# Bone and heart health after 40

> Small habits, big future payoff

Category: Perimenopause · 4 min read · Written by the Splash team · Sources checked October 2026
URL: https://splash.care/learn/perimenopause/bone-heart-health

## Quick answer

- Bone loss speeds up after menopause as oestrogen falls.
- Strength and weight-bearing exercise, calcium and vitamin D protect bones.
- Regular activity and health checks support your heart; HRT is not used to prevent heart disease.

[Oestrogen](https://splash.care/learn/glossary/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](https://splash.care/learn/glossary/menopause), which is why [Osteoporosis](https://splash.care/learn/glossary/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](https://splash.care/learn/glossary/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](https://splash.care/learn/period-care/exercise-on-period) (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](https://splash.care/learn/nutrition/caffeine-alcohol) within limits

## Heart-friendly habits

- Aim for 150 minutes of [moderate activity](https://splash.care/learn/glossary/moderate-activity) a week
- Eat plenty of fruit, veg and [fibre](https://splash.care/learn/glossary/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](https://splash.care/learn/perimenopause/hrt-basics) 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](https://splash.care/learn/conditions/talk-to-your-doctor), alongside the habits above.

**Quick quiz:** How much calcium do most adults aged 19 to 64 need each day?

1. 300mg
2. 700mg
3. 2,500mg

Answer: 700mg. The NHS says adults need 700mg a day, ideally from food. Taking 1,500mg a day or less is unlikely to cause harm, and more than that can cause stomach pain.

> **Splash says:** lifting weights is not just for your 20s. Strength work at any age helps keep bones and muscles strong.

### When to see a doctor

Ask a GP about your bone health if you had an early menopause, a broken bone from a minor fall, long-term steroid use, or a family history of osteoporosis. Call 999 for chest pain, sudden breathlessness, or signs of a stroke (face drooping, arm weakness, speech problems).

## Sources

1. [NHS: Osteoporosis](https://www.nhs.uk/conditions/osteoporosis/)
2. [NHS: Calcium](https://www.nhs.uk/conditions/vitamins-and-minerals/calcium/)
3. [NHS: Cardiovascular disease](https://www.nhs.uk/conditions/cardiovascular-disease/)
4. [NHS: Physical activity guidelines for adults](https://www.nhs.uk/live-well/exercise/physical-activity-guidelines-for-adults-aged-19-to-64/)
5. [NICE NG23: Menopause: identification and management](https://www.nice.org.uk/guidance/ng23)

This is general information, not medical advice. Splash can’t diagnose. If you’re worried, talk to a GP, pharmacist or sexual health clinic. In an emergency call 999 (UK) or 911 (US).