Frequently Asked Questions: What women need to know about heart disease

I thought heart problems were mostly a “man thing.” Why do women need to care about heart disease? 

More women than men die of heart disease. Surprised? Many people are. Because their symptoms often go unrecognized, women are less likely to survive heart attacks than men. Heart disease kills more than 500,000 women a year — with one life lost every minute, that’s a number we’re determined to reduce. 

Warning signs of heart disease
Are the warning signs of heart disease different for women than for men?

While men and women may have similar signs of heart disease, many women do not have the “classic” symptoms of heart disease or a heart attack. Signs of heart disease may come and go, and include:

  • Shortness of breath during everyday activities
  • Unusual fatigue or weakness
  • Unusual chest, stomach or abdominal pain
  • Anxiety
  • Dizziness or nausea
  • Swelling in ankles, legs and abdomen
  • Palpitations (irregular heart beats, skipped beats, racing sensation or "flip-flop" feeling in the heart)
  • Cold sweatiness
  • Extremely pale or gray skin
  • Back pain

As well as:

  • Uncomfortable feeling in the center of the chest (pressure, fullness, burning, squeezing, or other discomfort) that lasts more than a few minutes or goes away but returns
  • Chest discomfort that includes lightheadedness, fainting, sweating, nausea or shortness of breath
  • Pain or discomfort that spreads to the shoulders, neck or arms

Heart attack symptoms
What’s the difference between “classic” heart attack symptoms and “atypical” ones?

Women often do not have the “classic” symptoms of a heart attack. Instead, many women — and some men — have what are still called “atypical” symptoms. Whether classic or atypical, heart attack symptoms can hit hard and fast or start slowly and get worse and worse over an hour or two.  

Classic heart attack symptoms may include: 

  • Feeling of pressure/heavy weight on chest
  • Heartburn-like sensation
  • Discomfort in one or both arms
  • Shortness of breath
  • Cold sweatiness

Atypical heart attack symptoms may include:

  • Pain or discomfort in an odd spot, such as the jaw, elbow or a tooth
  • Unexplained sense of doom or anxiety
  • Vague feeling that something isn't right
  • Sudden weakness or deep fatigue (some women confuse this with the flu)
  • Shortness of breath
  • Nausea

Lowering risk
How can I lower my risk of heart disease?

One in three women in the United States will develop heart disease. That’s why we think it’s so important for both men and women to learn the basics about prevention. While there are a few risk factors that are genetic and cannot be changed, many behaviors that raise the risk of heart disease can be changed.

To improve heart health, try to: 

  • Stop smoking (and avoid secondhand smoke) 
  • Increase activity levels: Exercise at least 30 minutes a day, and aim for a total of 5 to 7 hours of exercise per week
  • Eat fruits and vegetables daily
  • Follow a low-fat diet
  • Keep diabetes under control 
  • Lower high blood pressure
  • Lower high cholesterol
  • Reduce or manage stress
  • Get weight within recommended range and maintain it there

Genetic risks for heart disease include: 

  • Being age 50 or older
  • Having an African-American ethnic background
  • Being past menopause
  • Having a family history of heart disease or heart problems


Hormone replacement therapy
Does use of hormone replacement therapy (HRT) mean I’m more at risk for heart disease?

While hormone replacement therapy — also called estrogen replacement therapy — was thought to help protect against heart disease, new studies suggest that HRT can have a negative impact on heart health. However, women often use HRT to reduce menopause symptoms like hot flashes or to prevent weakened bones (osteoporosis). Talking with a health care provider can help you evaluate your individual risk of using HRT.

Find information on women’s health and available services at our Providence Women’s Health Program site.

Want more information on HRT? Don’t miss our "hormone replacement therapy Q&A

Hormonal birth control methods (the pill, patch and ring)
What should I know about combined-hormone birth control — can the pill, the patch or the ring be bad for my heart? 

For women under 35 with no serious risk factors for heart disease: The low-dose birth control pill and birth control ring do not appear to increase the risk of heart disease. However, women who use the birth control patch may be exposed to more estrogen and this may increase the risk of blood clots, heart attack and stroke. Women who use high-dose birth control pills (more than 50 micrograms of estrogen) are at greater risk of heart disease. 

For women of any age: Talking with a health care provider can help evaluate individual risk of using the birth control pill, patch or ring. In general, the following factors increase the risk of heart disease: 

  • Smoking (greatly increases the risk for women 35 or older)
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Diagnosis of stroke or blood clots
  • Family history of heart disease
  • Weight above recommended range

For women 35 or older who smoke: Due to the high risk of heart disease, doctors advise women who smoke not to use the birth control pill, patch or ring.

Find information on women’s health and available services at our Providence Women’s Health Program site  

This information is designed for educational purposes only and is not provided as a professional service or as medical advice for specific patients. It is not a substitute for professional medical care. If you have, or suspect you may have, a health problem, you should consult your health care provider. Read our disclaimer.