Menopause
Study links heart health to fracture risk in postmenopausal women
Postmenopausal women with high cardiovascular risk face almost double the hip fracture risk, a new study has found.
Postmenopausal women face a high risk of bone fractures.
Due to declines in oestrogen levels, which can lead to an increased risk of osteoporosis, even a low-impact fall can result in a serious hip, back or wrist injury.
An estimated one in three women over 50 will experience a fracture due to bone loss in their lifetime.
The study found that heart health may affect fracture risk after menopause, with women at a higher risk of cardiovascular disease more likely to experience hip and other major bone fractures.
The association between cardiovascular disease risk and fractures was also stronger in women under 65, compared with women aged 65 and older.
In the study, published in The Lancet Regional Health – Americas, researchers used the American Heart Association’s recently developed PREVENT score to estimate a patient’s 10-year risk of cardiovascular disease. Women in the study were grouped as low, borderline, intermediate or high risk.
The strongest link was seen with hip fractures. Women in the high cardiovascular risk group had a 93 per cent higher risk of hip fracture than women in the low-risk group.
Women in the intermediate-risk group had a 33 per cent higher risk.
Higher cardiovascular risk was also linked to a greater risk of fractures in weakened bones in major areas such as the hip, spine, forearm or shoulder.
The findings could indicate that the PREVENT score, developed by the AHA in 2024, may be a valuable tool in identifying patients who could benefit from a bone density screening or referral to a bone health specialist.
Given the prevalence of both conditions and the economic burden they impose, reducing risk for both could improve the lives of older adults.
“While previous studies have suggested a link between cardiovascular disease and fracture risk, we were surprised by the magnitude associated with hip fracture risk,” said lead author Rafeka Hossain, a researcher with the Tulane University School of Medicine. “
Both of these conditions are prevalent and costly, and reducing risk for both could improve the lives of older adults.”
The study included data from more than 21,000 women in the Women’s Health Initiative, one of the largest national women’s health studies.
The findings add to growing evidence that heart health and bone health are closely connected.
Researchers say several biological processes may help explain the link, including chronic inflammation, oxidative stress, changes in calcium regulation and reduced blood flow to bone caused by atherosclerosis.
Hormonal changes after menopause, especially declining oestrogen levels, may also raise the risk of both heart disease and bone loss at the same time.
“Many of the same factors that protect your heart, regular physical activity, a balanced diet rich in calcium and vitamin D, not smoking and managing conditions like diabetes and high blood pressure, also help protect your bones,” Hossain said.
“If you’ve been told you have intermediate or high cardiovascular risk, particularly if you are a postmenopausal woman, it may be worthwhile to talk to your doctor about bone health screening, given the many effective treatments available that reduce fracture risk.”
The study found that women in the high-risk group tended to experience fractures sooner than women in the low-risk group.
For hip fractures, the median time to fracture was 15 years in the high-risk group versus nearly 20 years in the low-risk group.
The researchers caution that more work is needed before cardiovascular risk scores are added to standard fracture screening tools.
But they say the findings suggest that women with intermediate or high cardiovascular risk may want to talk with their doctors about bone health, especially after menopause.
“Taking care of your heart and bones should go hand in hand,” Hossain said.
Apple announced menopause and perimenopause tracking for its Health app at WWDC 2026, with symptom logging and cycle alerts for some users.
The update expands the app’s cycle tracking beyond fertility and menstrual periods.
If logged cycle patterns suggest a user may be experiencing perimenopause, the app will send a notification prompting a conversation with a doctor.
However, this perimenopause-specific cycle deviation notification is only for users aged 40 and over and is not intended to replace a doctor’s diagnosis or treatment.
Stacey Ford, Apple’s vice-president of OS management, said users will also be able to log menopause and perimenopause symptoms in the Health app.
Educational content will also be available to help users learn more about these life stages and understand changes in their bodies.
Every year, about 2 million women enter perimenopause, the stage before menopause when levels of the hormone oestrogen decline.
According to a February 2025 survey involving 4,432 participants aged over 30, more than half of women aged 30 to 35 experienced moderate or severe perimenopause symptoms.
The findings suggest perimenopause does not affect only older adults.
About 6,000 women in the US enter menopause every day, according to the Society for Women’s Health Research.
Given the number of women affected by perimenopause and menopause, the update broadens the Health app’s scope.
The app launched in 2019, meaning it has gone seven years without these women’s health tracking features, which could help users better understand their bodies and prepare for informed conversations with doctors.
A new free menopause toolkit has been launched to help UK employers respond better to menopause at work, improve wellbeing and retain experienced staff.
Wellbeing of Women has launched MENO-Kit in partnership with Lancaster University, which it describes as the UK’s first evidence-based menopause workplace toolkit.
The online resource translates more than a decade of academic research into practical guidance for employers.
It is designed for managers, human resources and occupational health teams, equality, diversity and inclusion leads, trade unions and employees.
Its four modules cover menopause awareness, symptom management, menopause champion training and cognitive behavioural strategies.
These are techniques that help people spot and change thought or behaviour patterns that can make symptoms harder to manage.
Amanda Griffiths, emeritus professor of occupational health psychology at the University of Nottingham, said: “I am so pleased the Wellbeing of Women’s toolkit is now available.
“It presents the culmination of many years’ research by Claire Hardy, Myra Hunter and myself at our three universities.
