Recognizing the unique experience each of us has as we age, most of us can expect to experience other physical changes during — and perhaps as a result of — the physical changes of perimenopause. If perimenopause occurs during a woman's forties, for example, here are some of the changes her body might be undergoing:

• Muscles may lose mass more easily and become harder to tone during your forties, so your old workout plan may not be enough to maintain the strength and body weight you enjoyed in your thirties. You may need a new workout program during this time; see Chapter 17.

• Bones can start to lose calcium as estrogen levels recede and the body becomes less efficient at absorbing calcium from food. You may need to adjust your diet to include more vitamin D and calcium, or consider taking supplements. See Chapter 15 for more information.

• Eyes become less efficient as the lenses lose elasticity and their controlling muscles weaken, making focusing close-up more difficult. Estrogen helps keep eyes and muscles elastic, so diminishing levels of estrogen contribute to this degeneration.

• Skin and hair can begin to thin in response to lowered levels of estrogen; most people start to get some gray hair in their forties. Estrogen also helps maintain the collagen content (the basic protein bridgework) of your skin, thus keeping it youthful and elastic. Your strong ally in the battle against this aging factor is a healthy diet and lots and lots of water. See Chapter 16 for more information.

• Metabolism slows down during your forties, so weight gain can creep up on you. Typical dieting methods are unlikely to work as well for you at this age, so maintaining or losing weight may require additional exercise and calorie cutting.

• Propensities for certain conditions such as diabetes and asthma can accelerate during this time, due to changing hormone levels, lowered resistance to stress and infections, and other factors of aging. Medical checkups and health maintenance are more essential than ever at this point.

Don't be put off by this list; yes, the perimenopause may be an introduction to the beginning of the aging process and the toll it takes on your body's systems. But there's never been a time when medicine and health care, public information, and healthy life practices have been better able to contribute to everyone's pursuit of a healthy, active middle age. You have more control than any generation that's preceded you in how quickly or slowly your body loses ground to the aging process. You can learn ways to manage the effects of perimenopause and its role in the aging process.

Stay on Top of Your Symptoms

This chapter has outlined a wide range of symptoms that can appear during the years preceding menopause. But it's important to remember that you may experience none, some, or all of these symptoms — or others that aren't even listed. To be certain that you are doing all you can to maintain peak health during this important time of transition, pay close attention to your body, and don't ignore the messages it sends you. Many of the symptoms that initially seem par for the course for middle age may be symptoms of problems requiring serious and quick medical treatment. So don't ignore any ongoing problem because you think it's just “the change.” Work closely with your health care provider to make sure that your body gets any and all of the help that it needs to stay strong, fit, and healthy.