Long COVID (symptoms persisting for four weeks or more after the acute infection) and menopause can cause some of the same symptoms, and they often affect women around the same time of life¹. This article looks at how their symptoms overlap, whether COVID-19 affects the timing of menopause, how doctors try to tell them apart, and what current research does and does not show.

Can long COVID cause symptoms that overlap with menopause?

Yes – long COVID has more than 100 possible symptoms, and many of them overlap with menopause symptoms ¹. Long COVID is when symptoms continue for four weeks or more after a COVID-19 infection ¹. It can affect many parts of the body ¹. Both long COVID and menopause can cause tiredness, brain fog (problems with memory and concentration), low mood, poor sleep and joint aches ^1,2.

The two conditions also affect women of a similar age. Women aged 45 to 54 are the age group most likely to report long COVID ¹. This is also the usual age for the onset of perimenopause (the years leading up to menopause) and menopause ¹. Some women feel that having both conditions together makes their symptoms worse ¹. Having similar symptoms does not prove that one condition causes the other; it means the two can be easy to confuse ¹.

Are women who had COVID-19 more likely to experience early menopause?

The honest answer is that we do not yet know, and the evidence so far is limited ³. COVID-19 can cause short-term changes to the menstrual cycle, such as irregular, missed or heavier periods ³. In one multi-country survey in menstruating women with long COVID, about a third reported the above menstrual problems/ issues ³.

In another survey, half of the women with long COVID reported that their periods had stopped or changed after long COVID infection ¹. Surveys like these record women’s own experiences, but do not show whether COVID was the cause ¹. Some studies have found temporary changes in the hormones that reflect ovarian function ⁴. These include a short-term fall in anti-Mullerian hormone, a marker of ovarian reserve (healthy, age-appropriate quantity of remaining eggs) ⁴.

The virus may affect the ovaries because it can enter ovarian tissue and cause inflammation ⁴. COVID-19 has also been linked in a few studies to premature ovarian insufficiency ⁴. This is when the ovaries stop working normally before the age of 40 ⁴. However, most of these changes appear to be temporary, and the long-term effects on the ovaries are not yet known ⁴. Overall, whether COVID-19 makes menopause happen earlier is not established ⁴.

How can a doctor distinguish between long COVID symptoms and menopause?

There is no simple test that separates long COVID from menopause, so doctors need to look at the whole picture ¹. After the age of 45, menopause is usually identified from your symptoms and changes in your periods, not from a blood test ².

A doctor may consider your age and whether your periods have changed ¹. They may ask when your symptoms began, including whether they started after a COVID-19 infection ¹. Long COVID often includes symptoms that are less typical of menopause, such as breathlessness or feeling much worse after activity ^1,5,6. These can be a clue ^1,5.

As the overlap in symptoms is so close, the two can be hard to tell apart, and they can also occur together ¹. Guidelines advise that when someone has menopause-like symptoms, other possible causes should also be considered ⁷.

Should women with long COVID who are in the right age group be assessed for menopause?

For women in the usual menopause age range who have these overlapping symptoms, greater awareness of menopause in women with long COVID alongside regular checks can help ¹. This may help avoid a missed or mistaken diagnosis and lead to more suitable care ¹.

Menopause can be identified from symptoms, age and change in menstrual cycle pattern, and there are treatments that may ease menopausal symptoms ². If menopause is the cause, or part of the cause, treating it may also make day-to-day life easier ². Menopause care can often be managed by your doctor ⁷. They can refer you to experts with more experience in menopause if your situation is more complex or your symptoms do not improve ⁷.

What does current research say about the overlap between long COVID and menopause?

Research on this topic is still at an early stage with most of what we know based on small studies where women have reported their symptoms ¹. These studies show that long COVID and menopause share many symptoms, and that women often feel each condition makes the other worse, but research has not shown that one condition causes the other ¹.

In fact, it has been shown that although women were more likely than men to have long COVID, having gone through menopause did not by itself raise the risk ¹. Other research has looked at how COVID-19 affects the menstrual cycle and the ovaries, and has found mostly short-term changes ^3,4. It has been suggested that certain hormones such as oestrogen and progesterone may play a part by affecting inflammation in the body, but these ideas are not yet proven ¹. Larger and longer studies are needed before firm conclusions can be drawn ¹.

Conclusion

Long COVID and menopause can cause many of the same symptoms, and they often affect women at the same time of life ¹. This can make them hard to tell apart ¹. Current research shows this overlap, but it has not shown that one condition causes the other ¹. The evidence on whether COVID-19 affects the timing of menopause is still limited ^3,4. If you have long COVID and you are in the age range where menopause may begin, being assessed for menopause as well can help ¹. Menopausal symptoms can be treated ². A healthcare professional can look at your symptoms, age and history and advise on how to better manage your menopause journey and understand the available options for relieving symptoms ^1,2.

FAQ

1. Are long COVID and menopause symptoms similar?

Yes. Both can cause tiredness, brain fog, low mood and poor sleep ¹. Many of these are also recognised symptoms of menopause ². Since the symptoms of both are so similar, the two can be easy to confuse ¹.

2. Can COVID-19 bring on early menopause?

The evidence is limited and not clear. COVID-19 can cause short-term changes to the menstrual cycle and to ovarian hormones and, in some studies, has been linked to the ovaries stopping work early, before the age of 40 ⁴. Most of these changes seem to be temporary, and there is no firm evidence that COVID-19 makes natural menopause happen earlier ⁴.

3. Is there a test to tell long COVID and menopause apart?

No single test can separate them ¹. After the age of 45, menopause is usually identified from your symptoms and changes in your periods, not from a blood test ². A doctor will look at your age, your periods and when your symptoms started to help work out the cause, and the two can also occur together ¹.

4. Should I be checked for menopause if I have long COVID?

If you are in the usual menopause age range and have these symptoms, being assessed for menopause as well can help ¹. Menopause can be identified from your symptoms and age, and there are treatments that may ease its symptoms ². Your usual doctor can do this and can refer you to someone with more menopause experience if needed ⁷.

5. Does menopause make long COVID worse, or the other way round? Women often report that the two conditions make each other worse, but this comes mainly from what people report about their own symptoms, not from studies that prove a cause ¹. It has been shown that women were more likely than men to have long COVID but going through menopause did not by itself raise the risk ¹. Researchers say larger, longer studies are needed to understand the link ¹.

This article was written with the assistance of generative AI technology and reviewed for accuracy.

Menopause is the time when your periods stop for good, usually between 45 and 55 years of age¹. Before menopause comes a transition stage called perimenopause¹. Learning about this stage early can help you know what to expect. This article explains simple steps you can take in the years before menopause: healthy habits, useful health checks, support, what to expect, and how to find menopause care.

What can I do in my 40s to prepare for the menopause transition?

Building healthy daily habits in your 40s can ease menopausal symptoms and support your heart and bone health over time ¹. During the menopause transition, body fat tends to rise and muscle tends to fall, and this change can begin about two years before your last period ². Staying active and keeping your muscles strong are important during this time ³. Women are advised to do at least 150 minutes of moderate intensity activity each week, such as brisk walking, cycling or swimming ^{1, 2}. This can be spread throughout the week in whatever way suits you.

A balanced diet also helps: one that is low in saturated fat and salt can support your heart ¹. Getting enough calcium and vitamin D helps keep your bones strong, and adults are generally advised to get about 1000 to 1200 mg of calcium and 800 to 1000 units of vitamin D each day ⁴. This matters because bones can weaken more quickly around menopause ⁴. Keeping a healthy weight can also help reduce vasomotor symptoms, as extra weight can make them worse ².

Limiting/ reducing excessive alcohol can also help your bones, because more than two drinks a day in women has been linked with bone loss ⁴. Not smoking helps your bones and your heart, because smoking raises the risk of weak bones and heart disease ¹. The years around menopause are an important time to care for your heart, because the risk of heart problems can rise during this stage ².

Which health checks are worth having as you approach menopause?

There is no routine single test that can show exactly when menopause will happen ¹. As menopause approaches, the focus is usually on general health checks – such as your heart and bones – rather than on a test for menopause itself. After the age of 45, menopause is identified from your symptoms and the changes in your periods, not from a blood test ¹.

Cholesterol levels can rise around the menopause, while blood pressure and blood sugar tend to rise with age, so these are useful to check from time to time ². Body fat around the middle can also increase during this stage, which can affect heart health ². Heart disease is a leading cause of death in women, so it can help to care for your heart early ¹. If you have a higher chance of weak bones, a healthcare professional can advise whether a bone scan is needed ⁴. It is also important to continue with any regular health screening offered to you ³.

How can I get support to help me through the menopause transition?

Access to information, education, and support can help women better cope with the menopause transition, especially when sought early. This support is linked to faster improvements in health-related quality of life ⁵. Joining a menopause education or support group, or having one-to-one support sessions, can improve quality of life and reduce some of your symptoms ⁵. These sessions often cover the changes in your body, ways to care for your health, and how to manage everyday worries ⁵. They also give you a platform to share experiences with other people at the same stage of life ⁵.

