February is American Heart Month, and in my last blog post I explained how various causes of infertility and certain events or transitions during a woman’s life are associated with a higher risk of cardiovascular disease. In this post, I’ll tell you what you can do to boost your heart health and reduce your risk of cardiovascular disease.

Obviously, you can’t turn off your PCOS, endometriosis or DOR (diminished ovarian reserve), and you certainly can’t change the fact that your periods will end and your hormones will fluctuate and reset to your new “normal.” But there are things you can do to reduce risk wherever you are in life.

1. Know your family heart history.

Your past informs your future, especially when it comes to your heart health (although you still have control over how things go down for you). If your parents or siblings struggle with heart issues—especially if a first-degree relative has suffered a heart attack at an early age (younger than 60) or had high blood pressure that started early—know that this can increase your risk as well.

2. Stop smoking.

Well, duh. With each inhalation of smoke and the carcinogens inside it, you’re damaging the lining of your arteries, which stiffens them. The best thing you can do today to improve your heart health is quit smoking.

3. Eat a heart-healthy diet.

An eating pattern that’s rich in veggies and fruit, beans, fiber, lean protein, healthy fats and nuts and seeds is key. There’s a place for animal products, especially if they’re lean and as “clean” (antibiotic and hormone free) as you can afford. The more processed they are—think: cured meats, lunch meat, bacon, hot dogs, and so on—the worse they are for you. That goes for food in general. Many healthy foods are processed (yogurt, whole wheat bread) but foods that have been loaded with chemicals and preservatives and stripped of any nutrition are bad for your heart health. (This recent article indicates ultra-processed foods make up 70% of our food supply!)

4. Get active!

But don’t overthink it! A daily walk, some gentle stretching, hiking, dancing, tennis. Just move your body. Zone 2 training (moderate intensity at about 70 to 80% of your max heart rate) is all the rage now, but there’s also benefit from doing more intense training like HIIT (high-intensity interval training) if you want. (Even cardiac rehab patients do interval training; it’s based on your subjective exertion levels.) I’d just limit more intense workouts to once or twice a week. And don’t forget strength training: It’s truly the fountain of youth, keeping your heart and muscles from aging too fast.

5. Manage stress.

It’s a killer, but being aware of your stress is the first step in trying to manage it. Mindfulness, intentional breath work, singing, prayer, meditation—all these things can help reduce stress and, perhaps more important, help your body adapt to and handle stress. For a relaxing meditation that also emphasizes self-compassion, check out one of my recent blog posts.)

6. Log good Z’s for better heart health.

Most research shows getting seven to nine hours a night is ideal for most people. If you’re struggling to fall or stay asleep or if you snore or, especially if you have sleep apnea, this can increase your risk of heart problems. Your doc can evaluate you for sleep apnea and a sleep tracker can help identify if you’re waking up many times throughout the night. Trying to keep your sleep schedule consistent—say, from 11 pm to 7 am each day—is also important, since your body loves a routine. Many of my patients say their partners, kids or pets keep them up so it’s not always easy to get rid of the things that are disturbing your sleep, but you have to decide how important it is for you.

7. Get tested.

Lab work can show you if your heart-healthy tactics are working. Your physician can order standard blood tests that measure cholesterol, blood sugar and your vitamin and mineral status. But sometimes you need to go deeper. You can look at inflammatory markers (which rarely tell you where the inflammation is coming from but can flag that you have inflammation—hsCRP is one such test), insulin levels (key, especially if your blood sugar is running in the prediabetic range—between 100–125—or higher), and even some more in-depth cholesterol tests that look at cholesterol particle size and your genetic propensity to high cholesterol. Just fyi, I can order these in my practice.

8. Share your full reproductive history with your doctor.

Tell your physician if you have endometriosis or PCOS. Let them know if you had pre-eclampsia, gestational diabetes or a pre-term birth during a previous pregnancy. These are part of your picture and help inform your doctor about your overall CVD risk. Many doctors don’t ask about your fertility or pregnancy experience, beyond number of pregnancies and births, but they should.

It can feel like the deck is stacked against you sometimes, but your lifestyle choices go a long way in boosting your heart health, reducing your risk, and staying healthy for years to come.