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18 Things Every Woman Should Know About Menopause

In Your 40s: What's Happening to Me?

One of the first signs of perimenopause—a stage before menopause that can last up to 10 years—are changes in your menstrual cycle. Periods may become irregular, heavier or lighter, or you may skip some altogether. Fluctuations in progesterone and estrogen levels, as well as changes related to aging, contribute to different perimenopausal symptoms.

To-Do List

Know the Signs. Worried that you find yourself welling up during ASPCA commercials or staring at the ceiling unable to sleep at night? Both insomnia and mood swings are signs of perimenopause. Joint pain, heart palpitations and forgetfulness are also on the list. "Many women are frightened that these symptoms mean something's seriously wrong," says Dr. Dweck. "They have no idea why they're feeling this way." Overcome the fear and ease symptoms with lifestyle modifications.

1. Hot Flashes

One minute you're on fire (off with the sweater!), the next you're freezing (on with the sweater!). Spicy foods, caffeine, hot drinks, alcohol and stress (like that fight you keeping having with your teenage daughter) are all common triggers. Try to avoid them.

2. Increased Anxiety

Life changes (kid switching schools, moving to a new town) along with hormonal fluctuations are major sources of stress. Tap into om mode with relaxation techniques or exercise for frazzled moments. A recent study found that middle-aged women who engaged in 50 minutes of aerobic exercise four times per week for six months experienced reduced night sweats, fewer mood swings and less irritability compared with those who didn't. Plus, moderate exercise reduces levels of the stress chemicals cortisol and adrenaline.

3. Joint Pain

Although the cause is unclear, about 40% of women approaching menopause experience aching joints. "Ease the pain by taking omega-3 fish oil supplements with 500 to 1,000 mg of DHA and EPA [combined], which help reduce inflammation," explains Susan Dopart, M.S., R.D., author of A Recipe for Life by the Doctor's Dietitian (SGJ Publishing).

4. Sleepless Nights

About 60% of women report disturbed zzz's during perimenopause thanks in part to the decline of sleep-promoting progesterone (not to mention waiting up for your kids to make curfew). Good sleep hygiene is critical. Establish soothing bedtime habits: Take a bath, sip chamomile tea, turn off the TV one to two hours before bed. And for short-term use, consider OTC meds like Tylenol PM (drugstore.com, $5) or Benadryl (drugstore.com, $5), suggests Manhattan-based ob-gyn Tara Allmen, M.D., a nationally certified menopause practitioner.

5. Decreased Sex Drive

Lower levels of estrogen cause those "not tonight, honey" moments, notes Dr. Landa. Plus, changes in your body can further decrease sexual desire, as can stress and lack of sleep. Communicating with your spouse about your emotional and physical needs (like incorporating more foreplay to feel aroused) is key.

Rx Relief

Talk to your ob/gyn about these two prescriptions, which can ease symptoms:

  1. Low-Dose Birth Control Pills: They're good for regulating hormones if you're a nonsmoker. "You can take active pills the entire month and skip the placebos. Most women can stay on them until they reach menopause, which a blood test can determine," says Dr. Allmen.
  2. Lysteda: Many people think periods dwindle to a trickle as you age. Not true. "In reality, many women find they get heavier, which contributes to anemia," says menopause expert Donnica Moore, M.D. She prescribes Lysteda, a medication to treat heavy menstrual bleeding.

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