It’s Not Just in Your Head: What is Actually Happening in Your Body During Midlife

We are starting a new series: The Midlife Collective: Because One Expert Is Never Enough.

I am bringing together a group of smart, thoughtful professionals who support women in different areas of midlife because women's lives are complex, and no single person has all the answers. This is what I call the Whole Woman Approach.

Midlife is not just about hormones, careers, relationships, money, health, faith, or what you see in the mirror. It is all of that and more. Our physical health affects our mental health. Our relationships affect our bodies. Our work affects our sleep. Our hormones can affect our mood. Stress can affect nearly everything.

So, instead of looking at one piece of the puzzle at a time, I want to look at the whole woman.

And sometimes that starts with asking a very simple question:

"Can you just tell me what I need to do?"

I hear this all the time in mental health and couples counseling. And honestly, I get it. When you are exhausted, anxious, angry, disconnected, or confused, sometimes you do not want another question. You want an answer.

Raise your hand if you have gone to the doctor or psychiatrist, had your blood pressure taken, stepped on the scale, answered a few questions, and then looked at your provider with baited breath, hoping they will tell you exactly what is going on.

Can't they see your anxiety? Your hot flashes? Your sleepless nights? The brain fog? The fatigue? The anger that seems to come out of nowhere? Can't they see that you are caring for aging parents while sending your kids off to school, managing a career, navigating a relationship, and trying to remember whether you actually drank enough water today?

We want someone to connect all the dots for us.

Recently, I attended a "Ladies Who Lunch" event where I heard Jenni Huberger, NP, speak, and I was immediately intrigued. Jenni is a dual board-certified Family Nurse Practitioner and Menopause Society Certified Practitioner (MSCP), and the founder and owner of Press Play Not Pause in Kirkland, Washington. Her practice focuses on women's health, midlife care, perimenopause, and menopause management.

I was so impressed by the information she shared that I made an appointment.

Jenni is the bomb when it comes to information, but what I love most is her desire to make the information understandable. She does not throw a bunch of medical jargon at you and send you on your way. She draws pictures. Specifically, stick figures.

"Yes, I draw stick figures," she told me. "They are basic but get the job done."

And they really do.

During my appointment, Jenni drew a stick figure of a woman and began explaining how the different systems in a woman's body connect: reproductive, thyroid, cardiovascular, brain, skin, pancreas, and more. As she talked, I remember thinking, "Why don't more providers explain it this way?"

Because looking at one "organ" in isolation can miss the woman standing in front of you.

Jenni puts it this way: "We get WAAAAAY too focused on numbers without paying attention to what our patients are saying." She also told me that she now tends to look more broadly at things like vitamins, minerals, cardiovascular health, and other lab markers when appropriate.

And yes, she laughed about her primitive stick figures while also telling me that she orders more lab work than she used to.

That combination of expertise and curiosity is exactly what I mean by the Whole Woman Approach.

So what is actually happening?

I asked Jenni about the interconnectedness of the systems involved in midlife and why it matters to look at the whole picture rather than treating every symptom as a separate problem.

Her answer was essentially this: our endocrine organs work together. When one system changes, the other systems respond and adjust as the body tries to maintain balance. During midlife, the reproductive system is changing dramatically, and those changes do not happen in isolation.

We often talk about menopause as though it is simply about our periods stopping. But the ovaries are part of a much larger endocrine system. Changes in ovarian hormone production can have ripple effects throughout the body.

This can show up in sleep, mood, cognition, temperature regulation, metabolism, bone health, cardiovascular health, sexual health, and more.

And one important distinction Jenni made really stuck with me: menopause is not a disease. The ovaries are not "broken." Reproductive aging is a normal biological process. The goal is not necessarily to prevent it. The goal is to understand what is happening, support the body through the transition, and find balance when symptoms are affecting quality of life.

That is a very different conversation.

What if we stopped treating symptoms like they exist in isolation?

• A woman comes in with heart palpitations and gets referred to cardiology.

• Another comes in with anxiety and gets a mental health referral.

• Another cannot sleep and is given something for sleep.

• Another has brain fog and is told she is stressed.

• Another is gaining weight and is told she needs to exercise more.

• Another has low libido and is told it is probably her relationship.

And sometimes those individual treatments are exactly what is needed.

