You know how people say, "Just drink some water and take a magnesium supplement" like it’s the answer to everything? Well… they’re not totally wrong. But like most good advice, the devil is in the details. Magnesium is one of the most essential minerals in the body, involved in over 300 enzymatic reactions , yet it remains one of the most commonly overlooked deficiencies in midlife women. And no, your annual bloodwork probably didn’t catch it. So What Does Magnesium Actually Do? Think of magnesium as a multitasking background assistant—it keeps the lights on and the gears turning across nearly every body system: Brain & Mood: Regulates GABA and NMDA receptors, supporting calm, focus, and resilience against anxiety and overstimulation. Muscles: Prevents cramping and twitching, supports strength and recovery, and reduces restless legs. Sleep: Plays a role in melatonin production and nervous system regulation. Bowel Function: Helps pull water into the colon to prevent constipation. Cardiovascular Health: Regulates blood pressure and helps with vasodilation. Hormone Balance: Assists in estrogen metabolism and combats insulin resistance. In short: if you’re exhausted, bloated, moody, foggy, tense, or irregular in your gut or cycle—magnesium deserves a spot on your radar. Why Is Magnesium So Important in Midlife? Estrogen and progesterone both influence magnesium levels. As hormone levels decline or fluctuate during perimenopause and menopause, so does your ability to retain and utilize magnesium. Add to that: Chronic stress (which depletes magnesium) Modern diets (often low in magnesium-rich whole foods) Medications like PPIs, diuretics, or certain antibiotics High caffeine, sugar, or alcohol intake (all increase magnesium excretion) And suddenly, a " borderline magnesium issue " becomes a perfect storm. Why Your Blood Test Might Not Show It Serum magnesium tests only reflect ~1% of total body magnesium. Most magnesium is stored in bone and tissue. So it’s very possible to have "normal labs" and still be clinically deficient. In practice, we go by symptoms, risk factors, and therapeutic response. Common Signs of Suboptimal Magnesium Trouble falling or staying asleep Anxiety or nervous system overactivation Fatigue or burnout that doesn’t resolve with rest Muscle cramps, spasms, or eye twitches Constipation Menstrual migraines or tension headaches Joint stiffness or tightness Sugar cravings or blood sugar crashes Best Food Sources of Magnesium Magnesium-rich foods include: Dark leafy greens (spinach, chard) Nuts and seeds (especially pumpkin seeds and almonds) Avocados Legumes Dark chocolate (yes, really!) Whole grains like quinoa and oats That said, many of us still fall short even with a healthy diet, especially during high-stress seasons or if absorption is impaired. Supplements: Which Type of Magnesium Is Best? Not all magnesium is created equal. Here are the forms we most often recommend: Magnesium Glycinate: Best for sleep, anxiety, and muscle relaxation. Gentle on the stomach.** Magnesium Citrate: Useful for constipation, but can cause loose stools at higher doses. Magnesium Threonate: May support cognitive function and brain health. Magnesium Malate: Good for energy and muscle pain, often used in fibromyalgia. We generally avoid magnesium oxide unless constipation is the only concern, as it’s poorly absorbed. **Mag Glycinate is generally my go to recommendation and what we take at our house Also, BLENDS can be good- but generally more expensive Dosing & Timing Most women benefit from 200–400 mg daily, depending on needs. Take it in the evening if you're targeting sleep or relaxation. Divide doses if taking more than 300 mg (e.g. AM + PM). Always start low and go slow, especially with citrate forms to avoid urgent bathroom visits. Final Thoughts If magnesium had better marketing, it would be a top-tier wellness darling. But because it’s quiet, essential, and boring on paper, we tend to overlook it. Yet for so many midlife women, magnesium is the missing link that helps all the other systems and strategies finally click. So if you're doing "everything right" and still feel off? It might be time to start taking magnesium!

