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During perimenopause, your hormone levels start to fluctuate. Not only can this mess with your periods, but it may also cause other symptoms—both physical and emotional. Because we’re all unique, this effect varies from person to person; symptoms can be mild for some or severe for others. (And just how long menopause symptoms last is an individual thing, too, with average estimates ranging from two to 14 years.)
“These changes might be inevitable, but suffering through them is not,” says Mary Claire Haver, MD, a board-certified OB/GYN, founder of The ‘Pause Life, and creator of The Galveston Diet, an anti-inflammatory nutrition program designed for those in perimenopause, menopause, and beyond. “It is critical that women understand what might happen, so that they are prepared,” she adds.
By educating yourself early on (like, way before perimenopause symptoms start and your periods stop), you’ll be ready to have meaningful discussions with your doctor about menopause. Here are a few simple steps you can take in your 30s to make the menopausal transition go more smoothly in your 40s and 50s.
1. Get enough calcium
“Bone loss accelerates through the menopause transition, and low dietary calcium can contribute,” says Dr. Haver. But odds are, bone loss isn’t top of mind in your 30s. Turns out, though, this decade is a critical time for bone health. “Our 30s is the last chance to ‘max out’ our bone density before the aging and menopause processes start leading to bone loss over time,” she says.
For healthy bones today and tomorrow, aim for 1,000 milligrams of calcium per day, which is the recommended dietary allowance (RDA) for women between the ages of 19 to 50, according to the National Institutes of Health (NIH).
While 1,000 milligrams sounds like a lot, you can totally hit your daily target by eating a variety of calcium-rich foods. Think: yogurt, milk, cheese, and kefir. And if you’re not a dairy fan? Canned sardines, salmon (with bones), and greens such as kale, broccoli, and bok choy have a lot of calcium too, per the NIH. You could even try making a kale smoothie or stir fry with bok choy and broccoli as delicious ways to increase your levels.
Also keep in mind, calcium supplements aren’t a great solution. “Studies show that calcium supplements do not decrease the risk of osteoporotic fracture,” says Dr. Haver. Unfortunately, they “increase the risk of atherosclerosis and kidney stones,” she adds.
In other words, talk to your doctor or a registered dietitian before trying a calcium supplement; they can offer other suggestions for upping your intake.
2. Prioritize your heart health
“The risk of heart disease increases during menopause, independent of age,” says Dr. Haver. Why? Because estrogen has a protective effect on heart health, and during menopause your body produces less of it, according to a December 2022 paper in the Archives of Medical Science.
Some people may also gain more belly fat in menopause, which raises your risk for chronic conditions like high blood pressure, high cholesterol, high blood sugar, and ultimately, metabolic syndrome and heart disease, per the American Heart Association (AHA).
All this to say, prioritizing your heart health is crucial, and creating heart-healthy habits in your 30s is a smart strategy. “Cardiovascular exercise, resistance training, and eating a protein- and fiber-rich, anti-inflammatory diet is key,” says Dr. Haver.
Getting enough quality sleep and managing stress are also a pivotal part of the equation if you want to keep your ticker in tip-top shape.
3. Fill up on fiber
You probably know that fiber is good for gut health (it feeds good bacteria and helps you poop regularly). But getting enough of this nutrient can also help protect you against metabolic problems during menopause. Menopause is a risk factor for developing diseases like type 2 diabetes and metabolic syndrome, per the NIH.
Again, lower estrogen levels and increased belly fat are at play. Visceral fat—the kind that accumulates in your abdominal area—increases insulin resistance, which can lead to elevated insulin levels, abnormal glucose metabolism, and a reduction in fat breakdown, according to the University of Rochester Medical Center.
That’s where fiber comes in. “Fiber decreases the rate of absorption of sugars into our bloodstream, thus lowering insulin levels,” says Dr. Haver. “Women need 25 grams or more per day for optimum gut health (though most are only getting about 12 grams per day),” she adds.
Don’t wait until menopause to start piling fiber-rich foods on your plate. You can add things like fruits, veggies, whole grains, and legumes, which are all full of fiber. Plus, they’re also “packed with vitamins, minerals, and [other] nutrients,” says Dr. Haver.
