Postmenopause shifts metabolic and CV risk substantially. GLP-1 therapy is often well-positioned for postmenopausal patients.
Why postmenopause changes the calculus
CV risk catches up with men's. Bone density loss accelerates without intervention. Sarcopenia risk increases. Visceral adiposity tends to be higher than premenopause.
Bone density
GLP-1 itself appears bone-neutral or modestly favorable in current evidence. The risk comes from any rapid weight loss without resistance training. Bone-loading exercise + adequate protein + calcium + vitamin D is the standard package.
Sarcopenia prevention
Higher priority than in younger patients. Protein target 1.8–2.2 g/kg. Resistance training 2–3×/week with progressive overload.
CV risk reduction opportunity
Postmenopausal women with BMI ≥27 + established CVD may qualify under the Wegovy CV indication. See CVD page.
HRT coordination
GLP-1 and HRT are not in conflict. Coordinate with your menopause specialist for indication, dosing, and monitoring.