5 Health Risks Women Face After Menopause
Updated on October 01, 2026
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, women can face new health challenges.
In addition, other changes related to aging, such as a slower metabolism, can increase your risk of heart disease, stroke, osteoporosis, and other conditions.
Menopause is diagnosed after the fact, once you have gone a full year without a single period. Before that, you might skip a cycle or have periods spread out farther than usual. During this phase, you are in perimenopause — during which your estrogen levels fluctuate — not menopause.
“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 Menopause Society.
1. Heart Disease
After menopause, women are more likely to develop cardiovascular disease, and the rate of heart attacks in postmenopausal women begins increasing.
A key reason is that estrogen helps keep blood vessels flexible, so they contract and expand to accommodate blood flow. Once estrogen diminishes, this benefit is lost. Coupled with changes such as a rise in blood pressure, which can thicken artery walls, the heart suddenly becomes more vulnerable.
The Study of Women’s Health Across the Nation (SWAN) has been examining the physical, biological, psychological, and social changes experienced by women in menopause during their midlife years. It has found that women who have more hot flashes earlier during menopause also seem to have a higher risk of heart disease, says John F. Randolph Jr., MD, a professor of obstetrics and gynecology at the University of Michigan Health in Ann Arbor.
A similar finding was also borne out in another study, which found that frequent and persistent hot flashes were associated with future cardiovascular disease.
“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 American Heart Association’s PREVENT calculator can help you assess your 10-year heart disease risk.
There is new research suggesting that hormone therapy may work double duty. A recent study looked at more than 2,700 perimenopausal or recently postmenopausal women who experienced vasomotor symptoms — hot flashes or night sweats. When compared to women who took no medication, those who used hormone therapy lowered their risk of cardiovascular disease by 22 percent.
2. Osteoporosis
Women are more likely than men to develop osteoporosis, a disease in which bones become thin and weak and fracture more easily. Before menopause, a woman’s bones are protected by estrogen, but around the time of the final menstrual period and continuing for several years after, bone loss is rapid.
Given that the acceleration of bone loss can start before a woman stops having periods, Randolph says that 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
You may not even notice that your bones are weakening, as osteoporosis may not cause symptoms for decades. A bone fracture can be the first sign of the disease. This is why women 65 and older are urged to get a test known as DXA or DEXA (dual-energy X-ray absorptiometry), which measures bone density in the spine and hips.
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.
You can also use an online tool called FRAX to estimate your fracture risk in the next 10 years. This takes into account your age, gender, BMI, alcohol intake, whether you smoke or take certain medications, and other risk factors.
How to Boost Bone Health in 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 an increased risk of bone fractures and osteoporosis.
Lastly, eat a healthy diet, including foods high in vitamin D (fortified orange juice, cereal, milk, and canned fish such as salmon or sardines) and calcium (dark leafy greens, and dairy). “Make sure you have adequate calcium and vitamin D,” says Randolph. “Most American diets don’t have enough of either [nutrient].” (Remember that you can also boost vitamin D by getting 15 minutes of sun exposure, several days a week.)
3. Weight Gain
Menopause has a definite effect on a woman’s metabolism. Extra weight, especially around the abdomen, is dangerous, Randolph says, because it can boost your risk of type 2 diabetes. According to a study published in 2021, women who quickly developed abdominal fat during menopause were at greater risk of heart disease, even if their weight stayed steady.
Menopause itself is also linked to an increased risk of metabolic syndrome — a group of health conditions, including high blood pressure, high blood sugar, excess abdominal fat, and abnormal cholesterol levels, that increase your risk of heart disease, stroke, and type 2 diabetes.
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. Women 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.
Cutting back on calories can help counter increased weight after menopause. Other helpful tips include adding more vigorous exercises to your routine, not snacking too often, and doing stress-reducing activities like mindfulness meditation or yoga to eliminate the need for that mood-mellowing pint of ice cream.
4. Urinary Tract Infections
After menopause, a decrease in estrogen levels can cause the vaginal tissue to become thinner and drier. This can make it easier for bacteria to flourish, which could eventually lead to a urinary tract infection (UTI).
While a woman’s risk of 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.
If you experience frequent UTIs (two UTIs in six months, or three in a year), be sure to talk to your doctor to find out what may be causing them and which treatment options — such as antibiotics or local vaginal estrogen — might be best for you.
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.
The most common type is stress urinary incontinence, where coughing, sneezing, or physical activity causes leakage. Urgency incontinence happens when leakage is accompanied by an uncontrollable urge to get to the bathroom immediately. Many women have a mix of the two.
Why Your Risk of Urinary Incontinence May Increase, and What You Can Do About It
The tissues of the bladder and urethra (the tube that carries urine from the bladder) contain estrogen and progesterone receptors and are thickened by those hormones. After menopause, these hormone levels drop, and the tissue thins and weakens. In addition, the muscles around the pelvis may lose tone with aging, a process known as pelvic relaxation.
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.”
To prevent urinary incontinence, empty your bladder as often as possible. And do Kegel exercises, contracting and relaxing the muscles of the pelvic floor. The key to proper Kegels is to work the subtle muscles controlling the stream of urine, rather than the butt muscles. Hold each contraction for two to three seconds, building up to five sets of 10 repetitions per day. If problems persist, talk to your doctor or seek a physical therapist with expertise in working the pelvic floor.
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.
In addition to the loss of estrogen, other shifts happen in the body that can harm your health after menopause. For example, blood pressure, LDL (“bad”) cholesterol, and triglycerides (a form of fat in the blood) tend to go up after menopause.
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.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
- Menopause and Your Health. Office on Women’s Health. March 12, 2025.
- Perimenopause. Cleveland Clinic. July 29, 2024.
- Ryczkowska K et al. Menopause and Women’s Cardiovascular Health: Is It Really an Obvious Relationship? Archives of Medical Science. December 10, 2022.
- About SWAN. Study of Women’s Health Across the Nation.
- Thurston RC et al. Menopausal Vasomotor Symptoms and Risk of Incident Cardiovascular Disease Events in SWAN. Journal of the American Heart Association. January 20, 2021.
- Know Your Numbers. American Heart Association.
- Wang Z et al. Menopausal Hormone Therapy and Cardiovascular Risk in Midlife Women With Vasomotor Symptoms. JAMA Internal Medicine. September 8, 2026.
- Osteoporosis. U.S. Food and Drug Administration. May 13, 2024.
- Calcium and Vitamin D. BHOF. May 23, 2023.
- Samargandy S et al. Abdominal Visceral Adipose Tissue Over the Menopause Transition and Carotid Atherosclerosis: The SWAN Heart Study. The Journal of the Menopause Society. June 2021.
- Fenton A. Weight, Shape, and Body Composition Changes at Menopause. Journal of Mid-Life Health. July–September 2021.
- Cichowski SB. UTIs After Menopause: Why They’re Common and What to Do About Them. American College of Obstetricians and Gynecologists. August 2025.
- 7 Tips to Prevent a UTI. UCLA Health. December 19, 2024.
- Urinary Incontinence. Office on Women’s Health. October 24, 2025.
- Menopause and Cardiovascular Risk. American Heart Association. September 12, 2024.
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