12 Steps to Prepare To Thrive in the Perimenopausal Transition
If you are in your 20’s, 30’s, or 40’s, read this. You may spend 50% of your life in menopause (if you are lucky), so commit yourself NOW to setting yourself up to thrive during those years. Studies show that many older people are happier than they’ve ever been and that those who feel optimistic about old age live longer and healthier lives. So rather than dread the menopausal years, find out what to do now so they will be awesome!
Here are some basic guidelines to think about:
1. Track your periods (on your phone, with an app, or on paper). This will be helpful for you and your medical provider to evaluate your bleeding pattern and to know when you are officially menopausal and whether there are any “red flags” in the pattern (such as vaginal bleeding after the 1-year menopausal mark).
2. Good nutrition is critical for all your body’s functions, especially hormone production and function. Eating healthy food and maintaining a healthy weight during all of adulthood will set you up for healthy aging.
3. Fiber aids in the elimination of excess hormones (estrogen) and supports a healthy microbiome.
4. A healthy gut microbiome is also essential to process and eliminate excess hormones. Probiotics may be needed if you have any disruption or have taken medication like NSAIDs, antibiotics, birth control pills, or PPIs for reflux.
5. While we should try to obtain most of the important nutrients through our diet, there are some basic supplements that a woman might want to consider during this time: a multivitamin, vitamin D if testing shows it is low, omega-3 fatty acids (from fish oil or algae), and magnesium (especially good for sleep and mood support).
6. Sleep is so important for all our body’s functions including regulation of hormones, but lots of women have sleep challenges. This is a good time to focus on learning what your body needs to optimize your sleep. We’ll tackle this in a future blog.
7. Stress management is critical since cortisol affects sleep, insulin resistance, and hormone levels. These are years when women are extra busy with work, young children, and aging parents. There’s no way to avoid stress, but there are lots of ways to find daily joy and relaxation, even in small doses. Spend some time thinking about what strategies you can incorporate into your life. This is not just for a limited time only. . . it is forever!
8. Exercise: women find that after menopause, it is common to gain weight and for that weight to accumulate around their waist (and this means around their important internal organs too). Both resistance training (to build muscle) and cardio for heart health are important during this time. Higher protein intake is needed to maintain muscle mass.
9. A sense of purpose, a reason to get out of bed in the morning has been shown to add years to your life. Many women make changes during perimenopause and menopause so that their work is more aligned with their passions and their life purpose, or they volunteer and find ways to contribute in other ways to the larger community.
10. Screening: staying up to date on health screenings will help ensure that any problems are caught early when they are so much easier to remedy. Make a plan with your healthcare provider based on current guidelines and your medical history and family history.
Pap smears: continue to have pap tests at least every 5 years after age 30 (more frequently if you have had abnormal paps in the past). Talk to your healthcare provider about when you will plan to stop screening.
Colonoscopy: guidelines now recommend an initial colonoscopy at age 45, and follow-up will depend on the results.
Mammogram guidelines differ so discuss them with your medical provider.
Bone Density Scan: usually first done at 65 but may be done earlier if a woman has specific risk factors.
Uterine and Ovarian Cancer: there are no commonly used screenings for these cancers, so know the symptoms and report them to your medical provider. The symptoms are so common that they are often overlooked: abnormal bleeding (need to rule out endometrial and uterine cancer) or bloating, pelvic pain, back pain, change in bowel habits, urinary frequency, fatigue, and weight loss, (need to rule out ovarian cancer).
11. Labs: regular screening should be done for diabetes, thyroid function, and cholesterol (talk to your medical provider about your risk factors, when to begin screening, and how often to screen). Many women have anemia and low vitamin D, so checking for those is important, and two markers for inflammation can be helpful: hsCRP (high-sensitivity C-reactive protein) and ESR (erythrocyte sedimentation rate).
12. Foster a social circle that is supportive and fun. While we need to interact with all types of people in our lives, we can build and nurture a community of those who feed our souls and appreciate us in our wholeness (both our strengths and challenges). This is a kind of wealth that money can’t buy!
Much of the advice above may seem pretty obvious to you, but many of us who recently passed through perimenopause got NO advice or even acknowledgment from our medical providers that perimenopause was happening! The medical visit is short and “to the point.” There may be medical history to review, a physical exam or pap to complete, lab work, and a mammogram to order. This pretty much gets us to the end of the 15-20 minute appointment, doesn’t it?
I always bring a little notebook (or at least a post-it) to my medical appointments to make sure that I ask all my questions and don’t get swept up in the rush and forget what was on my mind. And here’s the thing. . . I never, ever brought up anything about perimenopause or menopause with my medical providers, and they never asked! As I think back now (baffled about my reticence to communicate about my own health), I think perhaps the reason I never brought up any questions or concerns about this important aspect of my life was that I hesitated to take the clinician’s time discussing minor symptoms when they were obviously so busy. I didn’t want to be “a bother.”
Well, I just want to point out here that YOU are NOT a bother; you are the whole reason we (the medical providers) are here. So don’t be afraid to take up space and ask your questions!
About The Author
I’m a Certified Nurse-Midwife with a passion for supporting women through all of life’s major transitions — with a focus now on midlife, perimenopause & menopause. I blend down-to-earth women’s wisdom with evidence-based solutions to common concerns. I’m certified by the Menopause Society and trained in integrative and functional medicine so that I can offer a wide range of information, support, and guidance to women during this critical time in their lives.