Learning about your choices early can help you make decisions that are right for you when symptoms begin ⁵. Managing stress is part of preparing too, as stress can make menopause symptoms worse.⁶ Women who were upset by a stressful life event had about 21% more hot flushes and night sweats than women who had no such event ⁶. So gathering good information, arranging support, and finding ways to manage stress can all be part of getting ready.

What should I know about menopause before my symptoms start?

It helps to know that menopause is a normal stage of life, that symptoms can begin years before your periods stop, and that they are different for each person. Menopause usually happens between the ages of 45 and 55 ¹. Perimenopause is the stage before it, when periods become irregular and symptoms may start ^1,7.

In early perimenopause, the time between periods changes by about seven or more days from your usual pattern; later, periods become less frequent until they stop ¹. Symptoms can begin up to about ten years before your last period ⁷. The symptoms reported most often are hot flushes and night sweats, which affect about 70 to 80% of women ¹. Other symptoms include trouble sleeping, low mood, joint aches, problems with memory, and vaginal dryness ¹.

Symptoms last on average more than seven years, and more than a third of women have them for longer ¹. Not everyone has troublesome symptoms, and some people have very few ¹. You can still become pregnant during perimenopause, so you still need contraception until menopause is confirmed ⁷.

How do I find healthcare support from someone with menopause expertise? Menopause care can often be managed by your usual primary care provider, and you can ask to see someone with extra menopause training if your situation is more complex ⁸. You do not always need a specialist. A healthcare professional can explain your options and, if needed, refer you to someone with more experience in menopause ⁸. A professional with menopause training can look at your symptoms, your medical history and your own wishes, and help you choose what is right for you ⁸. It can help to see someone with menopause expertise if you have a health condition that affects your treatment choices, or if your symptoms do not improve ³. Whatever your situation, help and support are available, and a good first step is to speak with a healthcare professional ¹.

Conclusion

Preparing for menopause does not need to be difficult. Healthy daily habits, care for your heart and bones, good information, and support can all help you feel ready for this stage ¹. Knowing what to expect, and where to find help, means you can make a plan that suits you, together with a healthcare professional ¹

FAQ

1: When does menopause usually happen?

Menopause usually happens between the ages of 45 and 55 ¹. Before it is perimenopause, the stage when periods become irregular ⁷. Symptoms can begin several years before your periods stop ⁷.

2: Do I need a blood test to find out if I am near menopause?

If you are over 45, you usually do not need a blood test, because menopause is identified from your symptoms and your periods ¹. A blood test called FSH may be used if you are under 40, or between 40 and 45, when menopause is suspected earlier than usual ¹. A single test result is not always enough to be sure ¹.

3: Can I still get pregnant during perimenopause?

Yes. You can still become pregnant during perimenopause, so you need contraception until menopause is confirmed ⁷. Hormone replacement therapy is not a form of contraception ⁸.

4: Can changes to my daily habits help around menopause?

Yes. A healthy diet, regular physical activity, not smoking, and drinking less alcohol can ease symptoms and protect your heart and bones ¹. These habits can help at any age, and the years around menopause are a useful time to begin ².

5: What can help me cope with symptoms? Several options can help. Education and support sessions can improve quality of life and reduce some symptoms ⁵. Hormone replacement therapy can relieve symptoms, and talking therapies such as cognitive behavioural therapy (a structured talking treatment) can also help ¹. A healthcare professional can explain which options may suit you ^1,8.

This article was written with the assistance of generative AI technology and reviewed for accuracy.

Menopause is a natural part of life but it is also a turning point for heart health. Research shows that the hormonal changes of the menopausal transition are associated with an increased risk of cardiovascular disease (CVD), which remains the leading cause of death in women worldwide.^1,2 The good news is that understanding these changes early can help you and your healthcare provider take steps to protect your heart during midlife and beyond.

Why is menopause considered a turning point for heart health?

Menopause marks a significant shift in cardiovascular risk for women. Before menopause, the incidence of heart disease in women is delayed by 10 years as compared to men,^1,2 a difference that is thought to be linked to the protective effects of estrogen on blood vessels during the reproductive years.

Studies show that the rate of cardiovascular disease in women at midlife between the ages of 40 and 65 is rising, and this increase coincides with the timing of the menopausal transition.¹ Women who experience menopause before age 45 may face a higher cardiovascular risk than those who go through menopause at the typical age of around 50.^2,5

This does not mean heart disease is inevitable. But it does mean the menopausal transition is an important moment to pay attention to cardiovascular health.

What happens to your blood fats (cholesterol and triglycerides) during menopause?

Menopause is associated with significant changes in blood fat levels that may raise the risk of heart disease. Research shows that levels of LDL cholesterol (often called “bad” cholesterol), total cholesterol, triglycerides, and a particle called lipoprotein(a) tend to increase during and after the menopausal transition.^3,4

At the same time, HDL cholesterol (often called “good” cholesterol) may become less effective at protecting arteries, even when its measured level appears stable.⁴

How does estrogen normally protect blood vessels?

Estrogen plays an active role in keeping blood fats at healthy levels. It supports the liver’s ability to clear LDL cholesterol from the blood and helps blood vessels stay flexible and responsive.^1,3,4 When estrogen levels decline at menopause, these processes are disrupted, contributing to a blood fat profile that may increase the risk of plaque building up in arteries.³

Why do these changes happen at menopause and not just with age?

Studies have shown that changes in LDL cholesterol, total cholesterol, and artery structure during the menopausal transition occur independently of chronological aging alone.^1,3 Menopause itself, not just aging, seems to cause important changes in how the body processes fats in the blood. Regular lipid monitoring during and after the menopausal transition is therefore important.

Does your past pregnancy or gynaecological history affect your heart risk at menopause?

Your reproductive history may offer important clues about your future heart health. Several conditions that can occur during pregnancy are now recognised as risk factors for cardiovascular disease later in life and this is an important part of your medical history to share with your healthcare provider.

Women who experienced gestational diabetes, gestational hypertension, or pre-eclampsia during pregnancy have been found to have a higher risk of cardiovascular disease in the years following menopause.^1,5 For example, a diagnosis of gestational diabetes has been associated with a two-fold higher risk of cardiovascular events compared to women without this condition.¹ A history of pre-eclampsia has been linked to longer-term risks including hypertension, coronary artery disease, and stroke.¹

Women who experienced early menopause (before age 45) or premature loss of ovarian function (before age 40) may also face a higher cardiovascular risk, partly because they have had fewer years of estrogen’s natural protective effects.⁵

If any of these conditions apply to you, it is worth discussing your cardiovascular risk proactively with a healthcare professional.

Are hot flushes and other menopause symptoms linked to heart risk?

Some menopause symptoms may be associated with a higher cardiovascular risk though evidence is limited or inconclusive regarding a direct causal link. Hot flushes and night sweats are the most common symptoms of the menopausal transition, affecting up to 80% of women.¹ Research suggests that women who experience frequent or persistent hot flushes may have a less favourable cardiovascular profile, including unfavourable cholesterol levels and higher insulin resistance.¹

What does the research say and what does it not yet prove?

Data from large longitudinal studies, including the Study of Women’s Health Across the Nation (SWAN), suggest that women with frequent and persistent hot flushes may have an increased risk of cardiovascular events compared to those without these symptoms.¹ Sleep disturbances during menopause have been independently linked to markers of cardiovascular risk, such as increased arterial stiffness, a condition in which blood vessels become less flexible, making it harder for blood to flow smoothly and aortic calcification, which refers to calcium buildup in the aorta, the main artery that carries blood from the heart to the rest of the body.²

Depressive symptoms during menopause have also been associated with an increased risk of cardiovascular disease, including coronary artery calcification and cardiovascular mortality.²

These findings do not prove that hot flushes cause heart disease. They may, however, identify women who would benefit from earlier cardiovascular monitoring and lifestyle support. If your symptoms are frequent or severe, discussing them with your healthcare provider is a good opportunity to also check in on your heart health.

How can lifestyle changes protect your heart at menopause?

Healthy lifestyle habits are one of the most powerful tools for protecting the heart at and after menopause. Evidence supports several practical approaches that can meaningfully reduce cardiovascular risk in midlife women.^1,2

What kind of exercise is most supported by evidence?

Regular aerobic exercise such as brisk walking, swimming, or cycling aiming for at least 300 minutes per week of moderate intensity, or 150 minutes of vigorous intensity, is associated with improved cardiovascular health in perimenopausal and postmenopausal women.¹ Muscle-strengthening activities at least twice a week are also recommended.¹ Exercise improves cholesterol levels, lowers blood pressure, reduces insulin resistance, and supports a healthy body weight all of which matter for heart health.¹

Are there dietary patterns linked to better heart health in midlife women?

