Supervised by a doctor | Is microvascular angina the cause of menopausal chest pain?

Possible causes of menopausal chest pain include menopausal symptoms, mammary gland disease, and microvascular angina pectoris. In particular, under the supervision of a doctor, we will explain in detail what kind of disease “microvascular angina” is, which is often overlooked and goes undiagnosed, as well as its diagnosis, examination methods, treatment methods, and prevention methods!

Supervised by a doctor | Is microvascular angina the cause of menopausal chest pain?

Table of contents

  • What causes chest pain in menopausal women?
  • What is microvascular angina in menopausal women?
  • Symptoms and characteristics of microvascular angina
  • Causes of microvascular angina
  • Diagnosis and examination methods for microvascular angina pectoris
  • Treatment of microvascular angina
  • Prevention of microvascular angina
  • Menopausal chest pain should be treated as soon as possible by a specialist

What causes chest pain in menopausal women?

What causes chest pain in menopausal women?

During menopause , the amount of female hormones that were previously secreted drops sharply, which can cause chest pain.

Chest pain is one of the symptoms of menopause, but it may be hidden by other diseases, so it is important to have an early examination if there are any symptoms that you are concerned about.

One of the symptoms of menopause is pain in the breasts and nipples (nipples).

During menopause, various complaints may appear. Some people have symptoms so strong that they can be called menopausal disorders, but some people hardly feel any symptoms, and the way symptoms appear varies greatly from person to person.

Main menopausal symptoms include hot flashes, hot flashes, malaise, cold hands and feet, stiff shoulders, lower back pain, palpitations, headaches, and ringing in the ears. In addition, breast pain, nipple (nipple) pain, and a tingling sensation are also typical symptoms.

If no related abnormalities are found after mammography or ultrasonography in gynecology or breast surgery, it is possible that pain in the breast or nipple appears as a symptom of menopause.

mammary gland disease

Breast pain, which is a physiological change caused by an imbalance in female hormones, may also be the cause of breast pain. Mastosis is not a distinct disease like mastitis or breast cancer, but rather represents “changes and conditions that occur in the mammary glands as we age.”

Mammary gland disease is often seen in women aged 40 to 50 who are heading for menopause due to a major disruption in the balance of female hormones. Breast cancer typically presents with the following symptoms:

  • chest pain (pain worsens with pressure; pain may or may not be associated with the menstrual cycle)
  • tingling pain
  • Breast milk-like discharge
  • chest tightness
  • Cramps on the side of the chest and armpits
  • Lump etc.

Lumps in mammary gland disease are not a problem, but in the case of breast cancer, treatment should be started early. It is important to have a thorough check-up at a hospital instead of making a self-judgment that it is because of mammary gland disease and leaving it alone.

Since breast cancer is not a disease, no treatment is required. However, if breast pain is severe and interferes with daily life, it can be treated with hormones and pain relievers.

microvascular angina

When the coronary arteries that supply blood to the heart become narrowed due to arteriosclerosis, blood cannot flow properly. A disease that causes pain in the chest is called angina pectoris.

However, some menopausal women experience chest pain even though their coronary arteries are normal.

Microvascular angina is a heart disease that affects about 10% of menopausal women. Microvascular angina is caused by temporary constriction of hair-like blood vessels at the periphery of the coronary arteries. It is characterized by chest pain that lasts for a long time, and although it is not directly life-threatening, it can reduce the quality of life (QOL).

From the next section, we will explain in detail microvascular angina pectoris seen in menopausal women.

What is microvascular angina in menopausal women?

Small blood vessels called microcoronary arteries are stretched around the periphery of the coronary arteries surrounding the heart, delivering nutrients and oxygen to the myocardium that moves the heart. If these microcoronary arteries contract abnormally or do not dilate sufficiently, not enough blood can flow to the heart muscle, and symptoms such as chest pain (chest pain) may occur.

Unlike angina pectoris, microvascular angina does not pose a risk of sudden death, but if left untreated, it can lead to a heart failure called HFpEF, which requires treatment.

Microvascular angina is still a little-known disease, and it seems that some people who feel chest pain are not diagnosed correctly, and suffer from pain and anxiety for a long time. If you are suffering from unexplained chest pain, please visit a specialized hospital for a detailed examination.

Symptoms and characteristics of microvascular angina

Symptoms and characteristics of microvascular angina

Microvascular angina pectoris is more common in menopausal women. In general, angina pectoris is a sudden, intense chest pain, but microvascular angina is different.

In the case of microvascular angina, in addition to chest pain, the following indefinite complaints may persist for several minutes to several hours.

  • chest pain, chest tightness
  • palpitation
  • Shortness of breath, shortness of breath, difficulty breathing
  • digestive symptoms
  • radiating pain

Below, we describe the symptoms of microvascular angina pectoris.

chest pain, chest tightness

Microvascular angina causes chest pain and a feeling of pressure in the chest.

This occurs regardless of movement, whether you are exercising or at rest. The pain lasts from a few minutes to several hours, and in severe cases, it can last all day.

If chest pain does not go away after stent treatment (treatment of angina pectoris caused by arteriosclerosis), it is possible that you have microvascular angina pectoris or coronary spastic angina pectoris. is needed.


A heart palpitation is a condition in which you feel a throbbing, pounding, strong heartbeat without putting your hand on your chest, or a momentary feeling of tightness in your chest.

The pulsation may be strong, rapid, or rapid, depending on the person, but microvascular angina may cause palpitations.

Shortness of breath, shortness of breath, difficulty breathing

Difficulty breathing, shortness of breath, and a feeling that you are not breathing enough are also symptoms of microvascular angina.

digestive symptoms

Microvascular angina may also present with gastrointestinal symptoms such as stomach pain and nausea.

