By Rachel Kramer, MD, FACOG, OB/GYN—Virtua OB/GYN

Most women will go through menopause, experiencing symptoms like hot flashes and trouble sleeping that come with it. However, you can do a few things in your 20s, 30s, and 40s to prepare your body for the changes and ease your transition into this next phase. 

What is menopause?

Menopause occurs when a woman stops having her monthly period because her ovaries are no longer making eggs. You’re officially in menopause if you haven’t had your period for a year. 

Although women often experience natural menopause between ages 40 to 60, the average age for menopause is 51.5 years. If a woman has her ovaries surgically removed, she’ll experience “sudden” menopause after the procedure. 

There’s no way to tell precisely when natural menopause will occur. However, the age at which close female family members like your mother or sister experienced menopause can sometimes predict when it will happen for you. There are three stages of natural menopause: 

Perimenopause. Perimenopause typically begins two to eight years before menopause and lasts until your ovaries no longer release eggs. During this time, your ovaries may not release eggs regularly, gradually producing less estrogen. Changes in your estrogen levels may cause symptoms including: 

• Hot flashes
• Irregular periods
• Mood changes
• Night sweats
• Periods that are heavier or lighter than normal
• Trouble sleeping
• Vaginal dryness or painful intercourse 

Menopause. Menopause occurs when you haven’t gotten your monthly period for 12 months. This signals the end of your reproductive years. Your ovaries are no longer producing eggs and have stopped most of their estrogen production.

Postmenopause. Postmenopause refers to the years after menopause. Symptoms that are common during perimenopause and menopause should improve. However, postmenopausal women are more likely to develop conditions such as osteoporosis and heart disease due to lower estrogen levels. 

How you can prepare for menopause

Women who are healthy when they go into menopause stay healthy, generally. Here are a few things you can do in your 20s, 30s, and early 40s to take good care of your body and lower your chance of experiencing bothersome symptoms or medical issues during and after menopause. 

Eat healthy foods. A diet rich in fruits, vegetables, whole grains, and lean proteins can help you avoid excess weight gain. Also, eating foods with calcium and vitamin D can help you build strong bones and lower your risk of osteoporosis. Foods with anti-inflammatory benefits, such as blueberries, beets, green leafy vegetables, and wild salmon, can help reduce your risk of heart disease. To maintain a healthy weight, you should log the foods you eat using a calorie tracker, plan your meals, and aim to eat around 1,500 calories a day.

Exercise. Strive for 30 minutes of moderate-intensity activity every day. Women in their 50s should aim for a target heart rate of 130-140, and younger women should aim for a target heart rate in the 140-150 range. Doing weight-bearing exercises that require your skeleton to support your body weight—such as walking, running, and dancing—can lower your risk of osteoporosis.

Maintain a healthy weight. Research shows that women who are overweight experience more severe menopause symptoms. Although many women believe that hormonal changes in menopause lead to weight gain, the fact is that significant weight gain usually is related to lifestyle, genetics, and diet. Adopting healthy habits before menopause can prevent you from gaining more weight and lower your risk of developing chronic conditions.

Don’t smoke. In addition to putting you at a higher risk for serious health conditions such as lung cancer and heart disease, smoking also can lead to early menopause.

How are menopause symptoms treated?

Menopause treatment depends on the stage you’re in and the symptoms you’re experiencing. Before beginning menopause treatment, your doctor may want to perform tests to rule out thyroid problems, reproductive cancers, or other health conditions. 

Perimenopause treatments
If you’re in perimenopause, your doctor may recommend taking birth control pills containing estrogen to regulate the hormone levels in your body. Abnormal bleeding—having a period lasting longer than seven days or occurring less than 21 days after the start of your last period—sometimes is treated with progesterone birth control pills or an intrauterine device (IUD), both of which thin the lining of your uterus. 

You still ovulate during perimenopause, so you can become pregnant. Using a form of hormonal birth control also helps you prevent unwanted pregnancy. 

Menopause and postmenopause treatments
If you’re in menopause or postmenopause and experiencing bothersome symptoms, hormone replacement therapy may be an option for you. There are a few types of hormone replacement therapy: 

Estrogen-only. Estrogen-only hormone replacement therapy is used to treat hot flashes and night sweats if you’ve had a hysterectomy (surgical removal of the uterus). It comes in pills and patches, as well as skin creams, sprays, and gels. Vaginal estrogen comes as a cream, vaginal ring, or a vaginal tablet to treat vaginal dryness and pain during intercourse.

Research shows that estrogen-only hormone replacement therapy doesn’t increase your risk of developing breast cancer, but it may raise your risk of developing blood clots that can cause deep vein thrombosis (DVT) or stroke. Using an estrogen patch that delivers medication through your skin is shown to lower your risk of blood clots. 

Progesterone and estrogen. Progesterone and estrogen hormone replacement therapy, also called combination therapy, is used to treat women who haven’t had a hysterectomy and still have their uterus. Combination therapy is usually given in patch form, but it’s also available as a pill or IUD.

Using combination hormone therapy for five years or longer slightly increases your risk of developing breast cancer. Still, it’s shown to lower your risk of endometrial cancer, which occurs in the lining of your uterus. 

Bioidentical hormone replacement therapy (BHRT). With BHRT, an individualized amount of bioidentical hormones is delivered through a pellet placed under the skin. These hormones, derived from plant-based compounds identically matching human hormones, are released into the body as the body needs them to achieve a proper hormonal balance. BHRT is helpful in managing symptoms like hot flashes, night sweats, insomnia, irritability, worsening memory, and lack of mental clarity, and a decreased or absent sex drive. 

There also are several non-hormonal methods of treating menopause symptoms. Paxil, an antidepressant medication, has been approved by the U.S. Food and Drug Administration to treat menopause symptoms. Based on your symptoms, risk factors, and personal preferences, your doctor will recommend the menopause treatment that’s right for you. 

Get information about menopause treatment or call 844-896-6367 to find an OB/GYN near you.