Missed any newsletters? Check out the Progress Your Hormones newsletter archive​

Healthy aging doesn't happen by accident.

If you're ready to stop guessing and start building a plan for your hormones, metabolism, muscle, brain, and long-term health, check out Hormone Navigator.​

​Hormone Navigator is an AI app. I built it from my 20+ years of clinical experience helping thousands of women navigate perimenopause and menopause. It provides personalized education and guidance to help you better understand your symptoms, your hormonal phase, and the next steps you might consider.

While it isn't the same as being my patient, it is the closest thing I've been able to create to share what I've learned with women everywhere.

Learn more about Hormone Navigator here.

The 7 Things That Determine How You Age After Menopause

Dr. Valorie Davidson

Denise is Back!

Everyone really liked Denise from newsletter #30 (Starting HRT in Your 60s, Is It Too Late… or Just Different?).

Denise was 64 years old and had never taken HRT before. She was worried about her bone density and ‘aging.’ She was worried about her future health.

The question is not how long am I going to live. But am I going to live well? ​
​

Let’s get back to Denise:

‘Hi, it’s me, Denise, again. I’m 67 years old, and I’m doing really well. I was able to connect with an amazing doc;) And I am on low-dose HRT now, some progesterone at night, which has been fantastic for my sleep and mood. I am taking a low dose of biest (estriol and estradiol), and it's helped with my brain fog, mood, and I feel my energy is great.

I’m planning a trip to Ireland this year with my daughter, and so excited, bc I have always wanted to go there. Life is pretty darn good. ​
​

But the crazy thing is, I am even more worried about my health now than ever.

Menopause isn't what keeps me up at night anymore; it’s future-me. ​
​

My friend Michelle, her mom is 78, and she has been diagnosed with Alzheimer’s. Now Michelle is so overwhelmed bc she has to care-take her mom (whom she loves dearly). Her mom, Betty, is really cranky and mean (which she never was), and everyone is afraid that if they turn their heads for a second, she might hurt herself or the house.

They have hidden car keys and ‘Betty-proofed’ the kitchen, but it's sad and scary. Michelle is only 52, and I know she is under so much pressure and contemplating putting her mom in a memory facility, which Betty is not going to be happy about.

And my other friend, Mary, her husband just suddenly had a heart attack and died at 73. It’s awful, and now she is dealing with the fallout bc Hank didn’t have everything properly set up. The paperwork. The accounts. The bills. The legal documents. Trying to figure out what was set up, what wasn't, and what happens next.​
​

I am heartbroken for them, but I am so worried about, well, me. ​
​

Am I going to get Alzheimer’s, cancer, a heart attack, or not be able to recognize my daughter? I don’t want to become a burden bc I can’t take care of myself. I don’t want to have chronic pain. I don't want doctors' appointments to become my full-time job. ​
​

Where will I be when I am 75, 80?

Will I still be independent? Will I still be healthy? Will I still be me?’​
​

We all reach a certain age and begin to wonder: what will my health be like in 15, 20, or 30 years?

• Will I still be hiking at 80?
• Will I still be able to travel?
• Will I still be able to drive a car?
• Am I going to get cancer, heart disease, diabetes, or some other condition that always seemed like something that happened to older people... until I became one of them?
• Will I still be in my own home?
• Will I still be able to get up off the floor on my own?
• Will I even have the strength or energy to do the things that I love?

The goal is not to live longer. The goal is to live well for as long as possible.

It's not a guessing game or a matter of hoping your luck doesn't run out.

There are very real tactics you can use to help increase your lifespan, healthspan, longevity, wellspan, strengthspan, brainspan, or whatever ‘buzz word’ of your choice. AKA: Healthy.