"Is Ozempic safe?" "Do I have to be diabetic to use it?" "Will I regain weight if I stop?" "I eat well, lift weights, sleep, take hormones—and I still can't lose weight. What's going on?" These are some of the most common questions I hear from women in midlife. And they’re incredibly valid. For decades, the conversation around weight and health has been riddled with shame, assumptions, and surface-level advice. But we’re finally shifting into a new era—one that recognizes obesity as a chronic, complex disease, not a personal failure. One that looks at metabolism through the lens of hormones, inflammation, genetics, stress, and brain chemistry, not just calories in and out. And at the center of this shift is an exciting class of medications known as GLP-1 receptor agonists. What Are GLP-1 Medications? GLP-1 stands for glucagon-like peptide-1, a hormone your body naturally produces in the gut. It helps regulate blood sugar, insulin, and satiety (your sense of fullness). GLP-1s also slow gastric emptying and signal your brain to reduce appetite. Medications like semaglutide (Ozempic, Wegovy), liraglutide (Saxenda, Victoza), and tirzepatide (Mounjaro) mimic this hormone and have been revolutionary for treating type 2 diabetes—and more recently, for metabolic syndrome and obesity. These drugs are not stimulants or fad diet tools. They are hormone-based medications with powerful metabolic and anti-inflammatory effects. Why Are GLP-1s So Relevant for Midlife Women? Midlife is a time of massive hormonal transition. Estrogen, progesterone, and testosterone levels shift dramatically in perimenopause and menopause. This impacts insulin sensitivity, body composition, lipid metabolism, sleep, inflammation, and brain function. Even women who have optimized their lifestyle—dialing in nutrition, strength training, sleep, and hormone therapy—may find themselves stuck. GLP-1 medications can be the missing piece for women who: Have insulin resistance or prediabetes that isn’t budging with lifestyle alone Carry weight disproportionately in the visceral (abdominal) area Are at increased cardiovascular risk due to family history, labs, or existing conditions Are experiencing significant inflammation or joint pain related to metabolic dysfunction Have a history of PCOS or gestational diabetes Are postmenopausal and noticing rapid changes in weight or metabolism These medications work synergistically with hormone therapy and can reduce inflammation, improve insulin sensitivity, and help shift body composition. For some women, they are as life-changing as starting estrogen. It’s Not Just About Weight Loss GLP-1s are being studied for NAFLD (fatty liver), cardiovascular protection, neurodegenerative disease, PCOS, and even addiction and mood regulation. The benefits go far beyond the scale. That said, when stubborn weight is a major barrier to living fully—whether due to physical discomfort, comorbidities, or psychological toll—helping a woman reduce weight safely and effectively can open the door to movement, joy, and hope. So, Who Should Consider a GLP-1? I don’t believe in prescribing these meds as a first-line for someone who hasn’t addressed the basics. That’s not judgment—it’s strategy. If you haven’t worked on: Blood sugar balance through real food Resistance training and daily movement Addressing sleep and circadian rhythms Managing stress and nervous system regulation Optimizing hormones, micronutrients, and gut health … then you’re not giving yourself the best shot at lasting change. But if you have done the work and still feel like your body is working against you—or you have serious metabolic risk factors— then GLP-1 therapy might be a wise and evidence-based next step. Some women use it briefly to reset. Others may need it long-term, just like hormone therapy. It’s not a crutch. It’s a tool. And for the right woman, it can be life-changing. Common Questions I Hear "Will I gain the weight back if I stop?" Maybe—but not always. If the lifestyle foundations are in place, many women maintain progress even after discontinuing. But some women have chronic conditions that benefit from ongoing use. That’s not failure—that’s biology. "Are there side effects?" Yes. The most common are nausea, constipation, or bloating early on. Starting slow, staying hydrated, and eating smaller portions helps. Rare but serious risks exist, including pancreatitis. A good clinician will walk you through these carefully. "Will I lose muscle?" You can—unless you’re strength training and eating enough protein. We talk a lot about this at Wondercreek. Protecting lean muscle is critical. "Is this forever?" Not necessarily. Some women use these meds to reduce inflammation, restore insulin sensitivity, and break a cycle. Others stay on them longer due to underlying metabolic dysfunction. Every plan is individualized. Final Thoughts GLP-1 medications aren’t for everyone. But they are not cheating, shameful, or lazy. They’re a legitimate, science-based treatment for a serious, chronic condition. In my practice, we focus on healthspan—not just lifespans. That means preserving function, preventing disease, and helping you feel energized, sharp, and resilient for as long as possible. For some women, GLP-1 therapy is one of the most powerful tools we have to get there.

