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By HotPause Health, featuring insights from Beverly Joyce, MD, HotPause Health Medical Advisor
At HotPause Health, we’re committed to cutting through the noise and sharing evidence-based information from trusted experts in women’s health. Our medical advisor and OB/GYN, Dr. Beverly Joyce, attended The Menopause Society’s annual conference (Oct 21 – 25, 2025), one of the most important gatherings in the field of midlife and menopause medicine.
Here are her top takeaways about how emerging science is reshaping the way we understand menopause, ovarian aging, and women’s long-term health.
Women are living longer than men, but not necessarily healthier. While our lifespans are longer, our healthspans (the years lived in good health) are shorter. According to Dr. Joyce, ovarian aging may be a key factor.
We’ve long referred to ovaries as “reproductive organs,” but that framing misses their broader role. Even after egg production stops, the ovaries continue to communicate with nearly every organ system in the body, supporting bone, heart, brain, and metabolic health. Understanding how ovarian aging affects these systems could transform the way we approach women’s health across the lifespan.
Perimenopause can begin as early as the mid-30s, marked by subtle changes in menstrual cycles, or simply by “not feeling like yourself.” These early changes are often overlooked, leaving women confused or dismissed.
Dr. Joyce emphasizes the importance of early education and proactive counseling so women recognize what’s happening and can find knowledgeable providers.
Testosterone levels do dip in the perimenopausal and early menopausal years but often rise again later.
Low libido, however, isn’t only about hormones. Psychological, relational, and physical factors all play a role. Before jumping to testosterone therapy, it’s essential to explore other influences such as stress, mood, and medications. And measuring testosterone is only helpful when levels are suspected to be too high—there’s no medical diagnosis of “Testosterone Deficiency Syndrome.”
Sleep disruption is one of the most common—and impactful—symptoms of midlife. Hot flashes, night sweats, and even undiagnosed sleep apnea can all interfere with rest.
When sleep suffers, cortisol (the stress hormone) spikes, fueling inflammation, insulin resistance, and weight gain, all of which increase cardiovascular risk. Treating vasomotor symptoms and identifying sleep apnea can improve sleep, reduce inflammation, and support overall health.
Heart disease can look very different in women. Beyond cholesterol buildup in large coronary arteries, women are also vulnerable to dysfunction in the heart’s smaller vessels, a condition sometimes called coronary microvascular dysfunction or “Broken Heart Syndrome.”
Women with chest pain are too often told it’s anxiety when it could be something more serious. If you have a family history of heart disease, Dr. Joyce recommends asking your clinician about a lipoprotein(a) test—a genetic form of cholesterol that isn’t significantly influenced by diet or exercise.
Bone loss begins before menopause ends. Many women already show signs of osteopenia or osteoporosis by the time they have their first bone density test at 65.
Dr. Joyce suggests getting a baseline bone scan in perimenopause to monitor early changes. Menopausal hormone therapy (MHT) can help prevent osteoporosis in at-risk women, and bisphosphonates are an effective option for those who discontinue MHT or choose not to take it.
Women with dense breast tissue face a higher risk of breast cancer, especially those in the “Category D” (extremely dense) range. While supplemental ultrasound is often offered, newer imaging tools like fast MRI and contrast-enhanced mammography are more effective, and should be made more accessible and affordable. Make sure to stay on top of all the recommended screenings by age.
Finally, Dr. Joyce reminds us that misinformation about menopause is rampant. Always consider the source, be skeptical of oversimplified claims, and seek out menopause-trained clinicians who base their guidance on science, not hype.
Menopause affects every system in the body, from sleep to heart to bone health. Understanding and addressing these interconnected changes early can dramatically improve women’s long-term wellbeing. It’s time to move beyond outdated narratives and embrace menopause as an opportunity to take charge of lifelong health.
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