What Lifestyle Medicine Means For Perimenopause

Ever heard the term “lifestyle medicine”? You probably assume (like I did) that it means to eat well, move your body, and get some sleep. But I actually looked into it and realized there was more to it than I thought.

In this episode, I am breaking down the 6 pillars of lifestyle medicine, plus the seventh one that nobody else has added before.

Lifestyle medicine is a root-cause approach to your health, built to treat, prevent, and sometimes even reverse chronic conditions, which makes it essential in perimenopause and menopause.

I am walking through all six pillars, why each one hits harder once your estrogen starts to drop, the seventh pillar I refuse to leave off, and exactly where to start so you do not feel overwhelmed.

If you are leaning on HRT or a GLP-1 and quietly wondering whether that is enough on its own, this one is for you.

What You’ll Learn

- What lifestyle medicine actually is, and why it is so much more than eating well and working out
- The six pillars that matter most in perimenopause and menopause, and the real reason each one hits harder once estrogen drops
- The seventh pillar nobody puts on the official list, and why it is the one that makes everything else stick
- Why your HRT, GLP-1, and supplements can help, but were never built to do this job alone
- How to start first, so you stop trying to fix everything at once and actually see results

Resources and Ways To Connect

- Free 21-Day Anti-Inflammatory Guide
- DM me on Instagram and tell me which pillar you struggle with most
- Work with Me

Transcript

Ashley (00:07)

Hello there, my friend, and welcome back to the Family Fork. I'm so glad you're here with me today because we are going to talk about something that I actually thought I had figured out a long time ago. And then I kind of realized I've been underestimating it for quite some time. So let me set this all up for you. Now, if you spend any time in the menopause or perimenopause space, kind of the way that I do, doing research and learning.

You've probably heard this term lifestyle medicine. Now you can hear this phrase from Dr. Mary Claire Haver, Dr. Vonda Wright and lots of other well-versed, prolific doctors within this space. And they often like to say it like you already know what they mean, right? Like, well, you know, use life my lifestyle medicine as if we are supposed to be nodding along. So here's what's really funny: I am a health coach for midlife women.

I've spent more than a decade doing this work in my own body and walking alongside thousands of women. So when I would hear lifestyle medicine, I would just think, yeah, I know what that is. Eat well, eat healthy, move your body, get some rest, and that's about it, right? So I've known for a long, long time that there is no magic cure for weight loss or better health. So

I just figured lifestyle medicine was basically this like grown-up official sounding version of just be healthy.

But when I decided to sit down and actually look into it, there was a bit more to it than I realized. And I have a feeling it might be more than you realize too. So that's what we're going to talk about today. I'm going to walk you through what lifestyle medicine actually is, the six pillars that it's built on, and why every single one of those pillars matters even more in perimenopause and menopause.

And I'm gonna shed some light on the one pillar that everyone leaves off the official list that honestly I think is the most important thing of all.

Then we'll talk through exactly where you should start so you don't walk away from this episode feeling just completely overwhelmed and buried.

Now, before we get into the six pillars, I want to clarify something because you might be making this exact mistake and not even being aware of it. HRT, hormone replacement therapy, and GLP ones, the weight loss injections, they have become incredibly common. And it's really for good reason. They definitely have a place in your toolkit for midlife.

I even have my own personal experience with GLP ones, which I talked about in an earlier episode.

Now, these tools can be incredibly helpful for so many women. And I'm absolutely thrilled that we have more options today than our mothers did just 20 years ago. But here's what I keep noticing when you're on HRT or you're using a GLP-1 it becomes really easy to think, you know what, I've got it handled. Like the medical piece is doing the heavy lifting.

Just as long as you're eating mostly healthy and getting in a workout here or there when life allows, you think you're doing enough, right? And I can totally understand why it feels that way. But this is not the whole picture. It's just not even close. The medications, they're not building muscle for you. That weight loss injection, it's not repairing your body at night while you sleep. And that hormone patch, it's not managing your stress.

And it is certainly not keeping you connected to the people that you love. Those are all things that only you can do. And those things, my friend, are exactly what lifestyle medicine is made of.