You’ve probably seen it popping up in wellness podcasts, health stores, or even your friend's supplement cabinet: bovine colostrum. Marketed for gut health, immune support, and recovery, this early-life nutrient source for calves is now showing up in adult wellness routines. But is it worth your time and money? As a lifestyle medicine physician focused on women’s midlife health and longevity, here’s what I want you to know before you jump on the colostrum bandwagon. Let’s Start With the Basics: What Is Colostrum? Colostrum is the first form of milk produced by mammals (including humans) in the first few days after giving birth. It’s loaded with antibodies, growth factors, and immune-modulating compounds designed to jumpstart a newborn’s immune system and line the gut. Bovine colostrum—from cows—is the form used in most supplements. It's freeze-dried and packaged into powders or capsules, and often promoted for: Gut barrier support ("leaky gut") Immune system priming Exercise recovery Anti-aging benefits But let’s be honest: just because something has growth factors doesn’t mean it belongs in your Amazon cart. Does the Science Support It? Evidence in humans is limited— but not nonexistent. Some small clinical studies have shown potential benefits: Gut health: In people with NSAID-induced intestinal permeability ("leaky gut"), bovine colostrum has been shown to reduce damage and symptoms. Immune function: Some data in athletes suggests reduced upper respiratory infections. Exercise recovery: A few studies report improvements in performance, gut comfort, or muscle soreness—especially in endurance athletes. But these benefits aren’t guaranteed. And the quality and dosage of colostrum varies widely, with no standardized formulation across brands. So Should You Take It? Here’s where my clinical voice kicks in: Before you reach for colostrum, ask yourself: Have you addressed the basics? Are you sleeping? Managing stress? Eating fiber and whole foods? Getting enough protein? Building muscle? Moving your body? Supporting your gut with real food (not just powders)? If the answer is no—then colostrum is not your next step. You’re throwing powdered fuel on an engine that’s missing spark plugs. Do you have dairy sensitivity? Colostrum is a dairy product. Even if it's low in lactose, it may not be tolerated by everyone. Are you already taking quality foundational supplements? Vitamin D, omega-3s, magnesium, creatine, iron (when needed), and probiotics have stronger bodies of evidence for many women in midlife. When Might It Be Worth Trying? Colostrum might be a reasonable add-on if you: Have mild gut symptoms (especially post-infectious or stress-related) Are recovering from illness or antibiotics Train hard and experience frequent upper respiratory issues Want to support your immune system during travel or stress Even then, I recommend: A 2–3 month trial only after dialing in basics Choosing a third-party tested brand Tracking symptoms and benefits Cost, Hype, and the Bigger Picture Many women I work with are overwhelmed by supplement costs. Colostrum can run $50–100/month —and that adds up. So here’s what I tell my patients: Just because something is trending doesn’t mean it’s essential. And just because it works for someone on TikTok doesn’t mean it’s the right tool for your body right now. Your body is an incredible machine. When you give it rest, movement, nourishment, and support—it can do amazing things. Colostrum is not magic. It’s just one tool in a very big toolbox. Bottom Line Colostrum may hality sources. You’re not broken. You might just need a reset—not another powder.

