Being proactive about your future health can make a huge difference. It is never too late to make some simple changes which can help you enjoy good health in the future. We all want to be able to look after ourselves when we are older and to make it upstairs to go to the loo without help. Simple lifestyle changes now can support your health in the future.
Heart and blood vessel health
When hormones change at menopause, metabolic health can also change, affecting where you store body fat, your blood pressure, blood fats (lipids) and blood sugar.
Blood pressure rises as we age so it is sensible to check it at least once a year.
Blood lipids rise so we recommend you check yours. It might be that you need treatment to lower your lipids to reduce risk of cardiovascular disease.
There is natural gain weight through aging, which is accelerated around the time of menopause. The way body fat is stored changes, encouraging more around the middle.
The amount of muscle reduces (sarcopenia).
Insulin resistance can increase. Insulin is a fat storage hormone that helps to regulate blood sugar. Insulin resistance can increase risk of developing Type 2 diabetes.
Healthy lifestyle choices can improve your metabolic health. Advice is to have a healthy balanced diet similar to a mediterranean diet, keep a healthy weight, do moderate intensity exercise 150-300 minutes a week and strength based exercise at least twice a week, prioritise sleep to 7-9 hours a night, stop smoking and reduce alcohol to less than 14 units a week. Certain HRT regimes and other medications (like lipid lowering medications or blood pressure lowering medications) can also play a role at improving your metabolic health.
Bone health
The risk of osteoporosis increases after menopause. Osteoporosis is a disease which occurs because there is an imbalance in the normal process of bone remodelling by osteoclasts (break down old or damaged bone tissue, also called bone resorption) and osteoblasts (create new bone tissue). As we get older, bone breakdown by osteoclasts increases and isn’t balanced by new bone formation by osteoblasts. This results in a fall in bone mineral density (BMD) and a change in the composition, architecture and size of the bone. Osteoporosis is characterised by low bone mass and a structural deterioration of the bone tissue. Because of this, bones become fragile and are at risk of fracture. The prevalence of osteoporosis increases with age from 2% at 50 years to nearly 50% at 80 years of age.
Women are at greater risk of osteoporosis, due to the loss of oestrogen at menopause, which accelerates bone loss. Oestrogens are important for maintaining bone mineral density. Direct oestrogen effects on osteocytes, osteoclasts and osteoblasts lead to inhibition of bone remodelling, decreased bone resorption and maintenance of bone formation. A major consequence of loss of oestrogen at menopause is an increase in bone resorption and a fall in bone density.
Bone loss leading to osteoporosis starts before the menopause happens. There is a time of ‘fast bone loss’ which starts a year or so before the final menstrual period and continues for about 3 years and then the rate of loss slows, but continues post menopause.
Osteoporotic fractures usually occur in older postmenopausal women. Characteristically, occurring in the wrist, spine, and hip, but they can occur in other bones such as the arm, pelvis and ribs. One in three women will suffer from at least one osteoporotic fracture during her lifetime.
HRT has a protective effect against osteoporosis, and related fragility fractures, while is is being taken.
To protect your future health a recommended website to find out more about bone health, look at the Royal osteoporosis Society for advice about nutrition and exercise for bone health, check you are taking enough calcium in your diet using this link. You will need between 700-1200mg of dietary calcium daily.
Supplementing with Vitamin D 1000iu daily long term may be beneficial.
This article and attached videos from the Royal Osteoporosis Society are brilliant and definitely worth listening to.
Cancer
We cannot change our genetics but we can use healthy lifestyle choices to help protect us from cancer.
Attending regular screening when invited: breast, cervix and bowel can pick up cancers early.
Pelvic floor, vaginal/vulval and bladder health
Keep the pelvic floor muscles strong to avoid weakness causing bladder and bowel problems or prolapse.
If you are struggling a pelvic floor physiotherapist may be able to help. Please try using the Squeezy app to remind you or look at this link: how to do your pelvic floor exercises
Genitourinary Syndrome of the menopause is a term used to describe how low oestrogen levels affect the genitals and the bladder causing symptoms which affect almost 80% of women, but often they do not speak about them, due to embarrassment or thinking it is a normal part of aging. Vaginal dryness and bladder symptoms are common.
Treatment using intimate care regimes, pH balanced non hormonal moisturisers and lubricants, and with addition of low dose vaginal oestrogen products are really effective, take time to work and need to be used regularly, long term to help manage the symptoms. This treatment can be used safely by most women, please seek advice from your Dr.
Recommended websites to get more information about bladder health:
Brain health
It is common for women to struggle with brain fog and memory problems during the menopause transition.
Prioritising sleep, reducing stress, eating a mediterranean diet, drinking alcohol less than 14 units a week, socialising and learning a new skin can help with brain health; this video is helpful:
International Menopause Society: Professor Maki: short video
International Menopause Society: Professor Maki: short video menopause and cognition
Body checks
Breasts: please do monthly body checks of your vulva, skin and breasts and attend regular mammograms.
If you have questions about individual risk and benefit and require more information about this please make an appointment to talk about us about it.
Mental health
There are lots of ways we can positively support our mental health. Using nature and having a daily walk is the most simple and easy way to do this, evidence shows even just looking at greenery for less than a minute can improve mental health.
Reducing stress and finding things which bring you pleasure are simple starting points to support mental health.
You may need more help with mental health so please talk with us if this is the case.
This advice is for guidance only and please discuss with your doctor if you have any medical concerns
Book an appointment at Rowena Health to please speak with us – Dr Carys Sonnenberg Rowena Health – October 2025