40% of incarcerated women are in or approaching menopause

Imagine going through perimenopause without Google, without a sympathetic doctor, without hormone therapy, without even the word perimenopause in your vocabulary. Then imagine being formally punished for the symptoms.

That’s the world a new investigation from The Marshall Project and The 19th maps in detail. The female prison population has grown 600% since 1980. And the cultural peri/menopause conversation many of us are now part of — the books, podcasts, celebrity interviews, doctors specializing in menopause, The Midst — has barely reached most prisons.

An article in The Story Exchange tells the story of Kwaneta Harris, 53, a former nurse imprisoned in Texas, who spent three years cycling through specialists for shoulder pain, heart palpitations, acne, brain fog, and hair loss before a TED Talk on NPR gave her the word perimenopause.

Even after diagnosis, it took two more years for Harris to get a Premarin prescription — which was never refilled. Other women interviewed have been written up for blood-stained uniforms (when adequate menstrual products weren’t available), not pulling the covers over themselves through night sweats, and mood swing–related behavior that landed them in solitary. Disciplinary infractions can justify parole denials. Untreated perimenopause is, functionally, costing women their freedom.

But there is early hope: Impact Justice has launched a first-of-its-kind program training California prison medical providers on perimenopause care, with conversations underway in Idaho, Michigan, and South Carolina.

TL;DR

• Perimenopause symptoms are routinely misread as misconduct in prisons — with consequences that compound across years and can affect parole.

• Hormone therapy (MHT) exists in policy, but rarely in practice. Even one prescription is hard-won; refills are harder.

• Women teach each other inside prison walls because no one else will. Community is the medicine.

More about Kwaneta Harris

The adults most lost in midlife aren’t the ones whose dreams failed

They’re the ones who arrived at the destination they chose when they were between 18–30 — before they knew themselves well enough to choose other paths.

That sharp reframe of the conventional midlife crisis is the subject of this Silicon Canals story — I recommend you read it. Drawing on a MacArthur Foundation study that followed more than 3,000 midlife adults for a decade, the story notes that only about 23% of people experience a genuine midlife crisis — and when they do, it follows not the fear of aging but the arrival at a planned destination that doesn’t feel the way it was supposed to.

Counterintuitively, people whose early life plans “failed” may suffer less in midlife. Failure forced them to re-evaluate, pivot, and stumble into a plan B that actually fit. The people who succeeded at the inherited plan are the ones who, decades in, have to reconcile the person they’ve become with the person they wanted to become when they were 22.

Renowned psychoanalyst Erik Erikson's theory of psychosocial development proposes that personality develops in eight predetermined stages across the entire lifespan, from infancy to old age. The framework for midlife development centered on what he called generativity: the drive to contribute something lasting, to invest in the next generation, to build something that matters beyond yourself.

“The ‘crisis’ at midlife, in Erikson’s view, wasn’t existential despair but a developmental invitation,” writes entrepreneur Lachlan Brown. “It’s the point at which life asks you to stop organizing yourself around achievement and begin organizing yourself around meaning.”

TL;DR

• Midlife disorientation is often a success story, not a failure story. It signals you arrived where you said you were going.

• The “right” goals at 22 may not be your goals at 45. That’s growth, not crisis.

• Generativity is the upgrade. Stop optimizing for outcomes; start asking what you actually want to leave behind.

• A midlife pivot isn’t regression. It’s permission to choose, finally as yourself.

Read more about pivots in The Midst

Can a midlife career pivot connect you to your true purpose?

What happens when an award-winning author and TEDx speaker comes out at 50?

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The co-founders of ThriveOn, Victoria and Andrew O’Hare, are members of The Midst Founder network. Read their startup story here.

Let’s hang out here on Instagram too.

EXCLUSIVE EXCERPT

Love, Finally by Geneen Roth

“Shopping With My Mother”

My mother and I are shopping at the Healthy Food Expo in Huntington, New York, on a dolphin-­blue day. I am thirty, she is fifty-­two. We stop at a booth of tie-­dyed turquoise-and-­orange-­streaked scarves made from hemp. I wrap one of them around my neck.

“Sweetheart,” my mother says, “scarves should be made of silk. Always. Forget hemp. Besides, these striped tie-­dyed things are beyond ugly.”

I nod. She’s right. Her sense of style is impeccable. We keep shpatziring — a Yiddish word for strolling.

I love my mother.

I hate my mother.

I think she’s gorgeous with her blond upswept hair and perfectly applied makeup and crisp clothes. Her face is a double ruffled peony in full bloom. You can’t not look. You can’t not be struck dumb by the wide-­set eyes, the pouty mouth, the long straight nose. Men twenty years younger than she is who could be looking at me look at her. Whatever women have that command attention, that makes people go silent and gawk when they walk into a room, she has it. My friends tell me they’ve never met a mother like her. My boyfriends stare at her, gobsmacked, mesmerized like automatons.

In an unfortunate roll of the genetic dice, I look like my father. Round face, moon cheeks, short legs. When he and I go places together, he stops anyone —­ strangers on the street, salespeople — and, pointing at my face, says, “Tell me, whose face does she have?

The Big B, that’s who.” (His name is Bernie.) My mother tells me I have my own style, that my skin is clear and my hair is shiny, but I don’t care about clear skin and shiny hair. I want to look like her.

And so I love her face and I hate that it’s not my face. But there’s more. There’s what happened between us.

We walk up to a bench on the edge of the market.

“Sit,” my mother says, patting the bench on her right side. “Let’s talk.”

We cross our legs, face each other.

“When will I have paid enough for what I did? When do you stop talking about what a lousy childhood you had and get on with the present?” she asks, her voice rising, impatient.

I feel the wall slam down in my chest. I think about saying, “When you admit that it happened,” but I still don’t have the courage to stand up to her.

The crack of her hand on my face when I talked back to her. Her wild eyes as she backed me into a corner. Her hands with the red-painted talons. The welts left on my arms, face, legs.

She continues, “Everyone hit their kids in those days. Bobbi and Lil and Iza and Rose. Every kid you know got hit. That doesn’t amount to being beaten.”

“I was so lonely as a kid,” she says. “And then I met your father, who was my first boyfriend. I was fat and felt ugly and no one else had shown any interest in me. And when your father asked me to marry him, I said yes, and that I wanted two things: a television set and a baby. Nine months later you were born.”

I don’t want to hear what a terrible childhood she had. I want her to say, It’s true, I beat you.

I want her to say, I am sorry.

I want her to say, You’re right, I was so focused on myself I couldn’t focus on my children.

It’s like wanting a cat to bark, as Byron Katie says, but it will take fifteen more years before I understand that.

My mother says, “I never felt loved by my mother. She yelled at me because my fat legs rubbed together until they were raw and we had to buy expensive cream to make them better. She told

me I was so fat I would never find a husband, and then when I met your father, she told me that whether I loved him or not — I didn’t —­ I needed to get married right away because she and my

father would no longer support me going to Long Island University. Then she made fun of your father. She said, ‘Most people have thirty-­two teeth in their mouths. Why does he look like he has sixty-­four?’”

I’ve heard these stories before, and the same thing that happened to me when she hit me happens to me now: I become stone-faced.