If you’ve been wondering whether collagen is worth taking, you’re not alone. As a menopause & lifestyle medicine physician, I get this question every week—especially from women in their 30s, 40s, and 50s noticing changes in their skin, joints, nails, or hair. So yes, I take it daily. And here’s what the science really says. What Is Collagen? Collagen is the most abundant protein in the body, acting as scaffolding in our skin, joints, bones, blood vessels, and connective tissues. With age—and particularly during perimenopause—collagen production naturally declines, and falling estrogen levels slow your body's ability to build it. Evidence Spotlight: Skin & Wrinkles A 2023 meta-analysis of 26 randomized controlled trials (involving 1,721 people) concluded that hydrolyzed collagen significantly improves skin hydration and elasticity (p < 0.00001) ( article ). An earlier randomized trial also reported a 7.5% increase in skin elasticity after 8 weeks of supplementation ( article ). Joint Pain & Function In a 24-week randomized, double-blind placebo-controlled trial in athletes (n ≈ 97), daily collagen reduced multiple measures of joint pain at rest, walking, standing, carrying items, and lifting—with p-values as low as 0.001 (article ). A systematic review published just three months ago also confirmed that collagen improves joint pain and mobility, though evidence for bone density is less robust . Collagen Synthesis & Recovery: Emerging data suggest collagen peptides may boost markers of collagen synthesis (PINP) by 153% vs. 59% with placebo after resistance training, though more research is needed ( article ). My Clinical Take I see collagen as a nutritional tool—not a cure-all: It supports skin structure, joint resilience, muscle recovery, and possibly even pelvic floor health. It’s safe, easy to take, and backed by solid evidence. Taken consistently over 8–12 weeks, with vitamin C and strength training, it adds up. How To Take It Smartly Choose hydrolyzed collagen peptides (types I & III) from reputable sources. Take 2.5–15 g/day, depending on goals (skin vs. joint support). Add vitamin C to enhance collagen formation. Use it in coffee, smoothies, or tea—it's tasteless and heat-stable. Consistency > dose: it’s a daily habit, not a weekend cure. What’s Not Proven Hair and nail benefits: evidence isn’t strong yet. Replacing healthy protein—don’t forget whole food nutrition. Miracle anti-aging: collagen helps, but it’s one part of a broader lifestyle puzzle. Final Thoughts Yes, collagen is worth it— but only as part of a bigger health strategy: hormones, exercise, sleep, nutrition, and metabolic balance. You don’t have to chase youth. You just need to support your body so it can heal, repair, and stay resilient.

If you’ve ever been told that your mood swings, breast tenderness, or heavy periods are due to "estrogen dominance," you’re not alone. But the truth? The phrase "estrogen dominance" is often misunderstood and oversimplified—especially in midlife. In perimenopause, the problem is usually not that your body is producing too much estrogen. It’s that it’s not making enough progesterone to balance the estrogen you do have. And that fluctuating estrogen (sometimes high, sometimes low) can create chaos in your body and brain. Let’s dig in. What is Estrogen Dominance, Really? The term originally described a state where estrogen effects outweigh progesterone effects, either because estrogen is too high, or progesterone is too low. But in clinical practice—especially during perimenopause—we more often see the second scenario: Progesterone production drops first (due to fewer ovulations) Estrogen levels swing wildly (some months high, some months low) You end up with unbalanced estrogen, not necessarily excessive estrogen Symptoms can include: Mood swings or irritability Sleep disruption Heavy or irregular bleeding Breast tenderness or fibrocystic breasts Bloating Anxiety Brain fog If this sounds like your monthly reality in your 40s, you’re not broken—you’re probably in perimenopause. The Progesterone Problem One of the earliest hormone shifts in perimenopause is reduced ovulation. And if you’re not ovulating regularly, you’re not making enough progesterone. Progesterone is our calming, anti-anxiety, sleep-supporting hormone. It helps balance estrogen in the uterus, the brain, and the nervous system. When it's low, estrogen has no counterweight. Even normal estrogen levels can feel overwhelming without enough progesterone to buffer them. This is why so many women in perimenopause feel like their emotions are more intense, their PMS is worse, and their sleep is disrupted—even if their estrogen levels aren't technically high. Fluctuating Estrogen: The Rollercoaster Estrogen doesn't decline gradually in perimenopause. It