Post-Menopause, Bones and Healthy Ageing for Women

What changes after menopause

• Bones lose density fastest in the first five to ten years after menopause; see osteoporosis at home: preventing fractures and living well.
• Heart and blood vessels: the protective effect of oestrogen declines, and cholesterol, blood pressure and blood sugar often rise; see hypertension home care guide and nutrition for heart health after 60.
• Vagina, vulva and bladder: thinning, dryness, itching, burning, painful intercourse, urinary urgency, leaks and recurrent urinary infections; see urinary tract infections in older adults and incontinence in older adults explained.
• Hot flushes and night sweats may continue for years in some women.
• Sleep and mood: poor sleep, anxiety and low mood are common; see insomnia in older adults: sleep hygiene and when to get help and depression in older adults.
• Weight and body shape shift, with more abdominal fat.
• Joints and muscles: stiffness and aches; muscle loss accelerates without activity; see sarcopenia: muscle loss, protein and strength.
• Skin and hair become drier and thinner; see itchy, dry and fragile skin in older adults.
• Memory and thinking: "brain fog" is common around menopause and usually improves; persistent worsening needs assessment; see mild cognitive impairment: what it is and what families can do.

Checks worth doing

Ask your doctor which are right for you and how often; recommendations vary with age, history and local services.

• Blood pressure, at least yearly, and at home if high; see how to measure blood pressure at home accurately.
• Blood sugar and cholesterol, yearly or as advised.
• Weight, waist and height: loss of height may signal spinal fractures.
• Thyroid test if tired, weight changes, or symptoms; see thyroid problems in older adults.
• Bone density scan (DEXA) for women with risk factors, a fracture after fifty, or at the age the doctor recommends, commonly at sixty-five or earlier if risk is higher; see osteoporosis medicines and supplements: questions to ask.
• Vitamin D and calcium levels if risk of deficiency; see vitamin D deficiency in India and calcium and vitamin D after 60: doses, food and sun.
• Breast examination and mammography at the intervals the doctor advises; report any lump, nipple discharge or skin change promptly.
• Cervical screening as recommended, usually continuing until about sixty-five if previously normal.
• Bleeding after menopause (any spotting or bleeding a year or more after the last period) must always be reported to a doctor promptly; it needs investigation.
• Eye and hearing checks; see hearing and vision checkup schedule.
• Dental check; see mouth, teeth and general health in older adults.
• Vaccines as advised; see vaccines for older adults in India: a practical schedule.
• Screening for depression and memory, and bowel cancer screening as advised.
• Kidney and liver tests if on long-term medicines or with other conditions.

Protecting your bones

• Move your body: weight-bearing activities such as brisk walking, climbing stairs and dancing, plus strength work two to three times a week, build and preserve bone and muscle; see exercise for osteoporosis, resistance band routine for seniors and walking programme for older adults.
• Eat bone-friendly food: calcium-rich foods such as milk, curd, paneer, ragi, sesame, leafy greens and small fish with bones, and enough protein; see how much protein do older adults need.
• Get safe sun: short, regular exposure of arms and legs, as the doctor advises.
• Check supplements with the doctor: calcium and vitamin D are commonly needed but not for everyone; too much calcium can be harmful; see how to read a supplement label.
• Avoid smoking and tobacco, and limit alcohol.
• Prevent falls: footwear, lighting, vision checks, balance exercises; see falls risk assessment at home and balance exercises for seniors.
• Review medicines that weaken bones or cause dizziness.
• Treatment: if the scan or a fracture shows osteoporosis, medicines can reduce fracture risk; it is a decision for you and your doctor.

Protecting your heart

• Know your numbers: blood pressure, sugar, cholesterol, weight.
• Be active for at least about 150 minutes of moderate activity a week, built up gently.
• Eat well: more vegetables, fruit, whole grains, pulses, nuts and fish; less salt, fried and sweet foods; see nutrition for heart health after 60 and best cooking oils for seniors.
• Stop tobacco in all forms.
• Know the signs of a heart attack in women, which can be less obvious: chest pressure or discomfort, but also breathlessness, unusual tiredness, nausea, sweating, jaw, back or arm pain; call 112 immediately; see 7 early signs of heart trouble you cannot afford to ignore.
• Treat high blood pressure and diabetes as advised; see diabetes after 60: a home care guide.

Managing common symptoms

### Hot flushes and night sweats

• Dress in layers, keep the bedroom cool, use light cotton bedding, sip cool water.
• Identify triggers such as spicy food, hot drinks, alcohol and stress.
• Slow breathing and relaxation may help.
• If severe or disruptive, talk to a doctor about options, including hormone therapy and non-hormonal approaches; these have benefits and risks that depend on age, time since menopause and personal history, so decisions should be individual.
• Be cautious about "herbal menopause" products; quality varies, and some interact with medicines or are unsafe in certain cancers.

### Vaginal dryness, discomfort and painful intercourse

• Regular, gentle moisturisers and lubricants, as advised by the doctor or pharmacist.
• Low-dose local treatments exist and are generally considered safe, applied inside the vagina; ask a gynaecologist or doctor.
• Do not endure it silently: this is very treatable; see intimacy and sexual health in later life.

### Bladder symptoms

• Pelvic floor exercises, timed toileting, adequate fluids, treating constipation; see pelvic floor exercises for older adults and bladder training and timed toileting.
• See a doctor for burning urine, blood in urine, repeated infections or leaks that disrupt life.

### Sleep and mood

• Regular routines, daylight, activity and limited caffeine; see sleep problems in older adults.
• Talk to someone, a family member, friend or counsellor; seek help for persistent low mood or anxiety. If you ever feel hopeless or think of harming yourself, seek help the same day; Tele-MANAS (14416) is India's national mental health helpline (check the current number), and 112 is the emergency number.

### Weight and muscle

• Gradual, steady changes with protein, vegetables and activity rather than crash diets; ask a dietician.

Women as carers

Many women in their fifties and sixties care for parents, spouses and grandchildren while neglecting their own health. Keep your own appointments, share care, and take breaks; see caregiver burnout signs and prevention and sharing care among siblings.

When to see a doctor, and emergencies

See a doctor promptly for: any bleeding after menopause; a breast lump or change; persistent pelvic pain; new back pain or loss of height; fracture after a minor fall; severe or persistent mood change; urinary symptoms; unusual vaginal discharge; weight loss without trying.

Call 112 for: chest pain or pressure, severe breathlessness, stroke signs (face droop, arm weakness, speech difficulty), heavy bleeding, a serious fall with injury, or fainting.

When to ask a professional

Ask a family doctor, gynaecologist, endocrinologist, orthopaedic doctor, dietician or physiotherapist as relevant. Ask a pharmacist before supplements. Seek urgent help for emergencies.