Long-term health

Illnesses and conditions in menopause and beyond.

How does menopause impact our long-term health?

While many menopausal symptoms will peak throughout the perimenopause and menopause years, then start to eventually tail off, others will impact our long term health too.

This article sets out some of the health conditions such as osteoporosis and cardiovascular disease that may begin during perimenopause and menopause but can potentially affect us for the rest of our lives. 

We’ve included information on how to prevent these conditions where possible, and/or manage the symptoms.

Osteoporosis

We all lose bone as we age. This can lead to a condition known as osteoporosis, which shows up as weak, fragile bones which break easily. 

Because women lose bone rapidly after menopause, we are at more of a risk of osteoporosis. According to the International Osteoporosis Foundation, one in three women worldwide over the age of 50 years will experience osteoporotic fractures in their lifetime. 

It is a serious condition and can be painful. Bones can break quite easily - for example a wrist, an arm or you might fracture a hip. Sometimes broken bones don’t return to their previous shape and you might find you lose some height, see a curvature in your spine or a change in your posture, or experience ongoing back pain and muscle spasms.

Is Osteoporosis preventable?

Good lifestyle choices can help to reduce the risk of osteoporosis.

The main ways to prevent osteoporosis are:

• Good nutrition. Especially calcium for bone health and vitamin D to help the absorption of the calcium. Protein is also important. Reduce caffeine and alcohol and give up smoking.
• Exercise and activity: You’re aiming for strong muscles to support your body and improve your balance, and exercise that can strengthen and build your bones. Walking, running or any sports are good for weight-bearing and strength training using weights is great too. 
• Maintain a healthy body weight: This includes not being underweight or overweight.
• HRT: While not for everyone, HRT will replace the lost hormone oestrogen which is a leading cause of the weakening of the bones.

If you may be at risk of osteoporosis, a scan, the ‘DEXA scan’ can assess your bone density and help to predict the risk of you breaking a bone in the future.

Find out more: Dr Rachel Hines, a GP and menopause specialist has written a guide to Osteoporosis especially for women going through the menopause. 

Cardiovascular disease

Our risk of coronary heart disease increases after the menopause. Lower levels of oestrogen post-menopause is the main reason for this - because pre-menopause it offers a preventative effect against the risk of a heart attack. 

There are other risk factors too: high blood pressure, high cholesterol, smoking, diabetes, obesity, low levels of good cholesterol and your family history.

To reduce your risk of cardiovascular disease in later life:

• Good nutrition. Focus on reducing processed foods and enjoying whole foods with plenty of fruit and vegetables. 
• Give up smoking 
• Exercise: Regular activity, including walking, will keep you heart healthy.
• Maintain a healthy body weight

Find out more: The British Heart Foundation offers information and support about heart disease.

Brain health

Women are more likely to suffer from dementia than men. 

The Alzheimer’s Society explains: As Alzheimer's disease is more common in women after the menopause, it is possible that oestrogen plays a role in protecting the brain from the damage caused by Alzheimer’s, and that this protective effect is lost when oestrogen levels are decreased.

While your age, sex and ethnicity can affect your risk of developing dementia, you can protect your brain health by not smoking, eating a good diet and regular exercise. 

Find out more: The Alzheimer’s Society offers information and support about dementia and Alzheimer’s.

Pelvic health and pelvic floor issues

Vaginal dryness, vaginal atrophy and lichen sclerosus

Vaginal dryness is a chronic condition that can affect up to 70% of women. It is a broad condition that may include burning and sore vulvas, stinging and irritation of the clitoris, splitting skin. It can be a very distressing condition that takes its toll on everyday activities, sleep, and relationships because sex can be painful.

Find out more: Jane Lewis talks in this article about how she is living with vaginal atrophy as a long term chronic health condition.

Urinary symptoms 

Our pelvic floors can be weakened at many points during life - for example after childbirth, surgery or menopause.

Symptoms may include frequent urinary tract infections (UTIs), urge incontinence (the need to urinate more often and without much notice) and stress incontinence (leaking urine).

A lot of women choose to use incontinence pads to manage these symptoms rather than try to strengthen the pelvic floor and improve the symptoms. However, it’s really never too late to try to strengthen the pelvic floor.

Find out more: Jane Simpson, author of the pelvic floor bible, offers her advice in this article.

Pelvic floor weakness and prolapse

Weakening of the pelvic walls - the front wall of the vagina, the back wall and the high part of the vagina - can lead to less support for the pelvic floor. You might feel like you have a pulling or dragging sensation at the opening to your vagina, or a bulging feeling, or you may see a bulge at the entrance to your vagina. It is the weakening of the pelvic muscle that has led to a ‘prolapse’. If you feel these symptoms it’s important to seek help from your doctor or a women’s physio so that you can access the right treatment.

Find out more: Physio Elaine Miller talks us through how the pelvic floor works, why prolapse occurs and what else can happen as we age.