Gender-Specific Barriers in Female Cardiac Health: Understanding Delayed Care, Late Presentation, and Postmenopausal Risks

Background: Cardiovascular diseases (CVDs) are the leading cause of mortality among women, yet gender-specific barriers contribute to delayed care and late presentation, particularly in postmenopausal women. Atypical symptoms, sociocultural factors, and financial constraints further exacerbate disparities in female cardiac health. Understanding these barriers is crucial for improving early diagnosis and treatment. Objective: This study aimed to assess gender-specific barriers to cardiac care, focusing on delayed care, late presentation, and postmenopausal risks among female cardiac patients in Khulna, Bangladesh. Methods: This cross-sectional study was conducted at the Cardiology Department of Gazi Medical College, Khulna, from April to September 2024. Data were collected from 210 female cardiac patients aged above 45 years using structured questionnaires and medical records. Sociodemographic characteristics, symptom presentation, risk factors, and healthcare-seeking behaviors were analyzed. Statistical analysis included chi-square tests, logistic regression, and p-values to assess significant associations. Results: Most participants were aged 55-64 years (40.5%), with 81.9% being postmenopausal. Hypertension (62.9%), diabetes mellitus (54.8%), and obesity (40.0%) were the most prevalent risk factors. Common symptoms included fatigue (81.0%), chest pain (73.3%), and shortness of breath (64.8%), while 22.9% presented with atypical symptoms. Delayed care was observed in 41.9% of cases, significantly associated with postmenopausal status (OR = 2.31, p = 0.014) and atypical symptoms (OR = 3.02, p = 0.002). Financial constraints (32.9%) and symptom misinterpretation (35.2%) were major contributors to delayed presentation. Conclusion: Postmenopausal women face significant barriers to timely cardiac care due to financial, sociocultural, and clinical factors. Early screening, awareness programs, and gender-sensitive healthcare policies are essential to addressing these disparities and improving cardiac outcomes in women.