A diet rich in fruits, vegetables, whole grains, nuts, fish, and olive oil consistent with the Mediterranean or DASH (Dietary Approaches to Stop Hypertension) diet is associated with reduced cardiovascular risk.^1,2 Limiting processed meats, refined carbohydrates, and sweet food and beverages is also recommended.¹ Studies in postmenopausal women have found that healthier dietary patterns are linked to better cholesterol profiles and slower progression of artery changes.¹

Other important steps include stopping smoking, maintaining a healthy body weight, and prioritising good sleep quality.² Smoking is associated with a significantly higher risk of heart disease in women at midlife.¹

Can medications help and why does taking them correctly matter?

Some women may be prescribed medications to help manage cardiovascular risk factors such as elevated cholesterol, high blood pressure, or blood sugar.¹ Whether medication is right for you is a decision your doctor will make based on your individual health history, risk profile, and the results of routine tests.² It is an important conversation to have and not one to delay.¹

When a medication is prescribed, taking it as directed is one of the most important things you can do for your heart.⁵ Missing doses or stopping treatment without medical advice can reduce how well the medication works often in ways that are not immediately obvious.⁵

It is completely normal to have questions or concerns about side effects, cost, or simply remembering to take a pill every day.⁵ These are all valid topics to raise openly with your healthcare provider, who can help you find the best approach for your life. Sharing difficulties honestly is always better than stopping treatment quietly.

Conclusion

The menopausal transition is a meaningful moment for heart health, one that deserves attention and care. The hormonal changes of this period are associated with shifts in cholesterol, blood vessel function, and metabolic health that may increase cardiovascular risk. Understanding these changes, reflecting on your health history, and working with your healthcare provider to build healthy habits and an appropriate monitoring plan are all steps that evidence suggests can make a real difference. Awareness is a powerful first step and it is never too late to start.

FAQ

Q1. At what age does cardiovascular risk start to rise in women?

Cardiovascular risk in women begins to increase notably during the menopausal transition, which typically starts in the mid-to-late 40s. Studies show that rates of cardiovascular disease in midlife women aged 40 to 65 are rising in a way that coincides with the menopausal transition rather than with age alone.¹ Women who experience menopause before age 45 may see this risk increase earlier.^2,5 Discussing your cardiovascular health with your doctor during perimenopause is a good proactive step.

Q2. Does surgical menopause carry more heart risk than natural menopause?

Research suggests that surgical menopause particularly the removal of both ovaries before the age of 45 is associated with a higher cardiovascular risk than natural menopause occurring at a similar age.² This is thought to be due to the abrupt loss of ovarian estrogen production, rather than the gradual decline that occurs with natural menopause.¹ Women who undergo surgical menopause at a younger age have been found to have a higher risk of cardiovascular events compared to those with natural menopause.² If you have had or are considering this type of surgery, discussing cardiovascular risk with your doctor is recommended.

Q3. Does menopause cause changes in body fat that affect heart health?

Menopause is associated with a redistribution of body fat particularly an increase in fat around the abdomen and internal organs.¹ This change in fat distribution is associated with increased insulin resistance, unfavourable cholesterol levels, and a higher risk of cardiovascular disease.^1,4 These changes appear to be driven by the decline in estrogen levels rather than by aging alone.¹ Maintaining a healthy body weight through diet and exercise may help reduce this cardiovascular risk.

Q4. Are the cholesterol changes at menopause different from normal aging?

Yes, research has found that changes in LDL cholesterol, total cholesterol, and artery structure/ stiffness during the menopausal transition are independent of chronological aging. ² This means menopause itself drives specific changes in blood cholesterol and lipids that are distinct from the gradual increases seen with age in both men and women.⁴ The rise in LDL cholesterol during the late perimenopausal and early postmenopausal phases (around 50 years) is particularly pronounced.⁴ Regular lipid monitoring is therefore important during and after the menopausal transition.

Q5. Can I improve my cholesterol through diet alone at menopause?

A healthy diet can contribute meaningfully to better cholesterol levels at menopause. Research in perimenopausal and postmenopausal women has found that dietary patterns consistent with the Mediterranean or DASH diet are associated with improved cholesterol profiles.¹ However, diet alone may not be sufficient for all women, particularly those at higher cardiovascular risk.^3,5 Whether additional medical treatment is needed is a decision for your healthcare provider, based on your individual risk profile.

Q6. Are hot flushes a sign that my heart is at risk?

Hot flushes are not a direct cause of heart disease, but some research suggests they may be associated with a higher cardiovascular risk profile. Data from the SWAN study found that women with frequent and persistent hot flushes had an increased risk of cardiovascular events compared to women without these symptoms.¹ The connection is thought to involve unfavourable cholesterol levels and insulin resistance that can accompany vasomotor symptoms.¹ If your hot flushes are frequent or severe, this is a good opportunity to discuss your cardiovascular health with your doctor. Evidence is limited or inconclusive on whether treating hot flushes directly reduces cardiovascular events.

Q7. Does PCOS affect heart risk at menopause?

Polycystic ovary syndrome (PCOS) has been associated with a higher risk of cardiovascular disease, including ischaemic heart disease.¹ Women with PCOS often have insulin resistance, unfavourable cholesterol levels, and elevated blood pressure all of which can persist into and beyond the menopausal transition.^1,4 Women with a history of PCOS should discuss their cardiovascular risk with a healthcare professional, especially as they approach menopause.

Q8. What is Lipoprotein(a) and why does it matter at menopause?

Lipoprotein(a) also called Lp(a),is a type of fat particle in the blood that is mostly determined by genetics. Higher levels of Lp(a) are associated with an increased risk of cardiovascular disease.⁵ Research suggests that Lp(a) levels may rise after menopause, partly because estrogen appears to suppress its production.⁴ A single measurement is generally sufficient to assess Lp(a) levels, as they remain largely stable over time except during certain life transitions such as the menopausal transition.⁵ If you have not had your Lp(a) checked, it is worth discussing with your doctor, particularly if you have a family history of early heart disease.

Q9. I had gestational diabetes, what does that mean for my heart health now?

A history of gestational diabetes is associated with a significantly higher risk of developing type 2 diabetes and cardiovascular disease later in life.¹ Research suggests this risk is apparent within the first decade after pregnancy and is independent of the development of type 2 diabetes.¹ It is important to share this part of your medical history with your healthcare provider so that appropriate monitoring including regular checks of blood sugar and cardiovascular risk factors can be arranged.

Q10. How do I know if I need medication for my heart health at menopause? Whether medication is appropriate for managing cardiovascular risk at menopause is a decision that depends on your individual risk profile, health history, and the results of routine tests such as cholesterol and blood pressure measurements. Your healthcare provider is the right person to assess this, taking into account both traditional risk factors and any reproductive history that may be relevant.¹ If medication is prescribed, taking it consistently as directed is essential for it to work effectively. Do not hesitate to raise any concerns  about side effects, cost, or other aspects of your treatment with your care team.

This article was written with the assistance of generative AI technology and reviewed for accuracy.

When people think of osteoporosis, they often picture an older woman. It’s true that postmenopausal women have the highest risk, but they’re not the only ones who need to worry about their bones.

Osteoporosis affects both women and men.¹ In fact, about 20% of osteoporosis cases occur in men, and one in five men over age 50 will suffer an osteoporosis-related fracture in his lifetime.^2,3 That’s a significant number. Men tend to develop osteoporosis a decade or so later than women, but by age 70, men catch up in risk.¹ Unfortunately, awareness is lower in men. Many men don’t realize they can even get osteoporosis.

