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Midlife and menopause is a time of many transitions. Shifting hormones may produce hot flashes, night sweats, memory loss, insomnia, and mood swings. Our growing realization of life’s impermanence leads to taking stock of our lives’ successes and failures, how they’ve compared with what we expected, and what’s next. Identity and esteem issues arise as changing roles, like children leaving home, cause us to question “Who am I? Who do I want to be?” Through this, some of us will discover greater clarity, strength and confidence about ourselves, while others will feel confused, lost, distressed. We will be faced with our parents aging, ourselves aging, numerous relationship changes, leaving work, resuming work, and multiple situational influences which may destabilize our sense of self and well-being. Cultivating good health, mind, body and spirit, will be paramount to surviving and thriving all midlife and menopause brings. Here’s what I suggest:1. Being positive and open-minded. Viewing midlife as a journey, an opportunity to become more fully present to your life and who you are, will enable you to better weather the ups and downs. Research indicates that women who adopt this attitude have less intense physical symptoms, fewer mood issues, less esteem problems, and more personal satisfaction. Be prepared to let go of pre-conceived ideas of your life and how it was supposed to be. Marcus Proust said, “The real voyage of discovery consists not in seeing new lands, but in having new eyes”.2. Rediscovering you. Remember adolescence when you took those shaky steps to becoming who you are. Welcome to “second adulthood” as Susan Braun Levine describes it in her book, Inventing the Rest of Our Lives. Think about who you were before you became a worker, wife, mother, daughter, best friend, etc. Ask yourself “Who am I?” Deep down where roles fall away and your character emerges. This is a chance to reconnect with those parts of yourself you’ve buried and breathe new life into being creative, adventurous, bold, sensitive, who knows. It’s up to you.3. Listening to your inner guidance. With estrogen declining and a deepening sense of life’s impermanence, many women discover a newfound freedom to loosen the bonds of being who they “should be” and becoming who they choose to be. When you can quiet the voices of what others want or want for you, you can hear your inner wisdom. At first, it may be hardly audible. But, the more you tune in, the stronger and clearer it becomes. It is not the voice of self-centeredness, but inner knowing which begins with self-compassion and extends to others. Listen wisely.4. Choosing nourishing relationships. At midlife, we may find that relationships we’ve been involved in for years, aren’t working well for us. Why? While it occurs for many reasons like changing interests, frequently it’s because we don’t feel emotionally nourished and that there’s enough give and take. The bottom line is to not force yourself to stay in situations you’ve outgrown. Instead, ask yourself honestly, “Do I enjoy being with this person? Does she/he bring something positive to my life even if it’s changed over time? How much do I want them to remain a part of my life?” Respect what you want and need equally. It’s time.5. Reducing hot flashes. Now, for some body wisdom. While hot flashes are a product of estrogen shifts, certain substances/situations will aggravate them. So, limit your consumption of alcohol, caffeine, spicy foods, and hot beverages. Dress in layers and sleep with a foot or arm uncovered to stay cooler as heat intensifies them. Reduce stress by shortening your to-do list, taking regular breaks, working out, and practicing relaxation. 15-20 minutes of deep breathing or meditation daily was shown to decrease hot flashes up to 70%. If you have trouble sitting still, try yoga or pilates. Discover what works for you.6. Building heart and bone health. With declining estrogen, women are at increased risk for heart disease and osteoporosis. Heart disease is the #1 cause of death in women over 50 and complications from osteoporosis including hip fracture, likewise result in disability and death. Exercise and good nutrition are key. Twenty to thirty minutes of weight-bearing exercise, e.g. walking, weight training, circuit workout, combined with cardio building, e.g. jogging, aerobics, swimming, several times weekly, is recommended. Daily calcium intake for peri-and post-menopausal women should total 1200-1500 mg. Calcium and 800 IU Vitamin D for absorption. Choosing calcium rich, high protein, and low fat foods will support bone and heart health.7. Enjoying sex. With hormonal and relationship shifts, sex often changes at midlife and menopause. According to Dr. Jacob Klein, Director of Obstetrics and Gynecology at Missouri Baptist Medical Center, “As women go through perimenopause, arousal proceeds desire”, meaning that women need to feel aroused to be interested in sex. “It’s like going to a restaurant when you’re not really hungry, but your appetizer arrives, you see other people eating, and you start feeling hungry,” he commented. Physical symptoms of vaginal dryness and decreased lubrication may lessen interest and pleasure. But, having sex regularly will offset these some. So understand what’s going on, don’t take it personally, make adjustments, and have fun!8. Living on purpose. Creating the life you want may be the biggest challenge and opportunity midlife women face. It involves discovering and prioritizing what matters most to us, and then taking actions to pursue these values and goals. For one woman, it might be returning to school and completing her degree which she interrupted to have children. For another, leaving a marriage which has not been nourishing for years. It requires the courage to follow our hearts, whether others approve or understand. To accept our responsibility for the life we create, and living our dreams.9. Creating a spirit-filled life. What this means is having a sense of connection with something bigger than oneself, whether it’s God, nature, or the universe. Spirit gives us a feeling that there is more to life than our physical existence and at midlife when the reality of our mortality confronts us, many of us long for this knowing. The ways we attain spiritual connectedness are unique whether through organized religion or individual practice, but all have value. Look at Joan Borysenko, Ph.D. and Gordon Dverin, Ph.D., Your Soul’s Compass, for ideas about accessing your spirituality.10. Embracing stewardship. As our connection with something bigger than ourselves grows, we often discover an interest in protecting and caring for our communities and our planet. We want our children, others we love and even those we don’t know, to be free of the inner and outer obstacles that hindered us. In becoming more fully ourselves, we discover a love and respect for all that is. Healing ourselves helps the world toward a better tomorrow.For me, the journey of midlife and menopause has been rich beyond words. This doesn’t mean it’s been easy, and each of us will have our share of ups and downs as we traverse this unexplored terrain. But this second adulthood affords us the opportunity to re-examine our lives with the wisdom, strength and resources, we’ve gained, and to decide, if we’re willing, what matters and what’s next. A time to dream again and to live our dreams.