“So, call me a criminal,” she continues. “Call me a terrible mother when I put you on your first diet at age eleven because I wanted to spare you the pain of what I went through. I was trying to help you, for God’s sake. Which is why I took you to get those diet pills when you were fifteen. How was I to know that you would get addicted to those? Or that you would spend seventeen years with an eating disorder, gaining and losing a thousand pounds?”

I look at my mother’s beautiful face and don’t feel anything except that she really knows how to apply eyeliner. Which isn’t to say that I don’t understand her frustration. The days of hitting and screaming are over.

She is not the same woman who hit me with a stick, lied, and cheated on her husband. I can no longer figure out if the years I’ve spent in therapy have inscribed the “I was a victim of abuse” deeper by constantly talking about it or if talking about it is releasing it. Two therapists suggested I stop talking to my mother, urged me to cut off all contact. Another therapist told me I was raised by wolves and that I was lucky that I hadn’t become permanently deranged. But that might be because I tell them only half the story.

The way when I gained eighty pounds and was positive she would be disgusted at how fat I had become, she said, “You’re so beautiful. You always were.”

The way when I quit premed courses and despaired that I would never figure out what I wanted to do, she said, “I believe in you.”

The way she loved the beauty of dinner plate dahlias and crisp white shirts.

A few months later, she calls me. “Darling,” she says. “I’m sorry. I’m sorry for all the times I called you fat. And for telling you that your ankles were like piano stools.

“And there’s something else I want to say before it’s too late: I’m sorry for not being there for you and your brother. I was so lonely and so absorbed in my own problems that I wasn’t interested in you or what you were going through. I know I was a terrible mother, just like my mother before me. Just like my sister, who dropped Linda at an orphanage when she was two and left to be a stripper in New Orleans.

“I don’t want to die with you being angry with me. Can you ever forgive me?”

Forgive her.

I tell my brother that she asked for forgiveness and he says, “Yeah, right. Forget it. She’s lying.”

I tell my best friend from college that my mother asked for forgiveness and she says, “Don’t believe her.”

I tell my first therapist that my mother asked for forgiveness and she says, “She doesn’t mean it. Why are you still talking to her?”

I tell my second therapist that my mother asked for forgiveness and she says, “I thought you cut off contact with her years ago.”

I tell my mother I think it is brave to ask for forgiveness. I tell her that since she has always insisted that she was a good mother, I need some time —­ a few days, a week, a few weeks —­ to let her words settle.

Like everyone whose mother is still alive, I cannot remember a minute, an hour, a day without her. She is the beginning, the middle, the end of every story I’ve told even when I don’t mention the word mother. She is my “root guru,” the one from whom I received the direct teachings about what I needed to do, say, eat, wear, weigh, to take up space, to belong here. Even when I don’t mention her, she is the unseen force behind every story I’ve written or told. I’ve grown like an antitropism away from her harsh light.

But I do not want to keep living in reaction to her.

They say that trauma is passed through five generations.

I didn’t know my great-­grandmother, and my mother doesn’t remember her except that she made blintzes and the members of her temple in the Bronx came out to pay their respects to her hearse on its way to the cemetery. And I know she escaped Russia during the pogroms and so she must have been traumatized by the persecution and the two years it took, over land and in freight boats, to get to Ellis Island. And I know my mother’s mother was not kind, and that when my aunt June died, Lola said it was the happiest day of her life.

Forgive my mother?

What would it take? And is it even possible to drop the wall of resentment that slams down the second I hear her voice?

After my mother asks me to forgive her, I decide that now might be the time.

This excerpt was originally published here on the-midst.com.

For more than four decades, Geneen Roth has helped people step out of the exhausting cycle of control, shame, and self-judgment, and discover something far more lasting: peace. Geneen Roth is a writer and teacher whose work uses compulsive behaviors as a path to the inner universe.

She has written many bestselling books, including the No. 1 New York Times bestseller, Women, Food and God. Geneen Roth is a trusted voice guiding women to give up dieting and end compulsive eating. Subscribe to Geneen Roth's Substack here.

Why does cognitive load increase during perimenopause?

By Victoria O'Hare

TL;DR: Cognitive load is metabolic load

Every decision, every emotion you manage, every commitment you track draws on the same biological resources as physical work. During perimenopause, declining estrogen reduces the brain’s buffer against this cost. The result is not weakness. It is a real physiological shift that requires support.

She sits at the kitchen table with a cup of tea, looking out the window.

Still. Present. Not frantic, not disheveled, not the stock-photo version of a woman overwhelmed. Just a woman in the quiet part of the morning, before everything starts again. But look at the table around her. A child’s school paper. A laptop half-open. Her phone, face-down. The architecture of a full life, held quietly in place.

She’s not thinking about nothing. She’s running the calendar for the week while thinking about the dentist appointment she needs to reschedule, the milk that won’t last until Thursday, the work thing tomorrow, the text she promised to send before dinner, and the conversation from yesterday she’s still processing.

This is not overwhelm. This is an average Tuesday, and every bit of it costs something.

The work nobody calls work

Women don’t carry this kind of mental load because they’re unable to delegate. We carry it because this is what holding a life together looks like. The logistics, the emotional temperature, the anticipatory management of a dozen small things that would quietly fall apart without your attention.

Nobody recognizes this as work. Not because it’s not real, but because it’s invisible.

Cognitive load is metabolic load

Here’s the part that changes how you think about fatigue. Your brain does not have a category for “just thinking.” Every decision you make, every commitment you track, every emotion you manage, anticipate, or regulate draws on the same fundamental biological resources as physical work.

Intense thinking, decision-making, and emotional regulation (cognitive load) operate within the same metabolic and physiological constraints as physical exertion — consuming glucose, elevating cortisol, and triggering inflammatory pathways to manage allostatic stress.

Thinking hard triggers the same stress response and the same hormonal activation as physically training hard. The only difference is that one gets counted and one does not.

What does research‌ show about cognitive load and cortisol?

Studies on cognitive load and cortisol have consistently shown that sustained mental demand activates the HPA (The Hypothalamic-Pituitary-Adrenal) axis, the same stress-response pathway triggered by physical exertion. Same stress hormones. Same downstream inflammatory markers. Same pattern of nutrient depletion.

The brain consumes approximately 20% of the body’s total glucose supply at rest. Under sustained cognitive demand, that draw increases. Decision fatigue is not a productivity concept. It is a metabolic one.

The difference between cognitive labor and physical labor is not what it costs. The difference is whether anyone accounts for the recovery it requires.

Why the same cognitive load feels different at 45 than at 35

This is where perimenopause enters the picture. Not as a cause of weakness but as a shift in conditions.

Estrogen plays a significant role in the brain’s ability to manage and recover from cognitive demand. It supports glucose metabolism in the brain, reduces inflammatory signaling, and contributes to the neurological resilience that allows the HPA axis to return to baseline more efficiently after activation.

As estrogen fluctuates during perimenopause, that buffer gets smaller.

Before and during perimenopause

Before perimenopause: Estrogen is stable. The stress response is cushioned. Mental load is absorbed quietly, rarely showing the receipt.

During perimenopause: Estrogen fluctuates. The same load costs more in energy, focus, and recovery. The workload may be the same. The cost is not.