So they may not be screened or treated until after a serious fracture.³

Men and osteoporosis: Why do men develop osteoporosis later? One reason is that men generally have larger, denser bones to begin with, and they don’t experience the rapid hormonal bone loss that women do at menopause.⁴ However, as men age (especially beyond 70), the other age-related factors can lead to significant bone thinning.⁴ Men can also have secondary causes of bone loss. For example, long-term use of corticosteroid medications (for conditions like asthma or rheumatoid arthritis) is a common cause of osteoporosis in both genders.⁴ In fact, any adult, man or woman, who has been on high-dose steroids for several months should talk to their doctor about bone health, as these drugs can accelerate bone breakdown.⁵

Other medical conditions, like low testosterone levels (in men),⁴ prostate cancer treatments that suppress hormones,⁶ chronic kidney disease,⁷ hyperthyroidism, hyperparathyroidism or digestive disorders that impair nutrient absorption, can all contribute to osteoporosis in men.⁸ Men who smoke heavily or drink excessive alcohol are at particular risk.⁹

Other populations: Osteoporosis can occur in younger adults, too, though it’s less common. Certain situations can lead to early-onset bone loss. For instance, some women in their 20s – 40s might experience osteoporosis due to amenorrhea (the absence of menstrual periods for a long time) which can be caused by extreme exercise, eating disorders, or certain hormonal disorders. Without regular menstrual estrogen, their bones may not reach a strong peak or may start losing density early.¹⁰ Young people with conditions like rheumatoid arthritis,¹¹ type 1 diabetes,⁹ or anorexia nervosa¹² also have higher osteoporosis risk because of the disease’s effects on bone or the medications used to treat it.⁸ Additionally, some very rare genetic disorders and childhood conditions can cause osteoporosis even in kids or teens, but these are exceptional cases.¹³

Race and ethnicity: Osteoporosis is a global issue and affects people of all ethnic backgrounds. However, some groups have higher or lower rates statistically.¹⁴ For example, white women in the U.S. have the highest rates of hip fractures, with a lifetime risk of 15.8% at age 50, compared to 8.5% for Hispanic women, 2.4% for Chinese women, and 6.0% for men.¹⁵ Interestingly, African American women tend to have higher bone density, which may protect against fractures, yet they face more severe outcomes after a hip fracture, including longer hospital stays and higher mortality rates. Despite lower fracture rates in minority women, fractures are still more common than breast cancer, heart attacks, and strokes combined. Unfortunately, disparities in care persist: only 5% of African American women receive bone density screening compared to 33% of white women, and fewer receive treatment even when they meet guidelines. These differences highlight the importance of personalized prevention and care for osteoporosis across all communities.¹⁵

Special situations: You might hear about osteoporosis in contexts like space travel – astronauts in microgravity lose bone density rapidly!¹⁶ That’s a reminder of how important regular stress on bones is to keeping them strong. Closer to home, another special case is pregnancy-associated osteoporosis: in very rare instances, a woman might develop osteoporosis during pregnancy or breastfeeding (often temporarily).¹⁷ And certain disabilities or long periods of immobility (for example, being on bed rest for months) can cause bone loss in both young and older individuals.¹⁸

The takeaway is that osteoporosis isn’t exclusive to one demographic. Men need to be aware that they, too, can have fragile bones, and should take preventive measures like adequate calcium/vitamin D, exercise, and possibly screening if they have risk factors. People with chronic illnesses or on bone-affecting medications should be especially proactive in discussing bone health with their doctors. By recognizing that osteoporosis crosses gender and other lines, we can ensure that everyone at risk gets proper attention. Bone health is for everybody.

FAQ

1. Can men get osteoporosis?

Yes. About 20% of osteoporosis cases occur in men, and one in five men over 50 will experience an osteoporosis-related fracture.^2,3

2. What are the risk factors for osteoporosis in men?

Low testosterone, aging, long-term steroid use, smoking, excessive alcohol, and certain medical conditions increase risk.^4-10

3. At what age do men typically develop osteoporosis?

Men usually develop osteoporosis about 10 years later than women, but risk rises significantly after age 70.¹

4. Can younger adults get osteoporosis?

Yes. Conditions like eating disorders, amenorrhea, chronic illnesses, or certain medications can cause early bone loss.^8,9

5. Does race or ethnicity affect osteoporosis risk?

Yes. Caucasian and Asian women have the highest rates, but all ethnic groups can develop osteoporosis, especially with age.¹⁵

6. What medical conditions increase osteoporosis risk?

Rheumatoid arthritis, chronic kidney disease, digestive disorders, and hormone-related conditions can all contribute.^{6 -8,11}

7. Can osteoporosis occur during pregnancy or breastfeeding?

Rarely, pregnancy-associated osteoporosis can occur, usually temporarily, during late pregnancy or lactation.¹⁷

This article was written with the assistance of generative AI technology and reviewed for accuracy.

Staying active is one of the best things you can do for your bones. Like muscles, bones become stronger when you use them. Low-impact weight-bearing exercises (activities that make you move against gravity) help stimulate bone cells and maintain bone density.¹ Examples include walking, hiking, dancing, and climbing stairs. Swimming and cycling are not weight-bearing exercise, however.^2,5 In fact, research shows that healthy postmenopausal women who walk about a mile each day have higher bone density than those who walk shorter distances.³ Resistance and strength training (such as lifting weights or using resistance bands) is also highly beneficial for bone health.⁴ These exercises not only work your bones but also build the muscles that support and protect bones. 

Beyond building bone strength, exercise greatly improves balance and coordination. Better balance means you’re less likely to fall, which is critical in preventing fractures. Activities like tai chi, yoga, or simple balance exercises can stabilize your core and legs, reducing the risk of falls. In older adults, regular exercise helps maintain the ability to carry out daily activities and delays the loss of independence that can come with frailty.⁵ Even though exercise might not dramatically increase bone mass once you’re older, it can slow down bone loss and keep you stronger longer.⁵ 

It’s important to choose safe exercises, especially if you already have osteoporosis. High-impact workouts (like running or jumping) and exercises that bend or twist the spine (such as toe-touching or sit-ups) might need to be avoided to protect fragile bones.⁵ The good news is there are many low-impact options. Brisk walking, gentle aerobics, or water exercise can get you moving without undue risk.  

Consulting a healthcare professional before starting a new exercise program is essential. 

Ask your physical therapist or your doctor to recommend exercises tailored to your abilities. They can show you how to move and lift objects in ways that minimize stress on your bones. Always start new exercise routines slowly and use proper form. 

Consistency is key: aim to be active most days of the week, if possible. Even short daily walks or a few strength exercises every other day can make a difference over time. The NHS recommends that Adults aged 19 to 64 should do at least 2 hours and 30 minutes of moderate-intensity aerobic activity, such as cycling or fast walking, every week.² 

Remember to balance different types of exercise. Include weight-bearing cardio, muscle strengthening, and flexibility/balance training for a well-rounded routine. By “moving it” regularly, you truly can improve it, keeping your bones stronger and your body more resilient as you manage osteoporosis. 

If you’re not sure how healthy your bones are, talk to your care provider. Don’t let fear of bone fractures keep you from having fun and being active. 

FAQ

1.  Why is exercise important if I have osteoporosis? 
Exercise strengthens bones, improves posture, and reduces fall risk by enhancing balance and muscle strength.¹ 

2. What exercises are best for osteoporosis? 
Low-impact weight-bearing (walking, dancing), resistance training (weights, bands), and balance exercises (tai chi, yoga) are most effective.^1,5 Consulting a healthcare professional before starting a new exercise program is essential. 

3. Are there exercises I should avoid with osteoporosis? 
Yes. Avoid high-impact activities like running or jumping and movements that bend or twist your spine (toe touches, sit-ups, some yoga poses).⁵ 

4. Is walking enough to improve bone health? 
Walking helps maintain bone density, but it should be combined with strength and balance exercises for full benefits.⁶ 

5.  Should I consult a doctor before starting an exercise program? 
Absolutely. A healthcare provider can recommend safe exercises based on your bone health. 

This article was written with the assistance of generative AI technology and reviewed for accuracy.

Osteoporosis is best managed with a partnership between you and your healthcare providers. Good communication is key: it ensures that you understand your treatment and that your concerns are addressed. Many people with osteoporosis are cared for primarily by their family doctor, who might also refer you to specialists like an endocrinologist or rheumatologist (doctors who specialize in hormones and bone health). You may also interact with nurses, physical therapists, or nutritionists as part of your care team. Don’t be intimidated by the medical details; instead, take an active role in your bone health.

Come prepared to appointments: Doctor visits can feel rushed, and it’s easy to forget to ask important questions, especially if you’re feeling anxious¹. A great strategy is to prepare a written list of questions or points before each appointment. For example, you might ask: “What do my test results mean?”, “What are the risks and benefits of the medication you’re prescribing?”, or “Do I need any blood tests or supplements?”. Also, keep an up-to-date list of all medications and supplements you take (or bring the bottles with you). This helps your doctor check for any interactions and ensures nothing is overlooked. If you have a history of fractures or other medical conditions, make sure to discuss those as well¹.

Don’t hesitate to speak up: Remember that no question is “silly” when it comes to your health. If you don’t understand something your doctor says, perhaps a medical term like “T-score” or “RANK ligand”, ask for clarification. Doctors and nurses are used to explaining things in plain language when needed. It can help to repeat back what you heard in your own words, to confirm you’ve got it right. For example, “So my bone density went down a bit, but not enough that we need to change medications, correct?” This gives your provider a chance to affirm or correct your understanding¹.

Discuss lifestyle and concerns: Your appointments aren’t just about test results; they’re also a good time to talk about how you’re coping with daily life. If you’re afraid of falling or have stopped doing certain activities you enjoy, mention it. Your doctor or a physical therapist can suggest solutions. If you’ve been experiencing any side effects from medications (like stomach upset from a pill or soreness from an injection), let them know. There may be alternatives or ways to manage side effects, but they won’t know unless you tell them. If pain from an existing fracture is limiting you, ask about pain management or rehabilitation options. Additionally, if you feel sad or anxious about your osteoporosis (which is completely understandable), bring it up. Emotional health is part of the picture, and your provider can direct you to resources or support.

