The energy from the sold-out 2025 Women’s Health Summit in Scottsdale continues to reverberate. Between October 9-11, practitioners gathered at The Westin Kierland for an intensive deep-dive into menopause medicine, emerging from three days armed with protocols, data, and strategies that directly address the most pressing challenge in women’s healthspan optimization: menopause.
Our second-ever Summit delivered on its promise to equip providers to empower their patients’ journeys through this consequential and long-lasting hormonal transition. A lineup of leading female health experts presented evidence-based frameworks spanning metabolic health, hormone optimization, genetic influences, musculoskeletal preservation, mental health support, and systemic healthcare reform. Each session provided immediately applicable clinical tools designed to elevate women’s health outcomes in practice.
Transforming Menopause Care One Lecture At A Time
We gathered key insights from a selection of standout sessions and distilled some of their most notable takeaways, complete with data points, protocols, and practical implementation strategies. If you weren’t able to join us this year, keep reading to discover what breakthroughs are shaping the next chapter of women’s health and how to keep pace with the changing landscape.
Menopause Metabolism: Rewriting the Weight Gain Narrative
Carrie Jones, ND, FABNE, MPH, MSCP
Dr. Carrie Jones, a prominent voice in functional endocrinology, delivered a presentation that reframed the conversation around menopausal weight gain. Moving beyond the simplistic “estrogen deficiency” model, Dr. Jones examined the specific hormonal changes driving weight accumulation during the menopausal transition, with particular focus on visceral adiposity and its metabolic implications. The presentation provided evidence-based nutritional approaches that support metabolic function rather than simply restricting calories, and outlined practical interventions practitioners can implement to help patients achieve better metabolic outcomes during this critical life stage.
Lecture Takeaways
Estrogen loss impairs blood sugar regulation and reduces basal metabolic rate by 250-300 kcal daily, which can lead to an average weight gain of approximately 2 kg per year if lifestyle habits remain unchanged. Women gain an average of 1 lb per year during the menopausal transition, with average weight gain over 3 years of 4.4-5.1 lbs.
FSH elevation represents a newly recognized independent contributor to metabolic dysfunction. Elevated FSH levels contribute to the development of osteoporosis, obesity, and cognitive decline after menopause, independently of estrogen loss, challenging the traditional hormone-centric model of menopausal changes.
The “protein leverage effect” emerges as a critical factor in menopausal weight management. Hormonal shifts trigger this phenomenon, altering body composition through ongoing protein loss combined with relatively low dietary protein intake, leading to excess intake of fats and carbohydrates as the body attempts to meet protein needs, ultimately promoting weight gain.
Cardiometabolic risks escalate sharply postmenopause. Obesity impacts approximately 47% of women between the ages of 40 and 59, while hypertension affects roughly 55%. Postmenopausal women exhibit 36% more trunk fat, 49% more intra-abdominal fat area, and 22% more abdominal subcutaneous adipose tissue compared to premenopausal women.
Mediterranean and high-fiber dietary patterns demonstrate measurable benefits. The Mediterranean diet supports metabolic and cardiovascular health in menopausal women by promoting healthy cholesterol, blood pressure, and blood sugar levels. Adherence is linked with lower visceral fat in postmenopausal women.
Practical Pearls
Protein intake requires strategic adjustment.
Promote minor diet changes, including an additional 1-3% or 20-30g of high-quality protein per day, combined with regular weight-bearing exercise. Target 1.0-1.6 g/kg/day protein for most menopausal women, with per-meal dosing of 25-30g of high-quality protein per meal, including approximately 2.5g leucine.
Omega-3 fatty acid supplementation significantly reduces triglycerides.
Supplementation lowers serum triglycerides by up to 25% and is associated with a 26% lower risk of metabolic syndrome, particularly at higher dietary or blood levels.
Myo-inositol provides robust cardiometabolic benefits.
Supplementation at 2g twice daily for six months decreased insulin resistance by 75% as measured by HOMA-IR, reduced triglycerides by 20%, decreased diastolic blood pressure by 11%, and increased HDL by 22%.
Berberine offers comprehensive metabolic support.
Dosing at 300-500mg 2-3 times per day, alone or as an add-on therapy, improved cardiometabolic health by lowering HbA1c by approximately 0.7%, fasting glucose by 0.9 mmol/L, and two-hour glucose by 1.3 mmol/L, while also reducing insulin resistance, lipids, and inflammation. Modest BMI reduction was also demonstrated.