4. Focus on strength training
Hands down, lifting weights is one of the best things you can do for your body to prepare for menopause (and healthy aging in general). As we get older, we lose muscle and strength—a process known as sarcopenia. Once you turn 30, sarcopenia speeds up (you lose up to 5 percent of muscle per decade), according to Harvard Health Publishing. Making matters worse, going through menopause accelerates muscle mass loss, says Dr. Haver.
While you can’t turn back the hands of time, you can minimize muscle loss through strength training. “Muscle is the organ of longevity,” says Dr. Haver. Maintaining muscle with exercise helps preserve bone density, reduces the risk of osteoporosis, and protects against insulin resistance.
Rest assured, you don’t need to pump iron all day long for the muscle-building benefits. Aim to get about 150 minutes of moderate-intensity exercise with at least two days of resistance training per week, according to the current Physical Activity Guidelines for Americans.
Here’s how to start strength training, along with a 20-minute beginner strength workout.
5. Track your mental health
Sure, you’d expect hot flashes during menopause. But feeling low or even depressed? Not as much.
Turns out, “as our sex hormones decline in the menopause transition, so can our mental health,” says Dr. Haver. In fact, you’re two to three times more likely to have depression during perimenopause, according to the NIH. People with a history of mental health issues might be even more vulnerable because fluctuating hormones make it harder to handle stress, per Scripps Health.
This is why “it’s important to be aware of this possibility and be vigilant to any changes,” says Dr. Haver. You can do this by journaling your thoughts/feelings every day, meditating or incorporating a mindfulness practice, or even opening up to people you trust. And if you’re already feeling low and it’s disrupting your daily life, reach out to your doctor or a therapist. They can help you create a plan to take care of your mental health through this transition.
Once menopause comes around, hormone therapy (which is used to treat physical menopause symptoms) may also help your mental health. It “prevents dips in estrogen, and has been shown to decrease the risk of new onset or worsening mental health in menopause,” says Dr. Haver.
Ask your doctor if estrogen therapy is right for you. It may be beneficial for some, but for others, it can slightly increase your risk of developing breast cancer, heart disease, stroke, blood clots, and/or dementia, according to NAMS.
6. Start searching for a provider who’s well-versed in menopause
Hate to break it to you, but “not all doctors are created equal” when it comes to menopause care, says Dr. Haver. “Most receive only the barest of education about menopause.” Case in point: A February 2019 survey in Mayo Clinic Proceedings found only about 6.8 percent of family medicine, internal medicine, and OB/GYN residency trainees felt adequately prepared to discuss and treat people in menopause.
This is a major problem for anyone with a uterus, because getting the right treatment can often make or break a person’s menopause journey. The right clinician can help you manage menopause symptoms, demystify the process, and provide individualized care options that work for you.
So how can you find an informed menopause provider? “A good practitioner is hard to find,” says Dr. Haver, but she mentions The Menopause Society (NAMS), an organization with a handy search tool to help you find a certified menopause clinician in your area.
There are also great telemedicine options that offer online personalized care and support for perimenopause and menopause, including Alloy Health, Evernow, and Midi, she adds. Plus, Dr. Haver’s The ‘Pause Life website is another great resource for people in menopause (or heading there).
When to see a doctor about preparing for menopause
Dr. Haver says the best time to see your doctor about menopause symptoms is whenever you start feeling them. And they don’t have to be limited to the cliché hot flashes (that’s a menopause myth)—there are more than 70 identified menopause symptoms. That’s because a loss of estrogen can affect so many aspects of your health.
“There are estrogen receptors in every organ system in our bodies,” says Dr. Haver. This means the menopause transition can involve weight changes, mental health issues, sleep disturbances, musculoskeletal pain, and many other symptoms, she adds.
But with the right preparation, care provider, and lifestyle adjustments in your 30s, menopause symptoms will be much more manageable when they do arrive.
Well+Good articles reference scientific, reliable, recent, robust studies to back up the information we share. You can trust us along your wellness journey.
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Kling, Juliana M et al. “Menopause Management Knowledge in Postgraduate Family Medicine, Internal Medicine, and Obstetrics and Gynecology Residents: A Cross-Sectional Survey.” Mayo Clinic proceedings vol. 94,2 (2019): 242-253. doi:10.1016/j.mayocp.2018.08.033 -
Ryczkowska, Kamila et al. “Menopause and women’s cardiovascular health: is it really an obvious relationship?.” Archives of medical science : AMS vol. 19,2 458-466. 10 Dec. 2022, doi:10.5114/aoms/157308
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