Women who carried a high cognitive load at 35 and barely registered the cost often find the same load feels genuinely different at 45. Not because they have become less capable. Because the recovery cost is higher. Because the body is now accounting for something it used to absorb without showing the receipt.

Perimenopausal brain fog — the word-finding gaps, the sense of mental static, the difficulty concentrating through a long afternoon — is not a sign of cognitive decline. These are signs of a brain working harder with fewer biological resources. (Sandstrom et al., 2011)

The HPA axis and why recovery takes longer

When the HPA axis is activated repeatedly by high cognitive demand and the hormonal environment shifts to make recovery slower, the result is cumulative load. Each day starts from a slightly higher baseline of activation. The gap between what you carry and what the body has had time to recover from gets wider.

This is not a personal failure of resilience. This is biology, operating exactly as it should under the conditions you are actually in.

If you feel more depleted from the same life you have always handled well, there is a biological reason for that.

What would change if you recognized cognitive labor as work?

What would change if you treated your cognitive labor the way you treat physical labor?

What if, at the end of a day that contained no visible exertion but enormous invisible effort, you said: “I worked hard today.” And meant it. If you built recovery around what actually depleted you, not just what you can point to on a list.

If you stopped trying to explain your fatigue and started doing the math. The math that accounts for the full metabolic cost of running a life, not just the parts that anyone else can see.

You are not bad at rest. You have never been given credit for the work that requires it.

Naming cognitive load does not fix the problem, but it changes something

There is no version of this post that ends with five simple steps. The invisible labor does not disappear once you can see it clearly. The load does not lighten because you finally have words for it. But something does change when you stop treating your fatigue as a character flaw and start treating it as accurate feedback from a body that has been doing real, metabolically costly work for a very long time.

You stop asking what is wrong with you, and begin asking what the work actually requires. Then you support your recovery accordingly.

Can Creavitalis creatine help cognitive load during perimenopause?

As a woman in perimenopause, I created Stronger around this specific biology. Creavitalis creatine at the clinical 5g dose replenishes ATP in the brain, the cellular energy depleted by sustained cognitive demand. Rhodiola Rosea supports HPA axis recovery, reducing cortisol reactivity after cognitive and emotional stress.

I’m happy to offer Midst readers 20% off ThriveOn Stronger when you use this special link. The discount will be applied automatically during checkout and is good on your first order. We offer a no-questions-asked money-back guarantee.

The original version of this article was first published here on February 20, 2026.

Have you told your Grown Ass Lady friends about The Midst? We’re here on Instagram too.

Why women disclose child sexual abuse later in life

By Elizabeth Clemants

My grandmother was in her 90s when she told me something she had carried for nearly a century: her history of sexual abuse. I started to speak openly about mine in my mid-40s.

We tend to think of disclosure as something that should happen close to the time harm occurs. But for most women, it doesn’t. On average, survivors of child sexual abuse do not begin to speak about their experiences until their 40s or later.

So what changes in midlife?

If we divide a woman’s life into a first half and a second half, the difference is not just time. It is capacity. It is context. It is what is at stake.

There are obvious reasons a child doesn’t disclose sexual abuse. She may not understand what is happening to her. She may love the person who is harming her and not want to lose that relationship. She may fear getting someone in trouble or getting in trouble herself. The mind organizes around survival, not clarity.

Child sexual abuse is often described as a “perfect crime” because the conditions that allow it to happen also make it difficult to name or prove later. Children lack language. They dissociate. They adapt. They stay quiet out of fear, shame, loyalty, or the expectation that they will not be believed.

Even when the memory is there, it is rarely stored in a clean narrative. Survivors often recall harm in fragments — images, sensations, emotional impressions that take shape slowly over time. Making sense of what happened requires development. It requires an internal shift in how we understand ourselves in relation to others. It also requires an external mirror; someone, somewhere, who can reflect back that what happened was real, and that it was not our fault.

But understanding is only one piece. Disclosure is not just about memory. It is about consequence. In the first half of life, silence is often a rational choice.

Most abuse is committed by someone known to the child. That means telling the truth does not just risk one relationship. It can destabilize an entire family system. It may force parents to confront their own failure to protect, and siblings or partners to choose between maintaining existing bonds or standing with the person who was harmed.

During the years when we are building our lives, forming partnerships, raising children, establishing careers, holding families together, that kind of disruption can feel too costly. Disclosure does not just ask us to speak. It asks us to absorb the emotional fallout. To manage other people’s reactions. To risk losing people we love.

So we don’t put ourselves in that position. Not because we are in denial. Not because we are weak. But because we understand, often instinctively, what it might cost. Public reactions reinforce this calculation.

Prominent American businesswoman Amy Griffin published The Tell: A Memoir (March 2025), describing memories of sexual abuse that surfaced decades later. Much of the response – including high-profile articles in the New York Times – focused not on the harm itself, but on the timing, the method of recall, and whether her account could be proven. The message, whether intended or not, was familiar: if you speak, be prepared to endure the disruption.

Survivors know this. Many spend years questioning themselves before they ever tell anyone else. They are aware that disclosure can bring scrutiny, doubt, and loss. In that context, waiting is not suspicious. It is adaptive. However, something shifts over time.

What I did not expect, and what no one explained to me when I was younger, is the power that can come in the second half of life. I have found myself in a post-menopausal stage where the stakes feel different. I care less about how I am perceived. I feel less responsible for managing other people’s emotional worlds. The constant outward orientation toward caretaking, toward creating a life, toward holding everything together, begins to loosen.

This shift is often framed as a loss. I experience it as an increase in internal capacity. When the need to maintain appearances softens, something else becomes possible. I can look more directly at the harm I experienced earlier in my life, without the same weight of shame. I am less concerned with how the story will land and more concerned with what is true for me.

In the first half of life, how we are perceived matters deeply.

The first half shapes our relationships, our opportunities, and our sense of belonging. We are building something. We are directing our energy outward toward work, family, and stability. There is a particular kind of coherence we have to maintain, or everything we are carrying risks falling apart.

In the second half of life, that coherence is less externally defined. There is more room to make meaning on our own terms. Reflecting on and integrating our own experiences becomes less about anyone else and more about ourselves. And this is where disclosure often changes. It becomes less performative and more relational.

My grandmother did not sit me down with a plan. She did not frame it as a revelation. She simply mentioned, one afternoon while we were cutting strawberries, that she had been thinking about what happened to her as a 5-year-old. There was no agenda. No demand. No expectation that anything would come of it. It was not about justice. Everyone involved had long since died. It was simply a moment of sharing to be known.

We often assume that disclosure is about seeking validation, accountability, or public recognition. Sometimes it is. But often, especially later in life, it is something quieter. It is the decision not to carry something alone anymore.

Most women never disclose publicly. Some never disclose at all. Others speak only to one person, in one moment, without ever returning to it again. Healing does not always require an audience, but it does need to be witnessed. It does not always require a formal telling. It does benefit from a listener who can hold the truth without collapsing under it.

Timing, then, is not evidence of credibility. It is evidence of readiness. When a woman speaks about harm decades later, the question is not why she waited. The insight is what has shifted, internally and externally, that makes speaking possible now.

