The joint framework calls for clinicians to assess girls’ and women’s heart health across menstrual changes, pregnancy and menopause, linking care that has often been divided among specialties.
Four medical societies have issued a framework recommending connected heart and blood-vessel care for girls and women from adolescence onward. This account draws solely on the interview with STAT Health, published on October 26, in which writing-group chair Sadiya Khan called for clinicians to connect assessments across periods, pregnancy, perimenopause and menopause.
The American Heart Association, American Academy of Pediatrics, Society for Maternal-Fetal Medicine and American College of Obstetricians and Gynecologists published three guidance articles on October 26. Khan said women often see several clinicians, but those clinicians had lacked a shared approach connecting their separate areas of care.
Khan said assessment should begin around the first menstrual period and consider reproductive and hormonal health alongside cardiovascular and mental health. Changes in cycle length and the amount of bleeding are important signs for clinicians to assess.
Heavy menstrual bleeding can cause iron deficiency, which can limit a girl’s ability to exercise and impair cardiovascular health, Khan said. Menstrual changes can also flag a condition she called polyendocrine metabolic ovarian syndrome, formerly known as polycystic ovary syndrome. Diagnosis often takes years for teenagers and young adults.
During pregnancy, blood-pressure and diabetes problems can matter beyond the pregnancy itself, Khan said. The framework therefore emphasizes the transition from care after childbirth to primary care and continuing preventive care, rather than treating pregnancy as an isolated episode.
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The societies identify perimenopause as a distinct stage for cardiovascular assessment. This transition involves changing menstrual-cycle length, skipped periods and hormonal changes, generally around ages 45 to 51. Changes in cholesterol and metabolic health—how the body processes energy—can be early signs of cardiovascular risk, the guidance says.
These are recommendations for coordinating care, not mandatory screening requirements or proof of improved outcomes. Khan said identifying risk early and acting on it may reduce the risk of cardiovascular disease.
Khan called for clinicians and patients to share an understanding of what to expect at each stage, so they can prepare for the next transition, and emphasized assessing and treating symptoms when needed around perimenopause and continuing cardiovascular monitoring after menopause.
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