Be a team player in follow-ups: After each appointment, make sure you know the next steps. Do you need to schedule a DXA (Dual-Energy X-ray Absorptiometry) scan next year? When should you do your blood tests for vitamin D levels or kidney function (especially if you’re on certain medications)? Ensure you have a follow-up appointment on the calendar, if needed. Adherence to your treatment plan is crucial. If you have trouble with any aspect of it, discuss that openly. For instance, if the medication schedule is confusing or the cost of a drug is a burden, your healthcare team might have solutions (like simplifying dosing, switching to generics or biosimilars, or finding financial support programs). They’re on your side and want to help you succeed in managing your osteoporosis.

Leverage other resources: Doctors are central, but remember pharmacists can be extremely helpful too. They can explain how to take your medications properly (e.g. taking a pill with a full glass of water first thing in the morning, then staying upright for 30 minutes) and alert you to side effects. Don’t hesitate to ask them questions about injections, supplements or over-the-counter products. If you’re part of an osteoporosis support group or online community, you might also gather good questions to ask your doctor from others who have similar experiences (while always following your own doctor’s advice for medical decisions). In short, good communication means you and your healthcare team work together smoothly. Prepare, ask questions, and share your experiences. Being informed and engaged in your care will help you feel more in control and ensure that you get the maximum benefit from treatments. Remember, you are the most important member of your own care team. Your voice and your choices matter.

FAQ

1. What is the best way to communicate with my osteoporosis doctor?

Prepare questions in advance, bring a medication list, and clarify anything you don’t understand during your visit.

2. Who is part of an osteoporosis care team?

Your team may include a family doctor, endocrinologist, rheumatologist, nurses, physical therapists, nutritionists, and pharmacists.

3. What questions should I ask my doctor about osteoporosis?

Ask about test results, medication risks and benefits, lifestyle changes, and follow-up plans.

4. Why is communication important in osteoporosis care?

Clear communication ensures you understand your treatment, manage side effects, and stay engaged in your bone health.

5. How can I prepare for an osteoporosis appointment?

Write down questions, bring your medication list, and note any symptoms or concerns to discuss.

6. Can I talk about emotional health with my osteoporosis doctor?

Yes, emotional well-being is important. Share feelings of anxiety or sadness so your doctor can suggest support resources.

7. What lifestyle concerns should I discuss with my doctor?

Mention fears of falling, activity limitations, pain, or medication side effects to get personalized advice.

8. How often should I follow up with my osteoporosis care team?

Follow-up depends on your treatment plan, but typically includes regular DXA scans, blood tests, and medication reviews.

9. What role do pharmacists play in osteoporosis care?

Pharmacists can explain medication instructions, check for interactions, and advise on supplements or side effects.

This article was written with the assistance of generative AI technology and reviewed for accuracy. 

Menopause is a natural stage in every woman’s life, but it can bring changes that go well beyond hot flushes and sleep difficulties. One of those changes involves blood pressure. Research suggests that the years around menopause may be associated with a rise in blood pressure for some women, and this is something worth taking seriously for long-term heart health^1-4.
This article will help you understand what the science currently says, what to watch for, and most importantly, when and how to talk with your doctor.

Can menopause cause high blood pressure?

Menopause itself does not directly “cause” high blood pressure. However, the hormonal and physical changes that accompany menopause, including increased abdominal fat, changes in body composition and greater arterial stiffness, can increase the risk of developing high blood pressure.^2,3 

Before menopause, the hormone estrogen helps keep blood vessels flexible and supports healthy nitric oxide production, a substance which causes blood vessels to relax. When estrogen levels drop at menopause, these protective effects are reduced. After menopause, changes in hormone levels may make blood vessels less flexible and less able to relax, while also increasing activity in the sympathetic nervous system, changes that can contribute to higher blood pressure.^2,3 

The role of ageing and why it is hard to separate the two

It is still unclear whether menopause or reduced estrogen directly causes an increase in blood pressure. This is because menopause often happens alongside aging, making it hard to separate their effects. In addition, menopause and blood pressure share common influencing factors such as body weight, diet, smoking, and socio-economic status.³ 

The years around menopause represent a critical window for blood pressure surveillance: up to 41% of women develop hypertension following menopause, almost double the prevalence seen in premenopausal women and the prevalence of hypertension in late menopausal transition is nearly six times higher than in early menopausal transition.⁴ Indeed, 30-50% of women develop hypertension before the age of 60, with symptoms such as palpitations, hot flushes, headaches, and chest pain that are often mistakenly attributed to menopause itself, underscoring the importance of heightened blood pressure monitoring during the late 40s to early 50s.² 

Other contributing factors

Various changes that commonly occur during menopause can also contribute to higher blood pressure:

• Weight gain, particularly around the abdomen, is common after menopause and is independently linked to higher blood pressure.^3,4 
• Changes in lipid (fat) profiles, with higher LDL cholesterol and triglycerides and lower HDL cholesterol.^2,4 
• Increased sensitivity to salt due to lower estrogen levels affecting how the body handles salt and water.² 
• Metabolic syndrome, a cluster of risk factors including abdominal obesity, high blood sugar, and abnormal lipids, becomes more common after menopause.^3,4 

Understanding these overlapping factors helps explain why blood pressure tends to rise in midlife women and why lifestyle plays such a significant role in managing it. 

Should blood pressure be monitored more closely during menopause?

Yes. It’s a good idea to keep a closer eye on your blood pressure during and after menopause. Experts recommend assessing blood pressure and cardiovascular risk factors such as lipid levels during menopause.² 

The reasoning is straightforward: blood pressure can rise gradually and without obvious symptoms. Many women only discover elevated readings during a routine check.⁷ The earlier a rise is detected, the sooner lifestyle changes or, if needed, medical treatment under a doctor’s supervision can be started.⁶ 

Who especially benefits from closer monitoring?

While all women benefit from regular checks, some groups face a higher underlying risk and may benefit from even more vigilant monitoring: 

• Women who experienced high blood pressure or pre-eclampsia during pregnancy this history is associated with a significantly higher risk of cardiovascular disease and hypertension later in life.² 
• Women with a history of gestational diabetes.² 
• Women with premature ovarian insufficiency (POI): Menopause before age 40 who face an extended period of estrogen deficiency and a higher cardiovascular risk profile.^1,2 
• Women with polycystic ovary syndrome (PCOS) or other chronic gynecological conditions associated with increased cardiovascular and metabolic risk.² 

Your doctor or nurse can advise you on how frequently your blood pressure should be checked based on your personal history. Home blood pressure monitoring can also be a valuable tool, particularly for women with a history of pregnancy-related hypertension and should be discussed with a healthcare professional (HCP).² 

What symptoms might suggest my blood pressure has changed since menopause?

This is one of the most important points to understand: high blood pressure is often called a “silent” condition because most people have no symptoms.⁷ This is why regular measurement matters so much more than waiting for symptoms to appear. 

That said, some symptoms which can also overlap with menopause symptoms may occasionally be linked to blood pressure changes. These symptoms are worth discussing with your doctor: 

• palpitations,  
• hot flushes,  
• headaches,  
• chest pain,  
• pain between the shoulder blades,  
• tiredness  
• and sleeping disturbances² 

Research suggests that women who have more intense menopause symptoms, like hot flashes and night sweats, may also have a higher risk of heart-related issues. This may be linked to the body being in a more “stressed” state (overactivity of the nervous system).² 

What can you do to keep blood pressure healthy during menopause?

The good news is that your daily habits can really help manage blood pressure during and after menopause. Staying active, eating well, maintaining a healthy weight, drinking less alcohol, and not smoking can all make a difference and they’ll support your overall health too, not just your blood pressure.⁸ 

Exercise regularly

Regular exercise can help lower blood pressure in women during and after menopause. Research suggests that combining aerobic activities (such as walking or cycling) with strength training (like light weights or resistance exercises) is especially effective, leading to greater improvements than either type of exercise alone.⁵  

Eat well and manage weight

Eating a heart-healthy diet can help keep blood pressure under control. This means choosing plenty of vegetables, fruits, whole grains, and lean protein, while cutting back on fatty foods, refined sugar, and salt.⁹ 
After menopause, reducing salt is especially important, as the body becomes more sensitive to it, which can lead to fluid build-up and higher blood pressure.^2,4 

Population-based studies suggest that much of the blood pressure increase seen during the menopausal transition can be attributed to weight gain and changes in body composition, underscoring the value of weight management.⁴ 

Limit alcohol and avoid smoking

During the menopause transition, avoidance of smoking and alcohol consumption is an important part of cardiovascular risk reduction. Smoking accelerates the onset of menopause, worsens vasomotor symptoms, and is associated with higher cardiovascular risk. Stopping smoking during midlife reduces cardiovascular risk, lowers blood pressure, and improves overall health, even if some weight gain occurs.¹⁰ 

Alcohol intake also requires caution: Alcohol disrupts hormonal balance and may increase estrogen levels, influencing reproductive health and breast cancer risk. Heavy drinking is also linked to earlier menopause, bone loss, and higher fracture risk.¹⁰ 

A final word

Menopause is a natural transition, and being aware of how it may affect your blood pressure puts you in a stronger position to protect your long-term heart health. Regular monitoring, a heart-healthy lifestyle, and open conversations with your doctor are the three pillars of managing this risk. Each person’s experience of menopause is different, so your care should be tailored to you. 

