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Lowering your postmenopause health risks

woman tying shoe before run
May 20, 2019
Lily Moran

How did you get postmenopause? Some women ease through menopause with nary a hot flash, while others struggle with symptoms and distress. But regardless of whether the transition was a breeze or a challenge, all postmenopausal women end up at an increased risk of certain diseases.

Even women who have had little-to-no risk of health concerns in their younger years can experience a dramatic increase in health risks after menopause. The main reason for this is the decrease in estrogen production that occurs post-menopause. Estrogen has a lot of protective effects in the body, and the drop in levels causes you to lose that natural protection.

Two of the major conditions that become more common with menopause are cardiovascular disease and osteoporosis. Here’s why, and what you can do to lower your risk…

Cardiovascular Health

More than a third of women have some form of cardiovascular disease. It is the leading killer of females over 65. Risk of heart attack increases dramatically 10 years after menopause, and risk of stroke doubles every decade after 55.

Estrogen affects nearly every tissue and organ system, including the heart and blood vessels. This hormone’s effects on the cardiovascular system include:

  • Increased HDL (beneficial) cholesterol
  • Reduced LDL (harmful) cholesterol
  • Reduced risk of blood clots
  • Relaxed, dilated blood vessels, which leads to better circulation
  • Soaking up of free radicals, which can damage arteries

It’s important to note that menopause does not cause cardiovascular disease. But it does increase certain risk factors that make heart and blood vessel problems more likely.

In particular, the loss of estrogen causes changes in blood vessel walls, making them more likely to accumulate plaque. Changes in lipids (fats) can also occur, leading to higher LDL cholesterol and lower HDL readings. Menopause also causes the body to increase production of fibrinogen, a substance that helps with blood clotting. Higher levels of fibrinogen are linked to heart disease and stroke.

For a long time, the accepted thinking was that, if estrogen is so protective, then hormone replacement therapy (HRT) should improve postmenopausal heart health and reduce risk of cardiovascular disease. But data from large clinical trials have found that HRT actually significantly raised the risk of heart attack, stroke, blood clots, and breast cancer.

Medical guidelines now advise against HRT for prevention of cardiovascular disease, and if it is used (for instance, to relieve menopausal symptoms or for bone health), it should be for the shortest duration possible.1

The catch, however, is that most studies that unearthed the dangers of HRT involved synthetic hormones. The leading brand, Premarin, is synthesized from the urine of pregnant mares, and it contains a mix of horse estrogens, steroids, and other compounds.

In contrast, plant-based bioidentical hormones are designed to be chemically identical to what the human body naturally produces. And bioidenticals can be compounded to meet your unique hormonal needs. If you and your doctor decide that HRT may benefit you in some way, then opt for bioidentical.

Beyond HRT, there are other ways to lower your risk of heart disease after menopause.

Of course, lifestyle is a huge factor. Eat healthy, whole foods and shun refined sugar and processed junk. Avoid cigarettes and secondhand smoke like the plague. Control stress by any means possible (meditation, deep breathing, yoga, prayer, exercise, etc.) And speaking of exercise, take it seriously. Aim for at least 20 minutes a day, or more if you have poor cardiovascular fitness.

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Chronic Inflammation Decoded

On the supplement front, there are a few key nutrients that support healthy heart and blood vessel function.

Top of list is omega-3 fatty acids. Omega-3s (EPA/DHA) have been shown to raise HDL, thin the blood to prevent clotting, keep blood vessels flexible, reduce inflammation, lower blood pressure, protect against atherosclerosis (hardening of the arteries), and keep heartbeat regular. Recommended dose is 1,500-3,000 mg a day.

Curcumin is also beneficial because it’s a powerful anti-inflammatory—and blood vessel inflammation is the hallmark of cardiovascular disease. The daily dosage recommendation is 500 mg three times a day.

Finally, coenzyme Q10 (CoQ10) should definitely be part of your heart health regimen. This compound plays a major role in firing up the tiny mitochondria that provide your body with power, and it sparks the energy production for your heart. In addition, CoQ10 works as an antioxidant to protect your heart from free radical damage. The body naturally produces CoQ10, but levels decrease with age (and cholesterol-lowering statin drugs also lower CoQ10 levels)—making supplementation all the more important. The typical therapeutic dose of CoQ10 (as ubiquinol) is 300 mg daily, taken in divided doses.


Osteoporosis is a condition that causes your bones to become brittle and break much more easily. It affects an estimated 30 percent of postmenopausal women.

Bones are naturally designed to undergo a complete renovation every three to six months. The process begins with cells called osteoclasts, which secrete acid to break down old bone. Once they have completed this breakdown process, cells called osteoblasts take over. Osteoblasts produce collagen fibers and other substances to replace the bone that dissolved away. These new materials help your bones stay strong, flexible, and resilient.

This continuous breakdown/buildup cycle keeps the bones from becoming weak and breaking. But with age, this cycle tends to fall out of balance, leaving bones more porous and weaker, and more vulnerable to breaks. The decline in estrogen after menopause exacerbates matters. Estrogen has various important and protective roles when it comes to bone health. It reduces the amount of calcium drawn from the bones, and it boosts the levels of bone-enhancing hormones like calcitonin, which stimulates bone growth.

The first-line treatment for osteoporosis is drugs called bisphosphonates (Fosamax, Actonel, Reclast, etc.). But these drugs don’t build new bone. All they do is prevent the action of osteoclasts, which means they keep bones from breaking down. The problem with this is that tired, weak, old bone sticks around far longer than Mother Nature intended. Long-term treatment with bisphosphates usually backfires, as patients often experience a major increase in fractures over time, especially in the upper thigh bone (femur).

When it comes to osteoporosis treatment, bioidentical hormone replacement has some research backing its efficacy. One review concluded that “bioidentical estradiol (particularly oral or patch forms) is comparable to [synthetic horse-derived estrogens] for slowing bone loss, slightly increasing bone mineral density, and reducing fracture risk.”2

But by and large, the most important things you can do to keep your bones strong and prevent osteoporosis is to exercise and take bone-building supplements. But not just any exercise will do; you have to engage in resistance or weight training. Weight-bearing exercises place stress your bones, and this stress encourages the breakdown of old bone and buildup of fresh new bone much more quickly.

According to a study published in 2018, researchers concluded that resistance exercises, either alone or in combination with other osteoporosis interventions, “may be the most optimal strategy to improve the muscle and bone mass in postmenopausal women, middle-aged men, or even the older population.”3

Finally, supplements that promote strong bones include calcium, vitamin D, magnesium, vitamin K, zinc, copper, silicon, and phosphorus. You can usually find most of these vitamins and minerals in products specifically formulated for bones.

In conclusion, menopause does bring about new health challenges. But none of them are insurmountable. By making some lifestyle adjustments, you can cut your risk and continue to enjoy a fulfilling, worry-free life.


  1. Cleveland Clinic. Estrogen and Hormones. Updated April 29, 2019. Last accessed May 6, 2019.
  2. Cook SB. Bioidentical hormone replacement therapy in postmenopausal osteoporosis. Natural Medicine Journal. 2014 Aug;6(81). Last accessed May 6, 2019.
  3. Hong AR and Kim SW. Effects of resistance exercise on bone health. Endocrinol Metab (Seoul). 2018 Dec;33(4):435-44. Last accessed May 6, 2019.

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