Perimenopause and the early years of menopause represent much more than a hormonal transition phase. According to the most recent scientific evidence and the latest recommendations of the International Menopause Society (IMS), midlife is a true window of preventive opportunity. It is during this period that the foundations are laid for health in the years to come, not only in terms of symptoms, but above all in relation to cardiovascular, metabolic, bone, muscle and cognitive risk.

Thinking about prevention in menopause therefore means shifting the focus from the short term to the long term. It is not just about “feeling better today”, but about concretely reducing the risk of developing chronic diseases in later years, conditions that have a profound impact on quality of life and personal autonomy.

Prevention: don't wait for the signs to arrive

One of the clearest messages from the IMS guidelines is that many changes occur silently. The increase in cardiovascular risk, the loss of bone and muscle mass or the worsening of the metabolic profile often begin when symptoms are still mild or easily underestimated.

For this reason, prevention should not start “when something is wrong”, but when the body begins to change. Early identification of these signals allows for more effective and less invasive interventions.

Regular check ups and targeted tests

A menopause prevention pathway is based first and foremost on an appropriate clinical and laboratory assessment. Tests such as bone densitometry allow monitoring of skeletal health and early identification of osteopenia or osteoporosis.

Similarly, assessment of lipid profile, blood glucose and other metabolic parameters makes it possible to detect risk conditions even in the absence of weight gain or evident symptoms.

These assessments are not intended to medicalise menopause, but to provide useful information to personalise preventive strategies.

Physical activity: a cornerstone of prevention, not an add-on

IMS recommendations strongly emphasise that physical activity is one of the most powerful tools for prevention in menopause. Nutrition and movement act in synergy on body weight, insulin sensitivity, inflammation, cardiovascular health, bones and muscles.

In particular, strength training plays a central role. After menopause, the risk of sarcopenia increases, meaning the progressive loss of muscle mass and strength linked to ageing and hormonal changes. Sarcopenia is not only an aesthetic issue. It is associated with reduced basal metabolism, increased risk of falls and fractures, loss of autonomy and a decline in quality of life.

The good news is that sarcopenia is not inevitable. Regular physical activity, including strength exercises combined with aerobic movement, represents the most effective intervention to prevent it or slow its progression.

Metabolic prevention: beyond the number on the scale

During the menopausal transition, many women experience a change in body composition, with an increase in visceral fat even at stable weight. This fat, located in the abdominal area, is metabolically active and associated with increased cardiometabolic risk.

A key concept is insulin resistance, a condition in which cells respond less effectively to the action of insulin. In menopause, the decline in oestrogen can promote alterations in glucose regulation even in previously healthy women.

Intervening on nutrition, physical activity and lifestyle makes it possible to reduce this risk before overt disease develops.

An integrated approach: hormone replacement therapy and lifestyle medicine

When indicated, hormone replacement therapy can represent an important tool not only for symptom control, but also for the prevention of some complications related to oestrogen deficiency, such as bone loss. IMS guidelines emphasise the importance of an individual assessment that takes into account age, time since menopause and risk profile.

Alongside therapy, lifestyle medicine remains a fundamental pillar. Balanced nutrition, regular physical activity, stress management, sleep quality and social health act together to support overall wellbeing. In the Pausetiv protocol, these elements are summarised in the SAMBA approach, which integrates movement, nutrition, psychological wellbeing, a healthy environment and social connection.

The Mediterranean diet as a prevention model

The most recent scientific evidence confirms that the Mediterranean diet is one of the most effective dietary models for preventing chronic diseases in menopause. Rich in fibre, unsaturated fats, high-quality proteins and plant-based foods, the Mediterranean diet supports metabolic, cardiovascular, bone and muscle health.

Adapted to the needs of menopause, for example with greater attention to protein intake and meal distribution, it represents a sustainable long term strategy.

Menopause is not an endpoint, but a strategic transition. Addressing it with a preventive, multidisciplinary and personalised approach allows protection of health over time and the construction of a better quality of life in the years ahead.

Investing in prevention today means taking care of your future.

Accessible prevention and care pathways

Taking care of health during menopause also means having access to concrete preventive tools. For this reason, Pausetiv has launched a partnership with Cerba Healthcare Italia, allowing women who join our care pathways to benefit from a 20 percent discount on laboratory tests and a 10 percent discount on imaging exams across the Cerba network.

This collaboration stems from the desire to make prevention more accessible and integrated, facilitating the monitoring of key health parameters at a crucial moment in life.

Start your prevention journey with Pausetiv here.

Sources

International Menopause Society (IMS), Panay N. et al. (2025)
International Menopause Society (IMS) recommendations and key messages on women’s midlife health and menopause
https://www.tandfonline.com/doi/full/10.1080/13697137.2025.2585487

International Menopause Society (IMS)
IMS Recommendations & Position Statements
https://www.imsociety.org/statements/ims-recommendations/

International Menopause Society (IMS) (2025)
The role of lifestyle medicine in menopausal health – White Paper
https://kops.garda.ie/media/uidfsw0a/summary-ims-white-paper-the-role-of-lifestyle-medicine-in-menopausal-health-2025-ags.pdf

World Health Organization (WHO)
Guidelines on physical activity and sedentary behaviour (Adults)
https://www.who.int/initiatives/behealthy/physical-activity

Bull FC et al. (2020)
WHO 2020 guidelines on physical activity and sedentary behaviour
https://pmc.ncbi.nlm.nih.gov/articles/PMC7719906/

Cruz Jentoft AJ et al. (2023)
Sarcopenia revised European consensus on definition and diagnosis (EWGSOP2 update)
https://pubmed.ncbi.nlm.nih.gov/36724814/

Palacios S et al. (2024)
Menopause, body composition and cardiometabolic risk
https://www.tandfonline.com/doi/full/10.1080/09513590.2024.2312885

Maturitas Editorial Board (2024)
Midlife women’s health prevention strategies beyond symptoms
https://www.sciencedirect.com/science/article/pii/S0378512224000216

Morin SN et al. (2023)
Clinical practice guideline for management of osteoporosis and fracture prevention
https://www.cmaj.ca/content/195/39/E1333

Stevenson JC et al. (2023)
Menopause, lifestyle and healthy ageing
https://pubmed.ncbi.nlm.nih.gov/37240322/

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