In your mid to late thirties or early forties, it may seem like your body is morphing right before your eyes. You may notice — and be irritated by — the discovery that your clothes don’t fit as well as they used to, even if you haven’t gained any weight. Your skin becomes drier. A few wrinkles are visible. You look and feel more tired than when you were younger. It’s like seeing a stranger in the mirror. 

If these changes are happening to you, you’re most likely entering the first stage of hormonal fluctuation – perimenopause. This is a natural period of transition that begins several years before menopause. It can last from a few months to up to 10 years prior to menopause and is your body’s natural transition into making less estrogen. As your ovaries produce less estrogen, your periods become irregular. You may start to skip periods. Eventually, your monthly cycle will stop completely. Once you’ve gone a year without having a period, you’ve reached full menopause. 

Afterperimenopause comes menopause – the stage in which your ovaries stop producing reproductive hormones, and you have no monthly periods for twelve consecutive months. Although the average age for menopause is 51, it is normal to experience it as early as 45 and as late as 55.

To say that my own transition from perimenopause to menopause was grueling would be an understatement. It turned out to be hell, pure and simple – with hot flashes, night sweats, thinning hair, dry skin, and weight gain. I was so ready to be done with all of it. 

But now that I look back, I see things that were not clear to me at the time. I wish I had known, for example, that symptoms can begin in your thirties, that if I had started hormone replacement therapy earlier, I could have been a whole lot more comfortable, and that mental states like moodiness, depression, or anxiety do not mean we’re crazy!

If you aren’t sure where you are in your hormonal journey, I invite you to take this short quiz. It will measure the intensity of common symptoms and help you determine whether you are perimenopausal,menopausal, postmenopausal, or not quite in one clear phase yet. You can then refer to your score when visiting your own doctor and use it as you follow The Galveston Diet

Throughout our lives, we women pass through unique and beautiful gateways. Getting our period is the gateway to womanhood; becoming pregnant for some, and then the gateway to motherhood. Both are seen as miraculous “wins,” while menopause is commonly described as a loss—of fertility, beauty, sexuality, and self-worth. 

But I would argue that menopause is the gateway to a life change with an upside. Forty percent of a woman’s life is spent in postmenopause. Let that sink in for a moment.

Imagine what you can do with that time! Menopause tends to coincide with a time when your children—if you have them—are launching or have launched into lives of their own. This means you gain more time for yourself and the opportunity to reimagine you’re your future. You have time to uncover and embrace your passions – start a new business, devote your energies to a cause, write, make art, spend more time with your family and your friends, enjoy nature, run for office, or pursue whatever matters to you. Anything!

Along those lines, I consider menopause to be a privilege because it means you’ve lived a long time – an opportunity many don’t enjoy for one reason or another. I celebrate my birthday big-time each year because I’m so grateful to be here – even if that means a few wrinkles, some gray hair, and creaky joints.  

So view this period as a time to learn more about yourself. Instead of feeling bad about going through this natural phase of life and being upset about the symptoms, be more intentional about your choices. Learn more about your body and what does and doesn’t work for you, whether it’s with food, exercise, or relationships—and then focus on the positives over the negatives. I really believe that if you can reframe the way you think about menopause, and live the principles in The Galveston Diet, this can be an amazing time in your life.

Excerpted from THE GALVESTON DIET copyright © 2023 by Mary Claire Haver, MD. Used by permission of Rodale Books, an imprint of Random House, a division of Penguin Random House LLC, New York. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher. 


  • Mary Claire Haver, M.D., is a board-certified OB/GYN and a Certified Culinary Medicine Specialist. She is the author of The Galveston Diet: The Doctor-Developed, Patient-Proven Plan to Burn Fat and Tame Your Hormonal Symptoms.