The 7 Pillars of Aging Well

The 7 Systems That Determine Whether You Stay Independent

1. Muscle: Muscle is not just cosmetic.
   1. Loss of muscle (sarcopenia) is associated with increased all-cause mortality
   2. Grip strength is associated with mortality, disability, hospitalization, and cognitive decline
   3. Sarcopenia is one of the strongest predictors of loss of independence
   4. Muscle is like an endocrine/metabolic organ; it is a huge reservoir for glucose, and it improves insulin sensitivity
   5. Women with greater muscle mass and strength tend to have lower rates of disability, falls, fractures, and hospitalization
2. Brain: The brain uses about 20% of the body’s energy despite only being 2% of total body weight. Meaning that the brain is metabolically expensive. It requires a constant supply of blood flow, oxygen, glucose, and nutrients, as well as proper mitochondrial function.
   1. Alzheimer’s and other forms of dementia often begin 10-20 years before symptoms become obvious
   2. Insulin resistance, cardiovascular disease, poor sleep, inflammation, and sedentary behavior are all associated with increased risk of cognitive decline.
   3. Women account for nearly two-thirds of Alzheimer's disease cases.
   4. Sleep plays a critical role in clearing metabolic waste products, including beta-amyloid, from the brain.
   5. Hearing loss, social isolation, and depression are associated with an increased risk of dementia.
   6. Physical exercise is one of the most consistently studied lifestyle interventions for preserving cognitive function and reducing dementia risk.
   7. Estrogen influences memory, cognition, blood flow, glucose metabolism, and communication between brain cells.
   8. What is good for the heart is often good for the brain.
3. Heart: Cardiovascular disease remains the leading cause of death in women, killing more women than all cancers combined.
   1. Many women do not develop symptoms until significant plaque has already accumulated in the arteries
   2. Estrogen influences cholesterol metabolism, vascular function, nitric oxide production, and blood vessel health
   3. Insulin resistance, visceral fat, inflammation, and high blood pressure all contribute to cardiovascular risk
   4. A coronary calcium score can identify plaque years before symptoms develop
4. Bones: Women can lose up to 20% of their bone mass during the menopause transition and early postmenopausal years.
   1. Osteoporosis is often called a "silent disease" because bone loss occurs without symptoms until a fracture occurs
   2. Approximately one in two women over age 50 will experience an osteoporosis-related fracture during their lifetime
   3. A hip fracture is associated with loss of independence, disability, hospitalization, and increased mortality
   4. Bone is living tissue that is constantly being broken down and rebuilt throughout life
   5. Estrogen plays a critical role in maintaining the balance between bone breakdown and bone formation
   6. Resistance training (MUSCLE) and adequate protein intake are among the most effective lifestyle strategies for preserving bone health
   7. A DEXA scan can identify bone loss years before a fracture occurs
5. Metabolism: Insulin resistance can develop years or even decades before blood sugar levels become high enough to diagnose prediabetes or diabetes.
   1. Elevated insulin is associated with:
      1. Weight gain
      2. Visceral fat accumulation
      3. Cardiovascular disease
      4. Cognitive decline
      5. Certain cancers
      6. Accelerated aging
   2. Visceral fat is metabolically active and produces inflammatory compounds that affect the brain, heart, muscles, liver, and blood vessels
   3. Type 2 diabetes is associated with increased risk:
      1. Heart disease
      2. Stroke
      3. Kidney disease
      4. Neuropathy
      5. Vision loss
      6. Dementia
   4. Some researchers have referred to Alzheimer's disease as "Type 3 diabetes" because of the strong relationship between insulin resistance and cognitive decline
   5. Insulin is not just a blood sugar hormone. It is also a growth-promoting hormone. Chronically elevated insulin and insulin resistance have been associated with increased risk of several cancers, including breast, colon, endometrial, pancreatic, and liver cancer
   6. Metabolic dysfunction increases the risk of nearly every major chronic disease associated with aging
6. Hormones: Menopause is not simply the end of reproductive function; it is a major hormonal transition affecting multiple organ systems.
   1. Hormone receptors are found throughout the body, including the brain, bones, muscles, cardiovascular system, skin, vagina, bladder, and gastrointestinal tract
   2. The decline in estrogen during menopause is associated with changes in:
      1. Bone density
      2. Body composition
      3. Insulin sensitivity
      4. Cardiovascular health, cognition, and genitourinary health
   3. Estrogen plays a role in mitochondrial function, blood flow, glucose metabolism, and neurotransmitter activity
   4. Progesterone influences sleep, mood, brain function, and bone health
   5. Testosterone contributes to muscle mass, strength, libido, motivation, and overall vitality in women
   6. Hormones are not the sole determinant of healthy aging, but they influence nearly every system involved in aging
   7. Hormone replacement therapy is one tool that may help improve the quality of life and support healthy aging when appropriate
7. Purpose and Community: Loneliness and social isolation are associated with increased risk of cardiovascular disease, cognitive decline, depression, and premature mortality.
   1. Studies suggest that the health impact of chronic social isolation may be comparable to smoking, obesity, and physical inactivity
   2. Strong social connections are associated with lower rates of dementia and cognitive decline
   3. People with a greater sense of purpose tend to have lower rates of disability, chronic disease, and mortality

Denise:

‘I love these 7 pillars for a healthy, long life. But how do I accomplish them? They sound great in theory.

But how do I improve or maintain my: muscle, brain, heart, bones, metabolism, hormones, purpose, and connection?

I don’t want to worry, cross my fingers, and hope that I am lucky enough to miss cancer, heart disease, dementia, and all those things.

I need to stack the odds in my favor. I need a DIY guide!

​
In the paid version, we'll build Denise's DIY Guide to Healthy Aging.

I'll show you exactly how I assess each of the 7 pillars in my clinical practice, including the tests, measurements, goals, and lifestyle strategies I use to help women protect their muscles, brain, bones, metabolism, heart, hormones, and overall quality of life.

Just practical tools you can start using today to stack the odds in your favor.

Because healthy aging isn't about luck.

It's about having a plan.

Upgrade to the paid article

My grip strength sucks!

After working on this newsletter about healthy aging, I pulled out the Hand Dynamometer (AKA grip-strength gadget), put some batteries in it, and squeezed the handle-thing super hard.

Well, I squeezed 53.4 lbs on my left hand (my dominant hand).

And the little gadget said that it was ‘weak’.

Wait, I thought 53.4 lbs was normal?

That left me feeling a little confused and guilty about being a wimpy weakling.

Well, it turns out that I had the setting to a 25-year-old man.

Suddenly, my score didn't look quite so terrible, 53 lbs for being 53 yo.

The funny thing is that grip strength is one of the simplest measures researchers use to assess healthy aging. Lower grip strength has been associated with an increased risk of falls, frailty, disability, and loss of independence as we get older.

Who knew that squeezing a little plastic gadget could reveal so much?

The lesson? Before feeling bad about yourself, make sure you're not comparing yourself to a 25-year-old man.

xoDr. Valorie

Disclaimer

All content found in this newsletter, including text, images, audio, video, or other formats, was created for informational purposes only. The purpose of this website and blog is to promote consumer/public understanding and general knowledge of various health topics. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult your healthcare provider with any questions or concerns you may have regarding your condition before undertaking a new healthcare regimen. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. If your healthcare provider is not interested in discussing your health concern regarding this topic, then it is time to find a new doctor.