Heart Health Starts With Your First Period (And Nobody Told Us)

When I was a teenager, my period would disappear for months at a time, and the fix was a prescription for the pill “to regulate my cycle.” Nobody asked what else it might mean, and honestly, neither did I.

Twenty years later, someone finally did. Last month, the American Heart Association, the American Academy of Pediatrics, ACOG, and the Society for Maternal-Fetal Medicine put out their first joint framework on heart health for girls and women. It walks through the hormonal stages of our lives, starting around age eight, and asks doctors to treat the menstrual cycle like a vital sign, because heavy or irregular bleeding can be an early clue about cardiovascular risk.

Pregnancy gets called a stress test for the heart, which, as someone who carried twins, feels about right. Preeclampsia, gestational diabetes, and preterm birth are flagged as warnings that stick around long after the baby comes home, and perimenopause — the phase most of us are told to just white-knuckle through — is finally being treated as a chance to catch shifting cholesterol early.

And then there’s what happens after delivery: only about 60% of women with high blood pressure during pregnancy get follow-up care within six months. Most of us get one postpartum checkup and a cheerful “see you next year.”

Heart disease is the number one killer of women, and yet I worry about my heart far less than my ovaries.

My daughter is eight, right where the new guidelines begin. Her chart is going to look a lot different than mine.