What should I actually be doing about my bones and my heart after menopause?

Both risks rise after menopause because oestrogen was doing protective work, and both respond to the same unglamorous things: weight-bearing movement, enough protein, enough calcium and vitamin D, not smoking, and keeping blood pressure and blood sugar in view. Strength work matters for bone more than walking does, and it is the part most often left out.

Screening is not automatic. Whether you need a bone density scan or a cardiovascular risk assessment depends on your age, your history and your risk factors, and it is worth asking rather than assuming somebody is tracking it.

Early menopause, a family history of hip fracture, long-term steroid use, a low body weight, smoking and certain conditions all raise bone risk and change what is recommended.

Heart disease is the commonest cause of death in women in India and presents differently from the textbook picture more often than in men — which is a reason to take breathlessness and unusual fatigue to a clinician rather than dismissing them.

This cannot tell you your own risk, whether you need screening, or whether you need treatment. Those depend on measurements and a history this page cannot see.

• What is my cardiovascular risk, and should we calculate it?
• Do I need a bone density scan, and if not, when would I?
• Should my vitamin D or calcium be checked?
• What kind of exercise would you prioritise for me?

Seek urgent care for chest pain or pressure, breathlessness at rest, pain spreading to jaw or arm, or sudden severe back pain after a minor fall — the last can be a spinal fracture.