With an ever-increasing life expectancy, the average woman is post-menopausal for at least one third of her life. After menopause, women can experience a host of untoward physical changes in their bodies. As we age, hormone withdrawal increases women’s risk for many things from cardiovascular disease to osteoporosis. During this stage in life, women should adopt preventive health measures and focus on healthy lifestyle choices to live longer and have more vitality as we age.

Along with the many physical changes, menopause and the aging process also bring about a greater risk of developing cancer. Reducing your cancer risk entails healthy practices including exercise, eating a healthy diet, avoiding smoking and second-hand smoke, and maintaining a healthy body composition, such as preserving muscle mass and minimizing body fat. 

As a preventative measure, full-body MRI scans that can detect cancer early are now available and are increasingly becoming more popular. Full body scans, which require no radiation exposure, can be a useful tool especially if you have a family or personal history of cancer. This scan, which can take up to an hour, can provide early detection and an accurate look inside your body. Early cancer screening with a total-body MRI will be able to detect cancers in advance of other screening techniques and pick up many that are not routinely screened for. Early detection also means you have better treatment options to combat cancer.

All menopausal women should know their bone density and muscle mass. Low bone density may mean that you are at risk for osteoporosis which can lead to frequent bone fractures as you age. Osteoporosis is a major health risk to women after menopause as age-related bone loss increases. As you grow older, in the absence of hormonal optimization and regular exercise, you’ll lose about 1 percent of your bone mass every year. A DEXA scan is an imaging test that measures bone mineral density, body fat and muscle mass. This is the “Gold Standard” against which all other modalities are measured. It is a quick and painless test and can be the most useful, easy and inexpensive tool to help reduce your fracture risk.

According to the American Heart Association, estrogen withdrawal after menopause is a critical factor in the increase in heart disease among post-menopausal women. Cardiovascular disease is the number one killer of women, causing one in three deaths each year. With less estrogen, which helps keep blood vessels open, cholesterol can build up on artery walls increasing the risk of heart disease or stroke. 

A VO2 Max test measures the amount of oxygen the body is able to use during exercise and is a strong indicator of cardiovascular fitness. A kind of stress test, the VO2 Max has a mask which covers your nose and mouth and attaches to a heart monitor. This test is useful in determining your fitness level and it gives you a baseline against which you can measure yourself as you work to improve your overall fitness level. It is well established that maintaining lean body mass, along with working toward an optimal VO2 performance is the best way of codifying your longevity and quality of life as you age.

As we age, our hormone levels diminish. Most of the negative effects of aging are caused or accelerated by the withdrawal of these hormones in our bodies. Hormone replacement therapy or hormone optimization is the medical process by which these essential hormones are added back into the body to return it to a healthier state. 

It’s essential that the hormones used are bio-identical. Bio-identical hormones (as opposed to synthetic, “bench-made” hormones) are naturally produced from plant-based materials and are structurally identical to the hormones found in our bodies.

There are myriad myths surrounding hormone optimization therapy, including those associating the use of estrogen with the risk of breast cancer or the optimization of testosterone with risk for prostate cancer. Studies done with the use of bioidentical hormones show that the optimization of these hormones in later life are life-enhancing and protective against heart disease, sexual dysfunction, and loss of muscle mass and bone mineral density, to mention only a few of the positive effects of starting this journey. Close medical supervision with a qualified physician who possesses long experience in this field is essential. “Walking the walk”—exercise, nutrition and hormonal optimization—with the accountability built in is the secret to not only longevity, but maintaining real health and quality of life into old age.

As you age, your nutritional needs change. Post-menopausal women should have their calcium levels measured occasionally, but the average American diet typically provides plenty of calcium. Vitamin D and vitamin K2 levels should be watched serially, as vitamin D is essential for absorbing calcium and Vitamin K is what moves that calcium to the bones. Vitamin deficiencies can be common, even in those who eat a varied and healthy diet. 

To know exactly which supplements are best for your individual needs, it’s prudent to undergo in-depth blood testing, beyond the “executive panel” normally done at your yearly physical, which only scratches the surface. Vitamin and nutrition blood tests can detect mineral, iron and other deficiencies indicating where you’re lacking, or high levels of heavy metals, which is getting more and more common as a result of environmental exposures. You can then work with your physician to determine a targeted supplement regimen which can be tailored to meet your body’s needs.

Healthy eating and good nutrition can prevent disease and relieve symptoms that can arise after menopause. Making changes to your diet can lead to improved health during this stage of a women’s life. 

Begin by limiting your intake of highly processed foods such as chips, candy, crackers and fried foods. Drinks with high fructose corn syrup and added sugars aren’t healthy and should be eliminated from your diet. Avoid high salt foods like deli meats and canned soups. Limit your intake of alcohol and caffeine.

Increase your consumption of fruits and vegetables which are rich in vitamins, minerals, fiber and antioxidants. A 2020 study by The Journal of Menopause Society found that women who ate more fruits and vegetables have fewer menopausal symptoms than women who ate less of these foods.

Healthy fats including higher omega-3 fatty acids (found in salmon, anchovies, and flax and chia seeds) are associated with better health in postmenopausal women. Whole grain foods (brown rice, quinoa, oats and whole wheat bread) are high in nutrients and have been shown to reduce heart disease, cancer and premature death. In summary, sugar is definitely the enemy. Understanding the concept of what foods are high glycemic (spike your blood sugar) or low glycemic is critical in making choices.

In America, our health care system is quite good, by providing medications to treat the symptoms of a suboptimal lifestyle, at keeping you alive well into your 90’s. Achieving real health and maintaining an active, exceptional quality of life is on you, and the help of the health care professionals who are adept at treating the underlying causes of disease and will provide ongoing care and accountability as you embark on the journey into older age.