If you're in your 40s or 50s and you've gone a full year without a period, menopause is knocking on your door. Don't worry — it's a great time to fling open that door of opportunity.
While pop culture portrayals of "the change" may worry some women, menopause can be a chance to make a variety of healthy lifestyle changes that improve women's quality of life.
Menopause is a normal, natural part of being a woman that everyone goes through — and it's not a "disorder" or illness.
What's important, then, is keeping a positive attitude about the changes coming and taking action to manage your symptoms and your health.
There are a handful of serious health conditions that menopause increases your risk of experiencing because your body is no longer producing as much estrogen.
These include cardiovascular disease such as heart attack or stroke, osteoporosis (weaker bones), incontinence (it's harder to hold in your urine until you use the bathroom) and weight gain.
But like the symptoms of menopause, the risks of these conditions can be minimized by changing your behaviors and seeking treatment.
Here are nine ways to do exactly that — to take charge of your health as the "change" begins.
1. Know What to Expect
This might seem obvious, but it's important to spend some time actually reading about both the symptoms of menopause and the many ways those symptoms can be managed.
"Menopause" itself is technically the moment your periods have stopped for 12 months, preceded by the "perimenopausal" period during which the symptoms occur. The pre- and post-menopause symptoms could last a couple years or even up to six years or so, but nearly every symptom you have can be treated.
The most common symptoms women experience are hot flashes and night sweats, vaginal dryness, difficulty sleeping, mood swings, thinning hair, headaches, an increase in fat around the abdomen and fatigue.
Sounds delightful, right? But again, there are both behaviors and treatments that can reduce or even eliminate most of these symptoms, and about a third of all women don't experience any of these.
2. Make an Appointment with Your Doctor
The best way to learn and prepare for menopause and the years afterward is to have an open dialogue with your doctor. Most women go to their OB/GYN for menopause, though there are doctors that specialize in menopause. Others may consult their family doctor.
What's important is that you discuss menopause with a doctor you feel comfortable with and who keeps up with the latest developments in treatment, especially regarding hormone replacement therapy (HRT).
When you first notice the symptoms of menopause or your periods have stopped for a year, make an appointment with your doctor and go to the appointment prepared.
Keep track of any symptoms you've been experiencing, and make a list of any medications, vitamins or supplements you currently take. Bring a list of questions you have and a notepad to take notes on what the doctor tells you.
Ask your doctor about the specific symptoms you experience and what you can do to address them. Chances are, your doctor will mention HRT, which is commonly prescribed to treat nearly all of these symptoms.
3. Discuss Hormone Replacement Therapy with Your Doctor
Hormone replacement therapy, or HRT, means taking estrogen or combined estrogen and progesterone to replace what your body is no longer making on its own.
Most of the symptoms of menopause, as well as the health risks that increase, result from your body's decreased production of estrogen. Replacing it can therefore take care of many of them.
According to the Mayo Clinic, as well as vast amounts of research literature, "Estrogen therapy remains, by far, the most effective treatment option for relieving menopausal hot flashes." But it can also reduce other symptoms of menopause.
For all the benefits of HRT, there are also risks, and research continues on HRT. A number of studies have found an increased risk of breast cancer with HRT, which declines after a woman stops taking it.
Similarly, HRT has been linked to increased risks for cardiovascular disease, but there is still debate about this link, especially since women are at a higher risk for heart disease after menopause anyway.
The largest study to date whose findings most medical professionals rely on is the Million Women Study, a long-term study of the differences between women taking HRT and those who aren't. However, even the findings from this study are not etched in stone.
We may find out more soon when the results of another large randomized, controlled trial called the Kronos Early Estrogen Prevention Study (KEEPS) are published soon.
Again, the important take-away here is to discuss HRT and its risks and benefits with your doctor in light of your particular health history. You can also ask about alternatives, but the answers will be different according to each person's health history.
4. Enhance Your Sex Life
No more periods! No more worries about birth control! No more worries about pregnancy! Could there be a better time to have sex?
Well, that depends. While some women report better sex lives after menopause, one symptom of menopause is a decrease in libido. That, paired with the vaginal dryness that can occur, may hamper women's sexual satisfaction.
But there are vaginal creams that can take care of the dryness, and HRT (or even testosterone therapy for a small subset of women for whom it's appropriate) can restore your sex drive.
Then again, so can good old-fashioned romance. Now that periods and pregnancy concerns are behind you, take advantage of this opportunity to enjoy your sex life.
5. Kick Bad Habits
As mentioned above, heart disease risks go up once menopause begins. So this is an excellent time to finally quit any bad habits that might increase your cardiovascular risk or other health risks.
This means smokers should really take this opportunity to quit for good, and heavy drinkers should seriously start cutting back.
In general, menopause is a great time for women to take a step back and consider what unhealthy habits they might change.
6. Protect Your Bones
After menopause, women's bones become weaker and more brittle as they lose bone density. There are a number of things women can do to reduce their risk of osteoporosis, but ignoring it is not one of them.
Talk to your doctor about calcium supplements and about starting an exercise routine if you're not physically active. Women who are physically active are at a lower risk for bone problems.
If you do develop full osteoporosis, your doctor may recommend medications such as bisphosphonates like alendronate (Fosamax), risedronate (Actonel) and ibandronate (Boniva), to reduce bone loss and lower your risk of fractures. Like any medication, these should only be taken if you need treatment for serious loss of bone density, but they are options if that occurs later.
Speaking of physical activity, there's no better time to start a fitness routine if you don't already have one.
Increasing your physical activity is a five-in-one winner: it reduces your heart disease risk, it reduces bone fracture risks from osteoporosis, it reduces the risk of weight gain that can come with menopause, it helps with sleeping problems and it helps you feel better.
Increasing your physical activity doesn't mean you have to join a gym or buy a dozen workout DVDs. Look for activities you already enjoy and beef them up. Take walks with friends or partners, or take up a new low-impact activity like bicycling.
Swimming and aqua aerobics are great activities for post-menopausal women because they decrease the stress on your bones while giving your whole body a low-stress, high-cardio workout.
8. Eat Well
Physical activity alone will not prevent that natural increase in body fat that most women experience as they go through menopause. A healthy diet is key also.
The best thing women can do is to cut back on refined carbohydrates and including processed foods. If you don't eat a lot of vegetables, this a great time to learn some new veggie recipes or become adventurous and try vegetables you're not as familiar with.
The more food you can eat from the periphery of the grocery store — as opposed to the all processed stuff on the shelves in the aisles — the healthier your meals will be. You may also consider reducing your intake of red meat, another possible risk factor for heart disease.
9. Enjoy life!
Again, menopause is not a disease. It's normal, and it's natural. Sure, some parts aren't fun, but like any new chapter in life, most drawbacks are simply opportunities to make positive changes.
If you are experiencing blue moods or full-blown depression — which can occur to up to 10 percent of women at the onset of menopause — talk to your doctor about antidepressants or other treatments.
If you're finding insomnia or other sleep disturbances to be interfering with life, seek treatment for that too. Just because menopause itself is natural doesn't mean you should suffer in silence through some of its effects.
Is there something you've always wanted to try and haven't made time for? Take the time now. Take up gardening. Take up skydiving. Take time to meditate. Take up yoga. Take time to breathe. Take time to enjoy life.