Pump up the progesterone. According to hormone guru Christiane Northrup, M.D., author of Women's Bodies, Women's Wisdom (Bantam), the dreaded perimenopause starts eight to 12 years before your last period—which means you'll likely spend much of your 40s coping with symptoms like insomnia and irritability. "The bad news for women is that sometime in your 40s, you'll start skipping ovulations,"she explains. "That means you'll have less progesterone—the protective, calming hormone—in your system and you'll begin to see the problematic symptoms of perimenopause." Chasteberry (vitex) can be helpful during perimenopause, when hormones are raging, says Tanya Edwards, M.D., medical director of the Center for Integrative Medicine at the Cleveland Clinic in Ohio. During this time, progesterone levels often start to decline before estrogen levels fall, which can lead to depression, headache, bloating, fatigue, irritability, and breast tenderness. Unlike creams that introduce progesterone from an outside source, chasteberry helps the body increase its own natural levels of progesterone. Take vitex as a tincture of 40 to 80 drops daily.
Know your numbers. If you haven't had a full physical lately, now's the time to get a realistic picture of your health says Mimi Guarneri, M.D., medical director for Scripps Integrative Medicine in La Jolla, Calif., and author of The Heart Speaks: A Cardiologist Reveals the Secret Language of Healing (Touchstone). "In your 40s is when blood pressure, weight and cholesterol start to go up." she says. Numbers to know:
> Blood Pressure
> LDL ("bad") and HDL ("good") cholesterol levels
> High–sensitivity C–reactive protein (to check for inflammation in the body)
> Vitamin D levels
And if you haven't had a mammogram, schedule an appointment with your doctor now.
Eat your phytoestrogens. Of course, following the good eating habits you set in your 20s and 30s is essential. (And if you're a late bloomer in the healthy-eating department, making changes now will pay off). One way to mitigate the problems associated with the plummeting hormones of perimenopause is to add phytoestrogenic foods to your meals. Berries, beans, nuts and fruits—which include the reproductive organs of plants, essentially—are good sources.
If more help is needed to cope with hormone hell, consider taking a phytoestrogen supplement with the herb black cohosh, suggest North Carolina–based Randine Lewis, Ph.D., MSOM, LAc., author of The Way of the Fertile Soul (Atria Books). "Black cohosh will help you feel uplifted and energized without feeling wound–up." If insomnia is an issue, consider a blend that also includes relaxing herbs such as passionflower, valerian root and hops. We like Estroven Nighttime ($11 for 24 caplets; drugstore.com).
Choose better snacks. Traditional Chinese medicine (TCM) has a long history of tonic food thought to improve wellness throughout aging and extend the lifespan. Two to try: pumpkin seeds and goji berries. "Goji berries grow and flourish in Tibet and high up in the Himalayas, " says Lewis. "They have the ability to withstand harsh conditions, and they transfer that property to the body. Goji berries help us endure the weather of life." They're most often sold dried and are a tad bitter so add them to your favorite trail mix recipe if your don't enjoy snacking on them on their own.
Pumpkin seeds nourish the kidney chi—seen in TCM as the primary source of life–force energy. "Kidney chi is our foundation energy, which declines as we age—especially around menopause," Lewis explains. As a bonus, pumpkin seeds are a premium source of good fats, and have also been found in studies to reduce inflammation and lower cholesterol. Sprinkle some on top of oatmeal or salads.
Get centered. Study after study shows that meditation is one of the most healthful practices you can adopt. Now, in the shifting sands of your 40s, is the best time to start. "A deeper wisdom is becoming available to you now," explains Lewis. "You can get a better sense of what you need by going inside rather than gathering data from the external world." Meditation is especially important if the natural process of life assessment that happens during perimenopause is causing you excessive anxiety. "If you're looking at your life and not liking what you see, it can lead to panic," Lewis explains. "Panic will only lead to high cortisol levels, which will make it harder for you to adapt to whatever changes need to be made."
To keep sailing on an even keel, take time every day for a belly–focused meditation. "Bring your attention into the dan-tien, the energy center located deep in the belly," Lewis says. "In Chinese medicine, this is the source of the flow of life. Inhale fully, directing the breath into this center. As you breathe out, picture the energy flowing upward from the dan-tien through the top of your head.” Keep breathing and focusing this way for several minutes, sitting quietly, eyes closed and with a straight spine. If thoughts intrude, simply release them with the upward flow of energy. Return your attention over and over to the dan-tien. “When we meditate this way, we are moving into our own depth," Lewis explains. "Pelvic energy is deep, creative energy. It's our source—where our sense of internal purpose really lies."
Strengthen your pelvic-floor muscles. Let's face it: A leaky bladder is a real downer. Dribbling as we sneeze, cough, laugh or jump can happen to the best of us-especially if we've got a kid or two under our belts (so to speak). "The pelvic-floor muscles that govern bladder control naturally weaken as you get older— especially as you start going through perimenopause and there is a fluctuation of estrogen levels," explains Lynn Anderson, Ph.D., N.D., an ACE-certified fitness instructor in Maine and creator of Dr. Lynn’s Anti-Aging Workout DVD series. Kegels are the go-to move to strengthen pelvic-floor muscles. "Imagine that you’re urinating and you've got to stop peeing really quickly," Anderson says. "That stopping motion—the tightening of the pelvic muscle—is the Kegel." Do three sets of 10, holding for five seconds each.
Up your intensity. Weight gain can creep up on you in your 40s, as your metabolism naturally slows and muscle mass begins to drop. Stave it off by adding intensity, says Maryland-based Pamela Peeke, M.D., M.P.H., author of Fight Fat After Forty (Penguin). In your cardiovascular workouts, this means mixing in intervals of increased effort–pick up the pace for a minute or two at a time, even if it takes you out of your comfort zone. In your weightlifting, introduce pyramids—performing three reps of each exercise, increasing the weight each time. "With a bicep curl, do 10 pounds on the first set, 12 pounds on the second set, and maybe 15 pounds on the third set," she says. The goal? To challenge your muscles to the point of total fatigue