Bone and heart health after 40

Oestrogen helps protect your bones. As levels fall, bone loss speeds up. The NHS says women lose bone rapidly in the first few years after menopause, which is why osteoporosis is more common in women, particularly if menopause comes early (before 45) or the ovaries have been removed.

Heart health matters too. The risk of cardiovascular disease rises with age, so midlife is a brilliant time to invest in your heart. HRT does not raise coronary heart disease risk, but NICE is clear it should not be used to prevent heart disease. Habits and blood pressure checks do the heavy lifting.

Bone-friendly habits

• Weight-bearing exercise (walking, dancing, running) and strength work on at least 2 days a week
• Calcium: adults need 700mg a day, from dairy, fortified alternatives, tofu, leafy greens and tinned fish with bones. Taking 1,500mg or less a day in total is unlikely to cause harm, so do not overdo supplements.
• Vitamin D: the NHS suggests considering 10 micrograms a day in autumn and winter, and some people need it all year
• Not smoking and keeping alcohol within limits

Heart-friendly habits

• Aim for 150 minutes of moderate activity a week
• Eat plenty of fruit, veg and fibre, and less salt and saturated fat
• Get your blood pressure and cholesterol checked. In England you can have an NHS Health Check from the age of 40.
• Stop smoking, if you smoke

HRT does lower fracture risk while you take it, and the NHS says it is especially important to take HRT or the combined pill if your periods stop before 45. That is an individual choice to make with a doctor, alongside the habits above.