So here is the definition that kind of surprised me. Lifestyle medicine, it is not just quote unquote make healthy choices. It's an approach that goes after the root cause of disease. Lifestyle medicine is designed to treat, prevent, and in some cases, even reverse chronic conditions, things like heart disease and type 2 diabetes. And this approach is built on six different pillars.

Now for women in perimenopause and menopause, this is not just a nice little bonus. Living with this approach is essential. So let me walk you through all six pillars and why each one is so imperative in midlife.

The first pillar, you probably could guess this if you listen to the podcast for a while, is anti-inflammatory nutrition. The goal here is that it's protein-forward, plant-heavy, and as few processed foods as you can possibly manage. Now, here's why this matters so much for you specifically. When you start losing estrogen, your body reacts, and a huge part of that reaction is

increased inflammation. And I don't just mean like feeling bloated or having puffy fingers or getting puffy in the face. Although, yeah, that is definitely a part of it too. But I'm talking about systemic inflammation, the kind that really impacts your whole body, including your brain. And that's where a lot of your brain fog is actually coming from. Your irritability, that kind of low depressed mood that seems to come out of nowhere.

disrupted sleep, so much of what we shrug off is just saying, ⁓ well, just must be what it is to get older. That is actually systemic inflammation.

When you start eating foods that lower inflammation and you stop eating foods that keep pouring gas on, you are helping your body settle all of that down. And what does that look like in your real life? More energy, more patience with your kids, your partner, your coworkers.

less puffiness in the mirror, you slowly start to feel like yourself again. And if you're using a GLP1, it's not making healthy food choices for you. It definitely cuts down on the food noise, which definitely can be helpful, but it is not deciding what actually goes onto your plate. That's still your job. And you have to take it seriously. The second pillar is physical activity.

And for you in midlife, you guessed it, that means strength training. Now, moving your body every single day matters. Of course it does. We know this. But in perimenopause and menopause, losing estrogen also means that you are losing lean muscle mass. Your muscle is the thing that keeps you strong, keeps your metabolism awake, supports your joints, and it protects your bones as you get older.

This is a lot of the work, it's pretty much all of the work that Dr. Vonda Wright talks about, the importance of strength training to your bone density. So if you have not checked her out, I encourage you to go listen to some of her talks. She's really informative when it comes to strength training and bone density.

Strength training three to five times a week, it's just non negotiable. And I know that sounds pretty serious,

But you have to preserve the muscle that you already have. And you have to build more than you are losing on an annual basis if you want to be strong through middle age and all the way into your older years. From my own experience, for years, I was lifting in my home gym and I was feeling pretty good about myself. I got compliments on my arms and

I just kept assuming that I was already lifting as heavy as I possibly could. But this past year, I started working with a coach and I actually discovered that I could lift way more physically than I thought possible. I've practically doubled my weights in the last six months. So if you're already picking up those dumbbells, good for you. Keep at it. But I also want to encourage you that you can probably go heavier than you think.

Now, if you're using hormone replacement therapy or peptides, they are not going to build that muscle for you. You have to pick up something and ask your body to grow those muscles. Now, the third pillar is sleep. And ⁓ this gets really tricky in midlife, doesn't it? Nighttime is when your body does all of that good repair work.

It's when all the quiet behind the scenes maintenance happens. So if you are not getting enough sleep, which I know you're not, your body, it just does not have the time or the capacity to fix and restore itself. And of course, sleep, it gets so much harder when your hormones are all over the place.

The three AM wake ups, I get those. It's when your brain decides it's like the perfect time to review every decision that you've ever made in your entire life. The night sweats. I get it. I know. I have been there with you.

So the goal is to aim for seven to eight hours whenever possible. What you want to do is keep your room cold and dark. And I personally use a product called magnesium breakthrough, which you can just pick up on Amazon. And it has been one of the most helpful things in supporting me to get a good deep sleep now that I'm into menopause.

And here's something that I want to give you full permission for. I want you to be okay with taking a nap. Sometimes I need a nap because I slept poorly the night before. And sometimes I want a nap just because I want one. But to keep a nap from interrupting my nighttime sleep, I use what I call my 23 minute nap.