My grandmother’s disclosure did not change the past. It did not alter any outcome. And yet, 90 years later, it changed something quiet and profound in the present. She was saying, in the simplest possible way: I think I am done carrying this alone.

And that was enough.

Elizabeth Clemants is the Founder and Executive Director of Hidden Water, a nonprofit using a restorative justice model to interrupt the cycle of childhood sexual abuse. She is also the author of Healing Together: A Family Guide to Recovering From Sexual Harm.

Elizabeth’s recently published writings include:

• Stop the Epstein Frenzy — It’s Hurting Survivors and Hindering Real Accountability (Newsweek)

• What We Don’t Say About Child Sexual Abuse — and Why It Matters (Youth Today)

• Awkward But Essential Conversations to Prevent Child Sexual Abuse (New York Family)

• Understanding Consent to Protect Everyone on Campus (The Well News)

• Child Protection, Safety, and the ICE Surge in Minnesota (Star Tribune)

Follow Hidden Water

• LinkedIn (Hidden Water)

• LinkedIn (Elizabeth Clemants)

• Instagram

• Facebook

• Reddit

Trainings in how to become a Safe(r) Adult are now available online at Hidden Water.

Laziness can be good for your health

We women over 40 often think that resting or taking a break is a waste of time, but I think that’s just capitalism talking.

As a recovering corporate hustler, my ears perked up when I heard that scheduling one dedicated, guilt-free "lazy day" per week improves physical and mental health by reducing stress, lowering blood pressure, and preventing burnout.

According to health specialists in this Yahoo story, intentional downtime is viewed as a form of self-care that helps regulate cortisol, enhances creativity, and boosts long-term productivity, rather than a waste of time.

Research suggests that having one totally, guilt-free lazy day per week can help reduce stress and high blood pressure, and improve mental health. And “laziness” can make us more creative, too.

“Rest and relaxation allow your brain to wander and make new connections,” says Sanam Hafeez, a licensed psychologist and director of Comprehend the Mind in New York City. “This can foster creativity and innovative thinking.” For example, in a 2022 study, watching nature videos was associated with the promotion of alpha brain waves, which are linked to relaxation, daydreaming and creativity.

TL;DR: Why we should give ourselves permission to rest

• Physical benefits: Regular, scheduled rest can lower blood pressure, reduce muscle tension, and lower the risk of chronic stress-related illnesses.

• Mental health: A designated day for rest helps decrease anxiety, lower stress levels, and boost mood.

• Productivity boost: Far from being unproductive, taking time to do nothing is essential for recovery, which leads to improved motivation and creativity when returning to work.

• Intentionality is key: Researchers suggest scheduling these days on your calendar to ensure they happen and treating them as “non-negotiable” appointments for self-care.

I took pretty much all of yesterday off, and I feel fab today.
— Amy Cuevas Schroeder

The butt keeps the score

This doctor says the booty muscle quietly predicts how well you’ll age

When it comes to aging well, there’s no shortage of metrics we should keep in mind. Cholesterol level, blood pressure, bone density, weight — they’re all ready to be tracked. Dr. Michael Hunter MD, a Yale-educated cancer expert, says these numbers are important for sure, but there’s another telltale sign of how well you’ll age: your glutes strength.

“I notice it when someone rises from a chair or turns to leave the room. There is a difference between moving without thinking and moving with quiet negotiation, and it often appears earlier than most people expect,” writes Dr. Hunter. “A patient finishes a visit, places their hands on the armrests, and stands. Some do it fluidly, without shifting forward or bracing. Others lean, pause, or push off with their arms as if they are negotiating with the chair before committing to standing.”

Here’s the TL:DR

• Early warning signs aren’t always in your lab results
  Aging shows up in movement first — the slight hesitation before stepping off a curb, using your hands to push up from a chair, a subtle sway when standing on one leg. These quiet shifts often appear years before anything shows up on a scan.

• Why your glutes matter more than you think
  Your gluteal muscles aren’t just aesthetic — they’re the functional core of how your body moves. They stabilize your pelvis, protect your spine, and keep walking and climbing stairs feeling effortless. When they weaken, your lower back and knees quietly take the strain instead.

• Modern life is working against you
  Prolonged sitting is the main culprit. When you sit most of the day, your glutes essentially go offline — and the body slowly reorganizes itself around that lower demand. It’s not a discipline problem. It’s environmental.

• Try this simple self-test
  Stand up from a chair without using your hands, then sit back down slowly. If you find yourself leaning heavily forward, letting your knees take over, or it feels harder than it used to, that’s useful information.

• What actually helps

  Squats, step-ups, uphill walking, standing on one leg while brushing your teeth, taking stairs more deliberately. No gym required. Consistency matters far more than intensity — small, repeated signals to the body create lasting change.

• You can reverse this!

  Your body responds to what you ask of it, at any age. The goal isn’t impressive fitness — it’s moving through your life without negotiating with your own body.

The top 5 cancer-fighting foods

Here’s a mini summary of Mel Robbins’ interview with Dr. Dawn Mussallem, in case you don’t have time to watch the whole thing

Well, this is no fun: Food is the leading cause of death in the U.S., driven by ultra-processed foods making up 60% of the average American’s diet. Luckily it works the other way around: The right foods can switch cancer genes off and protective genes on.

Dr. Dawn Mussallem, DO, DipABLM is a renowned lifestyle medicine physician, four-time cancer survivor, and heart transplant recipient who serves as Chief Medical Officer at Fountain Life. Formerly of the Mayo Clinic, she is a leading expert in integrative oncology, cancer prevention, and plant-heavy nutrition.

The top 5 cancer-fighting foods

🫐 Frozen wild berries are loaded with anthocyanins, a powerful phytonutrient. Just two servings per week can reduce breast cancer survivors’ risk of dying from the disease by 25%. Frozen is just as good as fresh and far cheaper. Probably best to get the organic variety. I buy frozen organic blueberries at Costco on the regular.

🍠 Purple sweet potatoes contain 150% more anthocyanins than berries. Women in Okinawa, Japan — one of the world’s longest-living populations — eat these regularly. Dr. Mussallem eats one every single day.

🥦 Cruciferous vegetables (broccoli, cauliflower, Brussels sprouts):\ contain compounds that help the body fight cancer at the cellular level.

🫘 Fiber-rich beans: Most Americans fall far short of the recommended daily fiber intake.

Top high-fiber beans (per cooked cup):

• Navy Beans: ~19g per cup (or 9.5g per 1/2 cup)

• Lentils: ~15.5g per cup

• Black beans: ~15g per cup

• Pinto beans: ~14g per cup

• Kidney beans: ~13g per cup

🫛 Edamame/soy: The truth about soy and breast cancer: edamame actually reduces breast cancer recurrence by 25%. Learn more here on The American Institute for Cancer Research.

Aim for five or more servings of vegetables and fruit daily. People who do have a 10% lower risk of dying from cancer and a 12% lower risk of dying from heart disease. It’s the little things — they add up. 🫐

Ruck this way: What are the best weighted vests for women?

By Esther Sedgwick

I recently turned 40, learned all about perimenopause (the hard way), and went on a big health kick. I started walking with a weighted vest as part of my new regimen and got hooked. It’s honestly been the most enjoyable thing about adjusting to my new “midlife health” routine.

