Health after menopause: key risks and blood tests to monitor them
Explore the long-term health considerations after menopause, from heart health to osteoporosis.
In this guide, we explore the long-term health considerations after menopause and the key biomarkers that can help you monitor your health over time.
Whether you’re approaching menopause or are already postmenopausal, understanding what to look out for (and when to test) can help you take a proactive approach to your wellbeing. While some health risks may increase, there’s plenty you can do to stay informed, supported, and in control of your health.
We’ll cover:
- Why are there health risks after menopause?
- Cardiovascular health after menopause
- Brain health and cognitive changes
- Bone density and muscle loss
- Sexual and urinary health after menopause
- Weight, metabolism, and hormonal changes
- Cancer risk and screening
- Biomarkers to monitor after menopause
- Best blood tests for menopause health
Why are there health risks after menopause?
After menopause (defined as 12 months without a period) oestrogen levels drop significantly. While this is a normal part of ageing, oestrogen supports many systems in the body, so lower levels can influence things like heart and bone health.
Changes in your body you may see after menopause include:
- Slower metabolism
- Reduced bone density
- Increased inflammation
- Changes in cholesterol and blood sugar
- Changes in cognitive function
Over time, these changes can increase the risk of chronic conditions such as cardiovascular disease, osteoporosis, type 2 diabetes, and more.
It won’t happen overnight, and that’s why monitoring your health and catching symptoms early can be a great approach to looking after your wellbeing.
Cardiovascular health after menopause
Heart disease is often thought as a men’s health issue, but it’s actually the leading cause of death in women in the UK. In fact, coronary heart disease (CHD) accounts for 8% of female deaths[1].
Many people assume women are protected from heart disease because of oestrogen, which is true to some extent. Oestrogen protects the heart and can reduce the build up of plaques in blood vessels [2]. However, as oestrogen levels decline in the lead-up to and after menopause, levels of “bad” cholesterols and triglycerides can rise, increasing the risk of heart conditions.
Some increased heart health risks after menopause:
- Cardiovascular disease (CVD)
- Hypertension (also known as high blood pressure)
- Stroke risk
- Metabolic syndrome [3]
- High cholesterol [4]
Even if you have no history of heart disease, regular cardiovascular health checks become important in postmenopausal years.
A particularly useful biomarker to test is your lipoprotein(a) or Lp(a), as it can genetically determine your risk of heart issues, even if you have normal blood pressure and cholesterol profile. You can read more about the importance of understanding your Lp(a) levels in our blog, and we’ve written a guide to the best blood tests for heart health.
The best way to protect your heart at any age is with a combination of regular exercise and a balanced diet, such as the Mediterranean diet.
Brain health and cognitive changes
For many, menopause and neurological changes seem to go hand in hand (and it’s not just in your head).
Many people don’t realise that oestrogen plays an important role in how the brain functions. Research shows that as your oestrogen levels drop, the brain adapts by restructuring the brain [5,6]. It’s though that the reduction of oestrogen causes the brain to shift how it uses energy. This change in metabolism results in decreased grey matter in areas associated with memory and emotion.
The result? Symptoms like brain fog, forgetfulness, and trouble concentrating are common [7]. Additionally, some women also report increased levels of anxiety, depression, and sleep issues such as insomnia.
Does lack of oestrogen lead to Alzheimer’s?
Women account for around 65% of people living with dementia [8]. The most common cause of dementia is Alzheimer’s disease.
As Alzheimer’s is more commonly diagnosed in women after menopause, researchers theorise there may be a link, where oestrogen plays a protective role in the brain. This potential protective effect may be reduced, possibly increasing vulnerability to the changes associated with Alzheimer’s disease.
It’s important to understand that menopause doesn’t directly cause dementia.
Is there a blood test for dementia?
Researchers are developing a blood test that could diagnose Alzheimer’s or dementia before the condition has progressed [9,10]. But it’s still a while away from being available on the NHS or privately.
So, while there’s no single blood test to monitor cognitive decline, you can monitor certain biomarkers relating to brain health.
Nutrients to track include:
Keeping an eye out for deficiencies in these nutrients could protect your brain later in life [11–13]. You can check these biomarkers and more in our Advanced Diet and Lifestyle with Omega 3 and 6 Blood Test.
Bone density and muscle loss
Oestrogen plays a key role in maintaining musculoskeletal function, a.k.a. bone and muscle strength. But after menopause, bone breakdown can outpace bone formation.
This may increase the risk of:
- Osteoporosis (weak bones)
- Fractured or broken bones
- Osteoarthritis (joint pain)
In fact in the UK, half of women over the age of 50 will break a bone due to osteoporosis [14]. In addition, age-related muscle loss — known as sarcopenia — can accelerate, affecting strength, mobility, and balance.
If this all sounds a bit doom and gloom, don’t worry.
Optimising your vitamin D levels (try supplements if you're at risk of a deficiency), keeping an eye on your protein intake, and incorporating gentle pressure on your bones and muscles through resistance training can alleviate the risk.
Not sure where to get started? Head over to our blog on the importance of strength training for women for more information or try a Vitamin D Blood Test to see where you’re at.
Sexual and urinary health after menopause
Changes in sexual health are common during perimenopause and post menopause. Studies suggest between 40-50% of women experience changes such as loss of sex drive and vaginal dryness.
A key driver of these changes is the decline in oestrogen. This can lead to thinning and reduced elasticity of vaginal and vulval tissues, resulting in dryness, irritation, and discomfort. For some women, this may make penetrative sex painful or more difficult.
In addition to physical changes, hormonal shifts can also influence libido, mood, and energy levels — all of which play a role in sexual wellbeing.