If you are going through menopause and have not had your blood pressure checked recently, speaking with your doctor is a simple and important first step. 

This article is for general informational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional for guidance specific to your health situation. In a medical emergency, contact your local emergency services immediately. 

FAQ

1. Does every woman develop high blood pressure after menopause? 

No, not every woman develops high blood pressure after menopause, but the risk does increase. Research estimates that up to 41% of women develop hypertension, which is nearly twice as common as in women before menopause.⁴  

2. Can hot flushes affect blood pressure? 

Hot flushes (vasomotor symptoms) and blood pressure are linked in complex ways. Research has found that women with more severe hot flushes may have a less favourable cardiovascular risk profile.² However, hot flushes alone cannot be used to diagnose or exclude high blood pressure only a proper blood pressure measurement can do that. Speak to your doctor if you are concerned about the relationship between your menopausal symptoms and your cardiovascular health. 

3. Is weight gain after menopause linked to blood pressure? 

Yes, weight gain, particularly the accumulation of fat around the abdomen that is common after menopause, is a significant contributor to blood pressure rise and cardiovascular risk.^3,4  

4. I had high blood pressure during pregnancy. Does this increase my risk after menopause? 

Yes, a history of hypertensive disorders in pregnancy (including gestational hypertension and pre-eclampsia) is associated with a significantly increased long-term risk of hypertension and cardiovascular disease. Pre-eclampsia has been linked to a four-fold increase in the risk of heart failure and a two-fold increased risk of cardiovascular deaths and stroke.²  

If you have this history, it is particularly important to inform your doctor, maintain regular blood pressure monitoring, and address modifiable risk factors such as weight, diet, and exercise.² 

5. What is premature ovarian insufficiency (POI) and does it affect blood pressure? 

Premature ovarian insufficiency (POI) is defined as the loss of normal ovarian function before age 40. It results in earlier and more prolonged estrogen deficiency compared to natural menopause, and is associated with a higher risk of cardiovascular disease, including hypertension, coronary artery disease, and stroke.^1,2  

Women with POI benefit from early assessment of cardiovascular risk factors including blood pressure, lipids, and blood glucose.² Specialist medical care is important for women with POI, and this should include advice on cardiovascular health monitoring and management.² 

6. Can reducing salt in my diet make a difference to blood pressure after menopause? 

Yes, sodium sensitivity (the degree to which salt intake raises blood pressure) increases during the menopausal transition, making dietary salt reduction particularly relevant for postmenopausal women.^3,9 

This article was written with the assistance of generative AI technology and reviewed for accuracy.

Managing osteoporosis isn’t just about doctors and medications: it’s also about how you live day to day. Adopting certain healthy habits can help protect your bones and improve your overall well-being as you navigate this condition.

Quit smoking and limit alcohol:¹ Smoking is harmful to your bones (among many other things). If you smoke, make a plan to quit. Smoking accelerates bone loss and also interferes with blood supply to the bones.² Similarly, excessive alcohol intake can weaken bones and increase the risk of falls. It’s best to drink only in moderation (no more than one drink per day for women, or two for men). By avoiding tobacco and keeping alcohol to a minimum, you remove two significant risk factors for osteoporosis-related fractures.³

Stay on top of medical check-ups: Ensure you see your healthcare provider regularly and keep up with any tests or screenings they recommend. Routine check-ups are an opportunity to monitor your bone density, review your medications, and discuss any new symptoms (like pain or balance issues).⁴ If you’ve been prescribed osteoporosis medication, take it exactly as directed and inform your doctor of any side effects. Consistency with medication and supplements is key to getting their full benefit.

Practice good posture and body mechanics: Protecting your spine in everyday activities can prevent painful injuries. Try not to hunch or slouch: keep a good posture whether you’re sitting or standing. When lifting objects, bend at your knees and hips (not at your waist) and keep the load close to your body.⁵ Avoid lifting very heavy objects altogether if you can. If you have spinal osteoporosis (thinning in the vertebrae), ask a physical therapist to teach you safe ways to bend, reach, and exercise without putting undue strain on your spine.⁶ They can show you modifications for daily tasks (like how to tie your shoes or pick things up) that reduce the risk of compression fractures in your back.

Find support and stay positive: Osteoporosis can be challenging, both physically and emotionally. It’s normal to feel anxious about your fracture risk or frustrated by lifestyle changes. That’s why it’s important to be kind to yourself. Remember that your condition is just one part of who you are. Practice self-compassion and patience: take things one day at a time, and acknowledge the efforts you’re making to care for your health. Many people find it helpful to connect with others who have osteoporosis, whether through support groups (online or in person) or simply talking with friends and family about what you’re going through. Staying socially engaged and doing activities you enjoy can boost your mood and help you feel more in control.⁷ Stress management techniques, like meditation, deep breathing, or gentle exercise, can also improve your mental and emotional well-being.

Keep moving safely: While you should avoid hazardous activities (like climbing ladders or high-impact sports on hard surfaces), staying active with osteoporosis is crucial. Regular exercise, as discussed earlier, strengthens your muscles and bones and improves balance. Just make sure the activities are safe for your condition. Low-impact exercises (walking, swimming, tai chi) are generally good choices.⁸ If you’re uncertain about an activity, consult your doctor or a physiotherapist who understands osteoporosis. They can advise you on how to exercise safely and which movements to avoid. Remember, using assistive devices (like a cane) or asking for help with certain tasks is not a sign of weakness: it’s a smart strategy to prevent accidents and preserve your independence.

Conclusion

In summary, living well with osteoporosis involves a mix of medical care and mindful lifestyle choices. By avoiding bone-harming habits, nurturing your body with the right diet and exercise, and taking precautions in daily activities, you can maintain a good quality of life. Equally important, maintain a positive outlook and lean on others for support when you need it. Osteoporosis is manageable, and with healthy habits in place, you can continue doing many of the things you love while keeping your bones as safe as possible.

FAQ

1. How can healthy habits help manage osteoporosis?

Healthy habits like quitting smoking, limiting alcohol, exercising safely, and maintaining good posture can protect bones and reduce fracture risk.^2,3,5

2. Why should I quit smoking if I have osteoporosis?

Smoking accelerates bone loss and reduces blood supply to bones, increasing the risk of fractures. Quitting smoking is crucial for bone health.²

3. Does alcohol affect osteoporosis?

Yes. Excessive alcohol weakens bones and increases fall risk. Limit intake to one drink per day for women and two for men.³

4. What exercises are safe for people with osteoporosis?

Low-impact activities like walking, swimming, and tai chi are generally safe.⁸ Always consult your doctor before starting a new exercise routine.

5. What posture tips help prevent fractures?

Maintain good posture, avoid slouching, and bend at the knees and hips when lifting.⁵ Ask a physical therapist for safe movement techniques.

This article was written with the assistance of generative AI technology and reviewed for accuracy.

A menopause appointment is a conversation between you and your doctor — and conversations work well when both people are ready to take part. Whether this is a first appointment to understand what is happening to your body, or a return visit to discuss whether your current management is working, giving yourself a bit of time to think about what you want to raise can help you feel more confident walking in. This article offers practical guidance on how to prepare, what to bring, which questions you might want to ask, and how to assess whether the approach being taken is right for you.

How Do I Prepare for a Conversation With My Doctor About Menopause?

A useful first step before a menopause appointment is to think clearly about what you want from it — and to write that down. Appointments can feel rushed, and you may be having to leave having discussed only some of the symptoms while other important concerns go unraised. A written list of your questions, priorities, and symptoms helps ensure the conversation covers what matters most to you.

Start by reflecting on your experience. What symptoms are you living with, and which are having the most impact? Hot flushes, night sweats, sleep disruption, mood changes, brain fog (problems with memory and concentration), vaginal symptoms, and changes in libido are all relevant to a menopause consultation — and each one deserves to be named, not glossed over. ¹ If this feels like a lot to raise, know that you are not alone — around 1 in 4 women do not discuss menopause symptoms because they assume these are just a natural part of ageing, and a similar proportion of those who do speak up have felt their concerns were not adequately addressed. ² Even so, your doctor needs an accurate picture of your experience to give you appropriate guidance, and coming prepared with a written summary helps make sure nothing is overlooked.

Think also about what you want from the appointment — a diagnosis, a treatment plan, information about your options, or reassurance. If you have read about treatments or heard conflicting things, bring those questions — your doctor is there to discuss treatment options with you. ³

What Information Should I Bring to a Menopause Consultation?

