5 Health Risks Women Face After Menopause

Your period — or, more specifically, the lack thereof — isn’t the only thing that changes after you go through menopause. The hormone levels that keep your menstrual cycle regular have additional roles in the body. As levels of protective hormones — especially estrogen — decline, people can face new health challenges.

“Postmenopausal people are unique in that their health risks increase not just due to age but also due to the loss of estrogen,” says JoAnn Pinkerton, MD, a professor of obstetrics and gynecology at the University of Virginia Health System and executive director emeritus of The North American Menopause Society (NAMS).

1. Heart Disease

After menopause, people are more likely to develop cardiovascular disease, and the rate of heart attacks in postmenopausal people begins increasing.

The Study of Women’s Health Across the Nation (SWAN) has been examining the physical, biological, psychological, and social changes experienced by people in menopause during their midlife years. It has found that people who have more hot flashes earlier during menopause also seem to have a higher risk for heart disease, says John F. Randolph, Jr., MD, a professor of obstetrics and gynecology at University of Michigan Health in Ann Arbor.

“Women who have a family history [of heart disease] or early and significant hot flashes should ask their healthcare provider if they need additional screenings for cardiovascular disease,” says Dr. Randolph.

Reduce the Heart Disease Risk Factors That You Can

You cannot control your family history, which influences your risk, but you can lower your overall risk by following a heart-healthy lifestyle. This includes eating a diet packed with vegetables and low in red meat and sugar, exercising for 150 minutes or more each week, and quitting smoking.

The American Heart Association also encourages women to know their blood pressure, cholesterol, and blood sugar levels, as well as their body mass index (BMI).

Plugging these numbers into the ASCVD (Atherosclerotic Cardiovascular Disease) risk calculator, introduced in 2013 by the AHA and the American College of Cardiology, can help you assess your 10-year heart disease risk.

2. Osteoporosis

Given that the acceleration of bone loss can start before women stop having periods, Randolph says you may want to talk to your healthcare provider as your periods become less predictable to find out what you can do to try to maintain your bone health.

Osteoporosis Symptoms Can Be Invisible

Osteoporosis Screenings and Testing You May Need

If you are postmenopausal and have other risk factors, including rheumatoid arthritis, smoking, alcoholism, a low BMI, or a parent with a history of a hip fracture, talk to your doctor about having a DXA test before age 65.

How to Boost Bone Health Midlife

To keep your bones strong, make sure you include weight-bearing exercises, such as brisk walking or jogging, in your routine, because they allow your bones to work against gravity to get stronger. Also, don’t smoke — it’s linked to increased risk of bone fracture and osteoporosis.

3. Weight Gain

Why Fat Migrates to a Woman’s Midsection Midlife

Part of the reason for this increased risk of abdominal fat is the loss of estrogen, which shifts fat from the hips to the midsection. People close to menopause who experience sleep problems, night sweats, and mood issues may find that these symptoms interfere with eating a healthy diet or exercising.

4. Urinary Tract Infection

While a woman’s risk for UTIs depends on individual factors, such as overall health, the occurrence of UTIs generally increases with age.

To reduce your risk of UTIs, practice these good habits:

• Urinate when you feel the urge to go, and try to avoid going longer than three or four hours without urinating. (The longer your urine sits in your bladder, the more bacteria is able to grow.)
• Be sure to wipe from front to back.
• Drink plenty of fluids, preferably at least six to eight glasses of water a day.
• Urinate before and after sex.
• Avoid using douches or feminine hygiene deodorant sprays.
• Opt for breathable cotton underwear and avoid tight-fitting pants.

5. Urinary Incontinence

Difficulty controlling the bladder can begin in perimenopause and continue for years after. According to the Office on Women's Health, approximately half of postmenopausal women experience urinary incontinence.

Why Your Risk of Urinary Incontinence May Increase and What You Can Do About It

That said, the SWAN research indicates that urinary incontinence is probably more age related than specifically menopause related, says Randolph. “With incontinence, people have theorized for a long time that there is an estrogen piece of it, because there is an estrogen receptor in the base of the bladder and urethra,” he notes. “But, in general, that doesn’t seem to be a huge, directly associated feature.”

Self-Advocacy During Menopause

Journalist Ann McQueen discusses why your menopause experience is important to share with your doctor.

When Are You Postmenopausal?

Menopause is diagnosed after the fact, once you have gone a full year without a single period, Dr. Pinkerton says. Before that, you might skip a cycle or have periods spread out farther than usual. During this phase, you are in perimenopause, not menopause.

During perimenopause, the amount of estrogen in your body fluctuates wildly. Once you are menopausal, though, this hormone drops to a very low level and stays there, according to NAMS.

New Health Risks Emerge as Estrogen Level Declines

Women who have had no health issues before menopause can face increased odds of problems after going through the change.

While every woman faces unique risks based on genetics and other factors, it’s a good idea to be mindful of how to protect yourself against these common health conditions that can increase in risk after menopause.

The Takeaway

• Hormonal changes after menopause can increase the risk of heart disease, osteoporosis, and metabolic issues.
• Declining estrogen levels may affect bone density, muscle mass, and cardiovascular health.
• Menopause can also influence mental health, sleep quality, and weight regulation.
• Lifestyle changes and medical care can help reduce health risks and support long-term well-being after menopause.