Q&A with Dr Reena Virdi
Welcome to our Doctor’s Q&A corner!
We are back again with Dr Virdi, where expert insight meets real conversation. Peri-menopause and menopause, are stages in life that are often misunderstood, and not discussed nearly enough.
Here, we dive-in to real questions that you have sent us, and get clear, honest answers grounded in medical expertise.
Send in your questions for the next edition, and remember, all personal details remain confidential. We will only publish your question.
Question: "Does menopause increase my risk of heart disease or other conditions? Should I be monitoring things like cholesterol, blood pressure, or blood sugar more closely now? What lifestyle changes would have the biggest impact on protecting my long term health?"
Answer: Yes, menopause is associated with an increased risk of several health conditions, particularly cardiovascular disease. This is due to a decline in oestrogen, which normally protects blood vessels. As levels fall, this can lead to increased blood pressure, raised cholesterol, insulin resistance (including Type 2 Diabetes), and weight gain, increasing the risk of heart attack and stroke over time.
There is also an increased risk of Osteoporosis and osteopenia due to loss of bone density, leading to a higher fracture risk.
Menopause can affect the genitourinary system, causing vaginal dryness, urinary symptoms, and recurrent infections.
Hormone replacement therapy (HRT) may be offered to relieve symptoms and reduce risk in some women, particularly those with early menopause, depending on individual suitability.
Monitoring cholesterol, blood pressure and/or blood sugar
As a general guide, blood pressure should be checked every year. Cholesterol and blood sugar (Hba1c) may also need annual monitoring depending on other risk factors, such as:
You have previously had raised cholesterol or blood sugar.
You are taking medication for conditions such as hypertension, diabetes, or high cholesterol.
You have other risk factors (e.g. family history, obesity, smoking).
This is something a GP can guide you with depending on individual risk factors.
Lifestyle changes for long-term health
Lifestyle changes play a key role in reducing long-term health risks after menopause and reduce the risk of cardiovascular disease, help maintain a healthy weight, and support bone strength.
Diet
Aim for a balanced diet rich in vegetables, fruits, whole grains, lean protein, nuts, and fibre. Try to limit processed foods, as well as foods high in sugar, salt, and unhealthy fats. Staying well hydrated and moderating alcohol to less that 14 units/week, and limiting caffeine intake is also important.
Exercise
Regular physical activity is essential. Current recommendations are:
At least 150 minutes of moderate intensity exercise per week (e.g. brisk walking).
Strength or resistance training at least twice weekly to support bone health and muscle mass.
Weight
Along with diet and exercise, aiming for a Body Mass Index (BMI) of under 25. Although this can be one of the biggest challenges women face with menopause, obesity is all "all cause mortality" meaning it can lead to various disease and cancers, reducing life expectancy.
Smoking
Although it can be challenging, stopping smoking significantly reduces the risk of disease, including cardiovascular disease and cancer. Support is available through smoking cessation services.
Other important factors include maintaining good quality sleep, managing stress, and supporting mental wellbeing. Attending routine screening programmes, such as breast and cervical screening, is also essential. Certain supplements may also be beneficial such as vitamin D + calcium, vitamin B complex, magnesium.