female_health

Menopause — Bone + Heart Protection

Post-menopausal women lose 2-3% bone mass/year for first 5 years + face accelerated cardiovascular risk. Combined nutrition + resistance training + (in selected women) HRT cuts hip fracture 30-50% and major cardiac events.

Nutrition

Pattern

Mediterranean + bone-supportive

Foods to emphasise

Calcium-rich: dairy, fortified plant milks, sardines, leafy greens
Vitamin K2: fermented foods, hard cheese
Magnesium: nuts, seeds, dark chocolate, leafy greens
Protein 1.2-1.5 g/kg
Fatty fish 2-3×/wk

Foods to limit

Sodium > 2300 mg (urinary calcium loss)
Excess caffeine > 400 mg/day
Alcohol > 1 drink/day
Ultra-processed

Exercise

Aerobic

150 min/wk + 75 min vigorous if able.

Strength

3 d/wk PROGRESSIVE RESISTANCE — heaviest tolerable; weight-bearing impact (jump training) builds bone if pelvic floor + joints allow.

Flexibility

Daily; balance training to prevent falls.

Weekly target

150 minutes

Supplements

Vitamin D3

1000-2000 IU/day

RCT

Calcium (food first; supplement if needed)

Top-up to 1200 mg/day

guideline

Avoid > 500 mg in single dose; some signal for cardio risk if excess.

Vitamin K2 (MK-7)

90-180 mcg/day

RCT

Directs calcium to bone, not arteries.

Omega-3

1-2 g/day

RCT

Cardio + cognitive.

Creatine monohydrate

3-5 g/day

RCT

Strength + lean-mass + cognitive benefit in older women.

Monitor + cadence

What to track

DEXA at 65 or earlier with risk factors; repeat every 2 years if abnormal
Lipid panel annually
BP annually
HbA1c annually
Vitamin D annually
Annual fracture risk (FRAX) assessment

Red flags — seek care

Vertebral height loss > 2 cm → DEXA + spine X-ray
Postmenopausal bleeding → urgent gynae
Chest pain or unusual exertional dyspnoea → cardio workup

Sources

NAMS 2022
NOF 2022 Clinician's Guide
AHA 2020 Menopause + CVD

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