HRT Alternatives and Adjuncts: Evidence-Based Natural Approaches
Deanna Minich, PhD
Dr. Deanna Minich, an internationally recognized expert in functional nutrition and lifestyle medicine, delivered a comprehensive examination of natural and integrative approaches to menopause management. Addressing the reality that less than 5% of women use hormone therapy, Dr. Minich provided a systematic framework for understanding hormone physiology across five phases: synthesis, transport, activation, metabolism, and excretion. Her presentation offered clinicians a structured approach to supporting each phase through nutrition, lifestyle interventions, and evidence-based supplementation, creating a whole-person strategy that addresses antecedents, triggers, and mediators rather than simply replacing hormones.
Lecture Takeaways
The gut-gynecological axis demonstrates bidirectional influence. Ovarian aging drives systemic aging in females, and the gut-ovary axis exhibits a bidirectional relationship. Postmenopausal women exhibit gut dysbiosis characterized by reduced microbial diversity and lower levels of short-chain fatty acid-producing bacteria, such as butyrate producers. Animal models, including ovariectomized mice, exhibit gut barrier disruption, increased inflammation, and downstream effects on bone and reproductive tissues.
Environmental exposures impact ovarian function. Evidence links phthalates, PFAS, chlorinated organic compounds, and air pollution with adverse changes in ovarian function, including decreased estradiol, increased testosterone, and impaired ovarian reserve. Postmenopausal women often have higher blood lead levels than premenopausal women, with adjusted median blood lead levels approximately 25-30% higher, reaching around 2.0 μg/dL.
SHBG serves as a critical metabolic marker. Sex hormone-binding globulin levels below approximately 76.6 nmol/L are associated with increased risk of metabolic syndrome. High dietary glycemic load and glycemic index can lower SHBG in postmenopausal women, while greater intake of dietary fiber tends to elevate SHBG levels.
Practical Pearls
Target an Omega-3 Index of 8-12% through supplementation.
Given the dramatic decline in conversion efficiency after menopause, direct EPA/DHA supplementation becomes essential to maintain optimal omega-3 status.
Carotenoid intake may delay ovarian aging.
A diet containing approximately 400 micrograms of beta-cryptoxanthin per day from mandarins, oranges, and peaches may help delay ovarian aging by 1.3 years.
Melatonin supplementation supports multiple systems.
Clinical trials using 2-3mg nightly improve sleep, quality of life, and bone density. One-year treatment with 1mg melatonin increased BMD at the femoral neck in a dose-dependent manner, while high-dose 3mg melatonin increased volumetric BMD in the spine.
Maca supplementation shows promise for hormonal balance.
RCTs demonstrate an 84% success rate in reducing menopausal symptoms, with improvements in lipid and bone density markers. Maca-GO increased estradiol from a baseline of 26 pg/mL to 69 pg/mL at month 4 in postmenopausal women, while FSH decreased from 73 mIU/mL at baseline to 50 mIU/mL at month 4.
Ashwagandha provides comprehensive symptom relief.
In 91 perimenopausal women taking 300mg twice daily for 8 weeks, significant improvements in total Menopause Rating Scale and MENQOL scores were observed versus placebo, with increases in estradiol and decreases in FSH/LH.
Exercise caution with DIM during hormone therapy.
DIM users showed statistically significant changes in urinary estrogen metabolite profiles compared to estradiol-only users. DIM may alter estrogen metabolism in women on MHT, potentially reducing the intended estrogenic impact.
Breaking Barriers: Menopause, Equity, and the Future of Women’s Health
Erika Schwartz, MD
Dr. Erika Schwartz, a pioneering voice in women’s health reform, delivered a profound examination of the systemic failures that have left menopausal women underserved, undertreated, and dismissed by the healthcare system. Her presentation traced the lasting damage from the Women’s Health Initiative study, exposed the massive disparities in menopause care across racial, economic, and geographic lines, and outlined the staggering costs of inadequate menopause management (both to individual women and to society at large). Dr. Schwartz provided a roadmap for change, encompassing medical education reform, insurance coverage mandates, and cultural competency training.
Lecture Takeaways
The Women’s Health Initiative study created lasting damage through flawed methodology, leading to widespread controversy surrounding the use of hormone therapies and decades of regressed outcomes. The study’s design, interpretation, and dissemination created fear that left generations of women suffering unnecessarily from treatable menopausal symptoms. Unfortunately, the study’s limitations and subsequent reanalyses are rarely discussed and aren’t communicated to patients, perpetuating harmful myths.
