The risks and benefits of taking estrogen and progesterone will be the topic of a future article. Osteoporosis, or thinning of the bones, is a health problem that may evolve rapidly in women after menopause. Taking estrogen prevents bones from thinning, and is one reason estrogen may be recommended for middle-aged women. However, prevention of osteoporosis also includes reducing caffeine intake, reducing alcohol use, taking adequate amounts of calcium and vitamin D and doing regular weight-bearing exercise. Women at very high risk, such as those who have conditions or take medicines that thin the bone, who cannot exercise or who have proven osteoporotic fractures, may need stronger bone-building medicines, several of which recently became available.
Heart disease continues to be the leading cause of death in women and men.
Before menopause the presence of natural estrogen gives women some protection against coronary disease. After menopause, women who take no estrogen eventually develop the same risk for heart problems as men. Those with long history of smoking, diabetes, high cholesterol, strong family history of heart disease, and established hardening of the arteries are at especially high risk. Treatment of existing medical conditions, discontinuation of smoking, weight reduction, regular exercise, and low fat diet are generally advised. Women who experience chest pains or chest pressure, especially when it is associated with breathlessness, or brought on by physical activity or exertion, should see their physician. .