You might have come across the Instagram reels joking about wearing baggy-ass jeans that teenagers told you were cool. Trying to eat protein and creatine like it’s a job, and strapping on a weighted vest for bone density. And while that’s all funny, it’s no joke.

I’ve gone deep researching women’s health and longevity (like reading clinical trials on PubMed, crushing hundreds of hours of podcasts, and ordering the clinician’s guidebook from the Menopause Society). A consistent finding has stood out in terms of how we can live in good health, for longer.

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Meet Mimi Ison: Instagram fitness star

“I never did corporate, didn’t land my first real ‘career’ job until age 46, and now I create content. How the hell did I get here?”

Age: I’m an amateur 62-year-old, and an aging person in training.

Location: Los Angeles

Previous locations: My roots are in the (510) East Bay. Short stints in San Francisco and NYC.

I’m in the midst of: Assisting two aging parentals, about to start writing again on my dormant blog (and maybe Substack), learning new editing skills, and navigating thinning brows (tips welcome). Caring for three resident cats and three foster kittens. Cat energy is essential for life.

My income: Moolah fluctuates. Content creation started as a hobby, but now it’s my job. Fortunately, income has increased every year since I started. There’s no roadmap so I’m learning as I go. It’s super exciting and creative, and nothing I ever imagined would happen.

Monthly expenses in a nutshell: Mortgage, taxes, groceries, insurance, retirement accounts, investments, pets, eating out.

I used to be a fashion-obsessed shopper; I followed every trend in clothes, shoes, beauty products, hair, and nails, but since I don’t work in an office anymore, that spending has decreased to a sliver of our expenses.

The most unexpected spending has been insurance, which increased for our home, cars, and health threefold in the last couple of years.

I have multiple subscriptions because I love streaming (current faves: PokerFace, Hacks, Stick, and I can’t wait for Slow Horses season 5). Also coffee. Cannot live without my Nespresso.

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Who isn’t stressed?

A good way to get a sense of how people are feeling about life is to look at trending Google searches. The terms “feel overwhelmed” and “feel stressed” are being searched in the U.S. more than ever this year, according to an April 1 Google Analytics report. Same goes for “burnout at work” and “burnout from life,” and search interest in “cortisol” has nearly doubled since the start of 2026.

No kidding.

There are several documented studies from late 2025 and early 2026 about just how stressed we all are, so imagine what the stress level is like now, with even more socioeconomic uncertainty piled on in recent weeks.

So let’s take a breath, yeah?

We know a thing or two about stress here at The Midst. And the bulk of you brilliant readers are ~98% women over 40 in the midst of some of the heaviest sh*t in your lives.

Here are a handful of insights from our archive …

How to stop stressing about lowering your cortisol — while actually lowering your cortisol

By Amy Horton

Unless you are completely off the grid (in which case, you won’t be reading this), you’ve most likely heard the term cortisol and probably know it’s fairly important to pay attention to, especially in midlife. But take one foray into the TikTok land of #cortisol videos and it will instantly spike your, well, cortisol.

So how do we make sense of it all and begin to address the crazy of cortisol without adding even more stress to our lives? I mean, what’s the point of cramming 27 new self-care practices into your day if trying to do so ends up stressing you out more than when you started?

At 43 years old and perimenopausal, I’m as curious as the next GAL, so I set out to sort through the noise.

What is cortisol?

According to pausitive health (a resource for all things menopause), cortisol is a hormone that is naturally produced in our bodies, necessary for waking us up in the morning and keeping our energy levels up. But stress can raise our cortisol levels higher than we need them to be, which can have negative health effects.

As we age, cortisol levels naturally increase for both men and women. However, women are also dealing with fluctuating estrogen levels as they go through the menopause transition, which can cause spikes in cortisol — it can even make you more sensitive to stress than you might have been previously.

Cortisol and (peri)menopause

To find out more about how cortisol levels are affected during the menopausal transition, I connected with Z. Colette Edwards, MD MBA, the founder and chief medical officer of pausitive health. Edwards shared this article with me, explaining the science-backed link between cortisol and menopause.

During the menopausal transition, the balance of hormones — estrogen, cortisol, and progesterone — changes and those shifts, along with the typically increased stress experienced during this phase, can make menopause symptoms worse. While symptoms can vary from person to person, some common symptoms are hot flashes, night sweats, sleep problems, weight gain, migraines, depression, and hair loss.

What do we do about cortisol?

It’s one thing to make sense of the facts. It’s another thing to know what we can actually do to maintain healthy cortisol levels. I’ll be the first to admit that the more I learn about cortisol and the menopausal transition, the more stressed I become. (Hello, overwhelm!) So I went back to the experts to find out how to combat the stress that comes with dealing with all the stress!

Mindset matters: Don’t stress about stress

The first thing, says Edwards, is that we need to “set an intention and a commitment not to be stressed about being stressed.” She says that has to come first, before trying to take action on reducing stress — which can be many things like exercising, journaling, meditation, addressing diet, etc.

Dr. Thara Vayali, ND, Chief Medical Officer of hey freya co., also pointed out the importance of being able to notice our mindset around stress. “When we start to look at any wellness behavior as a ‘to do’ rather than a ‘to feel’,” she says, “we fall into the trap of trying to appear perfect and good either to ourselves or others, which furthers the problem.”

“When we start to look at any wellness behavior as a ‘to do’ rather than a ‘to feel’, we fall into the trap of trying to appear perfect and good either to ourselves or others, which furthers the problem.”

— Dr. Thara Vayali, ND, Chief Medical Officer of hey freya

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The art of letting go

By Lauria Locsmondy

My body resisted the deep twist, my breath was shallow, and my mind was fixated on holding the pose — on doing it right.

“Find steadiness and ease,” my instructor reminded us. “Flow … let go.”

Let go? I had always believed strength meant pushing through, enduring. But as I exhaled and softened, something unexpected happened — my body realigned, my breath deepened, and instead of falling, I found stability. I found balance.

That moment taught me something profound: clinging creates tension, while release creates space. And this isn’t just yoga philosophy — it’s neuroscience.

The science of letting go

Our brains are wired to resist change. The status quo bias, a cognitive tendency studied in behavioral psychology, makes us more likely to stick with what we know — even when it no longer benefits us. We hold onto jobs, relationships, and identities because they feel familiar, even when they no longer serve us.

But holding onto what isn’t working creates stress. Research shows that psychological attachment — whether to a negative thought pattern, a toxic relationship, or an outdated identity — activates the amygdala, the brain’s threat response center. This keeps us in a state of chronic stress, elevating cortisol levels and impacting both our mental and physical health.

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Managing midlife anxiety

By

Most women are familiar with feelings of anxiety. Whether it’s a few pre-menstrual jitters, anxiety about work, or worrying about your child on their first day at school or college, we know what it’s like to experience that sense of panicky dread and uncertainty. But during midlife, a new kind of anxiety emerges. One with no particular rhyme or reason but enough power to make you think you’re losing your mind.

Katherine Tyack-Grant, from Yorkshire, UK, was in her early forties when she began to experience overwhelming anxiety.