swings. You might have: One month with a sky-high estrogen surge (hello, swollen breasts and heavy periods) The next month with almost none (hello, hot flashes and low libido) This is normal. But it’s not easy. And these fluctuations are often missed on bloodwork because hormone levels change hour to hour, not just month to month. That’s why we treat you, not just your labs. What About Estrogen After Menopause? Once you hit menopause (12 months without a period), your estrogen levels tend to stay low—but the symptoms may continue. Many women assume they are still estrogen dominant if they have weight gain, mood issues, or breast tenderness, but the truth is: You are likely estrogen deficient You may also be progesterone and testosterone deficient Some of your receptors may be more sensitive, or inflamed, giving you exaggerated responses This is where hormone therapy can play a powerful role in restoring balance. What You Can Do Track your symptoms: Patterns can tell us more than one-time labs Consider bioidentical progesterone: Especially if sleep, anxiety, or PMS are your biggest issues Support your liver: Detox pathways help metabolize estrogen safely Strengthen your gut: Your microbiome (especially the estrobolome) helps regulate estrogen levels Reduce stress: Cortisol can suppress progesterone and worsen hormone chaos Strength train: Builds resilience, stabilizes blood sugar, and helps with hormone receptor sensitivity

If you’re chugging water all day but still feel puffy, tired, crampy, or thirsty—this post is for you. 💧 Hydration is about more than just how much water you drink. It’s also about how well your body holds onto that water, where it goes, and whether it’s helping your muscles, brain, and hormones function properly. And for women in midlife, things shift. A lot. Let’s talk about why your hydration needs change—and what to do about it. Estrogen, Aldosterone & Fluid Balance Estrogen doesn’t just regulate your cycle—it influences electrolyte balance, thirst cues, and fluid retention. When estrogen levels drop in perimenopause: You may lose more sodium and fluid through your kidneys You may feel more bloating or puffiness, even with water Your thirst cues become less reliable You may become more sensitive to dehydration and heat This means that simply drinking more plain water might not help you feel better. In fact, if you’re not replacing electrolytes, you could dilute your body’s salt balance—and that can make you feel worse. Signs Your Hydration May Be Off Some subtle signs that your fluid balance could use a boost: Headaches or afternoon fatigue Dizziness or lightheadedness when standing Muscle cramps or twitching Constant thirst despite drinking water Feeling bloated after water or meals Poor exercise recovery or temperature intolerance Sound familiar? It’s not just in your head—it could be a signal your body needs more minerals, not just more water. Enter Electrolytes: What & Why Electrolytes—like sodium, potassium, magnesium, and chloride—help your cells absorb and use water properly. They’re also key players in nerve conduction, hormone signaling, blood pressure regulation, and energy production. You don’t necessarily need a fancy powder (though some are great). You can start simple: 💡 DIY Electrolyte Mix: 8–12 oz water A pinch of sea salt (1/8 tsp) A squeeze of fresh citrus (lemon or lime) Optional: 1/2 tsp maple syrup or a few drops of trace minerals This combo can help you: Rehydrate more effectively Reduce bloating or cramping Feel more energized, especially in the morning Do You Need Electrolytes in All Your Water? Nope— you don’t need electrolytes in all your water. But adding them strategically can make a big difference in how you feel, especially in midlife. Here’s when it helps most: ✅ First thing in the morning (you wake up a little dehydrated) ✅ During or after a sweaty workout ✅ On hot days or after sauna ✅ If you’re getting headaches, muscle cramps, or bloating ✅ When you're feeling that “tired but wired” stressy fatigue ✅ During perimenopause, when estrogen drops affect fluid regulation and salt sensitivity If you’re sipping on water all day and still feel dry, puffy, or low-energy—that might be a sign you need some minerals with it. But don’t overdo it. Just 1–2 electrolyte-rich servings a day is usually plenty for most people. Your kidneys are smart—they’ll handle the rest! Final Thoughts Hydration in midlife is more nuanced than just "drink more water." With hormonal shifts affecting how your body holds onto and uses water, a more strategic approach can go a long way—supporting energy, metabolism, cognitive function, and even sleep. So go ahead—check what’s in your water bottle. A pinch of salt and a squeeze of citrus might just be the midlife magic you’ve been missing.

