Being proactive about future health awareness 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 have modifiable risk factors, these are things we may be able to change, like stopping smoking. Here are some things which we can bear in mind when making choices.
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 changes now can support health in the future.
Heart and blood vessel health
When hormones change at menopause, metabolic health can also change, affecting where we store body fat, blood pressure, blood lipids and blood sugar. Metabolic syndrome increases the risk of cardiovascular disease and diabetes.
Blood pressure rises as we age – it is sensible to check it at least once a year
Blood lipids rise – we recommend you have your NHS health check to check yours, or have this done using a private blood test
There is natural gain weight through aging, which is accelerated around the time of menopause. The way we store body fat changes, encouraging more to store around the middle, which increases the risk of metabolic syndrome. Our lean muscle reduces. For health reasons it is important to try to keep a healthy waist to height ratio (<0.5 if possible) and keep our BMI in the healthy range. This varies according to ethnic group and age, and in those with high muscle mass. In general if you have a BMI > 35 then it is helpful to measure your waist -height ratio, with a tape measure, which should be less than 0.5. If it is more than this please speak with your Dr about how we can help.
Insulin resistance increases. Insulin is a fat storage hormone that helps to regulate blood sugar. Insulin resistance can increase risk of developing Type 2 diabetes
If we have your BMI, waist circumference, blood lipids, blood sugar and blood pressure readings we can talk with you about your metabolic health. We can choose a regime of hormone replacement therapy to support your metabolic health. We can advise you if you need to have other treatments for high blood cholesterol or blood pressure. We can talk with you about weight loss strategies to help improve metabolic health. Treatment of metabolic syndrome can help improve your metabolic health and reduce your risk of developing cardiovascular disease and type 2 diabetes.
Bone health: the risk of osteoporosis increases after menopause
One in two women will suffer a fracture after the age of 50.
HRT has a protective effect against osteoporosis, and related fragility fractures, while is is being taken.
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, for example it is widely known that smoking cigarettes is associated with lung cancer so stopping smoking is a modifiable risk factor
Attending regular screening when invited: breast, cervix and bowel can pick up cancers early
Other examples of modifiable risk factors are obesity, drinking alcohol above the recommended limit each week, and exercising.
Pelvic floor, vaginal and bladder health
Keep the pelvic floor muscles strong to avoid weakness causing bladder and bowel problems or prolapse.
Pelvic floor exercises need to be done about 4-5 x a day
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
This 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:
Dry skin and hair
Simple advice of finding a moisturiser you enjoy using, vaseline is fine
Wearing sunscreen daily even in the winter and even inside will help protect against sun damage
The book What every woman needs to know about skin and hair by Dr Mandy Leonhardt is an excellent resource
Brain health
It is common for women to struggle with brain fog and memory problems
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
We need more research about HRT and dementia, the evidence from four properly conducted studies in post menopausal women is currently reassuring. The British Menopause Society advises gives the following advice “Women should be reassured that HRT is unlikely to increase the risk of dementia or to have a detrimental effect on cognitive function in women initiating HRT before the age of 60.”
Body checks
Breasts: please do monthly body checks of your vulva, skin and breasts and attend regular mammograms.
The British menopause Society advice about breast cancer and HRT is that “current evidence suggests that oestrogen alone HRT is associated with little or no change in the risk of breast cancer while combined HRT can be associated with an increased risk which appears dependent on how long HRT is taken for, and may vary with the type of progestogen used. However, this risk is low, particularly when it is compared to lifestyle risk factors such as obesity, alcohol intake and smoking, which can also increase the risk of breast cancer. For more information click this link.
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
If you are a patient at Rowena Health please speak with us if you have any questions about this advice, Dr Carys Sonnenberg Rowena Health December 2024