For this kind of nap, you're gonna get cozy on the couch or in a recliner, but not in your bed. And I want you to set an alarm for 23 minutes. The reason for this window is that it's just enough time to fall asleep and rest, but it's not enough time for you to drop into that deep REM sleep because then you'll wake up feeling groggy and maybe even feeling worse than before. And because you're not in your actual bed,

your body's not going to confuse you with having a full night of sleep. So I'm sure there's a lot of research out there on like speed naps or quick napping, but this is something that works for me, this 23 minute nap. So I wanted to share it with you.

All right, the fourth pillar of lifestyle medicine is stress management. Let's be honest. This pillar is the one that my clients struggle with the most inside of the perimenopause weight loss method. Because stress, it's everywhere. Your job, your family, your health, weight loss itself, news, politics, finances, aging parents. my gosh, it can feel

Like there is no possible way to get away from all of it. And the older that we get, the more it seems to pile on instead of easing up.

So, what I find helps the most is to stop trying to eliminate stress because it's actually not realistic. And I want you instead to start noticing your own patterns. Do you tend to react the same way every time you're stressed? Do certain situations make you shut down and withdraw while others make you anxious or snippy or just kind of angry?

And then are there some situations that you can actually meet with calm and patience? When you start to see your patterns clearly, you can figure out how you personally handle stress best. And then borrow that approach and bring it into the situations where you kind of usually fall apart.

We work on this so deeply inside of the method because stress is not just one of the pillars that's kind of sitting off to the side on its own. It actually affects every other area of your health, your sleep, your eating, your hormones, all of it. Your HRT, your supplements, the GLP-1, they're not going to help with your stress response. This one is entirely yours to learn to manage.

Okay, the fifth pillar is community and social connection. And this one is definitely more important than people actually give it credit for. So think about it. Who are you without your people? The friends who pick up the phone when you need to bend. That would be my sister. The other midlife women who just get it when you are quietly sweating through a hot flash right in the middle of a meeting. So embarrassing.

Connection gives us purpose and it makes us feel like we are part of something bigger than our own to do list. I personally have watched so many older adults lose their connections as they age. And I have to tell you, I think it's one of the loneliest ways to live. And I don't want that for you. This is one of the biggest reasons that the group inside of the method is so, so dear to me.

Women come in absolutely convinced that they're the only one, the only one who's feeling this frustrated, or who feels sad or inadequate, or like her body has somehow betrayed her. And then they get in a room with a group of women who feel exactly the same way. And you can almost watch this shame just lift off their shoulders. I promise, you are not the only one. You never were.

But the only way to see that is to be actively involved with a community of women who are just like you.

All right, sixth pillar in lifestyle medicine is avoiding harmful substances. Now, to be honest, I don't actually see too many women smoking anymore, but drinking, no, drinking is very much alive and well. Remember how we talked about estrogen helping to keep your inflammation in check?

Well, without as much of it in perimenopause and menopause, your body is already more prone to inflammation just at the baseline. And alcohol completely cranks that dial-up. You've probably already noticed that it's harder to bounce back from a night of drinking than it used to be, right? Even if it's only like a glass or two of wine with dinner. Now

Only you get to decide what works for your life. And I am not the one to be here to take away your girls' nights or celebrations or anything. But I do know for most midlife women, cutting back on alcohol or stepping away from it altogether, it makes you feel better all the way across the board. Better sleep, less puffiness, a steadier mood, more energy in the morning. We need that, right?

So I would gently invite you to just start paying a little bit of honest attention to how it actually makes you feel the next day and even a few days after that, and then let that guide your choices.

Okay, so those are the six official pillars of lifestyle medicine. But there is one more. And to me, it is the most important one of all, and the one that seems to be off every single list, and that is mindset. And here's why I know it is so important. The wrong mindset will quietly get in the way of.

