Menopause Notes and Updates from the 2025 Menopause Society Symposium

Hello all.  I am in sunny Orlando this late October and at the annual “Menopause Society” international symposium.  This is where menopause experts and women’s health/menopause clinicians of all levels of education and learning and expertise gather to share and advance knowledge.

Here are some key points to highlight from past research and some tidbits of  latest research:

• “Perimenopause is the portal to the rest of your life”
• Sleep and calorie reduction are the two most important determinants of a successful weight loss strategy
• If sleep deprived: women eat about 360 extra calories per day, eat more sugar and have a lower quality diet in general
• Any calorie restriction diet works, if one can adhere to it
• Physical activity is the intervention that will be most likely implemented by the most women…but has minimal to modest effect on weight loss although improves body composition, mood, sleep
• Mediterranean diet predicts better sleep quality at 1 year among women

Why?  More tryptophan and melatonin in the diet; more fiber improves microbiome

• Improved sleep may also improve diet (even just adding 21 minutes per night decreased the intake of free sugars)
• Reducing variability in sleep times and meal times, even without changing sleep duration, may reduce adiposity and inflammation in women
• While women live longer than men, women have a shorter “health span”
• 1 in 3 women have conditions associated with poor ovarian function
• Fractures are more common in ALL women than heart attack, stroke, or breast cancer combined
• A bone density test should be done in perimenopause for those women especially at higher risk of osteoporosis
• More women should consider starting menopause hormone therapy for the purpose of slowing bone loss at perimenopause and the first 4 years of menopause due to that being the time of accelerated bone loss

Perimenopause and menopause education for clinicians and the general public is more robust than ever.   That said, there is more misinformation than ever as well.  This often is in the form of hormone regimens and recommendations that are not taking into account the individual risks,  not just the potential benefits.  These regimens often involve postmenopausal women wanting to initiate systemic estrogen after the age of 60, which can increase the risk of strokes, hearts, heart disease, and possibly Alzheimer’s disease.  Another area of misinformation and hormone prescribing  are  those who have a uterus and are given systemic estrogen but inadequate doses of progesterone which then increases their risk for uterine cancer.  It can be challenging to find a practitioner who is truly well informed about standards of care for perimenopause/menopause management in terms of menopause hormone therapy.  Whether it’s a conventional, integrative, or naturopathic medicine clinician, or whether it’s podcasts, printed content, or social media…….be diligent.  Ask questions where you can, ask and look for science-based information, look for conflicts of interest and especially those who are not transparent and seek second opinions when you have discomfort.   The pendulum has swung again… from menopause hormones for all and “feminine forever” mindset  since the 1950s and its blockbuster status of the 1990s, to OMG hormones are dangerous for all postmenopausal women since 2002 and the Women’s Health Initiative, to now again the mantra of perimenopause /menopause hormones for all and start as young as possible and take them forever.  None of these three eras is smart and appropriate menopause management for all women.   Hormones or not, don’t forget the basics that buy us the best and longest “health span” .  The scientific evidence includes:  low alcohol, Mediterranean diet, regular aerobic and strength training exercise, adequate sleep, minimize exposure to pollutants, maximize time in nature, and healthy stress management habits.

That’s all for now.  I wish you a positive menopause journey and the wisdom, will, and capacity to seek good resources, and employ the best approach for you.