Key Wellness Practices for Perimenopause and Menopause

Your body changes during perimenopause — and so should your approach to health. ⁠ ⁠Hormonal shifts affect muscle, bone, sleep, mood, and metabolism all at once, which means the habits that worked in your 20s and 30s may not carry you through midlife the same way. ⁠ ⁠The good news: small, intentional changes across a few key areas can make a real difference in how you feel — now and for decades to come. Here, we break down the health practices worth prioritizing during perimenopause and menopause, from strength training to sleep to cultivating a sense of purpose.

Build Strength, Protect Bone, and Support Your Heart 

Muscle and bone naturally decline with age and shifting hormones. The following habits help you hold onto both: 

• Build and preserve muscle. Strength training becomes increasingly important during midlife when you naturally begin to lose muscle mass and strength as you age and hormones change. Women, don't be afraid to lift heavy. Progressive resistance training helps preserve muscle, build strength, and support metabolism and bones. 

• Maintain cardiovascular fitness. As estrogen declines, women benefit from being intentional about cardiovascular fitness rather than relying solely on long, steady-state cardio. Incorporating short, high-intensity intervals or sprint work alongside aerobic exercise can provide a powerful stimulus for cardiovascular fitness, metabolic health, and the maintenance of lean muscle. 

• Protect your bones. Estrogen is vital to your bone strength, and bone loss can accelerate during the menopausal transition. Weight-bearing exercise, strength and jump training, adequate protein, calcium, and vitamin D, plus appropriate screenings can all help protect your bone health and reduce fracture risk.  

Support Your Body, Sleep, and Stress Response 

Body composition, sleep, and stress are closely connected during this stage. Here are ways to support all three: 

• Maintain a healthy body composition. Hormonal changes during midlife can contribute to a shift toward more abdominal fat and less lean muscle, even when body weight doesn't change dramatically. Rather than focusing solely on the number on the scale, prioritize building muscle, staying active, eating well, and supporting metabolic health. 

• Prioritize sleep. Sleep can become more challenging during perimenopause and menopause due to hormonal changes, night sweats, stress, and changes in sleep patterns. But protecting your sleep is not a luxury. It supports mood, cognition, metabolic health, recovery, immune function, and overall resilience. Consistency is a key first step to maintaining high-quality sleep. 

• Managing stress. Stress isn't inherently bad, but chronic, unmanaged stress can affect sleep, mood, metabolic health, cardiovascular health, and overall well-being. The goal isn't to eliminate stress but to build the capacity to recover from it through movement, connection, mindfulness, time in nature, rest, and other practices that work for you.

Nurture Connection, Purpose, and Intimacy 

Physical health is only part of the picture. These habits support the emotional and spiritual side of midlife: 

• Nurture your relationships. Strong relationships are an important part of health and longevity, providing connection, support, belonging, and a sense of purpose. Midlife is an opportunity to intentionally invest in the people and communities that help you feel supported and energized. 

• Maintain purpose and curiosity. Purpose gives us a reason to get up and engage with life, while curiosity keeps us learning, growing, and adapting. Midlife can be an exciting opportunity to explore new interests, develop new skills, and reconsider what brings meaning and fulfillment. 

• Stay sexually and socially engaged. Sexual health is an important part of your overall well-being at every age, yet hormonal changes can affect desire, arousal, comfort, and sexual function. Open conversations with a healthcare professional and your partner, along with appropriate treatment when needed, can help you maintain intimacy and sexual health. 

Build a Strategy for the Next 20 to 30 Years 

Menopause is not an endpoint. It's an opportunity to take a more intentional approach to the decades ahead. Focus on the fundamentals that have the greatest impact on healthspan: strength, cardiovascular fitness, nutrition, sleep, brain, relationships, stress resilience, and preventive care. Prioritize your top three, start there, and build the habits that will help you to live well for years to come.