Common symptoms include:
- Vaginal dryness
- Pain during sex
- Recurrent urinary tract infections
- Urinary incontinence
These symptoms are often linked to genitourinary syndrome of menopause (GSM), a widespread but often underdiagnosed condition affecting the vaginal and urinary systems after menopause.
While GSM is typically diagnosed based on symptoms, certain biomarkers can still provide useful context. For example, low levels of oestradiol may help explain vaginal and urinary changes, while broader hormone testing — including testosterone — can offer insight into reduced libido or ongoing symptoms. In some cases, checking markers of general health (such as blood glucose or thyroid function) may also be helpful, as underlying conditions can contribute to fatigue, low mood, or reduced sex drive.
The best thing to do is talk to your health provider or a qualified menopause specialist about what you’re experiencing. The experts at My Menopause Centre may be a good place to start.
Weight, metabolism, and hormonal changes
The changes in hormones relating to menopause can have a big impact on your metabolism. The way your body stores fat and processes energy can cause common effects.
These include:
- Weight gain (especially around your middle)
- Reduced insulin sensitivity
- Increased risk of metabolic syndrome
- Risk of type 2 diabetes
There’s also a link between menopause and thyroid function, with conditions such as hypothyroidism becoming more common with age. You can read more about the link between menopause and thyroid in our blog.
Adopting a diet with lots of plants, whole foods, and healthy fats can help you manage your weight and metabolism. The Mediterranean diet is a good example of this. Keeping an eye on your blood sugar levels (HbA1c), cholesterol, and thyroid hormones can be a food idea.
Cancer risks after menopause and screening
Some cancer risks may increase after menopause, particularly those influenced by hormonal changes.
These include:
- Breast cancer
- Endometrial cancer
While menopause itself doesn’t directly cause cancer, hormonal changes alongside ageing can influence risk. The good news is that regular screening, staying aware of symptoms, and checking in on your health can all help with early detection and peace of mind.
Best biomarkers to monitor your health after menopause
The menopause brings about a variety of changes both mentally and physically. Monitoring certain biomarkers through blood testing can give you valuable insight into your personal risk of the conditions we’ve mentioned above and help you take a more proactive approach to your health.
Cardiovascular health
After menopause, changes in cholesterol and inflammation can increase your risk of heart disease. Look for blood tests that offer a full lipid panel and check your inflammation levels too.
- Cholesterol (LDL, HDL, total cholesterol)
- Triglycerides
- Apolipoprotein A and B
- Lipoprotein(a), Lp(a)
- Hs-CRP
Metabolic health
Hormonal changes can affect how your body processes glucose, increasing the risk of type 2 diabetes and insulin resistance. Thyroid conditions (which affect your metabolism) also become more common with age.
What to check:
Cognitive health
Certain nutrient levels can influence how your brain functions. Low levels may contribute to symptoms like brain fog and fatigue.
These include:
What are the best blood tests for menopause?
Menopause is a transition — not an endpoint. While it can increase the risk of certain conditions, it also presents an opportunity to take a more proactive approach to your long-term health.
Best for comprehensive women's health check: Advanced Well Woman Blood Test
Best for nutrition and omega analysis: Advanced Diet and Lifestyle with Omega 3 and 6 Blood Test
Best for advanced longevity insights: Optimal Health Blood Test
By understanding the changes happening in your body and using targeted blood tests to monitor key biomarkers, you can make informed decisions and reduce your risk of future health problems.
References
- British Menopause Society, Primary prevention of coronary heart disease in women. 2026
- My Menopause Centre, Menopause Symptoms | Heart Disease | My Menopause Centre. [cited 14 Apr 2026].
- NHS, Metabolic syndrome. In: nhs.uk [Internet]. 19 Oct 2017 [cited 14 Apr 2026].
- NHS, High cholesterol - Cholesterol levels. In: nhs.uk [Internet]. 28 May 2019 [cited 14 Apr 2026].
- Members M. How Menopause Restructures a Woman’s Brain. In: The Menopause Society [Internet]. 8 Oct 2025 [cited 14 Apr 2026].
- BBC, Menopause linked to Alzheimer’s-like brain changes. In: BBC News [Internet]. 27 Jan 2026 [cited 14 Apr 2026].
- My Menopause Centre, Why Brain Fog Happens And How To Beat It | My Menopause Centre. [cited 14 Apr 2026].
- Alzheimer's Society, Hormones and dementia risk | Alzheimer’s Society. [cited 14 Apr 2026].
- Blood Biomarker Challenge, The blood test set to “revolutionise” dementia diagnosis | Alzheimer’s Society. [cited 15 Apr 2026].
- Willyard C. The Vexing Promise of New Blood Tests for Alzheimer’s. Nature. 2025;645: S13–S15. doi:10.1038/d41586-025-02928-6
- King's College London, 2025, A startling omega-3 deficiency may explain women’s Alzheimer’s risk. In: ScienceDaily [Internet]. [cited 11 May 2026].
- Pignolo A, Mastrilli S, Davì C, Arnao V, Aridon P, Dos Santos Mendes FA, et al. Vitamin D and Parkinson’s Disease. Nutrients. 2022;14: 1220. doi:10.3390/nu14061220
- Vitamin D and the omega‐3 fatty acids control serotonin synthesis and action, part 2: relevance for ADHD, bipolar disorder, schizophrenia, and impulsive behavior - Patrick - 2015 - The FASEB Journal - Wiley Online Library. [cited 9 Oct 2025].
- Royal Osteoporosis Society - Better Bone Health for Everybody. [cited 15 Apr 2026]. Available: