Dr Nadja Auerbach
Written by Dr Nadja Auerbach, MBBS BSc Dip IBLM/BSLM
4th Oct 2023 • 5 minute read
Dr Nadja Auerbach
Reviewed by
Dr Nadja Auerbach, MBBS BSc Dip IBLM/BSLM

After menopause, a woman’s risk of developing chronic disease - specifically heart disease, stroke, diabetes, dementia, cancer, and osteoporosis - increases. These are largely preventable by adopting healthy lifestyle behaviours.  A simple blood test that measures your cholesterol, vitamin D and long-term blood sugar levels can give you an indication of your risk.

Menopause and heart disease

For women over the age of 50, heart disease, especially a type called coronary heart disease (CHD), is the top cause of death. A major factor behind this is the drop in oestrogen levels, which plays a protective role in maintaining the health of your blood vessels. After menopause, factors like increased blood pressure and a rise in LDL cholesterol levels become more common, further increasing the risk of heart disease.  We've seen this trend in Thriva results too, with 3 out of 4 women over 50 having high cholesterol results, and over half of these women having high LDL cholesterol specifically.  

How can I reduce my heart disease risk? 

  • losing weight if you’re overweight
  • following a healthy diet - such as the Mediterranean diet
  • cutting back on your intake of saturated fats
  • quitting smoking
  • exercising regularly — always check with your doctor before increasing frequency and intensity
  • reducing your intake of refined sugars and high fructose foods — opt for wholegrain carbohydrates high in fibre
  • limiting your intake of trans fats — found in highly processed foods
  • Monitor your cholesterol levels

Menopause and osteoporosis

Oestrogen plays a key role in maintaining bone density. When oestrogen levels drop after menopause, there's an acceleration in bone loss. This can lead to a condition known as osteoporosis, making bones more fragile and likely to break. The stage before osteoporosis is called osteopenia. This is when a bone density scan (known as a DEXA scan) shows you have lower bone density than the average for your age, but not low enough to be considered osteoporosis. The National Osteoporosis Foundation highlights that women can lose up to 20% of their bone density in the years following menopause.  

How can I reduce my osteoporosis risk? 

There is lots you can do to reduce your risk of developing osteoporosis, including:

  • Taking part in regular weight bearing exercise, such as resistance training and walking 
  • Eating a healthy, balanced diet, including calcium and Vitamin D rich foods
  • Taking a daily vitamin D supplement.  You can test your vitamin d levels to find out if you’re deficient. 
  • Stopping smoking 
  • Limiting alcohol 

Menopause and diabetes

Due to changing hormones and sleep disturbances, menopause can worsen insulin resistance.  Insulin resistance is a condition where cells in your muscles, fat and liver don’t respond to insulin as well as they should, making it difficult to take up sugar (glucose) from your blood.  Because of this, the pancreas has to work even harder to produce even more insulin, and your blood sugar levels stay higher than they should.  Over time, chronic insulin resistance can lead to prediabetes, then type 2 Diabetes, if it isn’t treated. Weight gain is also common during and after menopause, particularly around the waist or mid-section.  which, when paired with reduced physical activity, increases type 2 diabetes risk. Type 2 diabetes can increase your risk of heart disease and stroke. 

How can I reduce my diabetes risk? 

Certain lifestyle changes can help you prevent insulin resistance after the menopause, including:

  • Reducing intake of refined carbohydrates and sugars -  this will help to balance your blood sugar levels
  • Supporting sleep and your circadian rhythm - poor sleep can have a big impact on how we handle our blood sugar the next day.  Try to prioritise getting 8 hours of sleep a night, avoiding alcohol and caffeine before bed and not eating too close to bedtime. You may want to try a magnesium supplement, which can help improve sleep quality.
  • Engage in regular exercise - aim for 30 minutes of exercise 3 times a week at a minimum.  Resistance training and weight training are the best forms of exercise to keep your bones strong and prevent insulin resistance. Try to also add in some low-intensity exercises, such as walking, cycling, swimming, pilates, or yoga
  • Keep an eye on your HbA1c - this is reflective of your average blood sugar levels over the last 3 months, and can help determine whether you are at risk of diabetes

Menopause and mental health 

The period following menopause isn't just marked by physical changes; many women also report challenges related to mental health. Conditions like depression and anxiety can surface or intensify during this part of a woman’s life. This is thought to be due to the fluctuating hormone levels and the physical symptoms of menopause.  Depression is a constant feeling of sadness or low mood, with a loss of interest in activities, including those you would normally enjoy.   Anxiety involves constant worrying that gets in the way of you living your life normally. Both can make it difficult to concentrate, sleep, and take care of yourself and your loved ones. If you feel depressed for most of the day for more than 2 weeks, you should see your GP. 

How can I support my mood after menopause? 

  • exercise — boosts your mood, which can help with feeling low
  • self-help — daily journaling and talking about your feelings with someone you trust can be helpful
  • mindfulness — to improve your mood. You could try things like meditation and yoga or tai chi
  • online or group-based cognitive behavioural therapy (CBT) — a talking therapy where you work with a trained therapist to reframe negative thoughts into more positive ones. You’ll also learn tools to help you cope with triggering situations and improve your self-esteem. 
  • Try an omega-3 supplement - omega 3s support your overall brain function and can help improve a low mood

Taking action

Whilst menopause can increase your risk of certain chronic illnesses, these risks can be reduced through lifestyle interventions such as exercise, diet, sleep, and supplementation. 

If you want to get a clearer picture of these risk factors for yourself, our Menopause Insights Blood Test can give you a detailed look at your levels of cholesterol and vitamin D, as well as checking blood sugar and thyroid health.

For more information on menopause - including menopause symptoms, perimenopause, and HRT - visit our other health hub articles.