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Does Menopause Cause High Blood Pressure?

by | Last updated: Apr 6, 2022 | Menopause | 2 comments

Does menopause cause high blood pressure? Actually, it can. Let’s talk about how and what you can do about it. 

High blood pressure is often diagnosed in middle-aged people. It’s not uncommon for women going through menopause to need treatment for hypertension.

Hypertension is a sustained blood pressure over 140/90. The average healthy blood pressure is usually about 120/80. Clinically, it’s best to keep your blood pressure under tight control, because high blood pressure can lead to strokes, heart attacks, macular degeneration, and kidney disease.

We find that as women go through menopause, they tend to have an elevation in their blood pressure.

And that’s because of their falling estrogen levels. Estrogen stimulates collagen and elastin, which keeps blood vessels soft and flexible.

If your vessels become hard and rigid, they create more resistance for your heart to be able to pump blood, which then increases your blood pressure. You’ll notice this mostly in the systolic part of the blood pressure, which is the number at the top, versus the diastolic, the number at the bottom. The diastolic number at the bottom is really reflective of how hard your heart is working. The systolic number at the top is reflective of how much resistance is in your blood vessels.

Your heart has to pump with much greater force in order to move blood against your tight, menopausal vessels, and as a result, your blood pressure rises. If your vessels are very tight because you’ve developed arteriosclerosis, meaning clogging of your arteries, then your heart is going to have to work a lot harder.

Blood pressure issues are not uncommon in menopause, but they don’t happen to all women.

And that’s because lots of women have real healthy vessels to start with, especially women who are very active through their reproductive years. For women who maintain their ideal body weight, eat a healthy diet, and don’t stress too much, they will enter menopause with healthy vessels. They will also maintain normal blood pressure throughout their lives.

Women who come into menopause with chronic diseases like diabetes, struggle with obesity, and have a tendency towards high-stress response, are more likely to have blood pressure issues. Their HPA axis is constantly in fight or flight mode, so they tend to be hyper-reactive to stress. When they go through perimenopause and their progesterone starts dropping, their adrenal glands are less supported. Their stress response is higher, and all that extra cortisol causes inflammation. Over time, that inflammation increases the likelihood that the blood vessels develop arteriosclerosis. 

It’s incredibly important to keep your hormones in balance, as you go through the change.

Your hypothalamus also helps control your blood pressure by producing a hormone called vasopressin, which controls the volume of fluid around your cells. Vasopressin is also an antidiuretic hormone, which affects your kidneys’ production of urine. More vasopressin means less urine output, which results in higher blood volume and increases your blood pressure.

When your hypothalamus is out of balance, vasopressin production can be erratic, causing fluctuations in your blood pressure.

One of the best ways to deal with hypertension throughout menopause is to get your hypothalamus in balance. Supporting your hypothalamus can help keep your blood pressure stable by normalizing your stress response and vasopressin production. Getting enough sleep helps support your hypothalamus function, which I know can be difficult because of insomnia some women experience during menopause. Also, making sure that you keep your weight in check really helps lower your risk for hypertension and cardiovascular disease.

Regular exercise and a diet that’s low in starchy, sugary carbs, with adequate protein and healthy fats, and lots of colorful fruits and vegetables will make a big difference in keeping your blood pressure in control.

If hypertension runs in the family, know that while there are some genetic aspects that can affect your blood pressure, hypertension is usually lifestyle-related.

You learn the same habits as your parents and tend to eat the same way. You are similarly sedentary and react to stressors in the same unhealthy way. 

Lifestyle choices make a huge difference in how you’re going to age. If you’re a younger woman, this is the time to get in shape and really focus on your cardiovascular health. Exercise is key to bringing that blood pressure down. It’s never too late to start living a healthy lifestyle, even in midlife. You can lower your risk for diseases like heart disease, stroke, and diabetes by getting in shape. So the sooner you start being proactive with your health, the better. 

I like to instruct my patients to take their blood pressure first thing in the morning, and then again about 30 minutes after they exercise.

If their blood pressure is lower after exercise, that’s a good indication that they have healthy, elastic vessels. It also shows that most of their blood pressure issues are related to stress.

Waking up in the morning with higher blood pressure can indicate a high cortisol level. Starting your day in a fight or flight mode will cause inflammation, leading to chronic high blood pressure. Controlling that cortisol level by getting your hypothalamus in balance is the key to maintaining healthy, safe blood pressure.

Now, we’re getting a lot of questions in my hormone support group which you can access by signing up for my Hormone Reboot Training. We talk about everything hormone-related, including blood pressure and cardiovascular health. We talk about anything related to hormones, which is all sorts of things because your hormones control almost every aspect of what’s going on in your body, which is why it’s so important to keep your hormones in balance. Balancing your hypothalamus gives you the best chance at keeping your hormones healthy, which will help you transition through the change of life as gracefully as possible.

Research Reference: Severity of menopause symptoms associated with cardiovascular disease, Menopause and the Human Hypothalamus: Evidence for the Role of Kisspeptin/Neurokinin B Neurons in the Regulation of Estrogen Negative Feedback.

*Statements not reviewed by the FDA.

About the Author - Deborah Maragopoulos FNP

Known as the Hormone Queen®️, I’ve made it my mission to help everyone – no matter their age – balance their hormones, and live the energy and joy their DNA and true destiny desires. See more about me my story here…



  1. Debbie

    Can having sex help alone with exercise help to lower my blood pressure or should I take medication for my hot flashes

    • Deborah Maragopoulos FNP

      if exercise, diet, stress reduction and sex does not lower blood pressure enough, you may need antihypertensive medication


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