Why Midlife Women Should Consider Getting A Coronary Artery Calcium Scan

If you’re a woman in perimenopause or menopause and have elevated cholesterol, you may be wondering just how concerned you should be about your heart health. After all, you’ve been told cholesterol is a risk factor for heart disease, but what does that really mean for you?

One test that can provide valuable insight into your heart health is the coronary artery calcium (CAC) scan—a quick, non-invasive scan that can help predict your future heart disease risk. Let’s talk about why this test matters, especially for women in midlife, and how it could give you the peace of mind (or wake-up call) you need to take action.

What is a Coronary Artery Calcium Scan?

A coronary artery calcium (CAC) scan is a special type of CT scan that looks for calcium deposits (aka plaque) in the arteries of your heart. When cholesterol and other substances build up in your arteries over time, they can harden into calcified plaque. This can narrow the arteries and increase your risk of a heart attack or stroke.

The test gives you a calcium score:

• A score of zero = No detectable plaque → Low heart disease risk
• A score above zero = Some level of plaque → Increased risk
• Higher scores = More plaque buildup → Higher heart disease risk

It’s a painless test that takes only about 10 minutes—no needles, no contrast dye, and no downtime.

Why This Test is So Important in Perimenopause & Menopause

Heart disease is the #1 killer of women, yet many of us don’t realize how much our risk increases during midlife.

Here’s why:

✅ Estrogen is heart-protective—it helps keep cholesterol levels in check and arteries flexible. But as estrogen levels decline in perimenopause and menopause, cholesterol can start creeping up, and arteries can become stiffer, making plaque buildup more likely.

✅ Traditional cholesterol tests don’t tell the full story—you might have "high cholesterol" but no plaque buildup (low risk), or "normal cholesterol" but hidden plaque (higher risk). The CAC scan helps separate who really needs aggressive treatment from who doesn’t.

✅ Women’s heart disease symptoms are often silent—unlike the “Hollywood heart attack” where someone clutches their chest and collapses, women can develop heart disease with no warning signs. A CAC scan helps catch issues before symptoms start.

How a CAC Scan Can Help You Take Control of Your Heart Health

A high calcium score can be a wake-up call, prompting:

✔ Earlier interventions – If you have plaque buildup, your doctor may recommend starting or adjusting medication (like statins) to lower your risk.

✔ Lifestyle changes that matter – Seeing actual evidence of plaque in your arteries can be a big motivator to eat better, exercise more, manage stress, and get enough sleep.

✔ Better peace of mind – If your score is zero, you might be able to avoid unnecessary medications like statins and focus on prevention rather than treatment.

Recent Research Backs It Up

Medical studies show that CAC scans are one of the best tools for predicting heart disease risk, often outperforming standard cholesterol tests alone. A 2023 study in JAMA Cardiology found that adding a CAC score to traditional risk assessments helped better identify women who would benefit from preventive treatment—or, just as importantly, those who could avoid overmedication.

Should You Get a CAC Scan?

💡 Consider a CAC scan if you:

✔ Have high cholesterol or a family history of heart disease
✔ Are in perimenopause or menopause and noticing cholesterol changes
✔ Have other risk factors like high blood pressure, diabetes, or a history of smoking
✔ Want a more accurate picture of your personal heart disease risk

Many insurance plans now cover the scan when medically indicated and your MyMenopauseRx clinician is happy to provide you an order. We recommend always checking with your insurance first to see if your scan would be covered! If the scan is not a covered benefit on your plan, the scan costs between $100-$400 depending on where you choose to have it completed —a small price to pay for life-saving information.

Bottom Line: Know Your Numbers

If you’re in perimenopause or menopause and worried about your heart health, a coronary calcium scan can help take the guesswork out of your risk. Whether your score is zero (great news!) or higher than expected, the information you gain can help you make smart, proactive decisions about your health.

Your heart has been working hard for you—this is your chance to return the favor. 💜

👉 Talk to your MyMenopauseRx clinician to see if a CAC scan is right for you!