A few weeks ago I attended a women’s longevity conference. The stadium was packed, the questions were urgent, and the need for honest, evidence-based guidance on women’s health has never been more obvious. Here are my honest takeaways: what I’d want my patients to know and what deserves more nuance and a healthy dose of skepticism.
The Value of Being Believed
Women in midlife and beyond are routinely undertreated and not believed. They are told their labs are normal and the conversation moves on. One of the most valuable things this conference did was to validate the midlife woman’s experience. The brain fog, mood changes, joint pain, sexual changes, and fatigue in perimenopause are real physiological changes. While treatments are not always one-size-fits-all, tinkering with them often requires a good dose of self-advocacy and connecting with a trusted clinician who believes in you and will partner with you.
The Case for Getting Strong and Moving
The emphasis on resistance training was one of the clearest messages, and the right one here. The fitness culture women have inherited is largely oriented around smallness, a lower number on the scale and fewer calories. From midlife forward, the goal should be strength. Muscle mass drives metabolic rate, insulin sensitivity, and glucose disposal. It protects against falls and fractures and cognitive decline. Bone density responds to load-bearing work in ways supplements cannot do. Sarcopenia starts earlier than most people assume and is one of the most underappreciated threats to long-term independence.
At 92, Jane Fonda was a keynote speaker, and her presence alone made the case for why. Here’s the thing–she joked that every joint in her body has been replaced (“I’m all metal”) and yet none of it slowed her down. She said she is building muscle, even at her age. Watching her get up off the floor entirely on her own was one of those small moments that says everything.
Women’s Cardiovascular Health
This was given only a little bit of time, but I felt it was one of the most important conversations. Cardiovascular disease has been studied through a predominantly male lens — the metrics, reference ranges, and diagnostic thresholds were developed largely in men and applied to women. For example, women are more likely to develop heart failure with preserved ejection fraction, where the heart muscle appears normal on imaging but fails to relax properly. Women may go underdiagnosed and untreated because the phenotype doesn’t match what most clinicians were trained to recognize.
Hormones are not a panacea. When blood pressure and LDL rise during the transition, estrogen withdrawal is part of the picture, but so is visceral fat redistribution, arterial stiffening, and metabolic changes occurring alongside it. Some of this is related to estrogen shifts, but attributing everything to menopause can lead to a myopic focus on hormones and incomplete treatment for cardiovascular disease.
On Lp(a): we have been ordering this test for years and was glad to see it emphasized here. Lipoprotein(a) is genetically determined and elevated levels are an independent risk factor for cardiovascular disease and aortic stenosis. It explains why some patients with apparently normal LDL still have heart attacks. In fact, 20% of the U.S population has elevated Lp(a) levels.
Connection is Not a Soft Variable
Social connection was emphasized by many speakers, and gladly so. Loneliness increases the risk of premature death by approximately 26%, a figure comparable in magnitude to smoking 15 cigarettes a day. Social isolation has been linked to a 32% increased risk of stroke and a 29% increased risk of heart disease across forty different studies. For women in midlife especially, who are often navigating major transitions in identity, relationships, and community, this isn’t a peripheral concern.
Breast Cancer and Hormones
I attended a break out session with Dr. Mindy Goldman, a true expert in breast cancer survivorship. She discussed the complexity here, even for breast cancer survivors. The hormone therapy risk-benefit calculation depends on personal history, pathology, BRCA status, age, and other risk factors. It also depends on the type and formulation of hormones and which symptoms we’re trying to address. She offered hope and stated that no one should suffer needlessly – whether or not hormones are in the cards for you, there is always a treatment.
Worth knowing as an example: Duavee (conjugated estrogen with bazedoxifene) has emerging data suggesting a chemopreventive effect in women with high-risk precancerous pathology, including ADH, ALH, and DCIS. The possibility that a hormone-containing medication might reduce breast cancer risk in certain populations deserves far more attention than it gets.
Brain Health
Approximately ⅔ of individuals with Alzheimer’s disease in the U.S are women. The lifetime frequency of AD is almost twice as high in women as men, regardless of age. Estrogen is neuroactive: it affects cerebral blood flow, glucose metabolism, amyloid clearance, and synaptic function. Its decline changes how the brain works. The word-finding difficulty, slowed processing, and executive dysfunction women describe during perimenopause and early menopause have a real physiological basis.
A memorable moment: a psychiatrist specializing in ADHD was fielding a question from the moderator, and midway through her response asked: “What was your question?” The audience laughed, likely in recognition of this familiar moment. For women who are already neurodivergent and managing baseline executive function challenges, the menopausal transition can be particularly destabilizing. Demonstrating it in real time was more effective than any slide.
I would have loved to see Dr. Lisa Mosconi on the main stage — her research on how the female brain changes across the hormonal lifespan is among the most rigorous work in this area.
Genetics and the Limits of Lifestyle
A study published recently in Science used mathematical modeling to isolate intrinsic mortality and found that the heritability of lifespan likely exceeds 40% — substantially higher than the 20–25% from older twin studies. Genetics are doing more work in longevity than the current conversation often acknowledges. The variability we see in GLP-1 response, for example, appears partly explained by specific genetic variants. Genetic testing, including Whole Genome Sequencing, is increasingly useful clinically with the application of AI.
Wearables and AI
The potential is real and AI-assisted analysis of longitudinal data is a meaningful development. Only the benefits were emphasized at the conference, but the question worth sitting with: does more data make people healthier? Is it motivating or does it make people more anxious? It depends on the person. We don’t yet have good frameworks for helping patients know the difference, and I think that conversation deserves as much airtime as the devices themselves.
Where I Would Push Back the Most
In the spirit of the conference’s own emphasis on evidence-based medicine, a few things worth flagging.
Supplementation and products received a lot of coverage, and at times the gap between “plausible mechanism” and “clinical recommendation” got blurred. Supplements have a role, but it deserves to be stated precisely. When a speaker is also the founder of the company whose tests and products are being discussed, that context is important. We know how important financial disclosures are in pharmaceuticals, but supplements and their sellers bypassed this scrutiny.
The sessions on skin and hair are clearly important to women based on the crowds they drew, but I wish board-certified dermatologists were included in these conversations, alongside the founders of skin and hair supplement companies.
One point I feel strongly about: a prominent speaker claimed that “PCOS is a nutritional problem, not an ovarian one.” Nutrition genuinely matters in PCOS management, but the framing is incorrect. PCOS involves heritable hormonal dysregulation and metabolic complexity that diet can help modulate but doesn’t fully explain. Patients who try dietary approaches, find them insufficient, and conclude they’ve failed deserve a more complete picture. Lifestyle is a powerful lever but genetics and environment matter too, and the most useful version of this conversation holds all of it at once.
Ultimate Takeaways
Get your Lp(a) measured if you haven’t already. Build muscle with intention and progressive resistance. Focus on cardiovascular health, but go beyond just menopause hormone therapy. Invest in your relationships and mental health – it’s never too late, and the data on social connection and longevity is as strong as almost anything else discussed. Engage with women’s health conversations critically and don’t settle for simple answers to complicated questions. The signal-to-noise ratio in this space is imperfect. We’re here to help you finetune the dial so you get the most out of these conversations.
Dr.Judy Kim
