Well, this has been fun. If you haven’t been on this menopausal journey with me, now is the time to go back and start from the beginning. Go to my blog page called “At the Heart of it All”. Catch up to us, and then come back. This is not an advertisement. It is merely a suggestion. Why? Because now we are going to shake things up. I am done talking about the badness. I am through discussing all the horrors and annoyances. I am completely over the negative. I am done. Are you with me? I said (in my best motivational speaker voice), “Are you with me?!” Great. Now get up, stretch, breathe, sit back down, and let’s do this.

First and foremost, it’s time to be honest with yourself. You can’t help yourself if you aren’t being honest. Let’s start with the basics of what is really going on with you. I am going to ask you two very fundamental questions—deep questions, really—and I want you to think carefully before answering. Here they are:

• Who are you?

• Who do you want to be?

I told you they were deep! You may not be completely sure how to answer. Or maybe you think I’m kidding. But I’m not kidding. How you answer these two questions will help determine how you will go through menopause. You have a choice—not about whether you’ll get those hot flashes or insomnia or mood swings, but in how you decide to view them and deal with them. In many ways, the quality, if not the exact details, of this journey is up to you.

One of the most critical parts of going through menopause is getting connected to what exactly is going on with you. I always say, “Train for menopause like you are training for a marathon.” But unlike a marathon, you can start training even after you’ve started the race. It’s a long-distance race, so you have time. It’s also a race that requires diligence, persistence, patience, and a keen awareness of your mental and physical well-being.

So how do you do that? How do you answer those two questions I asked you before…and then, what do you do about your answers? As a matter of fact, I have a to-do list for you, that will help you answer and then act.

Know Your Numbers 

Who you are can mean a lot of things, but one of the things it means is measurable. Are you a woman with high cholesterol? A woman with a healthy hemoglobin A1C level? A woman with borderline blood pressure? This is the perfect time of life to schedule a “well woman” doctor visit (aka annual physical) if it’s been awhile. Besides a physical exam from your doctor, it should include some basic screening tests:

• Cholesterol level, including LDL (the bad kind), HDL (the good kind), and triglycerides (the kind attached to sugar that reveals how much sugar you are eating).

• Hemoglobin A1C, which is a measure of your average blood sugar level over the past 3 months.

• Blood pressure.

During menopause, LDL cholesterol, A1C, and blood pressure all tend to go up, and these are all risk factors for heart disease. Knowing your numbers will tell you whether you need to step up your menopausal training regimen. Heart disease is the number one killer of all women, and the rate is highest about 10 years after menopause, as risk factors continue to increase and the protective estrogen drops away. You will also be at increased risk of an expanding waistline and overall weight gain. You know these things happen, so train, train, train by eating a healthy diet and keeping up with regular exercise. You can control this process!

Check Your Bones

Here’s another menopausal truth: with the drop in estrogen that comes with menopause comes a drop in bone density. Check on this bone density! This is the time to eat well, get enough calcium and vitamin D, and stress your bones just enough to keep them rebuilding—through walking or running and weight training. Muscle mass also builds bone, while smoking and some medications can compromise bone density. A DEXA scan will assess your risk of osteopenia (diminished bone density) and osteoporosis (significant reduction in bone density). When you lose bone density, you are at an increased risk of fractures, and this can cause significant health issues, especially for women over 65 years old. Don’t give up on this—it is crucial for your long-term quality of life.

Check Your Breasts

Your doctor may tell you to get a mammogram every other year (or more often if you have risk factors for breast cancer), but be honest: Have you done it? Many women admit they ignore those orders and have gone five or more years without a mammogram. This is a serious mistake if you are over 40 years old. If you are over 50, many doctors believe you should be scanned yearly. Just bite the bullet and do it. Not knowing is worse than knowing and treating. Chances are, your breasts are just fine, but if they aren’t breast cancer is one of the most treatable and survivable cancers, especially when you catch it early.

Aim to schedule your mammogram for the week after your period ends for the best view. And if they want you to come back for additional viewing? Don’t worry yet. This happens quite frequently. Breasts change a lot, in many benign ways, and they just want to be sure. Newer, cutting edge techniques like 3-dimensional mammograms are increasingly available, and other technology like ultrasounds and MRIs can help verify the health of your breasts if the doctor needs a second look, so you can be even more certain about what’s going on in there.

Check Your Colon

I know. It’s not fun. It sounds horrible. You have to drink that stuff, and poop a lot the day before. Colonoscopy! But it’s really not difficult or as bad as it sounds, and think of it this way… you get a free internal cleanse in the process! Seriously, checking your colon is important. On the list of most preventable diseases is colon cancer, so if you are 50 or older, just get it done. If your colonoscopy is clean, you won’t need another one for 10 years, unless you have a strong family history.

You could also get your stool checked for blood, which can be done through a rectal examination along with an abbreviated exam called a flexible sigmoidoscopy every 5 years. Most doctors recommend the colonoscopy for now, but this task may get even easier and less invasive in the future. In the meantime, don’t miss out on knowing everything about yourself—inside and out.

When you know exactly what is going on with your body, you have a much better idea of how to answer the question, “Who Am I?” And that brings us to the second question: “Who do I want to be?” Who do you want to be in this second half of your life? Someone vibrant and alive, full of health and vitality, who can bravely step into her life to figure out what’s waiting for her…beyond motherhood or caretaking…beyond being a wife or partner…beyond the constraints of those earlier years?

Without health and an honest appraisal of where you stand right now, you may never be able to seek the answers to those lifelong questions. Be a woman who knows her health status. Be a woman who fights to stay healthy far into old age. Be a woman who leaves the question open: Who am I? Give yourself the years and decades to find out.