You’re not crazy. You’re not lazy. And no, you’re not just "getting older." If you’re dragging through your days, feeling foggy, heavy, or worn out—but your labs are "normal"—you’re not alone. One of the most overlooked causes I find in my practice is suboptimal ferritin levels. Let’s break it down—with science, a little wit, and a whole lot of hope. Your Body: A High-Performance Machine Imagine your body like a beautifully engineered, high-performance car. Hormones are your spark plugs. Micronutrients are your engine oil. Proteins are your gears and pulleys. Without the right balance of all these building blocks, the engine sputters. It doesn’t matter how good the outside looks—if you're low on fuel or missing key fluids, you’re not getting out of the driveway. And iron —stored as ferritin—is a huge part of that fuel system. What Is Ferritin, and Why Should You Care? Ferritin is your body's iron storage protein. It’s like your gas tank. Not your current speed, not your miles per gallon—your actual reserve of fuel. Iron is essential for carrying oxygen to every cell in your body. It's crucial for energy production (ATP) in your mitochondria. It supports your thyroid, neurotransmitter function, hair growth, immune system, and even mood. If you’re low on ferritin, you might still show " normal " hemoglobin or hematocrit—so traditional screening won’t catch it until you’re running on fumes. Symptoms of suboptimal ferritin can include: Fatigue and poor exercise tolerance Brain fog or poor concentration Mood swings or low mood Headaches Hair shedding Shortness of breath with minimal exertion Restless legs or poor sleep Sound familiar? But My Labs Say I'm Normal... Here's the kicker: most lab ranges are designed to flag anemia — not optimal function. You could have a ferritin of 12 and be told " everything looks fine " — but feel absolutely awful. For most women, especially those who are still menstruating or recently stopped, ferritin levels under 40–60 ng/mL can cause symptoms . Many functional and integrative medicine specialists aim for 70–100+ ng/mL to support optimal energy, cognition, and hair health. Low-normal is not optimal. When your engine light is blinking, topping off the tank halfway doesn’t cut it. Why You Might Be Low Menstruation: Every period can deplete iron stores, especially if cycles were heavy. Pregnancy and postpartum: Even years later, many women never rebuild their iron stores. Gut health issues: Poor absorption due to low stomach acid, celiac disease, or IBS. Dietary patterns: Plant-based diets can be low in easily absorbed heme iron. Chronic inflammation: Inflammatory signals can "hide" your iron from circulation. Food First, But Realistic Yes, food matters. Red meat, poultry, seafood, lentils, spinach, and pumpkin seeds all contribute iron. But rebuilding storage? That’s a bigger lift. Think of dietary iron like filling up your gas tank 10–15% at a time. Helpful, but slow if you're starting on empty. Sometimes you need a boost. That’s where targeted supplementation can help—whether it’s gentle oral iron (like iron bisglycinate) or occasional intravenous iron if needed. And by the way, ever wonder why "senior" vitamins have no iron? Because postmenopausal women typically don’t lose blood monthly. We don’t want too much iron. But we also can’t function with too little. Balance is everything. Final Thoughts If you’re feeling run down, foggy, achy, or unlike yourself—it’s not "all in your head." Your body is whispering (or screaming) for better support. And sometimes the missing piece isn’t fancy. It’s basic, foundational, and fixable. Ferritin matters. Iron matters. You matter. At Wondercreek Health, I believe in digging deeper, connecting the dots, and helping you rebuild the strong, steady foundation your body deserves. Because you weren’t designed to run on empty. Iron-Rich Foods to Boost Your Levels Beef, lamb, liver (heme iron is best absorbed) Dark poultry (chicken thighs, turkey) Shellfish (clams, oysters, mussels) Lentils and chickpeas Spinach and swiss chard Pumpkin seeds and cashews Fortified cereals and oatmeal Tofu and tempeh Tip: Pair iron-rich foods with vitamin C (like bell peppers, oranges, or strawberries) to boost absorption! Ferritin Target Chart Ferritin Level What It Means <15 ng/mL Severe deficiency 15–40 ng/mL Low stores (symptoms likely) 40–60 ng/mL Borderline (may still have symptoms) 70–100+ ng/mL Optimal for energy, cognition, hair health Individual needs vary—always interpret ferritin in the context of your full health picture! When to Suspect Low Iron Feeling tired despite good sleep Exercise feels harder than it used to Brain fog or poor memory Unexplained hair thinning Pale skin or brittle nails Frequent headaches Restless legs or poor sleep Shortness of breath climbing stairs If you’re nodding along to several of these, it’s worth a closer look at your ferritin levels.

