Midlife Strong: 2024 sneak peek (and a look back)

Getting ready for the best chapter yet

Photo by Walls.io on Unsplash

It’s been quite a journey that has brought me here. And like most things in life, it’s not at all what I expected.

Now just seems like the right time to reflect and plan for the year ahead. And those plans involve you!

Has it really been 5 years?

It's been five years since I made the choice to take on midlife. My very first post on my website was in January 2019 entitled: 5 signs you’re at midlife (and why it matters). At the end of this post, I made this declaration:

At midlife, our internal compass is trying to tell us where to go and what we need and it’s rarely pointing us in the same direction we’ve been going. And I’m determined to figure it all out.

I didn’t know what I was getting myself into. I knew I wanted to delve into research and writing about the midlife stage. I knew I was changing both physically and emotionally.

I wasn’t prepared for the gravity of “I’m determined to figure it all out.” My research started with where most of us start: changing hormones. Once I started researching, overwhelm hit me, and it’s safe to say it hasn’t stopped.

Very early perimenopause?

What planted the seed for my interest in midlife was a return of anxiety symptoms. I say return because I had these very symptoms right around age 30.

At 48, I got hit with increased heart rate, palpitations, driving anxiety, blood pressure phobia, fragmented sleep and swallowing problems that caused unintentional weight loss. I was a wreck!

I did a quick internet check to find that anxiety is common around perimenopause but didn’t really dig too deep. I saw a therapist, found the DARE program, and discovered deep and slow breathing, which helped. But not entirely.

As I dug deeper, I found more about anxiety and perimenopause. My research revealed that hormones shift before cycles are skipped or change drastically. They do not acknowledge this in the medical community as you can see below from the Straw staging system. The term I heard used was very early perimenopause and it would be somewhere around -3a (FMP is final menstrual period).

I assumed this early stage of perimenopause caused my anxiety, as I discussed in a post about the signs of perimenopause.

This can also help explain why I felt more anxious, a common complaint at midlife. In one study, out of 487 women aged 40-64, 53% of the premenopausal women reported anxiety and/or depressive symptoms, 66% of the perimenopausal did, and about half of the postmenopausal women. It’s no wonder that during this time women feel more stressed.

I made the mistake of blaming my hormones for how I was feeling instead of looking for underlying causes. But only a month after writing this post, I discovered I was anemic and had been low on iron for much of my 40s.

Iron deficiency is probably what occurred when I experienced these symptoms over two decades ago (heavy periods, running marathons, check).

Delving into iron and other micronutrients

My diagnosis of anemia sent me on a research rampage, which led to my most popular midlife-related post to date: Ferritin: the blood test women should be at every doctor’s visit.

It became clear that this was the primary reason behind my symptoms, particularly the fatigue, palpitations, and swallowing difficulties. Low iron revs up the sympathetic nervous system to keep up with oxygen demands, causing an increase in heart rate, palpitations, and sleep problems.

I can’t say it’s 100% because of low iron. My shifting hormones, which at the time likely meant higher estrogen, could very well have influenced these symptoms. As I started becoming iron replete, my symptoms pretty much disappeared.

This was also the impetus to check other micronutrients, and I discovered I was likely low on iodine and B vitamins and wasn’t optimizing vitamin D and omega-3 fatty acids. 

I also discovered the vital importance of nitric oxide, trying beetroot supplements and eventually focusing on diet and other aspects like breathing.

But what was the ultimate turning point in how I viewed the midlife journey was the release of the 2020 Dietary Guidelines for Americans.

Midlife: the overlooked developmental stage

The 2020 guidelines came out late - December 2020. When I read the report, something clicked. For the first time, they took a life stage approach. In it they had info on infants, young children, adolescence, pregnancy, adults, and older age. There was nothing about midlife.

Think about it. The needs of someone in their 20s was lumped in with people in their 40s, 50s and early 60s. This was around the time I found the work of psychologist and lifespan theorist Margie Lachman, who had been calling for more research on midlife.

I also posted about a recent study showing the dearth of research on midlife women. And doing my check, I found only one medical journal and organization/society dedicated to the midlife stage.

One way to think about it is by comparing it to how we approach adolescence and puberty. The developmental stage is adolescence, of which puberty is a part of.

We know that for both boys and girls, there is a growth spurt and that even after puberty; the brain is still developing until 25, and bones continue to grow until 30. We’ve also defined emotional and cognitive changes with early, middle, and late adolescence.

But for midlife women, menopause is "the" focus with very little about midlife. Although we are in a maintenance/decline stage, we just haven’t defined it very well or studied how it affects both males and females.

The fact remains that we are aging in addition to experiencing changing hormones. So, because we focus almost exclusively on menopause, there’s a tendency to attribute most of what goes on to our hormones. But we’re missing the other half!

Now we have all these menopause symptom "lists" which lack research showing hormones are the cause. How many women just wait it out, assuming once they hit menopause it will ease? I think this reflects a gap in the knowledge, which I want to start to fill.

In short, my aim is to address both the aging and hormone changes midlife women experience [aging pause], and how they can fine-tune their lifestyle to meet their changing needs.

False starts with the book

Early on, this book felt impossible to write, mainly because my focus kept developing as I was researching. I realize it was wrong to declare I was writing a book when I didn’t have the base level of knowledge needed.

I’m happy to say that I have made real progress and am committed to getting the book out in 2024 even if I must get up every morning at 4am!

But now I’m in such a good place to continue and get it done. Admittedly, this Substack set me back, but now I’ve got a better system down for my posts.

I understand that a book isn't everything and I can contribute a lot here. The book is just pulling everything together in one place.

I also will update you on my work to influence research and public policy regarding midlife women’s health issues.

Substack plans for 2024

In 2024, I not only want to grow this Substack but provide extremely valuable content. I’ll be writing more about what’s in the book, including details about each of the 6 lifestyle factors.

I plan to run periodic “fine-tune challenges” to turn information into doable action. My first one will be in January or February, so lookout for it.

I'll also be interviewing researchers and health experts who are making significant contributions but are not widely recognized.

People have been asking how they can support me, so I have turned on pledges. I would like to keep my posts free so more women can find them.

I will also work towards building a community and increasing engagement through more comments and interaction. So don't hesitate to like a post or comment.

I’d like to highlight reader questions, so if you have a burning question, let me know!

I would like to thank you for being here. Some of you have been with me since the very beginning. Thanks for sticking with me. I’m doing this for you and all the women out there that deserve so much more than they are getting.

Next Monday is Christmas so you’ll hear from me next on New Years day, 2024!

What would you like to see more of in 2024? Reply to this email or leave a comment!