Bringing relevant information to your appointment helps your doctor build a comprehensive picture of your health and tailor their recommendations accordingly. ¹ Here are some things it can help to have with you:

A symptom summary. Note each symptom you are experiencing, how often it occurs, how severe it is on a scale you can describe, and how it affects your daily life. If you have been keeping a symptom diary — tracking hot flushes, sleep quality, or mood changes over a period of weeks — bring it. These notes can be useful reminders.

Your menstrual history. If you still have periods, note their frequency, duration, and any changes. If your cycles have become irregular, note when. If periods have stopped, note when the last one occurred. ¹

Your medical history and current medications. Be ready to share any diagnosed conditions and medical history (particularly surgery such as a hysterectomy), and a full list of medications and supplements you currently take. ¹ Some conditions affect which management approaches are most appropriate, and your doctor needs this information to make safe recommendations. ¹

Your family history. A family history of breast cancer or ovarian cancer can affect which treatment is right for you. ^3,4

Any concerns or questions you have. Write down specific worries about a treatment, a symptom, or something you have read, so they are not forgotten during the conversation.

What Questions Should I Ask If My Doctor Suggests HRT?

Hormone replacement therapy (HRT) replaces the hormones (estrogen and often progesterone) that you produce less of as you transition through menopause and thus alleviate the symptoms that arise due to this hormonal decline. ^1,5 If your doctor suggests HRT, or if you raise it yourself, these questions can help you leave the appointment feeling well-informed.

What type of HRT is being recommended, and why? HRT comes in different types, different ways of taking it (patches, gels, tablets, or sprays), and different hormonal combinations. ⁴ Understanding which option is being suggested for you, and why it suits your circumstances, helps you make an informed decision. ^1,4

What benefits can I realistically expect, and over what timeframe? Ask what symptoms the recommended approach may help with, how quickly you might notice a difference, and the realistic level of improvement. ³

What are the risks specific to me? The risks of HRT vary depending on the type, how it’s taken, and your own health factors. ¹ Ask how these apply to your situation — your age, health history, and family history — and what the risk is. ³

Are there alternatives if HRT is not right for me, or if I decide not to take it? Non-hormonal options exist for managing menopause symptoms, and may be an option to consider if hormonal therapy is not appropriate for you. ³ Understanding what they are and how they compare to HRT supports a genuinely informed choice. Always consult your doctor regarding choosing the best treatment for you.

What happens if I decide to stop? Ask your doctor how you would stop HRT if you chose to, what the process involves, and what to expect in terms of symptoms returning. ⁴

Will my other medications be affected? If you take other medicines or supplements, share a full list with your doctor so they can flag anything to consider alongside HRT.

How Do I Know If the Treatment I Am on Is the Right One for Me?

Once treatment has been started, the question shifts from whether to begin to whether it is working — and if any adjustments are needed. ⁴ There is no single measure of this; rather, it is a combination of how your symptoms have changed, how you feel overall, and whether any unwanted effects are manageable.

Improvement in the symptoms that were most troubling you is one way to tell if treatment is having an effect. ^1,4,5 If hot flushes, night sweats, sleep disruption, or other symptoms have improved significantly, this is a positive sign. However, it can take some time for the full benefit to be apparent, and it is not unusual for a dose or type to need adjusting to get the right fit. ^1,4,5

If new symptoms have appeared since starting treatment — such as nausea, breast tenderness, irregular bleeding, or spotting — it’s worth discussing them at your review appointment. ¹ Many side effects can be managed by changing the dose, the way it’s taken, or the specific type used. ¹ It is reasonable to ask at your review what monitoring, if any, is appropriate for you.

If symptoms remain inadequately managed or side effects are difficult to tolerate, raise this openly with your doctor.⁴

How Often Should I Have a Review Appointment Once I Am on HRT?

Review appointments are an important part of menopause care — they are the opportunity to assess how treatment is going, to adjust what is not working, and to monitor ongoing health. ⁴ Avoid skipping review appointments with your doctor.

In the first year of starting HRT, a review appointment is typically recommended within three months, and annually thereafter. ^1,4 The first review is an important opportunity: to assess ongoing menopausal symptoms and whether the initial type and dose are appropriate, to address any side effects that have emerged, and to make adjustments before too much time passes. ¹ If significant concerns arise earlier, there’s no need to wait for a scheduled review — contact your healthcare provider sooner.

After the first year, annual reviews are generally recommended. ⁴ These cover how well symptoms are being managed, whether any new health conditions have developed, and whether the balance of benefits and risks remains favourable given your circumstances and age. ⁴

If you are uncertain how your reviews are being structured, it is appropriate to ask your healthcare provider what their approach is.

What You Can Do

• Before your appointment, write down your symptoms, their impact, and the questions you would like answered.
• Bring your full medication list, relevant medical history, and family history — this helps your doctor give tailored guidance. ¹
• Ask your doctor to explain any recommended treatment in plain language: what it involves, what benefits to expect, the risks for you, and the alternatives. ⁴
• If HRT is suggested, ask about the type, way of taking it, dosing, and what happens if the first approach doesn’t work well.⁵
• Book a review within three months of starting any new treatment, and annual reviews thereafter. ⁴
• If your symptoms are not adequately managed or side effects are difficult to tolerate, raise this at your next appointment — or sooner. There may be more options that can be tried. ⁴

Speak with a qualified healthcare professional before starting, stopping, or changing any treatment.

Conclusion

Preparing for a menopause consultation, knowing what to bring, what to ask, and how to assess whether treatment is working, can give you confidence walking in. Your questions are valid, and asking them is a valuable part of the conversation.

FAQ

1. Is it normal to feel nervous about raising menopause with my doctor? Yes — many women find it difficult to raise menopause symptoms in a healthcare setting, whether because of embarrassment, uncertainty about whether their symptoms are significant enough, or concern about being dismissed. ² It is worth knowing that clinicians are encouraged to ask about menopause symptoms and discuss treatment options — raising these conversations is a normal part of midlife healthcare. ³ Writing down your symptoms and questions beforehand can help you feel more confident and ensure nothing important is missed. If you leave a consultation feeling unheard, it is appropriate to ask for another appointment or seek a second opinion.

2. Should I ask my doctor specifically about HRT, or wait to be told about it? You do not need to wait to be told — asking directly about any treatment option, including HRT, is entirely appropriate.⁵ A menopause consultation should include a discussion of treatment options, taking into account your symptoms, preferences, and any relevant risk factors. ³ If HRT hasn’t come up and you’d like to know whether it might suit you, feel free to ask.⁵ If it has been recommended and you have any questions, those are worth raising too. Menopause decisions are a conversation — your thoughts and preferences are part of finding the approach that fits you.

3. What does “shared decision-making” mean in practice? Shared decision-making means that your doctor and you make treatment decisions together — your doctor explains the options, benefits, and risks, and you share your symptoms, preferences, and concerns. ^4,6,7 If you feel a consultation is one-sided — that decisions are being made for you rather than with you — it is reasonable to ask for more time to discuss your options.

4. What if I start HRT and it does not seem to be working? It’s common for the first type or dose to need some adjusting — finding what fits you well can take a little time, and that’s normal. ¹ If your symptoms haven’t improved, or side effects are hard to tolerate, get in touch with your doctor sooner rather than waiting for your next review. ⁴ Ask about trying a different dose, a different way of taking HRT, or a different type. Your doctor is there to help you find what works for you.

5. Are there things I can do alongside HRT to improve how well it works? Lifestyle measures can support your overall health and make menopausal symptoms more manageable, although they may not reduce the severity of symptoms on their own. ^1,2 Being physically active is helpful for mood, sleep, and muscle strength, and supports bone health over the long term. ^4,7 Small practical changes — such as dressing in layers, keeping a fan nearby, and choosing cool drinks — can help with hot flushes and night sweats. ⁷ Some women find that cutting down on caffeine, alcohol, and spicy food reduces how often hot flushes occur. ^2,7 These measures are not a substitute for treatment where treatment is needed, but they work well alongside it. Your doctor can talk through what might be most relevant for you.

6. What is the difference between the types of HRT? HRT comes in different forms — including tablets, patches, gels, and sprays — and different hormonal combinations, depending on whether a woman still has a uterus. ⁴ The way HRT is taken affects how hormones enter the body, which in turn can influence the risk profile and the management of specific symptoms. ³ The most appropriate type for you will depend on your symptoms, health history, preferences, risk factors, response to initial treatment, availability and costs. ³ If you’d like to know why a particular type has been suggested for you, feel free to ask — your doctor can talk you through the reasoning.

