Health after the menopause in five habits: exercise, diet, sleep
After the menopause, low oestrogen affects your bones, heart, sleep and weight – but according to the NHS, a great deal is in your hands. Five habits that carry the most weight: regular exercise with strength training (at least 150 minutes of moderate activity a week), a balanced diet with enough calcium and vitamin D, a steady sleep routine, caring for your heart by stopping smoking and cutting salt and alcohol, and regular conversations with your doctor – especially about any bleeding after the menopause.
- The NHS recommends at least 150 minutes of moderate or 75 minutes of vigorous activity a week plus strength exercises, including for bone density.
- According to Cambridge University Hospitals NHS, oestrogen keeps blood vessels flexible and helps control cholesterol; after it falls, the risk of high blood pressure and heart disease rises.
- The NHS recommends 700 mg of calcium a day from food and 10 micrograms of vitamin D as a supplement in autumn and winter.
- Women should not exceed 14 units of alcohol a week; alcohol can make hot flushes and sleep worse.
- Any vaginal bleeding more than 12 months after your last period should be checked by a doctor.
Habit 1: How should you exercise to protect your bones and heart?
According to the NHS guidance cited by Cambridge University Hospitals, adults need at least 150 minutes of moderate activity (brisk walking, cycling, water aerobics) or 75 minutes of vigorous activity (running, swimming, fast cycling, team sports) a week – split into short sessions or done in one go. On top of this come strength exercises: weights, resistance bands or bodyweight exercises such as press-ups.
The NHS stresses that weight-bearing and resistance exercises are the most beneficial for bones – walking, running, dancing, working with weights. The Cambridge University Hospitals guide adds that progressive resistance training for at least 4 to 6 months has a positive effect on bone density, and that starting later in life still brings benefit. A simple example: standing up from a seated position without using your hands, 8 to 12 repetitions. Choose activities you enjoy and build up gradually.
Habit 2: What should you eat after the menopause?
The NHS recommends a healthy, balanced diet with plenty of fruit and vegetables and sources of calcium – milk, yoghurt, kale. The Cambridge University Hospitals guide is more specific:
- at least five portions of fruit and vegetables a day
- fewer ultra-processed foods and ready meals
- fewer refined carbohydrates and sugar, which cause spikes and dips in blood sugar
- no more than 6 g of salt a day
- 700 mg of calcium a day, ideally from food – low-fat dairy products, tinned sardines, salmon, leafy vegetables, fortified bread and cereals
- a supplement of 10 micrograms of vitamin D a day from October to March; the NHS reminds you that sunlight on your skin helps your body produce it during the warmer months
According to the same guide, phytoestrogens (isoflavones in soya, tofu, lentils, chickpeas; lignans in cereals, flaxseed, fruit and vegetables) may help with hot flushes and vaginal dryness, while caffeine, alcohol and spicy food can make them worse. With age, metabolism slows and calorie needs fall – a smaller plate is a simple way to control portions. The NHS advises talking to a doctor before taking herbal supplements.
Habit 3: How can you sleep better after the menopause?
The NHS recommends a regular sleep routine and enough rest, and for sleep problems – cognitive behavioural therapy (CBT). The Cambridge University Hospitals guide gives specific steps:
- go to bed and get up at the same time and leave yourself time for an evening wind-down routine
- keep your phone, the TV and work out of the bedroom; limit light and noise and keep the room pleasantly cool
- do not eat within a few hours of going to bed
- limit caffeine and alcohol, especially later in the day
- exercise regularly during the day and avoid napping
- write down your worries before bed or during the night so you can look at them the next day
Relaxation such as yoga, tai chi or meditation is also among the NHS recommendations, as is talking to people who are going through the same thing.
Habit 4: How can you protect your heart after the menopause?
According to the Cambridge University Hospitals guide, oestrogen helps blood vessels stay flexible and plays a part in controlling cholesterol. When its levels fall, women are at higher risk of high blood pressure and the build-up of plaques, which can lead to coronary heart disease, heart attack or stroke. Reaching the NHS-recommended levels of exercise has a positive effect on the cardiovascular system, and healthy eating can help against the long-term problems linked to low oestrogen, including heart disease and stroke.
Two things carry great weight: smoking and alcohol. The NHS advises not to smoke – smoking makes menopause symptoms worse, and according to the guide, smokers enter the menopause earlier and have more severe hot flushes. For alcohol the recommendation is no more than 14 units a week, with alcohol-free days; besides the heart, this matters for your bones and sleep too. Being overweight is linked to more severe hot flushes and a higher risk of heart disease and diabetes, and resistance training improves metabolism and can help against fat building up around the waist.
Habit 5: Which check-ups and conversations with your doctor should you not skip?
According to the NHS, early advice from a doctor can reduce the effect of the menopause on your health, relationships and work – you do not need to wait for symptoms to become unbearable. The Cambridge University Hospitals guide encourages you to discuss HRT and other treatment options with your doctor, as well as any concerns about your mental health; for pelvic floor problems (for example urinary incontinence) you can be referred to physiotherapy.
The most important rule according to the NHS: any vaginal bleeding more than 12 months after your last period should be checked – even if it is a one-off, very little, or pinkish-brown spotting. It is usually not serious, but it can sometimes be a sign of cancer, which is easier to treat when found early.
When should you see a doctor?
According to the NHS, see a doctor (non-urgently) if:
- you have any vaginal bleeding 12 or more months after your last period
- you have symptoms such as palpitations
- you think you have menopause symptoms and want to discuss your options, including HRT
- you are considering herbal supplements or complementary remedies
- you need contraception – the NHS reminds you that HRT is not contraception
- you have a diagnosis of osteoporosis and want to start a new exercise programme
The Cambridge University Hospitals guide adds: talk to your doctor about your mood and about pelvic floor problems too.
Frequently asked questions
Why am I gaining weight around my waist after the menopause?
According to the Cambridge University Hospitals guide, hormonal changes together with cortisol (the stress hormone) may contribute to fat building up around the tummy, and metabolism slows with age. Resistance training and portion control help.
Should I take vitamin D all year round?
According to the NHS, all adults need 10 micrograms of vitamin D a day. The Cambridge University Hospitals guide recommends a supplement from October to March, when the sun is too weak; in the warmer months, a short time outdoors every day helps.
Do soya and flaxseed help with hot flushes?
According to the Cambridge University Hospitals guide, the phytoestrogens in soya, tofu, lentils, chickpeas and flaxseed may help with hot flushes and vaginal dryness. The NHS advises talking to a doctor before taking any herbal supplements.
Sources
- NHS – Things you can do to help menopause and perimenopause symptoms – last reviewed by the NHS: 19 May 2026
- Cambridge University Hospitals NHS Foundation Trust – Menopause: A healthy lifestyle guide – approved: 16 July 2024 (version 2)
- NHS – Symptoms of menopause and perimenopause – last reviewed by the NHS: 19 May 2026
Informational article retold in our own words from the sources listed. It does not replace a consultation with a doctor; in an emergency call 112. If you spot an inaccuracy, write to [email protected].