9 Things Women’s Health Doctors Would Never, Ever Do

Not only does menopause bring hot flashes, mood changes and bone density loss, it also brings negative changes to heart health.

“There’s a big shift that happens there. We lose our natural estrogen levels, and with the loss of natural estrogen, our whole cardiometabolic profile shifts for the worst,” Freaney said.

“I try to counsel my female patients that the years around menopause are really a time of accelerating cardiovascular risk, and we need to go into that decade of life in the most optimal cardiovascular health to brace ourselves for this transition that is going to inevitably come to every woman,” she said.

Around menopause, your blood pressure increases, your LDL cholesterol (also known as the bad cholesterol) goes up and your HDL cholesterol (your good cholesterol) goes down, according to Freaney. Your fat mass goes up while your muscle mass goes down, she added. Your sleep and mood worsens, too, which can have downstream effects on exercise and nutrition — because who wants to go for a bike ride after a night of bad sleep?

“There’s a whole batch of things that happen together that, when taken in full, create an overall riskier cardiovascular environment for a woman,” Freaney said.

“A lot of this people don’t realize it’s going to happen, and so they haven’t gone into the menopausal years optimizing for it,” she noted. If you can focus on strength training to build muscle mass and setting good cardiovascular exercise habits and nutrition habits, you’ll be more equipped to handle these changes and counteract them, Freaney said.

And, this is true no matter if you’re in menopause, post-menopausal or pre-menopausal — it’s never too early or late to make a change.

This article originally appeared on HuffPost.