activity, the participants wore activity monitors continuously for a full week during their one or two years both before and after retirement. The spike in sedentary time occurred after retirement, and remained at the reduced level for the next two years or more following retirement. Men, by contrast, saw a gradual decline in their activity level over time, but no sudden spike after they left their jobs. So, if you're retiring in the near future, it may be worth keeping an eye on your activity level to make sure you don't slow down after you leave your job.

Focusing on your future

Make your remaining years the best possible with these strategies.

There's a saying: "The trouble is, you think you have the time." People may understand their lives are limited, but they often don't internalize how much time they actually have left. This mindset can delay goal setting and long-term preparation, which increases the chances of later problems — for instance, with finances, housing, or health.

"People don't like to talk about their mortality because they don't want to see themselves as 'old,'" says Joan Gillis, a geriatric clinical social worker and senior clinical team manager with Harvard-affiliated McLean Hospital. "But embracing this reality can help people grasp a sense of urgency, so they get the most from their remaining years."

More intensive treatment of DCIS reduces the risk of invasive breast cancer

With increased rates of diagnosis of very early breast cancer known as ductal carcinoma in situ, there has been controversy about treatment. A recent study found that having DCIS was likely to lead to invasive breast cancer later, and also that women who chose more intensive treatment early were less likely to have invasive breast cancer.

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