AFTER the menopause, a woman may experience changes that may or may not be related to the decreased hormone levels. These include serious conditions like cardiovascular disease and osteoporosis. Early measures taken may prevent or detect these conditions early.
Cardiovascular disease
Cardiovascular disease is a term that describes conditions of the circulatory system and includes heart disease and strokes. Cardiovascular disease is the commonest cause of death in post-menopausal women.
Although many women worry about cancer, especially breast cancer, there are more women who die from heart disease than from breast cancer.
Women who have not reached menopause have a much lower risk of cardiovascular disease than men. The risk to a woman increases significantly after the menopause when the oestrogen levels fall so much that the risk of heart attacks is twice or thrice that of pre-menopausal women the same age.
There are several cardiovascular risk factors. Some cannot be changed but others can be controlled or modified to reduce the risk. The risk factors include:
-- Increasing age.
-- Post-menopause especially if the menopause is premature i.e. below 40 years of age.
-- Family history. The risk of cardiovascular disease is increased if the woman's father or brother had a heart attack before the age of 55 years; the mother or sister had a heart attack before the age of 65 years or a family member had a stroke.
-- Cigarette smoking. Of all the cardiovascular risk factors, smoking cessation has the greatest impact on saving lives. Smokers are considerably more prone to heart attacks than non-smokers. When a woman ceases smoking, however much or long she has smoked, her risk of heart disease decreases by 50%. Apart from that, there is a decreased risk of lung disease and many other conditions.
-- Physical inactivity is almost as great a risk factor as smoking because of decreased circulation and weight gain. Heart disease is almost twice as likely to affect inactive people than those who exercise regularly.
- Excess weight, especially when it is 30% above ideal weight, increases the risk of heart disease.
-- Hypertension i.e. arm cuff blood pressure above 140/90mm Hg increases the risk of heart attack or stroke. Regular checks are important as hypertension seldom causes symptoms. Although it cannot be cured, it can be controlled by eating a healthy diet, limiting alcohol and salt intake, regular exercise, maintaining an optimal weight and reducing stress.
-- Abnormal cholesterol levels cause an increase of fatty deposits on the inner walls of arteries (atherosclerosis) supplying the heart and the rest of the body. The fatty deposits harden the arteries, decrease the blood flow and can eventually block the artery entirely. If it affects an artery supplying the heart, a heart attack can occur. If it affects an artery supplying the brain, a stroke can occur. Many post-menopausal women have raised cholesterol levels, which increases their risk of cardiovascular disease. Cholesterol can be kept at normal levels by a diet with plenty of fruits and vegetables, and little or no animal fat. Regular exercise is also effective. When diet and exercise are insufficient, cholesterol lowering medicines are prescribed by the doctor.
-- Diabetes increases the risk of cardiovascular disease. Women with diabetes have twice the risk of having a heart attack than those who are not diabetic. Women who have a family history of diabetes, diabetes when they were pregnant (gestational diabetes), those who are obese or of a high-risk ethnic group should be screened for diabetes. Diet, exercise and optimal weight control are important for diabetic women or those at risk of the condition. Medicines may be needed to control diabetes.
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Exercise and Fitness 