“It’s a clear story: women represent nearly half the working population and menopause is a normal event in their lives.
“Those who experience difficulties appreciate understanding and support. And it’s not difficult to provide.
“I really hope that the next generation of working women, their colleagues and their managers will find the toolkit helpful.”
MENO-Kit was informed by research studies conducted by Lancaster University, the University of Nottingham and King’s College London.
This included the UK’s first large-scale study of women’s experience of menopause at work, carried out at the University of Nottingham, which identified fatigue, poor concentration, low mood and hot flushes as symptoms affecting working life.
It also highlighted the kinds of employer support working women said they would find helpful.
The toolkit has been tested in eight UK organisations across the public, private and charity sectors.
A total of 2,162 people, mostly women in their mid-40s and 50s, contributed across the studies.
The launch comes at a time of growing urgency for employers.
Research from McKinsey & Company highlights the economic opportunity of closing the women’s health gap, estimating it could unlock up to £11bn a year for the UK economy.
The NHS Confederation has also highlighted the economic case for investing in women’s health, linking better support to improved workforce retention and reduced pressure on employers and public services.
Alongside this, research has continued to show the impact of menopause at work.
Separate polling by Benenden Health found that 28 per cent of women had considered leaving work because of symptoms, while 31 per cent reported reduced productivity.
MENO-Kit has been developed to help organisations respond with practical, evidence-based tools that build confidence, reduce stigma, improve wellbeing and help retain experienced staff.
The launch is being marked by an online event featuring a keynote from the Rt Hon Dame Diana Johnson, minister of state for employment, a live demonstration of MENO-Kit by Dr Abigail Morris, and a discussion on practical approaches to creating menopause-supportive workplaces.
Janet Lindsay, chief executive at Wellbeing of Women, said: “Too many women still struggle in silence during menopause at work, with many employers lacking the tools to respond effectively.
“MENO-Kit addresses this gap, offering practical, evidence-based ways for organisations to better support their people.
“It helps women stay working, thrive, and realise their potential at work.
“We’re hugely grateful to the research teams whose expertise has made this possible.”
Dr Abigail Morris, lecturer in workplace health and wellbeing at Lancaster University, said: “We’re delighted to launch Meno-Kit which represents an important step forward in supporting organisations across the UK to take a proactive and informed approach to menopause in the workplace.
“By providing practical tools, evidence-based guidance and a structured framework for action, the resource will help organisations develop effective menopause action plans, foster more inclusive and supportive workplace cultures, and better support women experiencing menopause to remain healthy, engaged and thriving at work.
“We believe Meno-Kit has the potential to drive meaningful organisational change while improving the everyday working lives and wellbeing of women across the UK workforce.”
Davina McCall, Wellbeing of Women ambassador, said: “Menopause shouldn’t be something women hide or struggle with alone at work or anywhere.
“It’s a normal life stage, not a personal failing.
“By talking about menopause openly and putting the right support in place, workplaces can make a huge difference to women’s wellbeing, confidence and careers enabling them to thrive at work.”
Women with primary infertility may face a higher risk of early menopause and reach it about a year earlier, a study suggests.
The findings suggest women with primary infertility may be more likely to enter menopause before the age of 45.
The increased risk appeared most notable among women with unexplained infertility or a history of endometriosis.
Dr Stephanie Faubion, medical director for The Menopause Society, said: “This study shows that women with primary infertility, specifically those with unexplained infertility or a history of endometriosis, were at risk for early menopause.
“Given that early menopause is linked to adverse long-term health consequences, these women may benefit from counselling that they are at risk of early menopause.
“This will allow them to monitor for early menopause and to seek treatment with hormone therapy, if indicated.”
Early menopause is usually defined as menopause before age 45, while premature menopause is menopause before age 40.
Women who experience menopause earlier may face symptoms for longer and have a higher risk of long-term health problems.
These can include cardiovascular disease, osteoporosis and neurocognitive disorders. Osteoporosis weakens bones, while neurocognitive disorders affect memory, thinking or brain function.
The study, highlighted by The Menopause Society, involved nearly 700 people, roughly half of whom had been diagnosed with primary infertility.
It found that women with a history of primary infertility underwent natural menopause about one year earlier than those without such a history.
Researchers found no association between infertility and premature menopause.
Infertility affects around one in six people globally and can have consequences beyond family planning.
Previous research has linked infertility with higher rates of cancer and cardiovascular disease, although causes vary and may involve genetic, hormonal, in-utero or lifestyle factors.
In-utero factors are influences that occur while a baby is developing in the womb.
Earlier studies looking at links between infertility and early or premature menopause have produced mixed results, with some not accounting for different types of infertility.
The new study suggested that women with unexplained infertility or a history of endometriosis may have an increased risk of early menopause.
Endometriosis is a condition where tissue similar to the lining of the womb grows elsewhere in the body. It can cause pain, heavy periods and fertility problems.
Known risk factors for early or premature menopause include tobacco use, low body mass index, not having given birth and starting periods at a younger age.
Women who have had more childbirths and those with a history of oral contraceptive use have previously been linked to later menopause.
The researchers said women with primary infertility may benefit from additional counselling because of the systemic and long-term health effects of early menopause.
They also said women should be encouraged to seek evaluation and treatment if they experience a new loss of menstrual cycles.
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