Every single one of these six pillars. Your mindset is this voice that says, ⁓ my gosh, this is too much. I don't have time for this. Or this is too hard to keep it all going. It's that voice that says, you know what? I've been trying to fix my sleep for weeks and it's not working. So I'm just going to give up on that one. Or that voice that says, I am not motivated to work out. Or I'm trying so hard to lose weight and nothing is working.

Or my least favorite is this is just what midlife looks like and there's nothing that I can do about it.

In my own health journey and in my work with the women inside the method, I have discovered that mindset is the one key that makes all the other pillars actually work together. So without it, consistency is nearly impossible. And you miss those small wins along the way. Those are the ones that keep you going when the novelty actually wears off.

I personally had my own version of this for years, and sometimes it still comes up. I carried around this belief that nothing ever works out for me, no matter how hard I try. And I had quietly attached that belief to my weight. And as long as I believed it, my brain went looking for all the evidence that it could find that that was true, that nothing would ever work for me. So I teach my women how to catch these thoughts.

And then how to deliberately create new ones that actually move them closer to what they want. Not by piling on more willpower or desperately looking for more motivation, because those things run out quickly. We change the thought underneath instead. And that is a piece that something like medication, it can't give you. You could be on the best HRT protocol and the most effective GLP-1 on the market.

But if your mindset is still quietly whispering to you that nope, nothing's ever gonna work for you, you are going to struggle to stay consistent with any of it. Mindset is the foundation. It always has been.

So now you're probably hearing this whole list of six pillars or seven if we count mindset, and you're thinking, cool, Ashley, this is great, but I don't even know how on earth I'm supposed to get started with all of this. So you're not. Please let me be clear. You're not supposed to do all of these things at once, even though every high achieving bone in your body wants to restart your entire life every Monday morning. You wake up and you're like, I'm just gonna start over this week.

I know this because I'm exactly the same way. But trying to do everything at once is your fastest path to feeling overwhelmed. And overwhelmed is where good intentions go to quit.

So here's what I want you to do instead. Start with one, just one pillar and keep track of how it goes. Kind of journal out your progress if that is going to help you to stay aware. And I'd give it about 30 days before you decide to add in another pillar and then another. So one at a time, each one building on the last until they slowly start to stack up into something that actually feels doable. And if you're wondering which one to start with.

Let me make it easy for you. Start with nutrition. Anti-inflammatory nutrition is going to give you the biggest return on your effort because it makes every other pillar easier. It lowers your inflammation, which is going to make strength training feel better. It's going to help your sleep come quite a bit easier. It's going to give your body that steady energy that you need to actually be social and connected instead of canceling plans again.

I know you know what I'm talking about. And when you are well fueled, you can handle stress better, which helps you to sleep better, which lowers your inflammation even more. Can you see how this all loops back around and feeds itself? So the pillars all work together as a team. And you will notice it when one or two of them are not pulling their weight. But since you have to eat anyway, several times a day, actually.

The most natural place to begin is with your food. And I know that you will be amazed at how quickly you start to feel this shift in your energy, your brain fog, your patience. It happens like within a week or two.

So here is what I want you to do right now. First, if you want a little bit of help getting started with that nutrition pillar, be sure to download the 21-day anti-inflammatory guide that is free. And I linked it right in the show notes for you. And follow it for 21 days and really pay attention to how different you feel. So many women tell me that they had no idea how much of their midlife misery.

was actually inflammation until they were able to manage things and they could feel the difference for themselves. Second, I really want to hear from you. So come find me over on Instagram @theashleymalik and send me a message and tell me which pillar you struggle with the most. Maybe it's sleep or maybe it's stress, stepping back from the wine. Some of these, I get it, they're harder than others.

And I would love to help you figure out the one that feels most doable for you to start with so that you're not staring at all of them, wondering where to begin.

Because you do not have to fix everything at once. You just have to start with one. If you take nothing else away from our time together today, I want it to be this. The medications, the hormones, all of that can absolutely help you. But they were never designed to do this job all on their own. Your body still needs you. It needs good food, movement, rest, calm, connection, and

all of the time, a mindset that keeps you showing up day after day. And that part is something that only you can create. Thanks so much for being here with me today. I hope that this was helpful and I can't wait to see you back here next week on the Family Fork.