After menopause
Protecting bones, heart and brain, treating common vaginal and bladder changes, and why any bleeding after menopause needs a doctor.
- 1BonesBone loss speeds up in the first 4 to 8 years after menopause because estrogen falls. Osteoporosis affects about 1 in 5 women over 50 in the US. Screening is recommended from 65, earlier with risk factors, and exercise, calcium and vitamin D help.
- 2HeartHeart disease is the leading cause of death for women. Estrogen's protection fades after menopause. Chest pain is still the most common heart attack symptom in women, but shortness of breath, nausea, and back, jaw or arm pain are common too.
- 3BrainDementia affects women more than men, even accounting for longer lives. Hormone therapy doesn't appear to raise or lower dementia risk, so it isn't used to prevent it. Nearly half of dementia may be preventable by addressing 14 risk factors.
- 4Vaginal and bladder changesAt least half of women develop vaginal dryness, irritation, painful sex or urinary symptoms after menopause, called genitourinary syndrome of menopause. It doesn't go away on its own, but moisturizers, lubricants and low-dose vaginal estrogen treat it.
- 5Bleeding after menopauseAny bleeding after menopause needs a doctor, even once, even spotting. It's usually not serious, but it can be an early sign of uterine cancer, which is most often found early when treatment works best.
- 6For loved onesAfter menopause, the big risks are quieter ones, like weaker bones, heart disease and dementia. Know the heart attack signs, encourage screening and movement, and take any bleeding seriously.
- QuizA short quiz on this section. Try again for new questions.
Where can I learn more?
- ACOG: The menopause years
- USPSTF: Osteoporosis to prevent fractures, screening (2025)
- NIAMS (NIH): Osteoporosis
- The 2022 hormone therapy position statement of The North American Menopause Society, Menopause 2022
- CDC: Heart disease facts
- American Heart Association: Heart attack symptoms in women
- ACOG Committee Opinion 736: Optimizing postpartum care
- ACOG: Preeclampsia and high blood pressure during pregnancy
- UCL: Menopause hormone therapy does not appear to impact dementia risk (on a 2025 Lancet Healthy Longevity review)
- NHS: Menopause symptoms
- ESHRE, ASRM, CRE-WHiRL and IMS: Evidence-based guideline on premature ovarian insufficiency (2024)
- Alzheimer Europe: 2024 Lancet Commission identifies 14 modifiable risk factors
- Cleveland Clinic: Vaginal atrophy (genitourinary syndrome of menopause)
- Cleveland Clinic: Pelvic floor muscles
- NHS: Post-menopausal bleeding
- ACOG: Abnormal uterine bleeding