Being told you have high blood pressure can come as a shock, especially if you've had normal blood pressure your whole life. Blood pressure often increases with age — a trend that often coincides with the menopause transition. This overlapping time frame might make you wonder whether the cause of your high blood pressure is actually menopause itself.

Women often begin perimenopause — the transition between fertile years and menopause — in their mid-40s. During perimenopause, hormone levels change constantly and menstrual cycles become irregular. After a woman goes one full year without a period, she's officially entered menopause.

The hormonal changes of the menopause transition can have surprising impacts on the body, such as raising the risk of heart disease. Other effects of menopause like weight gain and disrupted sleep can play a part in blood pressure changes as well. Combined with older age, these risk factors can all contribute to higher blood pressure after menopause.

Below, we'll explore how menopause may influence your blood pressure and why your risk of high blood pressure rises around this time.

How Does Menopause Affect Blood Pressure?

Postmenopausal women have a higher risk of developing heart disease and health conditions that affect both the heart and blood vessels. There are several factors that contribute to this risk.

Hormonal Changes

Starting in perimenopause, your ovaries begin making less estrogen. The hormone estrogen has many roles in the body, one of which is helping to regulate menstrual cycles. This is why falling estrogen levels during perimenopause often lead to irregular periods. Estrogen also has other important jobs outside of the reproductive system, such as helping to maintain cholesterol and blood sugar levels, promoting blood flow, and supporting strong bones and muscles.

After women reach menopause, levels of estrogen are much lower than their bodies are used to. Before menopause, estrogen helps blood flow by relaxing blood vessels. After menopause, lower estrogen levels may make it harder for blood vessels to stay open and relaxed. Specifically, lower estrogen levels can cause blood vessels to constrict. The heart then has a harder time pumping blood through these narrowed blood vessels.

Having less estrogen can also affect how you respond to salt. Without the hormone, you may find that eating salt makes you retain fluid, which can raise blood pressure.

Perimenopause and Menopause Symptoms

Some symptoms of the menopause transition may also contribute to high blood pressure, including:

• Weight gain — It's common for women to gain weight after menopause. People who are overweight or have obesity are at a higher risk of developing high blood pressure.
• Lack of sleep — Some women may have trouble falling or staying asleep during this time. Getting fewer than six hours of sleep per night is linked to increased risks of high blood pressure and cardiovascular disease.
• Hot flashes — Having daytime hot flashes or night sweats has been shown to raise the risk of high blood pressure.
• Mood changes — Research has shown that having depression during perimenopause is linked to higher cardiovascular risk.
• Stress — Ongoing stress from dealing with perimenopause symptoms may increase blood pressure.

One woman who responded to a survey conducted by ThisIsMenopause shared how she developed high blood pressure alongside perimenopause symptoms. "I have had sweating, mood swings, spiked blood pressure, and anxiety," she said.

Is It Menopause or Aging?

Your risk of high blood pressure increases with age. The health issue is more common in people ages 56 and older. This is because blood vessels become less relaxed with age. Stiffened blood vessels are harder for the heart to pass blood through, which can lead to higher blood pressure. Older age may contribute to overall high blood pressure or may cause only your systolic pressure to rise — sometimes referred to as isolated systolic hypertension.

Most of the time, high blood pressure develops from a combination of risk factors rather than one alone. This makes it likely that the effects of both menopause and aging are contributing to your high blood pressure. Other factors can also contribute to increased blood pressure, such as a family history of high blood pressure, smoking, alcohol intake, and lack of exercise.