Past Sizzling Flashes: Rethinking Menopause and Midlife Health

For many ladies, midlife well being adjustments can really feel sudden, complicated, and deeply private. Weight acquire regardless of “doing everything right.” Sleepless nights that stretch into exhausting days. Brain fog, aching joints, and an amazing sense of depleted vitality.

“These symptoms are real,” says Dr. Mahima Gulati, an endocrinologist at UConn Health and a pacesetter in way of life medication. “This is not something women are imagining, and it’s not ‘just aging.’ There are real biological changes happening, and women deserve evidence-based care and support as they move through them.”

At UConn Health, Gulati works with ladies throughout the lifespan from youthful sufferers with polycystic ovary syndrome (PCOS) to ladies navigating perimenopause, menopause, and postmenopause. Central to her strategy is way of life medication, a rising medical specialty that focuses on treating and stopping illness by way of prescriptive, evidence-based adjustments in day by day habits.

Rather than providing fast fixes, way of life medication addresses the muse of well being that embrace how individuals sleep, eat, transfer, join, deal with stress, and keep away from dangerous substances.

“These six pillars form the core of lifestyle medicine,” Gulati explains. “They give us practical, science-backed tools we can prescribe during a medical visit to help patients change their day-to-day habits in meaningful ways.”

Why Lifestyle Medicine Matters During Menopause

Menopause is commonly misunderstood as a single second in time, the tip of menstrual cycles. In actuality, it’s a lengthy transition, typically starting as much as a decade earlier than a lady’s last interval and lasting years afterward.

During this time, declining estrogen ranges take away what Gulati calls a “protective umbrella” that had beforehand helped regulate metabolism, bone density, muscle mass, ldl cholesterol, and blood sugar.

“Once women enter their 40s, cardiometabolic risk can rise quickly,” she says. “We see changes in body composition, loss of muscle and bone mass, and unfavorable shifts in cholesterol, glucose, and blood pressure, sometimes even if lifestyle habits haven’t changed.”

Research additionally reveals that after menopause, resting metabolic charge can drop by a mean 100-250 energy per day, making weight acquire extra possible and weight reduction harder. Many ladies acquire 10 to twenty kilos throughout this transition, together with a rise in physique fats and a lower in lean muscle mass.

“That’s why lifestyle medicine becomes so critical at this stage,” Gulati says. “It gives women a sense of ownership over when their bodies may feel unfamiliar or frustrating.”

Pillar One: Social Connection – Not Suffering Alone

One of essentially the most highly effective and sometimes underestimated instruments Gulati makes use of is connection.

At UConn Health, she leads shared medical appointments, also referred to as group visits. These are physician led medical visits the place sufferers obtain scientific care, lab assessment, and professional steerage alongside different ladies navigating comparable challenges.  Each session covers a unique side of way of life medication.

“For women to sit in a room and realize they are not alone is incredibly therapeutic,” she says. “Connection itself reduces the burden of chronic conditions.”

Patients typically uncover that adjustments they as soon as thought had been remoted comparable to new loud night breathing, disrupted sleep, elevated sensitivity to alcohol, or lowered vitality are widespread experiences throughout this stage of life.

Group visits can be found for these residing with any sort of persistent illness. The doctor-led visits are a possibility to fulfill with different sufferers who might have comparable issues.

“They learn from one another,” Gulati says. “That shared understanding creates momentum for change.”

Pillar Two: Sleep – Addressing the ‘Energy Crisis’

Sleep disruption is without doubt one of the commonest and debilitating signs of perimenopause and menopause.

“Estradiol impacts REM sleep,” Gulati explains. “Women often wake at 1 or 2 a.m., experience night sweats, and struggle to fall back asleep. When that happens night after night, it becomes an energy crisis not just fatigue.”

Her strategy consists of each training and sensible methods:
• Establishing constant sleep routines
• Avoiding caffeine and alcohol within the night
• Limiting blue gentle publicity after 7 p.m.
• Keeping gadgets out of the bed room when doable
• Using rest practices like yoga and meditation

Hydration, she notes, can also be key. “Adequate water intake during the day can help regulate body temperature overnight and reduce hot flashes.”

Pillar Three: Stress – Changing the Relationship, Not Just Reducing It

Rather than attempting to eradicate stress a near-impossible job, Gulati helps sufferers redefine their relationship with it.

“We talk about embracing stress as a signal for growth,” she says. “What can I let go of? What can I say no to? And for the stressors I can’t avoid, who can I ask for help?”

This reframing helps ladies transfer from a biology of worry to a biology of braveness and connection, encouraging resilience reasonably than burnout.

Pillar Four: Movement – More Than Just Exercise

Exercise turns into non-negotiable throughout midlife, however Gulati emphasizes that motion should be multidimensional.

“Strength training is essential,” she says. “Preserving muscle and bone is the goal not just losing weight.”

She additionally stresses the significance of breaking apart lengthy intervals of sitting, incorporating stability coaching as ladies age, and prioritizing flexibility and mobility.

“It’s not just about a 30-minute workout,” she says. “It’s about how often we move throughout the day.”

Pillar Five: Avoiding Harmful Substances and Behaviors

Lifestyle medication additionally addresses tobacco use, alcohol consumption, and behavioral addictions.

Alcohol, Gulati notes, is commonly tolerated otherwise after menopause. Even small quantities can worsen sleep, enhance visceral fats, and lift the chance of breast most cancers and osteoporosis.

She additionally addresses digital overuse, encouraging sufferers to restrict display screen time at evening and keep away from scrolling throughout in a single day awakenings.

“These behavioral changes can dramatically improve sleep and overall well-being,” she says.

Pillar Six: Nutrition – Fueling the Body Through Change

Nutrition is without doubt one of the most requested subjects in Gulati’s group visits. Discussions vary from studying meals labels to rising vegetable and protein consumption, bettering hydration, and exploring meals that will ease menopausal signs.

“We focus on progress, not perfection,” she says. “And we emphasize celebrating what’s working, better sleep, improved labs, more energy, not just the number on the scale.”

Replacing Misinformation with Evidence

As menopause dominates social media feeds, Gulati urges ladies to hunt credible, vetted sources of data.

She recommends organizations such because the American College of Lifestyle Medicine, the Endocrine Society, the North American Menopause Society, and trusted well being methods like UConn Health, Mayo Clinic, and Cleveland Clinic.

“The only way to counter misinformation is to replace it with good information,” she says.

A New Narrative for Midlife Health

Gulati believes menopause shouldn’t be framed as decline, however as transition.

“There is emotional maturation that happens,” she says. “Women become clearer about priorities. They conserve energy for what truly matters.”

Lifestyle medication, she says, helps that shift not by preventing change, however by serving to ladies transfer by way of it with energy, readability, and confidence.

“This is a journey,” Gulati says. “And it deserves care, compassion, and evidence-based support every step of the way.”

Referrals for way of life medication appointments might be directed to Dr. Mahima Gulati , UConn Health, Endocrinology Division.