Women’s Risk of Atrial Fibrillation and the Importance of Early Detection

More Than “Just Menopause.” Don’t Underestimate the Signs.

“It's just menopause, so there's nothing I can do about it” - That assumption can cause life-threatening illnesses to go undetected. 

Palpitations, shortness of breath, fatigue—when you experience these symptoms, do you assume they are ‘just signs of aging’”? This assumption could actually delay the discovery of a serious illness. 

According to Professor Kyoko Soejima of the Department of Cardiovascular Medicine at Kyorin University, palpitations and shortness of breath, common menopausal symptoms, closely resemble those of atrial fibrillation. The problem is that many women dismiss these sings as “just menopause” and avoid seeking medical attention. 

A survey of 1,000 people conducted by OMRON Healthcare revealed that most women experiencing symptoms such as hot flashes and shortness of breath, had not consulted a medical institution. 

Yet behind these symptoms may be atrial fibrillation (AFib), a dangerous arrhythmia and a major cause of severe strokes.  

Atrial Fibrillation: The Risk Behind Ignored Symptoms  

According to a survey conducted by OMRON Healthcare, more than 80% of women in their 20s to 60s experience palpitations and shortness of breath in their daily lives, and over 60% of them feel anxious about these symptoms. Despite this, more than half of all respondents do not seek medical care, believing their symptoms are “not serious enough to warrant a hospital visit.” This tendency is one of the factors contributing to the delayed detection of atrial fibrillation in women.

Specialist Explains How to Distinguish Menopausal Symptoms from Atrial Fibrillation

Characteristics of Menopausal Symptoms and Their Overlap with Atrial Fibrillation 

According to Prof. Soejima, “menopause” refers to a period of about 10 years, spanning the five years before and after a woman’s final menopausal cycle. Common symptoms include heart palpitations, hot flashes, sudden sweating, unexplained fatigue, and insomnia. These symptoms closely resemble those of atrial fibrillation (palpitations, shortness of breath, fatigue), making it difficult to tell the two apart. 

The Complex Risks Posed by Hormonal Changes 

During menopause, shifts in the balance of female hormones accelerate heart conditions and aging processes that were previously suppressed by these hormones. As a result, many women attribute their declining health to “just getting older.” However, experts recommend considering the possibility of underlying atrial fibrillation and consulting a primary care physician promptly if any abnormalities are noticed. 

The Basic Mechanism of Atrial Fibrillation 

Atrial fibrillation is one of the most common arrhythmias, affecting approximately one million people in Japan. In a healthy heart, pacemaker cells in the atria (upper chambers) generate regular beats, typically 60 to 100 times per minute. In atrial fibrillation, however, the atria become impaired and begin to quiver about 500 times per minute. As a result, the pulse can become irregular or excessively fast, often causing sensation of palpitations. 

Atrial Fibrillation That Progresses Even Without Symptoms 

About 40% of people with atrial fibrillation have no symptoms at all. Yet the absence of symptoms does not mean there is no cause for concern. The risk of stroke among those with atrial fibrillation is about five times higher than in people without it. Furthermore, even when atrial fibrillation is asymptomatic, the risk of stroke and mortality is no different from that of symptomatic patients. 

Stroke Caused by Blood Clots: The Most Dangerous Complication of Atrial Fibrillation

How Blood Clots Can Form in the Heart 

According to Prof. Soejima, atrial fibrillation prevents the atria from contracting properly, hindering efficient blood flow and causing blood to stagnate. This can lead to the formation of blood clots within the atria. These clots sometimes travel to the brain and cause a stroke, which can be especially dangerous. 

Risk of Severe Stroke 

Strokes caused by atrial fibrillation are often particularly severe. Clots formed due to atrial fibrillation are often large, increasing the likelihood of severe outcomes. 

Points of Special Concern for Women 

Atrial fibrillation in women often presents with mild symptoms that are easily overlooked and frequently mistaken for menopausal symptoms, making early detection challenging. 

Risk Factors for Atrial Fibrillation

Increased Risk with Age 

The most significant risk factor for atrial fibrillation is age. Compared with people in their 50s, the risk becomes about five times higher in their 60s, seven times higher in their 70s, and nine times higher in their 80s. 

Other Risk Factors Beyond Age 

However, risk factors for atrial fibrillation expand beyond aging. These include hypertension, obesity, sleep apnea, smoking, excessive alcohol consumption, and overly strenuous exercise habits. 

Female-Specific Risk: Menopause and Hormonal Balance 

Historically, it was believed that women had a lower incidence of atrial fibrillation than men. However, recent studies have shown that women without a history of cardiovascular disease may actually face a higher risk of developing atrial fibrillation. A particular concern is that many women self-diagnose symptoms such as palpitations or dizziness as ‘just menopause,’ overlooking the possibility that these could be signs of atrial fibrillation.

Rethink the Idea That “It's Just Menopause”

The Importance of Home ECG Monitoring 

Prof. Soejima strongly recommends: “Don’t just assume ‘It’s menopause’—first check whether it might be atrial fibrillation.” Because about 40% of atrial fibrillation cases have no symptoms, it is essential to use a home ECG monitor, such as those from OMRON, to check whether your heartbeat is normal.”  

The Dangerous Assumption of “It's Just Menopause” 

Prof. Soejima emphasizes an important message for many women: “Don't just dismiss everything as ‘it's just menopause.’ You need to check if there's an underlying illness.” It's vital to recognize that palpitations or shortness of breath dismissed as “just menopause” could actually be signs associated with atrial fibrillation.

Seek Early Medical Attention Without Delay 

Prof. Soejima strongly emphasizes that “seeking early medical attention without delay is paramount.” Since atrial fibrillation in women is often advanced by the time it is detected, consulting a healthcare provider promptly upon noticing any symptoms is key to preventing serious complications.  

A Message to All Women 

Based on her experience as a specialist, Prof Soejima offers a heartfelt message to all women entering menopause: Don’t dismiss symptoms such as palpitations, shortness of breath, or fatigue as “just part of aging” or “just menopause.” By paying close attention to your body and seeking appropriate medical care when necessary, you can protect your life and health.