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Are you a midlife woman who doesn’t understand what is happening to your body and your mind?

Have you told your doctor how you’re feeling and were dismissed with medications or hormone replacement therapy?

Do you feel overwhelmed by the volume of information available about managing midlife and peri-menopause?

I am not only a practicing internist but a midlife woman. I have been helping midlife women for over two decades with their menopausal symptoms and have gained significant personal insight about how little support is currently available for us.

During my forties, I noticed my body and energy level change. I began to feel tired and heavy. I also felt restless and had trouble sleeping through the night. I looked for answers to these symptoms in my medical books and journal articles. I even went to my gynecologist to understand why I was feeling this way. All she had for me were prescription drugs and hormone replacement therapy. She told me that this is peri-menopause and that I have entered this category in midlife. “It’s downhill from here,” she said. My visit was a huge disappointment. As a scientist and a problem solver, I was determined to understand why I was having these symptoms and what I could do to restore my sense of health and well-being.

I found a lot written on this subject. What I read though was theoretical but not practical and it did not address the deeper aspects of what I was looking for. Why did my soul feel restless? Why did I feel emotional ‘heaviness’? Why was my body changing in this way and why were issues resurfacing that I thought were solved? I was forty-two when I began to feel this way. I was an intelligent and dynamic woman who had lived a very healthy lifestyle. I had also created a successful medical practice and on the surface, appeared to be at the top of my game. Deep inside, I felt empty and disconnected. My marriage felt deeply unsupportive and I found myself less able to tolerate the disrespectful ways I was being treated. It was as if I was not able to compromise myself in order to adapt anymore. My tolerance for the superficial was receding. I found myself being more reactive and angry.

What I discovered was that hormonal shifts in my body that were normal during this stage of life brought with them emotionally and soul shifts that were offering me an opportunity to take a look at my life from a deeper perspective. Since I was conditioned to pathologize this, it engendered a deep fear of aging and degeneration. It was anything but.

This time in a woman’s life holds immense transformational power. When a woman arrives at this gateway, her hormones shift, recalibrating her identity. She is meant to question who she has pretended to be and move her deep into her soul and her authentic self. Our society deems this a ‘midlife crisis’. I like to think of this as the alchemical process of becoming real. Women need to learn how to take care of themselves through this gateway and beyond. They need to learn how to use the framework of transformation to connect with their intrinsic power and truth. At this juncture, women are in need of balance at all levels of their body, mind, emotions, and soul. Many have lived unbalanced lives up to this point, neglecting to take care of themselves. As their bodies change they are called to heal their self-neglect.

I would like to offer some simple solutions to support your midlife transformation:

  1. Work with a physician who can help you balance your hormones, not replace them. Bio-identical hormones are much safer alternatives to synthetic ones. They can quickly restore your feeling of well-being when used correctly in small doses. Most women are in need only of natural progesterone to balance the estrogen to progesterone ratio. Taking estrogen in even natural form can aggravate many symptoms of the menopausal transition. This needs to be customized by your physician to suit your biology and your sense of well-being. There is no “cookie-cutter” way to balance hormones.
  2. Acupuncture can make a significant difference in your well-being particularly if you are having a difficult time with menopausal symptoms such as hot flashes and night sweats.
  3. Have your thyroid levels checked? Make sure your physician orders a thyroid panel to give her/him a better understanding of the status of your thyroid as it can become sluggish during midlife. Make sure you have free T3 levels checked. These commonly decrease in midlife resulting in weight gain, fatigue, and foggy thinking. Replacing your free T3 and normalizing your TSH to a value between 1 and 2 will make a big difference in your sense of well-being. Moreover, low free T3 levels have been correlated to an increase in all-cause mortality.
  4. Clean up your diet. Change your diet to one that is mostly organic and plant-based. A plant-based Mediterranean diet has been shown to significantly lower the risk of heart disease, diabetes, and cancer, three of the most common diseases in the U.S. that present in midlife and beyond.
  5. Begin taking a therapeutic grade omega-3 supplement and vitamin D. These will decrease inflammation and strengthen your immune system, reducing the risk of disease.
  6. Make aerobic exercise a priority. At least 20 minutes of exercise, 6 days a week is needed to decrease the impact of physiological stress and restore cardiac health.
  7. Incorporate massage therapy, yoga, and meditation in your life as ways to heal stress and bring you closer in contact with your authentic self.
  8. Work with a psychotherapist to gain a better understanding of your real needs and desires and to dismantle the parts of you that no longer serve your life. Many feel that they can do this alone and with the help of friends, but it is much more effective and efficient to engage a professional who is objective and can clearly mirror what you need to work on to connect to your authenticity.
  9. Make a commitment to be true to yourself and seek a deeper sense of meaning every day. Stop compromising your real needs to be liked or accepted. This is one of the hardest patterns for women to break. Garner the courage to be true to yourself. You will earn the respect of many around you.

I invite you to reframe midlife from a time of crisis to one of transformation. The best years of your life are yet to come. Grace them as a seeker with deeper meaning and understanding so you can experience the power and sacredness of your authentic self and most of all experience a deeper sense of meaning now and for the rest of your life.

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Evidence Based Integrative Medicine