The current standard of medical education is woefully inadequate for menopause care. Only 2% of medical school curricula include menopause education, with an average of just 4 hours total training dedicated to a condition affecting half the population. This systematic educational gap directly translates into provider knowledge deficits, with 73% of providers admitting insufficient knowledge to care for menopausal patients adequately.
Massive disparities exist across multiple dimensions. Racial disparities manifest in symptom severity, treatment access, and clinical outcomes. Economic disparities limit access to specialists, compounded therapies, and quality care. Geographic disparities leave rural women particularly underserved. Cultural disparities result in misunderstandings, dismissals, and inadequate culturally competent care.
Provider knowledge gaps directly harm patients. When healthcare providers lack adequate training and knowledge about menopause, patients receive substandard care, experience symptom dismissal, face delayed diagnoses, and encounter resistance to evidence-based treatments. The widespread “it’s just aging” response perpetuates a system that has failed women for centuries.
Practical Pearls
Implement standardized screening tools in practice.
Adopt validated instruments for assessing menopausal symptoms, mental health status, and quality of life impacts. Consistent screening enables early intervention and objective monitoring of treatment efficacy.
Develop cultural competency protocols.
Create practice protocols that acknowledge and address racial, ethnic, artistic, and socioeconomic differences in menopause experience, symptom presentation, and treatment preferences. Training staff on cultural sensitivity improves patient-provider communication and treatment adherence.
Pursue menopause certification to enhance expertise.
Specialized certification programs provide the depth of knowledge that medical school and residency training lack. Completion signals expertise to patients and positions the practice as a destination for quality menopause care.
Advocate for insurance coverage expansion.
Work with professional organizations, contact legislators, and document patient cases to advocate for improved insurance coverage of menopause treatments, including hormone therapy, mental health services, and complementary approaches.
Treat women with respect and empower patient autonomy.
Recognize that patients are experts in their own bodies. Providers don’t live in patients’ bodies; they must treat patients with respect. Women should feel empowered to seek providers who honor their experiences rather than remaining with dismissive practitioners.
Inside The Female Code: Genes That Shape Hormones, Fertility & Mood
Yael Joffe, PhD
Leading expert in nutrigenomics and personalized medicine, Dr. Yael Joffe, translated genetic science into insights for women’s health. Her lecture explored how individual genetic variations influence hormonal responses throughout a woman’s life, from puberty to menopause. Dr. Joffe demonstrated how to evaluate genetic insights and translate them into personalized clinical strategies for patients struggling with fertility challenges, mood disorders, or elevated thrombotic risk, effectively bridging the gap between ordering genetic tests and actually using genomic data to inform treatment decisions.
Lecture Takeaways
Polygenic background significantly modifies clinical expression. The cumulative effect of many low-penetrance genetic variants can alter the clinical expression of high-penetrance monogenic variants. For example, a polygenic background can influence breast cancer risk, even for women with high-risk single-gene mutations like BRCA1/2.
Factor V Leiden significantly elevates thrombotic risk, especially with hormone therapy. The F5 R506Q SNP creates resistance to activated protein C, impairing the body’s ability to regulate clot formation. Heterozygotes have a 4-8 times increased risk of venous thromboembolism, while homozygous carriers face up to an 80 times increased VTE risk. Women with Factor V Leiden on estrogen therapy face up to 30-50 times higher VTE risk, making genetic screening essential before initiating hormone therapy.
Prothrombin G20210A compounds clotting risk. The F2 variant increases prothrombin levels, enhancing clotting potential. Carriers have a 2-3 times increased risk of VTE. Similar amplified risk applies to the F5/F2 heterozygote combination, particularly when combined with estrogen-containing therapies.
Genetic variants provide insight, not determinism. There are no good or bad gene variants. Instead, they provide information and insight into how key biological pathways may be impacted. Genetics is not absolute, but it does provide the “why” for what is observed in patients.
Practical Pearls
Consider genomic testing for specific presentations.
Order genetic testing for patients with ADHD symptoms, anxiety disorders, autism spectrum disorders, or unexplained developmental delays. In women’s health, consider testing for patients with fertility challenges, recurrent pregnancy loss, severe PMS or PMDD, treatment-resistant mood disorders, or family history of hormone-sensitive cancers.
Screen for thrombophilia before hormone therapy initiation.
