Your body changes as you enter menopause, even if your diet and exercise routine haven’t. But if you’re approaching menopause and your jeans are a little snug or your cholesterol levels increase, don’t despair. Changes in weight, shape and lab results are to be expected, but you don’t have to accept a decline in heart health. Small adjustments can go a long way in keeping you happy and healthy.

Whether you’re in menopause now or you’re years away from the transition, the best way to protect yourself from heart disease is to have your blood pressure, blood glucose and cholesterol screened by a doctor—and make active lifestyle changes.

"Menopause is a natural transition in life, and everyone experiences it differently," said Lily Stern, MD, a cardiologist at the Cedars-Sinai California Heart Center in Beverly Hills. “It’s important that you talk to your doctor about your symptoms and changes in your body, no matter how petty they seem.”

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Menopause can correlate with weight gain, more fat distribution in the belly, elevations in cholesterol and blood pressure, and more insulin resistance (prediabetes)—which increase the risk of heart disease.

Women may notice such shifts in their weight or health and wonder what they’re doing wrong—but the changes are common and experts don’t know the exact cause.

"It’s hard to determine whether these issues are related to a drop in estrogen, genetic factors, aging in general or just not being as active as you used to be," said Stern.

Even menopause symptoms like mood and sleep disturbances can indirectly increase the risk of heart disease and should be discussed with a doctor.

"When poor sleep or depression leads women to stop being as active, it can contribute to weight gain and higher cholesterol, and subsequently a greater risk of heart disease and diabetes," she said.

Perimenopause and menopause are crucial periods to get screened for heart disease, said Martha Gulati, MD, director of Preventive Cardiology, associate director of the Cedars-Sinai Barbra Streisand Women's Heart Center, and the Anita Dann Friedman Chair in Women's Cardiovascular Medicine and Research. Symptoms like headaches can be a sign of high blood pressure—but are also commonly written off by women during this phase.

"Important diagnoses often get delayed in women, because they’re attributed to menopause," she said. "It’s a great time to be seen by a physician to talk about what you’re feeling and what is changing, because high cholesterol and blood pressure, and other cardiac conditions, can be uncovered."

Read more: Perimenopausal Symptoms: What You Should Know

The best way to protect your heart in menopause is to prioritize a healthy lifestyle throughout your life. When you reach perimenopause or menopause, work closely with your doctor to adapt to changes in your body. Adjustments in diet and exercise have significant impact in preventing heart disease, the leading cause of death for women.

"Try to get ahead of the game," Stern said. "There are certain risk factors that we can't control, like genetics. But we want to get a jump on the factors we can control."

But it’s never too late to get the benefits of a heart-healthy lifestyle, Gulati said—especially physical activity, which is as important as every risk factor.

"You don’t need to be overly focused on the scale, but get active—the more active you are, the better you’ll be in terms of longevity and freedom from cardiovascular disease," she said. "Gardening, walking, swimming, and even housework all count."

Resistance training is crucial to help prevent frailty and preserve metabolism to counteract lost bone density and muscle mass.

"Building muscle makes you stronger, and enables your body to burn more calories," Gulati said. "What we all want is more graceful aging—we don’t want to be frail and we want to maintain our metabolism."

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Hot flashes and night sweats affect up to 80% of women in perimenopause and menopause. Hormone therapy is effective against these bothersome symptoms, and though it doesn’t treat or prevent heart disease, for most women, it won’t increase your risk either. Studies show that women who begin hormone therapy within the first 10 years of menopause don’t see an increased risk for cardiovascular disease.

"There's a lot of misinformation about hormone therapy and cardiovascular health," Stern said. "This treatment is really helpful for women, who shouldn’t have to suffer through this big change in their life."

Hormone therapy—which can also prevent bone loss—might not be right for everyone, but even women who are at high risk for heart disease should consult their doctors about options, Stern said.

"Have a risk-benefit discussion with your doctors to sort out a plan that’s safe for you," she said. "Women deserve to maintain a good quality of life as they age."