7. How long is it safe to stay on HRT? There isn’t a fixed time limit for how long women can stay on HRT — it’s something that’s looked at individually rather than set by a single rule. ^1,3 Some women wish to stop HRT after some time to assess their symptoms; others may continue it for a longer duration depending on how well it is working and how they feel over time. ¹ It’s worth talking about the likely length of treatment when you first start, and revisiting the conversation at each review — your preferences, your symptoms, and the balance of benefits and risks for you can change as time goes on. ⁴ If you’re thinking about how long to continue, bring it up at your next review — it’s a good thing to discuss together.

8. What should I do if I experience unexpected bleeding while on HRT? Some bleeding or spotting is common in the first few months of HRT and usually settles within 2 to 6 months. ^1,4,7 If bleeding continues beyond that, starts again after settling, or happens after the menopause (once your periods have stopped), it’s worth letting your doctor know — you don’t need to wait for your next scheduled review. ^1,4 Often it’s related to the type or dose of HRT and can be addressed by adjusting treatment, but it’s worth having it checked to be sure. ⁷ Noting when the bleeding happened, how heavy it was, and how long it lasted can be useful to share at your appointment.

9. Can I stop HRT at any time if I want to? You can choose to stop HRT, and you have the option of either gradually reducing your dose or stopping immediately. ⁴ Gradually reducing may limit the return of symptoms in the short term, but in the longer term there is no difference in symptoms between the two approaches. ⁴ Symptoms may return when HRT is stopped, and treatment can be restarted if needed. ⁴ If you want to stop HRT — for any reason — talking it through with your doctor will help you decide the approach that works for you.

10. What should I tell my doctor at a review appointment? It helps to come to your review with a clear picture of how things have gone since your last visit — how your symptoms have changed, whether any side effects have appeared, and anything new in your health or medications. ^1,4 If something has been on your mind but felt too small to raise, your review is a good time to bring it up. Your doctor may also talk about other health conditions including bone health with you and do any other checks relevant to your situation. ⁴

This article was written with the assistance of generative AI technology and reviewed for accuracy.

Menopause is more than the end of your periods. It is a natural change in your hormones that can affect many parts of the body — including the brain, bones and heart.¹ These changes begin quietly, often years before you notice any symptoms.²

Which Hormones Change During Menopause, and Why?

Menopause happens as the ovaries age.² The ovaries, the brain and a small gland in the brain (the pituitary) normally work together to control your monthly cycle. As the ovaries slow down, this whole team is affected.²

Your ovaries hold a set number of eggs, and this supply only falls over your lifetime.^2,3 There are around a million at birth, about 250,000 by puberty, and fewer than 1,000 by menopause.^1,2 From your mid-thirties, the supply drops faster and the ovaries start to work differently.²

The first changes are the body trying to keep things going. As the egg supply shrinks, the brain sends out more of a hormone called FSH to push the ovaries along — so FSH rises even while oestrogen is still fairly steady.^2,4 A blood test for FSH (or a related marker called AMH) can be an early sign that the ovaries are winding down.^1,2

Later, oestrogen levels swing about and then drop, and progesterone falls too as egg release becomes less regular.^2,4 By the time periods stop for good, the ovaries have largely stopped making oestrogen.²

How Does the Changing Hormonal Environment Affect the Body?

Oestrogen acts on tissues all over the body, so when it changes you can feel the effects in many places at once.⁵

In the brain, these changes affect temperature, mood, sleep and thinking.^3,6 The brain’s built-in thermostat becomes more sensitive, so even a small rise in body temperature can trigger the body to cool itself down quickly — causing the flushing and sweating of a hot flash.⁶ Night sweats are the same thing happening while you sleep.⁶

After menopause the risk to the heart goes up, as falling oestrogen is linked to changes in cholesterol, blood vessels and inflammation.^5,7

Bones are affected too. Oestrogen helps slow down the cells that break down old bone.¹ When oestrogen falls, these cells become more active, bone is lost faster, and bones can weaken fairly quickly.^1,8

The tissues of the vagina and bladder are very sensitive to oestrogen. As it falls they become thinner, less stretchy and drier, which can cause vaginal dryness, itching or burning, discomfort during sex, and a need to pass urine more often or more urgently.^1,3 Unlike hot flashes, these changes tend to build up over time rather than settle on their own.⁴

What Happens to the Menstrual Cycle as Menopause Approaches?

Your periods don’t just stop overnight — they change over several years first.⁵ This run-up is called perimenopause, and it brings unpredictable changes in egg release and in your bleeding pattern.^4,5

Often the timing changes first, so periods may come closer together at the start.^1,2,4 Over time they become irregular — some shorter, some longer, and some months skipped altogether.⁴ An egg isn’t always released, which makes bleeding less predictable.^2,4

During this time oestrogen doesn’t fall in a smooth line — it goes up and down, sometimes higher than usual before dropping away.^2,4 That is why symptoms can change from week to week.² Menopause is only confirmed looking back, once you have gone 12 months in a row with no period.^1,3

Does the Body Produce Any Oestrogen After Menopause?

Yes, but only a little. After menopause the ovaries mostly stop making oestrogen, but the body still makes a small amount of a weaker form by converting other hormones in fat tissue.^2,7,9 Women with more body fat tend to make a bit more this way.^5,9 However, it isn’t enough to protect the bones, heart and other tissues from the drop in oestrogen.⁷

How Does a Woman Feel When the Hormonal Environment Changes?

Symptoms come from these hormone changes affecting the body and brain.¹⁰ They vary a lot — some women barely notice them, while for others they really affect daily life.^3,7

The most common symptoms are hot flashes and night sweats, which affect most women.^1,4 They come from the changes in the brain’s thermostat described above.⁶ They can be mild and occasional, or happen many times a day and badly disturb sleep.^1,6

Poor sleep is common — partly from night sweats, and partly because these hormones affect sleep itself.^1,6,8 Mood changes such as irritability, low mood and anxiety are also common, especially in perimenopause when hormones swing the most.^1,10 Oestrogen affects brain chemicals linked to mood, which may help explain this, though it isn’t fully understood.¹⁰

Many women also notice trouble concentrating, forgetfulness or a feeling of “brain fog”, especially in perimenopause.^10,11 Physical changes can include vaginal dryness, bladder symptoms, achy joints, and changes in skin and hair.^1,3,7 Sex drive may change too, both from the hormones and from coping with other symptoms.^1,3,11

The link between hormones and symptoms is complex: the same changes can feel very different from one woman to the next, depending on her genes, general health, lifestyle and life circumstances.^1,6,10

What You Can Do

• If you are noticing changes — in your periods, your mood, your sleep, or your body — that you think may be related to menopause, it is worth speaking with your doctor or primary care provider.³
• Keep track of your symptoms, including when they occur and how they affect your daily life.
• Understand that menopause is a gradual process, not a single event — and that it involves several hormone changes, not just oestrogen.^2,5,6
• Be aware that hot flashes and night sweats, mood changes, poor sleep, and vaginal and bladder symptoms all come from the same underlying hormone changes.^1,7
• Ask about bone health — bone is lost fastest in the first few years after menopause, so knowing early helps you act early.^1,8
• Always speak with a qualified healthcare professional before making any decisions about treatment or management.

Conclusion

Menopause is a normal stage of life, when periods stop and hormone levels fall.^1,2 Because these hormones act all over the body, the effects can reach the brain, bones, heart and more.^3,5 Understanding what is happening makes it easier to talk to your doctor about managing your symptoms. It can be a tough time, but there are real ways to feel better.⁴

FAQ

1. How long does perimenopause usually last?

Perimenopause can last anywhere from about two to ten years, and it’s different for everyone.^3,5 It’s the run-up to menopause, when egg release and your periods become unpredictable, and it can start before your periods turn irregular.^4,5 How long it lasts depends on things like your genes and lifestyle.^5,6

2. Why do my joints ache during menopause?

Achy, stiff joints are a common menopause complaint.^7,12 This may be linked to oestrogen’s role in calming inflammation, though it isn’t fully understood.¹² These aches are often blamed on age alone, but they may ease or settle as you move through the transition.¹²

3. Does menopause affect the heart?

Yes — the hormone changes of menopause are linked to changes in cholesterol, blood vessels and inflammation, which can raise the risk to your heart.^5,7 This is part of why heart risk goes up after menopause, although many things besides hormones play a part.⁷

4. What causes vaginal dryness after menopause?

The tissues of the vagina and bladder are very sensitive to oestrogen. As oestrogen falls they become thinner, less stretchy and drier — a common part of menopause.^1,11 This can cause vaginal dryness, discomfort during sex and bladder symptoms.^1,4,11 Unlike hot flashes, it tends to build up over time rather than settle on its own.⁴ There are effective treatments, so it’s worth talking to a healthcare professional.¹¹

5. Can menopause affect memory and concentration?

Yes — trouble with memory, concentration and “brain fog” is commonly reported during menopause. It’s most noticeable in perimenopause, when hormones swing the most. Poor sleep can make it noticeably worse.^10,11

This article was written with the assistance of generative AI technology and reviewed for accuracy.