Many of us fear wrinkles, gray hair and other signs of aging. But not as many people seem to worry about aging associated with our vascular system, the network of vessels that circulate blood throughout our body. Years of blood flowing to and from the heart can lead to some consequential changes that set the stage for cardiovascular disease, the leading cause of death in women worldwide. How can we protect our vascular system from aging before we do?

Interestingly, cardiovascular disease risk is relatively low in most young women until menopause, the phase in which the menstrual cycle stops. Heart disease risk surges during this time. To understand why, we have to recognize the important role of estrogen, a hormone that regulates our menstrual cycle. Estrogen is a powerful protector of our blood vessels, bones and tissues. During menopause, the body’s production of estrogen decreases dramatically. With a lot less estrogen, our body is left to handle increases in blood pressure and stiffening of arteries that come with typical aging without this key protective hormone. Women’s risk of heart disease during this time of life catches up to risk in men of the same age and can even accelerate faster.

There are also several conditions unique to females that may speed up the aging process of our vessels. Preeclampsia, or high blood pressure during pregnancy, and polycystic ovarian syndrome, a complex condition often marked by irregularities in the menstrual cycle, are both accompanied by a collection of vascular-related issues. Dysfunction of the blood vessels in these conditions can lead to premature vascular aging, making diagnosis and treatment critical to cardiovascular health.

Like other aspects of aging, we only have so much control over how our bodies carry us through life. Because so much is out of our control, it’s important to recognize the stages and conditions when we do face an increased risk. While we have yet to pinpoint the best strategy to remedy the effects of vascular aging in females, there is evidence to support that being proactive is a key approach.

Exercising regularly and eating a heart-healthy diet during the early menopausal years may offset some of the risk associated with this major hormonal transition. Additionally, meeting regularly with a doctor to discuss how to keep the risk factors that we can control low can set us up for success as we prepare to navigate this next stage of life.