“We had recently moved house and the cat went missing for a few days, which made me feel a little anxious,” she explained. “But then it began to increase. I was incredibly anxious about everything and felt like I couldn’t breathe properly, and my heart was racing.”

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Can stress be a good thing?

And when does it turn into distress overload?

By Sally Duffin

Stress gets a bad rap. We say that work is stressful, the kids are stressing us out, there’s too much to do, and we need to learn better stress management. But what if stress isn’t all bad? What if we’ve become programmed to think of it as a negative, when in fact a little bit of stress might just be good for us?

What happens when we’re stressed?

Whenever we’re faced with an exciting or challenging situation, the nervous system switches into “fight or flight” mode. The adrenal glands pump out the stress hormones epinephrine and cortisol, which make your blood pressure rise, pulse increase, and pupils dilate. You might feel tension or butterflies in your stomach, and may need to dash to the bathroom.

These are all normal responses designed to heighten your senses and mobilize energy stores, so you can either handle the situation or get away from it. In cavewoman times, this would have meant dealing with a rampaging woolly mammoth; nowadays we’re faced with traffic jams, an angry boss, and sassy teens — not so easy to deal with or run away from.

Can stress be a good thing?

Sometimes, yes. There’s a sweet spot on the scale of stress called “eustress”, which means “good stress”. First defined by the father of modern stress theory, Dr. Hans Selye, eustress describes any situation that invokes optimal levels of stimulation and results in a sense of growth, mastery, fulfillment, or achievement. This might be starting a new job, moving, giving a speech in public for the first time, or passing your driving test.

Alongside eustress, small amounts of uncomfortable stress or distress can also be beneficial. After all, the “fight or flight” response is designed to be protective, not harmful. For example, short bouts of stress can improve alertness and concentration. Ever noticed that a tight project deadline can make you come up with even better ideas? That’s the positive effect of stress hormones on the brain, heightening your performance.

From good stress to distress

Problems arise when too much eustress or distress tips over into chronic, ongoing distress. At this point, we no longer experience that warm glow of achievement or sense of growth, because the stressful situations are relentless and overwhelming. The challenges outstrip our capacity to cope. And rather than having short-term bursts of “fight or flight”, we become permanently stuck in this alarm state, unable to relax and rebalance.

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Let’s talk about stress, baby. What are you stressing about, and how are you coping?

Leave a comment

Inner Pace Reset

Our friend Stephanie Lewis is hosting Seasons of Stillness, a simple weekly rhythm to help ease stress, mental chatter, and the pressure that builds through the day.

April 10– May 1, 2026

• Weekly reflections and 3 simple practice lanes to rely on (most practices are 3–12 minutes)

• Live online group practice circles with replay

• Registration ends soon!

Learn more

The Dirty Dozen

What if our fruits and veggies aren’t all they’re cracked up to be?

We all know we need to eat more plants to live longer, but what if pesticides cancel out the health benefits?

A study in the International Journal of Hygiene and Environmental Health tracked nearly 1,900 adults and found that people who ate more high-pesticide-contaminated produce had measurably higher pesticide biomarkers in their bodies — particularly for organophosphate, pyrethroid, and neonicotinoid insecticides.

What does this mean for your health?

SuperAge says we don’t know with certainty at dietary exposure levels. “The strongest evidence for harm comes from occupational exposure, not your salad. But associations at lower levels exist and are worth taking seriously.”

The down and dirty: This is absolutely not a reason to eat fewer vegetables. But it’s good information to keep in mind.

The “dirtiest” produce

Pesticide residues were found on 96% of these items, with 203 different pesticides detected across the 12 produce types. Long story short: Buy organic when possible.

1. Spinach

2. Strawberries

3. Kale, collard and mustard greens

4. Grapes

5. Peaches

6. Cherries

7. Nectarines

8. Pears

9. Apples

10. Blackberries

11. Blueberries

12. Potatoes

Honorable mentions: SuperAge reports that bell and hot peppers and green beans ranked just outside the dozen but topped the list on toxicity of detected pesticides.

The Clean 15

Nearly 60% of samples from the following list had no detectable pesticide residues, reports SuperAge. Don’t worry so much about buying organic, and save your budget on:

• Pineapple

• Sweet corn

• Avocados

• Papaya

• Onions

• Frozen sweet peas

• Asparagus

• Cabbage

• Watermelon

• Cauliflower

• Bananas

• Mangoes

• Carrots

• Mushrooms

• Kiwi

4 tips to reduce pesticide exposure

1. Single out your top 5 '“dirtiest”. Which Dirty Dozen items do you eat most frequently? For example, if you eat grapes every day, they’re a higher priority swap than, say, summertime peaches.

2. Wash everything under running water. A 2022 study found that washing leafy vegetables under running water reduced pesticides by an average of 77% — beating out detergent washes.

3. Clean apples with baking soda. A dilute solution (about 1 teaspoon per 2 cups of water) outperformed both plain water and bleach at removing surface residues. It requires a 12–15 minute soak, and can’t touch residues that have penetrated beneath the skin — but it’s a useful tool if apples are a daily habit.

4. Frozen organic is a good thing. Frozen organic strawberries, blueberries, and spinach are nutritionally comparable to fresh and quite a bit cheaper.

The Half Sandwich Generation:
I’m child-free with aging parents

By Dr. Huong Diep

When people ask me if I have children, I’m tempted to respond, “Do two adult parents count?”

It’s not entirely a joke. For many of us midlife women who are child-free, whether by choice or by circumstance, caregiving hasn’t disappeared. It has simply shifted directions. Instead of raising children, many of us find ourselves supporting our aging parents. And unlike the well-documented “sandwich generation,” our experiences are quieter, less visible, and oftentimes, misunderstood.

And in the moments between being on hold with insurance companies (again) and navigating hospital bills, we might notice an even quieter thought: If I am the one taking care of everyone else, who will take care of me when I’m older?

The default caregiver

Meet Sarah*, a composite of many clients I’ve worked with over the years. She is in midlife and has always been the caregiver in her family, partly because she is the eldest daughter, but also because she has been labeled the most “competent.” Growing up, she helped raise her younger siblings while her parents worked multiple jobs. Somewhere along the way, her own needs became secondary.

Sarah had romantic relationships in the past, but when conversations turned to “starting a family,” the timing never quite worked. Either her partner was not ready, or she found herself on the fence, already worn down from caring for her siblings. Now she finds herself single and living alone. She works a stable job that pays reasonably well, but it offers little flexibility and comes with high healthcare costs. She knows she cannot easily step away from it.

Her parents are aging, and as expected, she has become the default caregiver. Her siblings live farther away and have children of their own, so much of the responsibility falls to her. She schedules doctor appointments, drives her parents to the grocery store, and reminds them when to take their medications. Their memory is starting to decline, and she worries how much longer they can live independently. At the same time, she knows she does not want to move in with them and wonders what kind of facility they could afford.

Financially, she is starting to feel the strain. After her father’s fall, she began dipping into her savings while waiting for disability support. She knows she should prioritize her own future, but that feels almost impossible when her parents need help now. Sometimes she goes on small shopping sprees just to release some of the pressure, but then finds herself struggling to pay off her credit cards.

