What should I be doing to take care of my health throughout the menopause transition? I know hormonal changes can impact other aspects of my health. Is there anything I can do to combat this?
Over the last few years, more people have started paying attention to menopause and the midlife transition that most women experience in their 40s and 50s. This is a welcome change. Women deserve quality care from medical providers who understand menopause’s unique challenges and how to manage its symptoms appropriately.
Midlife is a time of major changes in a woman’s health, but it’s also an opportunity to set yourself up for healthy aging. As an OB/GYN who specializes in caring for women at this crucial time, I talk to my patients a lot about how their lifestyle changes can help protect their health during this transitional time and beyond.
Most women start having symptoms during perimenopause, the years leading up to menopause (when it has been 12 months since your final period). Those symptoms are not just hot flashes and night sweats. Perimenopause can cause new or worsened anxiety, irritability, depression and anger. Sleep disruption is also common and can cause daytime fatigue and worsen mood symptoms. Additional symptoms may include joint pain, frozen shoulder, palpitations (feeling like your heart is racing or pounding), dry or itchy skin, hair loss and vaginal dryness, to name just a few.
But also importantly, perimenopause brings changes to your heart health and metabolic health. During perimenopause, cholesterol often gets worse — your “bad” cholesterol, or LDL, increases while your “good” cholesterol, or HDL, goes down. Weight distribution often changes: Many women may notice they start to gain more fat specifically in their midsection. This, along with other hormonal changes, can lead to an increased risk of Type 2 diabetes.
This means midlife is a critical time that influences a woman’s risk for heart disease, stroke, dementia and cancer for the rest of her life. Of course, we’re all dealt a genetic hand that also factors into whether we end up with these diseases. But there are a few steps you can take to lower your risk and set yourself up for success.
Here’s what I suggest every woman over 50 starts doing to prioritize their health now and into the future.
Eat for metabolic, muscle and bone health
Generally, insulin resistance (the body’s inability to process carbohydrates as efficiently) and Type 2 diabetes risk increase as estrogen levels go down. So it becomes more important to focus on a diet that is high in protein, vegetables and fruits, and limits simple carbohydrates and sugars.
Additionally, women lose not only muscle mass but also bone density as they age. While hormonal changes play a role, so do lifestyle changes that are common in midlife — such as becoming more sedentary and not prioritizing a diet and exercise regimen focused on building a healthy, strong body. Reduced muscle mass can contribute to insulin resistance and make weight gain more likely. Deficits in muscle mass and bone density can lead to frailty and increase the risk of falls and fractures as you age.
Increasing protein intake (along with exercise, which I’ll get to next) can help bolster muscle and bone, and keep you feeling strong and capable. There’s no hard-and-fast rule for how much you need, but nutrition experts typically suggest around 1 gram of protein per kilogram of body weight per day, distributed throughout all your meals and snacks, is a good target. That would be 70 grams of protein for someone who’s 150 pounds.
For bone health, focus on getting adequate calcium (1,000 to 1,200 milligrams) and vitamin D (600 to 800 IU for most adults), ideally through food and sun exposure, every day.
Move, even if it’s for just a few minutes
Our bodies did not evolve for sedentary jobs and evenings in front of a screen, and most adults in 2026 move far less than people did even 100 years ago. That means that we must carve out time for physical activity.
The biggest enemy of regular exercise is time. Many midlife women are juggling full-time careers, raising children and caring for older parents. On a typical day, it feels like a victory to cross off the top three items on the to-do list. If exercise is not in that top three, it’s unlikely to get done.
Finding strategies to incorporate more movement into your regular routine is a good way to get started and add a few minutes of activity here and there. Guidelines recommend getting 150 to 300 minutes of moderate-intensity aerobic activity, like brisk walking, each week. But some movement is always better than nothing. Aim for consistency at first, even if it’s just a 10- or 15-minute walk each day, and then focus on increasing the time you move and even adding in some vigorous activity a few days a week.
Two to three days per week, your daily movement should include weight-bearing exercise, which is essential to maintain bone density and muscle strength. This can include strength training with weights, body weight or resistance bands, but any aerobic activity that includes some impact — such as running, dancing, hiking, tennis and jumping rope — counts, too.
Prioritize sleep
We know from decades of research that inadequate sleep can affect your health in many ways. Namely, it increases the risks of high blood pressure, Type 2 diabetes, heart attacks and stroke. Poor sleep is also associated with higher rates of depression and anxiety, and may even contribute to long-term dementia risk.
Unfortunately, sleep can be elusive for women at midlife. Many women have difficulty falling asleep. Even more common is waking up through the night. This can happen due to night sweats, increased need to urinate, anxiety (ruminating or spiraling thoughts) or simply lighter sleep. And some women find that they wake earlier than needed and cannot go back to sleep.
Of course, sleeping better is certainly not as easy as just deciding you’d like to do it or “trying harder.” Rather, I suggest focusing on taking what small steps you can each day to work toward that goal.
While alcohol may help you fall asleep, it clearly interferes with sleep quality, so reducing or eliminating alcohol can be helpful if you are waking in the night or not feeling rested in the morning. Limiting caffeine is also critical. Ideally, you should stop drinking caffeine about 10 hours before bedtime.
If you are having night sweats or other symptoms that interfere with your sleep, talk to your doctor about treatment options. For some women, starting menopausal hormone therapy can help improve sleep quality. If you snore, you should be screened for sleep apnea, which gets more common in midlife and poses its own health risks.
One of the best medication-free ways to improve your sleep for the long term is cognitive behavioral therapy for insomnia, or CBT-I. This focuses on developing a specific set of tools that help you fall asleep in the evening and fall back asleep if you wake up. I’ve seen it work incredibly well. CBT-I is a specific type of CBT, so you want to be sure to see a provider who is trained for it.
Stay connected — and not to your device
The changes of midlife can feel isolating, especially if you are also navigating the anxiety or depression that may crop up in these years. Thankfully, talking about the challenges of midlife has become normalized (as it should be), so reach out to your friends and family. Sharing your experiences and hearing theirs is validating, builds connection and trust, and reminds you that you are not alone in what you’re feeling.
Connection to others is also protective against dementia in the long term. Research suggests that social connections — having a broad network of friends and staying in regular contact with them — may reduce the risk of Alzheimer’s disease. In contrast, social isolation is associated with a 60 percent increase in Alzheimer’s risk. Isolation also increases depression and anxiety.
So pick up the phone and actually call a friend. Take a walk with a co-worker at lunch — and get some steps in at the same time. Whatever it is, make it a point every day to have some sort of meaningful interaction with another human being.
In perimenopause and menopause, women often feel like they’ve lost control of their bodies. There is no magic bullet — no supplement or peptide or vitamin or potion — that is guaranteed to “fix” that feeling. Instead of lingering on what you can’t control, I suggest taking the reins on what you can control and setting yourself up for a healthy body and mind for the coming decades.
Dana R. Gossett, MD, is a professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, the director of the Center for Sexual Medicine and Menopause at Northwestern Medicine and a Menopause Society Certified Practitioner.
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