No matter where you are in the menopause transition, it's never too late (or early) to get your health act together to ensure the next 40 or so years are as terrific as or better than the first were. Here are 10 things you can do right now.
1. Choose the right health-care provider
Perimenopause is the perfect time to find a health-care provider you can trust to help you manage any serious medical problems, should they arise in the future. Ask your friends for recommendations or check out the NAMS list of credentialed Menopause Practitioners (www.menopause.org/consumers) to see if one is in your area. Always interview your potential choice before committing to be a patient.
2. Book a physical exam
Have your blood pressure and cholesterol levels checked and ask for a thyroid test. About one-quarter of perimenopausal women develop hypothyroidism, in which thyroid hormone levels drop too low. Symptoms include irregular periods, mood disturbances, low energy levels and sleep disturbances -- quite similar to those of perimenopause. And if you haven't had a mammogram, schedule one today. Then, check with your clinician about how frequently you should have one in the future.
3. Watch your diet
Limiting saturated fats may help curb the gain of five or more pounds that most women experience in midlife. It can also help reduce the menopause-related rise in LDL cholesterol, the "bad" cholesterol known to increase your risk of cardiovascular disease in later years. Be sure your diet includes lots of fatty fish like salmon, which is rich in heart-healthy omega-3 fatty acids (alternative sources of these healthy fats include flax seeds, flax oil and walnuts).
4. Learn your risk of osteoporosis
Your family history, ethnic background, smoking, being underweight and any history of digestive illnesses can increase your chances of developing the brittle-bone disease. Early menopause also increases your risk. Boost your intake of calcium-containing foods, such as dairy products, nuts, leafy greens, blackstrap molasses and fish with edible bones to ensure you're getting enough dietary calcium.
5. Mind your mood
If you were prone to hormonal mood swings during your reproductive years, you may experience them again with the fluctuating levels of estrogen during perimenopause. Pay close attention to your moods, especially if you have experienced depression in the past, including the postpartum variety.
6. Get moving
Not only will you feel better if you exercise, but a regular physical activity routine has been shown to help alleviate depression, curb weight gain, lower heart disease risk, maintain bone health and a provide whole host of other benefits.
7. Limit your alcohol intake
There's some thought that alcohol may affect the liver's ability to process estrogen efficiently, which may be one reason the Harvard Nurses' Health Study found the risk of breast cancer in women who had one or more drinks per day was 60 percent higher than in women who abstained.
8. Stop smoking
And if you don't smoke, don't start. If you smoke, you're going to hit menopause earlier than if you don't. Nicotine has also been shown to increase the frequency and duration of hot flashes. Smoking increases the risk for osteoporosis -- plus lung cancer, cervical cancer, heart disease and diabetes.
9. Continue birth control
While irregular periods signal the impending end of your reproductive life, menopause (and inability to conceive) is not reached until you've been without periods for 12 consecutive months. So unless you're trying to become pregnant, don't throw out your birth control just yet. Hormonal contraceptive use will cause periods to continue, even after menopause, so talk to your health-care provider about when to stop taking "the pill."
10. Manage your stress
Midlife can be stressful, particularly because new stressors often appear at this time. Stress has multiple adverse effects on the body, including an increased risk for heart disease, diabetes and cancer. Stress also can cause a heightened state of alertness that can keep you from getting a good night's sleep, something that's difficult enough during this transitional period.
Jennifer Pirtle writes about health, fitness, nutrition and other lifestyles topics for Self, Health, Lifetime, Martha Stewart Living, Fitness and Cosmopolitan.