Maybe you know someone like Sarah. Maybe you are Sarah.

You’re definitely not alone

In my work as a psychologist and certified financial therapist, I see this pattern repeatedly. Many of my clients do not have children, yet they carry significant caregiving responsibilities. They are coordinating medical care, helping with finances, and absorbing the emotional weight of their parents’ aging. At the same time, they are trying to build their own financial futures, often on a single income, without the buffer of a partner, and with the added pressure of what many refer to as the “single tax.”

This sits alongside another reality that is rarely discussed. Approximately one in six women in the United States reach their early 40s without having children and in recent Pew Research, a growing number are also unpartnered, meaning they are navigating both caregiving and financial planning on their own. Despite this, women without children are still often labeled, implicitly or explicitly, as “selfish,” “career-focused,” or lacking in care and responsibility.

There is also what is now coined the “daughter penalty.” Women make up approximately 61%of caregivers in the United States and experience an estimated financial impact of around $7,200 per year in lost wages and out-of-pocket costs, according to a recent Forbes article. That number does not include missed promotions, reduced retirement savings, and the mental toll of consistently putting one’s own needs on hold. Unfortunately, much of this labor is still rarely questioned.

For women without children, caregiving can take on an additional meaning. There can be an unspoken message: at least you are taking care of your parents. For some, this brings a subtle and toxic sense of validation in a culture that otherwise judges their choices. Caregiving becomes not just a responsibility, but a twisted way to prove one’s worth or role in society.

My story

As I sit with clients like Sarah, I often find myself reflecting on my own upbringing as the eldest daughter of Vietnamese refugees. My parents were boat people who fled Vietnam in search of opportunity and worked in sweatshops, construction, and other labor-intensive jobs to make ends meet. Supporting my parents was never framed as a choice. It was a given. They would say, matter-of-factly, that they were investing in me so that one day I could help them. It was difficult to argue with people who had risked their lives for your future.

And yet, even as a child, there was a part of me that wanted to say, “But I didn’t ask you to get on that boat!” Even thinking that felt like a betrayal. Worse, it risked being seen as ungrateful. I often felt caught between two worlds, my collectivist family and a more individualistic, American context. I carried a quiet sense that I was somehow failing both. Not Vietnamese enough. Not America enough.

Over time, through my own therapy and professional training, I began to understand that it is possible to hold multiple truths. I can feel deep gratitude for my parents’ sacrifices and also feel anger and resentment at the implicit expectation that I would one day take care of them. Both are real. Both deserve space. Because of this, I have much more compassion for the younger grad- school version of me, the one horrified at the growing student loan balances while quietly shaming herself, wondering how she was supposed to support her parents when she could barely take care of herself.

Now I find myself thinking not only about how to support my parents, but also about my own future. How do I take care of myself in a way that preserves my mobility and independence? What kind of support system and community am I building now? And how do I make decisions while holding all of the roles I carry?

It is not an easy process. But it is one I must be willing to have with myself if I encourage my clients to do the same.

Practical starting points

Many of the thoughtful women who seek financial therapy with me express a desire for freedom, stability, and long-term security. At the same time, their financial decisions, particularly around caregiving, may conflict with those values. This is not because they are “bad with money” or lack discipline. It is the result of bigger competing forces, including cultural expectations, emotional bonds, and long-held beliefs about what it means to be a “good” daughter.

While every caregiving situation is different, here are a few questions that can start what is often a difficult set of conversations. Death and decline are not easy to talk about, but avoiding them usually makes things harder later.

1. Start by determining what is actually sustainable. Supporting a parent should not require sacrificing your own long-term financial stability. Providing care with dignity does not mean doing everything or doing it perfectly.

2. Have conversations early so that decisions are not made in crisis. This includes talking through finances, expectations, and preferences, and understanding what resources are already in place such as Social Security, retirement accounts, and other assets.

3. Put legal structures in place. Power of attorney, healthcare directives, and other documentation can prevent confusion, reduce family conflict, and make it easier to act when decisions need to be made quickly.

4. Assess available support. Even if it feels like the responsibility falls on you, it is worth taking a step back to look at the full picture. This might include extended family and community resources. Organizations like the National Alliance for Caregiving and AARP offer practical guides, planning tools, and education around navigating caregiving.

5. It is also important to recognize the signs of caregiver burnout. Chronic fatigue, irritability, resentment, and emotional numbness are not personal failures. They are signals that something needs to shift.

6. Finally, notice your internal responses. Before making financial or caregiving decisions, pause and ask what emotions are present and how they may be influencing your choices. Guilt, fear, and obligation can be powerful drivers.

Expanding the definition of care

Caregiving is oftentimes framed as something directed outward. What we give to others. However, sustainable caregiving requires expanding that definition to include ourselves.

This includes protecting our financial future, setting boundaries, and allowing space for our needs, relationships, and goals.

For those without children, this becomes especially important. Without the assumption of reciprocal care later in life (though, maybe that’s another assumption to be challenged?), intentional planning and self-investment are essential. More and more, I see women beginning to approach this differently: planning to age in place, building community with friends (a la Golden Girls), and creating alternative support systems.

So the question I keep coming back to, with myself and with my clients, is this: What would it look like to care for others without abandoning ourselves?

This story was first published here on the-midst.com.

*Names have been changed to protect identity.

Dr. Huong Diep, PsyD, ABPP, CFT, is a board-certified psychologist and Certified Financial Therapist whose work sits at the intersection of money, mental health, and identity. She works with individuals navigating caregiving, cultural expectations, and complex life transitions, helping them make decisions that honor both responsibility and self. Learn more at drhdiep.com and connect with her on Linkedin.

For the first time in maybe forever, I’m feeling content. Not like I’m-totally-done-trying content. But joy in the little things. At peace with myself and my life despite the chaos of the world. I attribute much of this contentedness to feeling less guilty about, well, being alive as a woman today. Much less than I did in my 30s and 40s.

Maybe it’s because I’m on the eve of turning 50 and I’m aging out of f#cks. Maybe it’s because I left the corporate tech grind. Maybe it’s because I’m creating my own career path at The Midst alongside like-minded women. Either way, I hope you’re on the path to inner peace too.

Identifying Your Guilt Triggers

This is an exclusive excerpt of Chapter 5

Let’s take a moment to consider a philosophical puzzle.

If you are indeed able to adjust your unhelpful or maladaptive thoughts, feelings, and behaviors, as I have witnessed thousands of women do, this creates a challenging question: Who exactly are you?

What I mean is, what is the underlying stable force holding firm as you notice and adjust these different aspects of yourself? If you can recognize you are having a guilty thought, who exactly is doing the recognizing?

Your answer is likely influenced by your culture, religion, and other belief structures. You may refer to this true self as your soul, your inner psyche, or the core of your identity. Whatever you choose to call this deep knowing — which exists in all of us, buried underneath layers of unhelpful expectations and habits — it is ready to guide you toward a much more powerful and pleasurable future.

In other words, knowing who you are underneath all this guilt and self-​­criticism will allow you to finally mobilize true agency.