Test for Factor V Leiden and Prothrombin G20210A variants in women considering estrogen-containing hormone therapy, particularly those with personal or family history of blood clots, stroke, or cardiovascular events. Positive results require alternative treatment approaches or careful risk-benefit assessment.
Use genomic data to guide intervention strategies.
Tailor vitamin B supplementation based on MTHFR variants. Carriers of MTHFR C677T may benefit from methylated B vitamins, including methylfolate and methylcobalamin. Adjust zinc and magnesium supplementation based on genetic markers indicating increased requirements or impaired absorption.
Implement detoxification protocols for genetic susceptibility.
Focus on supporting glutathione production for patients with GSTP1 and GPX1 variants. Consider targeted support, including NAC, glutathione precursors, and sulfur-rich foods, for patients with genetic susceptibility to heavy metal toxicity or impaired phase II detoxification.
Active Aging: Musculoskeletal Health & Mobility in Menopause
Debra Atkinson, MS, CSCS
Certified strength specialist Debra Atkinson delivered an evidence-rich examination of how menopause affects bone density, muscle mass, and joint health. Her presentation synthesized the latest research on exercise prescription for menopausal women, including specific protocols for bone density preservation, muscle building despite hormonal changes, and joint health maintenance. Atkinson provided practical interventions addressing the reality that most menopausal women are starting from a sedentary baseline, requiring carefully structured progression to prevent injury while achieving measurable results.
Lecture Takeaways
Menopausal status is the strongest predictor of muscle mass loss. The landmark ERMA study by Juppi et al. (2020) revealed that menopausal status was the strongest predictor of muscle mass loss, more substantial than age or activity level alone. By age 80, 56% of women are sarcopenic, highlighting the urgent need for early intervention.
Bone loss accelerates dramatically during menopause. Normal bone loss is approximately 1% per year after age 35, but during menopause, it accelerates to 2-3% per year for 5-7 years, resulting in 10-20% total bone loss in early menopause.
Among women aged 70-79, 25.7% have osteoporosis. One in three women over 50 will experience an osteoporotic fracture, and hip fractures carry a 20% one-year mortality rate. Estrogen loss disrupts the balance between bone-building osteoblasts and bone-removing osteoclasts, accelerating bone density decline.
Musculoskeletal symptoms affect the majority of menopausal women. Seventy percent of women experience musculoskeletal symptoms, 25% report joint pain, and 40% experience mobility limitations. Estrogen plays three critical roles in joint health: collagen synthesis, which is essential for cartilage health; modulation of inflammatory cytokines; and the production of synovial fluid, which lubricates joints.
Women can build muscle at any stage of menopause. Studies show 12 weeks of resistance training (not on HRT). Findings revealed no difference in the ability to gain strength or muscle mass between menopausal stages. There are no non-responders, including 85+ year olds. Patients can build muscle at any stage of menopause, though approaches may need to be tailored to achieve functional and body composition outcomes.
Combined exercise and HRT optimize bone density. Combining resistance training, impact exercise, and hormone replacement therapy produces the most optimal outcomes for bone mineral density in postmenopausal women. Resistance training with compound movements demonstrated greater benefits for bone density than HRT alone, emphasizing the importance of exercise as a foundational therapy.
Premenopausal women showed improvements in body composition with standard protocols, whereas postmenopausal women require higher training volumes for greater metabolic benefits.
HRT status does not directly limit muscle-building capacity, though it may improve exercise adherence by reducing symptoms; exercise should not be delayed pending HRT decisions.
Practical Pearls
Structure progressive exercise programs for the 80% starting from a sedentary baseline.
Weeks 1-4 focus on establishing movement: daily walking regimen, twice-weekly strength exercises, and a daily stretching routine.
Add one element at a time and let patients win before moving on.
During weeks 5-12, progressively build by extending walking time, adding strength exercises, and including balance challenges.
Week 13+ transitions to structured programs: adherence to evidence-based protocols, ongoing monitoring for exercise intolerance, and recovery period adjustments.
Results only come if patients stick with it. Slower starts may be the answer to reduce injury and discomfort while improving sleep and blood sugar control.
Consider alternative modalities for limited mobility.
The Fishman protocol, a specific 12-pose yoga sequence, has proven benefits for maintaining bone mineral density, significantly improving balance, and reducing fall risk. A 6-month program involving whole-body vibration sessions has shown significant increases in hip and femoral BMD, offering a practical option for patients with limited mobility who cannot perform traditional resistance exercises.
