Before menopause, estrogen provides a protective effect on the cardiovascular system, helping to maintain healthy cholesterol levels and flexible blood vessels. After menopause, the loss of this protection leads to a rapid increase in cardiovascular disease (CVD) risk. This transition is often accompanied by unfavorable changes, including a rise in “bad” LDL cholesterol, an increase in blood pressure, and a shift in fat storage to the abdomen, all of which are risk factors for heart attack and stroke. As a result, heart disease becomes the leading cause of death for women in the postmenopausal years.