Our Feisty Menopause 2024 Wish List

More research, resistance training, and grace rank high on our want list for the New Year.

By Selene Yeager

It’s a brand new year with days on the calendar lying at our feet like a blanket of new fallen snow. We here at Feisty Menopause are excited about what’s in store for 2024, including exciting podcast content with top menopause researchers like Dr. Rebecca Thurston, presenting on menopause at USA Triathlon’s Endurance Exchange, and a new course we have in the works (get a glimpse here!). 

We also want to see this menopause conversation continue to grow and for women to finally have access to the information and care they deserve. So as we start our journey into the next 52 weeks filled with conversations about all things menopause, here are a few things we’d like to see gain more traction in 2024.

Clear Communication & Understanding of Hormone Therapy

This is a biggie. We often talk about hormone therapy in one breath as though it’s one thing when it’s a whole lot of things. 

It’s estrogen, which comes in various forms, including 17beta estradiol (which is the same molecular structure as our predominant circulating estrogen) and conjugated equine estrogens or CEE (like Premarin a mixture of 10 to 50, depending on the source you check, estrogens derived from urine from pregnant mares), among others. It can be applied topically or taken orally. If you have a uterus, HT also includes progesterone (like micronized progesterone) or progestogens (synthetic compounds that mimic progesterone), which are also available in various forms, including combined with estrogen in a patch or pill. All of these may have different effects. 

Often people, including credentialled experts will say, “Hormone therapy does X, Y, and Z!” when they really mean estrogen therapy does those things, because when you add progesterone, the picture can often change. Research that is drawing from older studies that used older formulations of hormone therapy don’t necessarily reflect what women are using today. The list of confounding factors goes on and on. As we move forward, sorting through this confusion and drawing the clearest picture possible is important. 

Spotlight on Resistance Training 

Boy oh boy…this is a drum I’ve beaten nearly to tatters, but I’ll say it again: resistance training should be presented as priority #1 for women, especially once they hit the menopause transition. We can lose 10% of our muscle mass during perimenopause. We can lose up to 20% of our bone density during the five to seven years following menopause (yet most women with osteoporosis are treated with nothing…). The hormone irisin, which is secreted by skeletal muscle, is very good for brain health and may be protective against Alzheimer’s disease. Muscle loss during menopause is a driver behind body composition and important cardiometabolic changes we see during and beyond the menopause transition. We need to be doing regular resistance training, full stop.

Right now the official exercise guidelines still put their focus on aerobic exercise most days a week with muscle-strengthening activities recommended twice a week. There are exercise scientists who are pushing to change that because of evidence that resistance training can elicit similar health benefits to aerobic training. Let’s put it on our priority list, and hope that the health and medical system does as well. 

Clarity on Hormone Testing

Hormone testing is a waste of time and money. Everyone should do hormone testing. Spend 5 minutes on the Menopause Internet and you’ll find people arguing passionately on both sides. Again, hormone testing isn’t just “one thing”. It’s a lot of things, including markers beyond estrogen and progesterone. At a time when we can test and track pretty much everything, it makes sense that women want to know their levels of hormones that play important roles in their lives. But what it all means is as clear as mud. Right now it feels like it’s being simultaneously both undersold and oversold. Women deserve better. 

Lean Body Mass/Strength Goals

In my dream world, we would go to our doctor and instead of having you stand on the scale and telling you to lose weight based on your BMI (which, let’s face it, happens a lot), they would do a body composition scan and strength test and give you a lean body mass and/or strength score to work on. Sure, you can talk about fat loss. But let’s give people a positive metric to work on that will make a giant, measurable difference in their lives. 

Grace

Menopause can be a challenging time. Midlife can be a challenging time. The internet is a challenging place. We don’t have to agree with each other. Heck, we don’t really even have to like each other. We also don’t have to name-call, yell, and go to virtual war with each other online. We can observe without absorbing every post we come across. And most importantly, we can give each other a whole lot of grace as we navigate this space in our lives. Wishing you all a happy and healthy new year.