Let’s start with this: there is nothing shameful or trivial about wanting a healthy sex life. If you're in your 30s, 40s, 50s, or beyond and wondering where your libido went, why sex feels different (or uncomfortable), or why no one ever warned you about vaginal dryness, you’re not alone. And you’re not imagining it. At Wondercreek Health, I talk to people every week who feel confused, dismissed, or ashamed about the sexual changes happening in their bodies. Many are thriving in every other area of life—careers, caregiving, health—but when it comes to intimacy, they feel stuck or unseen. So let’s say this together: sexual health is part of whole-person health. And pleasure is not optional . It’s a reflection of nervous system safety, hormonal balance, connection, and self-awareness. It belongs to you. What Happens to Sexual Health in Midlife and Beyond? Hormonal shifts during perimenopause and menopause can affect every part of your sexual experience. But so can chronic stress, birth control, antidepressants, trauma, and the weight of daily responsibilities. This is never just one thing. Common symptoms include: Vaginal dryness, burning, or itching (genitourinary syndrome of menopause, or GSM) Pain with sex (dyspareunia) Loss of libido or arousal Less intense or harder-to-reach orgasms Urinary urgency or UTIs Pelvic floor tension or dysfunction These changes aren’t "just in your head" and they’re not a moral failure. They reflect real shifts in tissue, blood flow, hormones, and brain chemistry. Sex Isn’t Just for Someone Else’s Benefit Let’s say the quiet part out loud: many of us were raised to believe that sex was about someone else's pleasure. That we should be desirable, responsive, available—regardless of how we felt. That conditioning runs deep. But sex isn’t about performance. It’s about connection, intimacy, and pleasure—for you. Pleasure is your birthright. Intimacy can be tender, playful, spiritual, or wild— but it should never feel like pressure. Your desire may look different than someone else's, and that’s okay. This is true whether your partner is male, female, nonbinary, or you're navigating intimacy solo. There is no one-size-fits-all experience. Why Your Desire Might Feel "Off" Sexual changes can happen at any age. Oral contraceptives (OCPs) can suppress libido by lowering free testosterone. SSRIs and other antidepressants are well known to impact arousal and orgasm. Perimenopause often starts in the mid-30s, long before you notice hot flashes. Chronic stress and the mental load of caregiving, multitasking, and decision fatigue can leave no room for desire. Because here’s the reality: desire doesn’t live in your genitals. It starts in your brain . And when your brain is overloaded with to-dos, responsibilities, or unspoken resentment, it’s nearly impossible to shift into a space of curiosity, connection, and arousal. Unwinding the mind can be hard. For some of us, it means learning to use tools like mindfulness, breathwork, somatic practices, therapy, or just having space and time away from the demands of the world. Creating room for desire isn’t selfish. It’s a form of self-trust and reclamation. The Good News: This Is Treatable Sexual health doesn’t have to decline just because estrogen does. There are safe, effective, empowering ways to reconnect with your body and reclaim your pleasure. 1. Local vaginal estrogen (or DHEA or testosterone): Restores tissue health, lubrication, and blood flow Improves comfort, arousal, and pelvic health Safe for most people, even those with a history of breast cancer (with appropriate guidance) 2. Systemic hormone therapy: Can improve libido, mood, sleep, and confidence Testosterone therapy (when indicated) can support arousal and orgasm 3. Pelvic floor physical therapy: Addresses pain, tension, and coordination issues Supports better sensation and comfort 4. Nervous system regulation: Practices like breathwork, somatic therapy, or trauma-informed care help shift from "fight or flight" into connection When the nervous system feels safe, desire can return 5. Sex therapy or coaching: Helps explore personal blocks, relationship dynamics, and pleasure mapping Let’s Talk About Desire You might notice you don’t feel spontaneous desire anymore— but that doesn’t mean you’re broken . For many people, responsive desire (desire that follows arousal) becomes the norm in midlife. And it’s perfectly valid. Touch, connection, and intimacy may need more warming up. But your ability to experience pleasure is still intact—and it can grow deeper, richer, and more grounded as you reconnect with your body on your own terms. Final Thoughts You don’t need to be fixed. You deserve to be heard. You deserve to feel good in your body. Sexual health is not about keeping up with anyone else’s timeline or expectations. It’s about reclaiming what intimacy and connection mean to you in this season of life. At Wondercreek Health, I’m here to help you connect the dots, reduce shame, and support you with science-backed, judgment-free options that honor your experience. Because this is not the end of your sexual story. It might just be the beginning of the most powerful chapter yet.

