From practically the moment a girl first gets her period, she starts hearing about the day she’ll stop getting it—and all the uncomfortable symptoms that lead up to and surround that time, often referred to as menopause. 

But are all women destined for hot flashes, mood swings, and mid-life breakouts? Not necessarily. With the right lifestyle on your side, you can thrive throughout the changes of menopause—and beyond.

Back Up: What Exactly Is Menopause?

The American College of Obstetricians and Gynecologists (ACOG) defines menopause—which occurs when a woman’s ovaries stop producing hormones—as having no menstrual period for 12 months. 

Most women hit menopause between the ages of 45 and 55. (The average age of menopause in the U.S. is 51.)

The transition phase that leads up to menopause, which can last months or years, is called perimenopause. During this time, the menstrual cycle grows increasingly irregular.

How Menopause Affects Women’s Health

“Going through the menopausal transition is a challenge for all women,” notes Felice Gersh, M.D., O.B.-G.Y.N., and author of PCOS SOS. Though we typically think of menopause as just the end of periods and fertility, it has major effects on women’s health.

Related: 6 Period Symptoms That Warrant A Trip To The Doctor

As the ovaries’ production of estrogen and progesterone tapers off, a number of changes throughout the body occur.

Declining estrogen levels, specifically, affect bones, heart health, and mood—among a bevy of other physiological functions. Reduced levels of progesterone (which is often referred to as the ‘pregnancy hormone’), meanwhile, can trigger uterine bleeding and mood symptoms. 

Changes in other hormones (including cortisol, DHEA, and testosterone) during menopause, can also impacts women’s wellness—both body and mind—around menopause. 

Of course, the changes in these hormones—and symptoms they cause—vary from woman to woman. “The biggest issue I see is patients not knowing what their hormonal levels are,” says Tara Scott, M.D., F.A.C.O.G., F.A.A.F.M., integrative women’s health physician and founder of Revitalize integrative practice. 

“Everyone assumes when they stop their period, they have low estrogen,” she says. However, estrogen-dominant women (who had a high ratio of estrogen to progesterone pre-menopause), may experience different issues come menopause. 

Making Menopause Less Of A Menace

Knowing your hormonal baseline is key to devising an effective game plan for bolstering your wellness during menopause, Scott says.    

In addition to finding targeted therapies suited to your individual hormonal picture, a few general lifestyle factors can help women dealing with menopause optimize their health.

1. Eat Phytoestrogens

Phytoestrogens, compounds found in certain plant foods that bind to estrogen receptors, may offer positive health effects for menopausal women. 

Found in legumes, soybeans, beans, nuts, flax seeds, and sesame seeds, phytoestrogens have been linked to reduced risk of breast cancer, osteoporosis, high blood pressure, and heart disease. 

Bumping up phytoestrogen intake during menopause has been shown to reduce hot flashes and support bones, muscles, and gut health, Gersh says.

Gersh recommends menopausal women incorporate three to four ounces of organic whole soy (tempe, edamame, tofu, or miso) and two tablespoons of ground flax into their diet per day. 

That said, if lab work reveals you’re in that ‘estrogen dominant’ camp, don’t lean too hard into this lifestyle move, warns Scott.

2. Do More Resistance Training

Estrogen and testosterone—among other hormones—both support muscular health, say Gersh. When their production declines at menopause, muscles and bones can suffer.

That’s why experts recommend resistance training. “Resistance exercise is helpful in stimulating bone formation and reducing the chance of osteoporosis,” explains Michael Tahery, M.D., a Los Angeles-based OB/GYN. “It also increases muscle mass, which increases metabolism and helps with balance.”

The 2018 Physical Activity Guidelines for Americans, published by the U.S. Department of Health and Human Services, includes the following recommendation: “Adults should also do muscle-strengthening activities of moderate or greater intensity that involve all major muscle groups on two or more days a week, as these activities provide additional health benefits. As part of their weekly physical activity, older adults should do multi-component physical activity that includes balance training, as well as aerobic and muscle-strengthening activities.”

The takeaway: For better bones, pencil in at least two strength-training workouts per week. 

3. Get Enough Quality Sleep

Estrogen is a major regulator of your circadian rhythm, explains Gersh. When estrogen dips at menopause, you might feel like you’re constantly jet lagged. 

The fix: Invest in your sleep hygiene and focus on getting a “deep, restorative sleep without frequent awakenings,” says Mary Clifton, M.D., national speaker on women’s health and osteoporosis. Not only will you wake up feeling more refreshed, but will likely experience fewer hot flashes.

Ways to bolster sleep hygiene, according to the National Sleep Foundation:

• limiting daytime naps to 30 minutes
• avoiding stimulants
• exercising
• steering clear of foods that might be disruptive before bedtime (anything heavy, rich, or acidic)
• ensuring adequate exposure to natural light
• establishing a regular, relaxing bedtime routine
• keeping your sleep environment between 60 and 67 degrees

Clifton recommends using an app (like SleepScore, which provides detailed sleep-stage data) to better understand any underlying sleep problems.

4. Get More Sunlight

To stave off the bone loss related to declining estrogen, Clifton recommends bumping up your sunlight exposure. The vitamin D we get from the sun helps the body absorb calcium, a key nutrient for building strong bones. 

“Spending some time in the sun converts cholesterol in your skin to the active form of vitamin D,” Clifton notes. “Just 10 minutes of arm and chest exposure daily will help maintain healthy vitamin D.”

Related: Women Are More Likely To Be Low In These 7 Nutrients

Live in a cooler climate far from the equator? Clifton recommends taking a vitamin D supplement during the long dark days of winter.

According to the Cleveland Clinic, most people over age 50 can safely take 400 to 2,000 IU of vitamin D a day. (You can also get some from eggs, fatty fish like salmon, cereal, and fortified milk.

5. Try Acupuncture

This Eastern practice has all sorts of health applications—menopause-related issues included.

According to a 2016 study, women who underwent 20 treatments of acupuncture over six months experienced a 36.7 percent decline in hot flash occurrences. (The control group experienced a 6 percent increase.)

“There are two types of acupuncture—one is a whole qi treatment, where they treat the body holistically,” explains Scott. “The second is symptom-related acupuncture, in which they’ll focus on something specific, like knee pain,” explains Scott. “The former holistic approach has been shown to help with menopausal symptoms.”

According to Scott, acupuncture helps the body—specifically the nervous system—shift into a parasympathetic (or ‘rest and digest’) state. This helps modulate the stress hormone cortisol and reduce menopausal symptoms.

6. Do More Yoga

Speaking of relaxing and regulating your stress hormones… Yoga has also been shown to be beneficial for women going through menopause—especially when it comes to sleep.

A 2014 study published in the journal Menopause found that when menopausal women took weekly 90-minute yoga classes, they experienced less insomnia. 

7. Cut Back On Sugar

Cutting out cookies and ice cream may sound like pure torture when you’re dealing with menopause. (You need comfort!) However, it can really work wonders in reducing symptoms, Scott says.

Research shows that maintaining stable blood sugar can help reduce hot flashes—and scaling back on sugar makes keeping that blood sugar steady a whole lot easier. “Eliminating processed foods and soda—and eating whole foods—helps a lot,” Scott says.

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