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18 Things Every Woman Should Know About Menopause

Hot flashes. Sleepless nights. Weight gain. Intense crabbiness. You don't have to struggle through symptoms. There's actually an art to surviving, even thriving, through the change. Here's what your mother, sister, best friend and doctor never told you.
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Just like booking an Eat-Pray-Love solo trip abroad or visiting a plastic surgeon, bringing up the (formerly) "silent passage" is no longer taboo. Experts and real women revealed all about "second springs" for our by-the-decades survival guide. Read on to find out how to outwit, outplay and outlast the next chapter in your life.

In Your 30s: What's Happening to Me?

"By the time you reach 35, your fertility starts to gradually decline and it may become more challenging to get pregnant," says Alyssa Dweck, M.D., Family Circle Health Advisory Board Member and co-author of V Is for Vagina (Ulysses). Levels of the hormones estrogen and progesterone slowly decrease, as do the number and quality of eggs your ovaries release.

To-Do List

Become Your Healthiest Self. What you do now impacts how early menopause starts, how intense the symptoms are and how they affect your body. "Women who are in better physical shape before menopause are more likely to maintain a reasonable body weight and reduce their risk of disease after the change," says Dr. Dweck. So get into a good-health groove.

1. Bust Stress

Mini meltdowns will be happening. "Devise a go-to stress management technique to help alleviate menopause-related anxiety," advises Jennifer Landa, M.D., chief medical officer of the BodyLogicMD women's and men's health office in Orlando, Florida, and co-author of The Sex Drive Solution for Women (Atlantic). Try tai chi or yoga, or turn to technology by creating a peaceful playlist on your iPod and using sites like calm.com for guided relaxation

2. Drop Pounds

Carrying excess weight worsens menopause symptoms. Since your metabolism slows as you get older, find a physical activity you love now (biking, swimming, hiking) and eat healthfully to slim down and beat the "middle-aged spread."

3. Quit Smoking

Light up and your risk of early menopause rises by about 60%, according to a study in BMC Public Health. Quit at least 10 years before menopause and you'll be 87% less likely than current smokers to enter the change early.

4. Get Strong

Preserve your calorie-torching muscle mass, which decreases as you age, by strength training twice weekly. One big bonus: Resistance exercises also increase bone density to prevent osteoporosis.

5. Boost Nutrition

Phytochemicals, found in broccoli, kale and other cruciferous veggies, help your body keep hormones balanced. Ever-present B vitamins are involved in producing mood-regulating brain chemicals like serotonin. Build a healthy recipe repertoire now.

6. Wear SPF

Sun damage is the number one cause of fine lines and wrinkles, which worsen as estrogen levels drop during menopause, stymieing collagen production. Make wearing a broad-spectrum facial moisturizer with SPF 30 a daily habit.

7. Control Cholesterol

LDL ("bad") cholesterol jumps nearly 10% in the two years surrounding menopause. Eat right and exercise to keep it in a healthy range as you age.

The #1 Test You Need Now

"Have your ob/gyn run a baseline hormone panel, which is an easy blood, saliva or urine test that determines your optimal hormone levels," says Dr. Landa. If you decide to get hormone therapy later, your doc can use your results to put you on hormones specific to your ideal range instead of the range of an average woman.

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