Let’s be honest: midlife can feel like your body is changing the rules without warning. You’re doing what used to work, but the results aren’t the same. The scale doesn’t budge, your sleep is disrupted, your energy is inconsistent, and your moods might feel like a rollercoaster you didn’t sign up for. And while hormone therapy, supplements, and nutrition are powerful tools for navigating perimenopause and menopause, movement—especially strength training and nervous system-aware exercise—is one of the most underutilized forms of medicine. As a lifestyle medicine physician and menopause specialist, I talk about this daily with my patients. Movement isn’t just about burning calories. It’s about retraining your stress response, building metabolic resilience, preserving muscle, and improving insulin sensitivity. Why Movement and Muscle Matter in Midlife During perimenopause and menopause, we experience natural declines and fluctuations in estrogen, progesterone, and testosterone. These shifts impact far more than reproduction—they affect how we regulate blood sugar, manage stress, build muscle, sleep, and recover from daily life. In this stage of life: Muscle mass declines more rapidly if not actively maintained Insulin sensitivity drops, raising the risk for metabolic syndrome and weight gain Cortisol levels rise and become harder to regulate, especially in women with high stress or trauma histories Nervous system resilience weakens, making it harder to bounce back from emotional or physical stressors Movement is the antidote to all of this. What the Research Shows Muscle is a metabolic organ. It stores glucose, improves insulin sensitivity, regulates inflammation, and even contributes to hormone production and detoxification. Building and maintaining muscle in midlife is one of the most powerful ways to protect against: Type 2 diabetes and insulin resistance Cognitive decline Cardiovascular disease Falls, fractures, and osteoporosis And beyond the physical? Movement is critical for regulating the autonomic nervous system, which influences: Your ability to sleep Your mood and anxiety levels Your response to daily stressors Your digestive and immune function Not Just Any Movement This isn’t about hitting the gym for 90 minutes or going hard every day. It’s about intentional movement that supports your biology. Here’s what I recommend: 1. Prioritize strength training. 2–3 times per week of bodyweight, resistance bands, dumbbells, or machines Focus on form, tempo, and functional movement—not just reps or weight 2. Include low-impact, nervous-system regulating movement. Walking, mobility flows, Pilates, yoga, or tai chi Think of this as your recovery and resilience training 3. Move throughout the day. Break up sedentary time with stretching, light movement, or standing tasks Movement snacks matter for metabolic health 4. Don’t overtrain. Too much high-intensity exercise can increase cortisol, disrupt sleep, and worsen hormonal symptoms Listen to your body and focus on consistency over intensity It’s Not About Looking Fit. It’s About Feeling Well. This phase of life isn’t just about managing symptoms—it’s about building your future resilience. Every time you lift something heavy, take a walk, or stretch with intention, you are: Supporting your insulin and glucose balance Reinforcing your bone, brain, and cardiovascular health Regulating your nervous system Building muscle that keeps you independent and active for decades to come Movement is medicine, & muscle is your midlife superpower. Final Thoughts If you feel like your metabolism has shifted, your sleep is off, or your body feels unfamiliar—you’re not alone. But you’re not broken. You’re evolving. And your body is still responsive to thoughtful support. Start small. Lift something. Go for a walk. Move in a way that honors your nervous system, builds strength, and reminds you that this phase of life is not a decline—it’s a recalibration.