But sometimes we need to step back and ask: What else is happening here?

This is where the Whole Woman Approach becomes so important.

I asked Jenni what a woman should say when she knows something has changed but cannot quite explain what it is.

Her advice was simple: don't necessarily walk into the office and lead with, "I think I'm in menopause."

Instead, start with the whole picture.

How are you sleeping? What are you eating? How is your energy? Are you exercising? What has changed emotionally? Are you experiencing anxiety, mood changes, hot flashes, night sweats, palpitations, changes in libido, brain fog, or changes in your body composition? What does your day-to-day life actually look like?

In other words, start with yourself.

Most healthcare providers are trained to respond to the immediate presenting problem. If you walk in saying you are having palpitations, the appropriate next step may be a cardiology workup. But that does not necessarily mean the bigger midlife picture gets explored.

You have to help tell the story.

Can you just tell me what I need to do?

Here is where my work as a therapist and Jenni's work intersect.

I don't want you to stop asking for help. Quite the opposite. I want you to become a better participant in your own care.

When we expect someone else to tell us exactly what is wrong, exactly what we need, and exactly what will make us better, we can slowly lose our ability to trust ourselves.

Many women have spent decades being taught to override themselves.

• Don't be too much.

• Don't rock the boat.

• Don't be difficult.

• Take care of everyone else.

• Be small.

• Be quiet.

• Push through.

Maybe you learned that exhaustion was something to overcome instead of information from your body. Maybe you learned that your needs were inconvenient. Maybe you learned that you should be grateful and stop complaining.

And then we wonder why, at 50 or 57 or 62, we are not entirely sure what our own bodies are trying to tell us.

Your body is yours. Learn to listen to it.

Jenni said something else that I think is so important: you cannot expect a healthcare provider to understand you in a 15-minute appointment if you do not know much about yourself after 40, 50, or 60 years of living in your body.

That is not a criticism of you. It is an invitation to start paying attention. Track your symptoms. Notice your sleep. Pay attention to your mood, energy, appetite, movement, hot flashes, headaches, libido, stress, and whatever else feels different. Apps such as Bearable, How We Feel, Calm, and Moodfit can help you begin collecting that information.

The point is to collect data on the most important person in your world: you.

Then bring that information to your healthcare provider. Instead of saying, "Tell me what is wrong with me," you can say, "Here is what I have noticed. Here is what has changed. Here are the patterns I am seeing. Can we look at the whole picture?"

That is advocacy.

Be curious, not consumed by the internet

There is a lot of information about menopause, hormones, supplements, weight loss, aging, and women's health.

There is also a lot of misinformation.

Jenni's advice for becoming a better advocate? Don't go down the social media rabbit hole.

I laughed because, as someone who spends plenty of time online, I know exactly what she means.

It is easy to start with one menopause video and three hours later find yourself on someone's Patreon, buying their supplement protocol, downloading their hormone guide, and wondering if you need 17 different vitamins.

Instead, look for people who are specifically trained in menopause care. Organizations such as The Menopause Society and ISSWSH can help you find qualified practitioners. Good research and patient education are also available through resources such as the NIH and ACOG.

And ask yourself one simple question: Who benefits from me believing this - me or their bank account?

Information should help you become more informed, not more afraid. And a good healthcare provider should be willing to teach you.

Work with your provider, not against yourself

Jenni made another important point: we can become so focused on getting the "right" answer that we forget treatment often takes time.

Your friend's treatment may not be your treatment. Your sister's symptoms may not look like yours. Your best friend's experience with HRT, supplements, medication, exercise, or menopause may be completely different from yours.

There is no universal midlife prescription.

Your body is yours.

That means advocating for yourself does not necessarily mean walking into an appointment demanding a specific treatment because you saw it on Instagram. It means becoming informed, asking good questions, understanding your options, communicating clearly, and giving reasonable treatments time to work when appropriate.

It means partnering with your healthcare provider. And it means learning to trust yourself enough to speak up when something does not feel right.

This is the heart of the Whole Woman Approach.

We are not just our hormones. We are not just our anxiety. We are not just our marriages, our careers, our bodies, our children, or our lab numbers. We are whole, complicated, evolving women. And that is exactly why one expert is never enough.

Welcome to The Midlife Collective.