Menopause gets painted with a pretty dirty brush. Hot flushes, mood changes, vaginal dryness, weight gain, pelvic floor dysfunction and incontinence, joint pain, muscle weakness, sleep disturbance, loss of libido. So what to do? Is there a safe path through the mess that can be perimenopause?

Menopause has a known and generally negative impact on overall muscle and bone health. It is associated with osteoporosis (bones become weaker and brittle), osteoarthritis (degeneration of joints leading to pain, inflammation and stiffness) and sarcopenia (think muscle wasting or thinning and loss of muscle function. Sarcopenia can happen regardless of your weight or size too. All of these issues are contributed to by the primary driver of menopause – loss of the hormone oestrogen. Poor musculoskeletal health can progress to frailty and an increased risk of falls and fractures which in turn is associated with increased risk of death and other disease.

It is now well accepted that ageing, genetic, medical and lifestyle factors all contribute to the risk of dementia in our population. Whilst some people are more at risk than others, everyone has the ability to ensure their long term physical and mental health.

It is reported that around a third of dementia cases can be linked to risk factors such as physical inactivity, smoking, and high blood pressure. All of these factors can be avoided if you take responsibility for your health and wellbeing.

The best type of exercise to prevent bone loss? Short Answer: A combination of progressive resistance training, weight-bearing exercises and balance/mobility training. To improve or maintain bone health, exercise is integral to slowing this decline! Activities that create a ‘loading’ effect on the bone stimulate extra deposits of calcium and nudge bone-forming cells into action. Relatively few loading cycles or repetitions are needed - short bouts separated by periods of rest are most effective. The result is stronger and denser bones!

Along with managing lots of other lifestyle factors, exercise should form a part of your ongoing treatment when you leave hospital. Most people will hopefully begin a cardiac rehabilitation program before or soon after leaving hospital.

It is important to talk to your doctor or cardiac rehabilitation team about when you can start different activities again and how to pace your program.

If you have a heart condition it is always important to consult your Cardiologist or General Practitioner before undertaking a new physical activity routine. The important thing to remember is that any physical activity is generally better than none and in most circumstances it is more beneficial to remain physically active than not.

If you have had medical advice regarding your capacity to be active that should provide a good guide about what you can be working toward. You may need some specialist advice to accommodate your individual requirements and your GP or cardiologist may advise you to see an Exercise Physiologist or a Physiotherapist.

The Heart Foundation of Australia (www.heartfoundation.org.au) website provides information on the benefits and general guidelines of physical activity for your heart and overall health.