Menopause & Mental Health: Tools for Thriving
Judith Joseph, MD
Renowned mental health expert, Dr. Judith Joseph, delivered a comprehensive session addressing the profound mental health impacts of menopause that extend far beyond the commonly discussed hot flashes. Her framework, organized around the acronym T.I.E.S., provided structure for understanding and addressing cognitive changes, identity shifts, mood symptoms, and sleep disturbances. Dr. Joseph presented practical tools and strategies for supporting patients through this challenging transition, recognizing that modern women face not only menopausal changes but also epidemic levels of burnout and stress.
Lecture Takeaways
Menopause profoundly impacts mental health across multiple domains captured by the T.I.E.S. framework: Thinking (60% report brain fog affecting memory and decision-making), Identity (midlife body and role changes challenge sense of self), Emotions (20-40% experience mood symptoms), and Sleep (40-60% report disturbances).
High-functioning depression is increasingly recognized in midlife women, often presenting as persistent emotional exhaustion and low joy that persists outside the workplace, blurring the boundaries between burnout and true depressive syndromes.
Joy differs clinically from happiness. Happiness is superficial and fleeting, dependent on circumstances, while joy is deep and lasting, independent of circumstances. This distinction matters clinically when helping patients set realistic expectations and treatment goals.
The ever-growing mental health burden of modern technology and collective trauma can be alleviated by teaching patients the R-E-S-E-T method, a stepwise approach to recalibrating tech use that includes self-awareness, education, habit reengineering, and ongoing reflection. This helps women buffer against digital burnout and reclaim a sense of agency in their daily lives.
Practical Pearls
Implement the 5 V’s framework for supporting thriving during menopause.
Validation: Acknowledge how patients are feeling and encourage them to be honest with themselves about their mental health. Vitals: Prioritize a healthy lifestyle with daily nutritious food, movement, healthy relationships, healthy tech habits, and good sleep. Venting: Open up about burdens with supportive people and express feelings. Vision: Don’t be stuck in the past – celebrate wins, be present with friends and loved ones, and make plans to look forward to. Values: Don’t lose sight of mission and morals; don’t get caught up in analytics.
Address “brain fog” with comprehensive decluttering strategies.
Declutter both internal and external spaces: maintain short to-do lists, don’t overcommit, simplify wardrobe, limit spending, and create a “launchpad” for essential items. Implement organizational skills therapy: use simple file systems, simplify desktop organization, employ timers and planners, prioritize tasks effectively, use digital assistance, and create vivid visual reminders and cues.
Support cognitive function through lifestyle interventions.
Promote brain-healthy diets, including the MIND diet or Mediterranean-DASH pattern, and maintain physical health. Encourage household support structures, body doubling for accountability, clutter buddies, support groups, executive coaches, or therapists as needed. Integrate mindfulness and cognitive-behavioral therapy techniques to regulate emotions and challenge unproductive thoughts. Prioritize sleep hygiene and neuroplasticity interventions.
Recognize and validate identity shifts.
Many women experience profound identity changes during midlife as their bodies change, roles evolve, and self-perceptions shift. Create space in clinical encounters for patients to discuss these changes, validate their experiences, and explore how identity evolution intersects with physical and emotional menopausal symptoms.
Prioritize sleep as a foundational intervention.
With 40-60% experiencing sleep disturbances, addressing sleep quality can have cascading positive effects on cognitive function, emotional regulation, and overall quality of life. Implement comprehensive sleep hygiene protocols, address physiological contributors like hot flashes, and consider both behavioral and pharmacological interventions as appropriate.
The New Standard of Care
From metabolic optimization to genetic insights, systemic advocacy to musculoskeletal preservation, mental health support to evidence-based alternatives, every session provided comprehensive insights and tools that translate directly into improved patient outcomes. The 2025 A4M Women’s Health Summit positioned attendees at the forefront of an urgently needed revolution, equipping them with the knowledge, protocols, and confidence to transform menopausal care, one patient at a time.
Secure Your Spot For 2026
The third annual A4M Women’s Health Summit takes place October 8-10, 2026, at La Cantera Resort & Spa in San Antonio, TX. Building on the sold-out success of 2025, the 2026 program explores “From Perimenopause to Power Years”, the next chapter in women’s health.
Registration is open, with early-bird pricing available through December 31, 2025. To learn more and save your spot, click here.