Chest pain and gastrointestinal symptoms are also seen in “reflux esophagitis”, so if you also feel symptoms such as heartburn and a bitter or sour feeling in your mouth, there is a possibility of reflux esophagitis. You should also think about getting tested.

radiating pain

Referred pain is pain that appears in a location completely separate from the source of the disease. In the case of microvascular angina, chest pain, pain in the pit of the stomach, shoulder pain, back pain, and pain in the throat, jaw, and back of the ear can be seen.

These symptoms are also seen in menopause, so microvascular angina may go unnoticed. In addition to chest pain, if these symptoms continue without improvement, let’s take a detailed examination at a specialized medical institution.

Causes of microvascular angina

Although the detailed cause of microvascular angina is not known, “mental stress”, “overwork”, “cold weather”, “smoking”, and “insufficient sleep” are known to trigger attacks.

In addition, it is closely related to the onset of microvascular angina, and one of the causes is considered to be ” menopause .”

In women, the function of the ovaries declines around the mid-40s, and the secretion of estrogen, one of the female hormones, begins to decrease. By the time menopause approaches, estrogen levels drop even more sharply, disrupting the balance of the autonomic nervous system, which leads to menopausal symptoms.

Estrogen also plays a role in keeping blood vessels strong and flexible, and also plays a role in dilating blood vessels to protect blood flow.

The age of menopause is a time when both the mind and body are prone to stress, such as increased work responsibilities, caring for parents, and changes in one’s physical condition. It is said that the combination of these factors makes microvascular angina pectoris more likely to occur.

Diagnosis and examination methods for microvascular angina pectoris

In microvascular angina, even when an attack occurs, there are not many changes in the electrocardiogram, and coronary artery abnormalities are difficult to detect clearly even with cardiac catheterization. may not be.

Microvascular angina is a difficult disease to diagnose, so it is necessary to undergo a detailed examination at a specialized hospital.

At present, there are measurements of lactate metabolized from the myocardium during cardiac stress, measurements of coronary flow reserve in cardiac catheterization, and examinations using positron emission tomography (PET). In addition, research is underway with the aim of establishing examination methods to determine disease from changes in blood flow using magnetic resonance imaging (MRI).

Treatment of microvascular angina

Microvascular angina is treated with oral medications and lifestyle changes such as quitting smoking.

Drugs used include nitrites (such as nitroglycerin) and calcium channel blockers. For some people, Chinese herbal medicines used to treat depression are effective, and depending on the symptoms, it seems that some medicines are used in combination.

Prevention of microvascular angina

Prevention of microvascular angina

To prevent microvascular angina, it is important to take care of the blood vessels. High blood pressure, dyslipidemia, metabolic syndrome, diabetes, arteriosclerosis, etc. will damage blood vessels throughout the body.

Preventing these lifestyle-related diseases will also lead to the prevention of microvascular angina pectoris. From here, we will introduce specific methods.

moderate exercise

Exercise helps maintain and improve cardiopulmonary function. It also prevents waste products from accumulating in the body.

In addition, exercise has effects such as improving and preventing obesity, alleviating menopausal symptoms, and improving immunity, so it is a good idea to start at a comfortable pace and make it a habit.

Avoid drinking and smoking

It is advisable to avoid alcohol, as it increases triglycerides and cholesterol. In addition, quitting smoking is recommended because smoking worsens menopausal symptoms and accelerates arteriosclerosis.

avoid stress

Since stress is one of the triggers for microvascular angina, it is important to avoid stress as much as possible.

However, it can be difficult to distance yourself from stress depending on the situation or environment. In such a case, try not to let stress build up and de -stress regularly .

improved diet

Improving your diet is also important. Try to eat three well-balanced meals a day that are low in fat and salt.

In particular, foods that contain nutrients such as isoflavones, vitamins, and dietary fiber are foods that you should actively take.

take herbal medicine

Kampo medicine is good at improving the malfunction caused by the disturbance of female hormones.

Kampo medicine improves the symptoms by improving blood flow and by working on the autonomic nervous system to balance the mind and body. Improving blood flow also improves gastrointestinal function, which in turn helps build a body that is resistant to fatigue and stress.

Kampo medicines can be selected according to each person’s symptoms and constitution, and you can feel a quick effect and aim to improve the constitution from the root.

Herbal medicine recommended for menopausal discomfort

The following herbal medicines are recommended for menopausal stress and hormonal imbalance.

  • Kamishoyosan : Promotes blood flow and balances hormones. It is used to treat autonomic nervous system disorders such as irritability, anxiety, and insomnia caused by female hormone imbalance.
  • Toukaku Jokito : Promotes blood flow. It contains laxative ingredients and is especially suitable for people with constipation. It is also used for menopausal irritation.
  • Keishibukuryogan : Used for people with hot flashes. Promotes blood circulation and balances hormones. It is suitable for those who have stiff shoulders, headaches, blemishes and acne caused by stagnation of blood flow.

If you are looking for Kampo medicine that suits your body, symptoms, and purpose, it is important to consult and judge by experts who are familiar with Kampo, such as doctors and pharmacists.

If you do not have a family doctor of Chinese medicine or a pharmacist who you can consult with, how about using an online Kampo service such as “ Anshin Kampo ,” where you can easily consult and deliver Kampo medicines that match your constitution and symptoms ?

Menopausal chest pain should be treated as soon as possible by a specialist

Menopausal chest pain may be caused by one of the menopausal symptoms, mammary gland disease, or microvascular angina pectoris.

Menopausal symptoms and mammary gland disease do not require special treatment if they do not interfere with daily life, but microvascular angina requires treatment.

Microvascular angina is difficult to diagnose, so if you have symptoms such as chest pain that bother you, go to a specialized hospital for a detailed examination.

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