Menopause and Your Health

After menopause, your ovaries make very little estrogen. Women who have gone through menopause have very low estrogen levels. Low levels of estrogen and progesterone raise your risk for certain health problems after menopause. Other health problems may happen naturally as you age.

Examples of common health problems in the years after menopause include:

• Heart disease: Before age 55, women have a lower risk of heart disease than men. Estrogen helps keep blood vessels relaxed and open and helps the body maintain a healthy balance of good and bad cholesterol. Without estrogen, cholesterol may start building up on artery walls leading to the heart. By age 70, women have about the same risk for heart disease as men of the same age.
• Stroke: Your risk for stroke doubles every decade after age 55. The lower levels of estrogen in your body may play a role in cholesterol build-up on artery walls leading to the brain.
• Osteoporosis: Having less estrogen after menopause causes you to lose bone mass much more quickly than you did before, which puts you at risk for osteoporosis. Osteoporosis is a condition that causes your bones to become brittle and weak and break easily. A recent large study found that women who have severe hot flashes and night sweats during the years around menopause usually have more bone loss and are at higher risk for hip fractures than women who do not have severe symptoms.
• Lead poisoning: Lead that you are exposed to over your lifetime gets stored in your bones. Because bone begins to break down much more quickly after menopause, that lead is more likely to be released into the blood. Older women can have blood lead levels 30% higher than before they reached menopause. This lead increases your risk for high blood pressure and atherosclerosis (sometimes called hardening of the arteries). This lead in your blood can also cause your kidneys to not work as well. It can also cause symptoms similar to dementia, affecting your memory and ability to think.
• Urinary incontinence: About half of postmenopausal women have trouble holding in their urine. Lower estrogen levels may weaken the urethra.
• Oral issues: Dry mouth and an increased risk for cavities are more common after menopause.

No. Menopausal hormone therapy is medicine to help relieve your menopause symptoms, such as hot flashes and vaginal dryness. Menopausal hormone therapy may actually raise your risk for blood clots, stroke, and some cancers and does not help prevent heart disease or dementia.

All women need regular checkups and screening tests throughout their lives. Most women can help take care of their health with:

• Regular mammograms after age 50 through age 75
• Regular Pap tests, even after menopause. You should get a Pap test and HPV test together every five years if you have a cervix, until you are 65 and have had three clear tests in a row.
• Regular height measurements to detect loss of height due to bone loss
• Blood, urine, and other tests to screen for risk of diabetes and heart disease
• Blood pressure, cholesterol, and other tests your doctor recommends

Ask your doctor or nurse about flu shots and other vaccines. Besides the flu shot, vaccinations are available for pneumonia, shingles, and other diseases.

Your doctor or nurse might also recommend other tests, depending on your health. For example, you might need to see a specialist for some specific problems, like urinary incontinence.

There are many important steps you can take to build your health in the years around menopause.

Quit smoking: Quitting smoking is the most important step you can take to be healthier. Smoking hurts your health in many ways, including by damaging your bones and causing heart disease and as many as 12 types of cancer in women. Stay away from secondhand smoke and get help quitting if you need it. Visit Women.Smokefree.gov for woman-specific information, tips, and tools.

Be active: Getting at least 30 minutes of physical activity on most days of the week is one of the best ways you can be healthier. Physical activity can help your bones, heart, and mood. Exercise doesn't have to be complicated. Brisk walking and regular household chores are good for your health. Ask your doctor about what activities are right for you. Aim to do:

• At least 2 hours and 30 minutes a week of moderate aerobic physical activity or 1 hour and 15 minutes of vigorous aerobic activity or some combination of the two
• Exercises that build muscle strength on two days each week

Get a free exercise guide and other tips for older adults at the Go4Life from the National Institute on Aging at NIH website.

Eat well: Getting vitamins, minerals, fiber, and other essential nutrients is just as important as when you were younger. But older women usually need fewer calories for energy. Find out how many calories you need each day, based on your age, height, weight, and activity level.

Talk to your doctor or nurse about dietary supplements:

• Women older than 50 need 2.4 micrograms of vitamin B12 and 1.5 milligrams of vitamin B6 each day. Ask your doctor or nurse if you need a vitamin supplement. 
• After menopause, calcium needs go up to maintain bone health. Doctors recommend that women 51 and older get 1,200 milligrams of calcium each day. Vitamin D also is important to bone health. Doctors also recommend that women 51 to 70 get 600 international units (IU) of vitamin D each day and women ages 71 and older get 800 IU of vitamin D each day. Ask your doctor or nurse if you need a calcium supplement or if you need more vitamin D.

Practice safe sex: After menopause, you can’t get pregnant. But you can still get a sexually transmitted infection (STI, or STD). Condoms are the best way to prevent STIs when you have sex. After menopause the vagina may be drier and thinner, leading to small cuts or tears during sex. Vaginal cuts or tears put you at higher risk for STIs.

Maybe. Many women gain an average of 5 pounds after menopause. Lower estrogen levels may play a role in weight gain after menopause. But weight gain may be caused by your metabolism slowing down as you age. You may also not eat as healthy or be as active as when you were younger. You also lose muscle mass as you age (muscle burns more calories at rest than other types of tissue in the body).

Weight gain can raise your risk for high blood pressure, cholesterol, diabetes, heart attack, and stroke. The risk is greater if you are already overweight or are not active or eating healthy. Learn about the effects of overweight and obesity on heart health.

The best way to lose weight, if you are overweight or obese, is to eat fewer calories each day. Exercise or physical activity is also important for good health, but works better to keep weight off than it does to help you lose weight. Researchers think this might be because people who are physically active are usually hungrier. Eating healthy and getting at least 30 minutes of exercise on most days is the best way to keep a healthy weight.

References

1. Becker, R.C. (2005). Heart attack and stroke prevention in women. Circulation; 112: e273–e275.
2. Crandall, C., Aragaki, A., Cauley, J., Manson, J., LeBlanc, E., Wallace, R., et al. (2015). Associations of Menopausal Vasomotor Symptoms with Fracture Incidence. Journal of Clinical Endocrinology and Metabolism; 100(2): 524–534.
3. Jackson, L.W., Cromer, B.A., Panneerselvamm, A. (2010). Association between bone turnover, micronutrient intake, and blood lead levels in pre-and postmenopausal women, NHANES 1999–2002. Environmental Health Perspectives; 118(11): 1590–1596.
4. Shifren, J.L., Gass, M.L.S., for the NAMS Recommendations for Clinical Care of Midlife Women Working Group. (2014). The North American Menopause Society Recommendations for Clinical Care of Midlife Women. Menopause; 21(10): 1038–1062.
5. Surgeon General’s Report on Smoking and Health. (2014). Smoking and Cancer. [PDF–829 KB]
6. Henley, S.J., Thomas, C.C., Sharapova, S.R., Momin, B., Massetti, G.M., Winn, D.M.,…Richardson, L.C. (2016). Vital Signs: Disparities in Tobacco-Related Cancer Incidence and Mortality — United States, 2004–2013. Morbidity and Mortality Weekly Report (MMWR); 65: 1212–1218.

Sources

The Office on Women's Health in the U.S. Department of Health and Human Services

Content last updated September 21, 2018