I’m so inspired by the possibility of agency, rather than guilt, providing a framework for forward momentum. Agency invites you to experience your roles from a place of true empowerment, to be in charge of your own life and feel confident in your path forward. You can use this power to nurture a deep awareness of where you currently stand, revealing the confidence and motivation to intentionally shape your own circumstances. By tapping into this self-​­knowledge, you can establish a different command center for your life, governed by what you want and need, rather than what you think you should be doing.

Consider, for a moment, the meticulous care an art conservator applies to the cleaning of a celebrated painting. The challenge of removing layers of accumulated sediment without disrupting the stunning work underneath means they must take their time. The final result is a revelation of the true image, unburdened and undimmed.

I have witnessed women undergo a similar transformation, peeling back the heavy layers of guilt with care and patience, finally emerging as they truly are, and the results are breathtaking.

Identifying Your Guilt Triggers

It is my firm belief that you do not have to comply with the world’s opinions about how you should live your life. You should also not have to respond to the biases and limitations placed on you in this modern era by striving for unrealistic perfection.

You will never reach an unimpeachable level of femininity, productivity, or caretaking, no matter how many beauty products or organizational tools you purchase, how many critical remarks you make about yourself, or how many tasks you add to your already endless to‑do list. What you can do, instead, is engage with the world differently, beginning with a shift from decision-​­making based on guilt to authentic choices grounded in agency. If you shift the conversation to problem-​solving rather than self-​­improvement, you can gain confidence and rewrite your own expectations in much more reasonable and helpful ways.

The other important downstream effects of your commitment to lowering guilt by bolstering agency? You will model this change to the women around you. If they can see, reflected in you, their own ability to choose a life that replaces guilt with desire, and likability with respect, they may be more welcoming of this in themselves. Also, crucially, if generational transmission of trauma can occur, it makes sense that generational transmission of empowerment, agency, and hope is also possible. Part of the staying power of guilt involves its widespread use among women, normalizing the presence of this constant emotion. If the message changes, however, and young girls from an early age witness women making decisions based on agency and a balanced approach to their needs and responsibilities, rather than guilt, they will learn how to view the world through a different, more empowering lens.

This means we cannot make decisions based on groupthink. If we do, the status quo — whether it’s your willingness to accept responsibility for others’ feelings or trying to control yourself with guilt — will always win out.

Until it doesn’t.

Eventually, there will be a tipping point, when your continued effort to make authentic decisions in your own life will overtake your years of self-​­critical thoughts and excessive guilt, opening the door to an incredible transformation. This is the image that helps me approach each day with renewed energy, and it is the perfect place to begin your transformation to a life with less guilt.

SPEAK: How We Build Agency

We begin with SPEAK. After years of helping thousands of women transform their thinking and behaviors away from those pressured by guilt toward those guided by agency and authentic desires, I’ve boiled down this process of change to five key steps:

• Show up

• Pay attention

• Examine your thoughts, feelings, and behaviors

• Take Action

• Keep going

I chose the acronym SPEAK for several reasons.

One, I wanted to optimize our memory by grouping key concepts into a simple mnemonic — a helpful strategy employed by overwhelmed students everywhere as they try to memorize important information.

Two, these changes cannot be effective without our willingness to communicate differently, both within ourselves and with the world around us. Third, and most important, I want to emphasize the power of women’s voices when we are united toward a common goal.

The first step to building agency is identifying your guilt triggers, particularly your sky-​­high expectations, so you can begin quieting them. This is what the first three steps — showing up, paying attention, and examining your thoughts feelings, and behaviors—are all about, and what we’ll be focusing on in this chapter.

Read more of Guilt Free — order the book here on Amazon or here from Penguin Random House.

From GUILT FREE by Jennifer Reid, MD, published by Penguin Life, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright © 2026 by Jennifer Reid.

This article was originally published here on the-midst.com.

Jennifer Reid, MD, is a board-certified psychiatrist, educator, and author of Guilt Free: Reclaiming Your Life From Unreasonable Expectations (Penguin Life). She’s also the creator and host of A Mind of Her Own on Substack, an assistant professor at the University of Pennsylvania and an associate professor at Cooper Medical School of Rowan University. She attended medical school at Columbia University and completed her psychiatry residency at UCLA.

Jennifer grew up in rural North Dakota, in a family of physicians, nurses, teachers and librarians, and she choose to honor that legacy through education, whether it’s with her podcast interviews with amazing people working to make us healthier and happier, her writing, both serious and humorous, or teaching the next generation of psychiatrists.

She is a married mother of two boys, trying to raise them to be compassionate, productive, and thoughtful members of society.

It was 1983. I was 15 years old.

By Lisa Williams

My mom was 40, newly divorced with three daughters, no formal education, no job, and $300 a month in child support. And something most people don’t know about that era — a woman couldn’t get a loan or buy a house without her husband’s signature. Legally couldn’t.

Let that sink in for a moment!

I remember running out of gas. Regularly. On the way to my grandparents’ house, coming home from school, she’d pull over, we’d find a payphone, call my grandfather, and wait on the side of the road until he could come. We’d wait until she got paid or until child support cleared to go to the grocery store, clipping coupons all week, walking in with $100 and a calculator, making it stretch to feed four people. If we could save $10 by the end, we’d order a pizza when we got home. That was the goal every single trip. That was the win. Most of our dinners consisted of PB&J, tuna fish sandwiches, and 39-cent mac and cheese. Corn tortillas with butter and melted cheese that we called quesadillas.

I got my first job at Chick-fil-A so I could buy my own clothes. That wasn’t really a choice — it was just how it was.

For a long time, I was angry about it all. At her, honestly. The instability, the scarcity, the things I felt like we missed. Not fully understanding the systems designed to fail her.

Then I had kids. And something quietly shifted in me, the way things only happen on the other side of circumstances, and I finally understood what it actually costs. You see your own mother differently when there’s a child looking up at you the way you once looked up at her. You start to feel what it takes to hold something together every day for people who are counting on you when you have almost nothing to hold it together with.

Fast-forward to 2016: my own divorce.

Two teenagers. No backup, no support, completely on my own. I qualified for a home loan on my own, started a business from scratch, and was the only person responsible for everything — and I had rights and options she never had. I was exhausted and scared, and figuring it out day by day. And she had done all of it with a fraction of what I had available to me.

Through every hard year, every thin month, every moment of holding it together in the dark, my mom never said a bad word about anyone. Not about my dad. Not about anyone making her life more difficult. Not once, not ever, as far back as I can remember. That’s what I’d call quiet persistent dignity. She just carried it, without making a thing of it, without asking anyone to notice.

March is Women’s History Month. And I keep thinking about women like her — the ones who didn’t get a platform, a celebration, or even a fair set of options. The ones who built something from nothing, who kept showing up when the ground wasn’t there, who gave their kids a foundation made of sheer will.

This world is asking a lot of women right now. It always has. And I believe more than ever that the women who know what it means to carry something hard and keep moving are exactly who we need leading, building, raising the next generation.

Lisa Williams is the founder of Hello Again, CBD suppositories for menopause, sleep, and periods.

Pssst … Applications for The Midst Mastermind are due by March 31!

Learn more here

Happy International Women’s Day!

This year’s theme is Give To Gain, encouraging a mindset of generosity and collaboration — a core part of The Midst Founder network.⁠

Wondering what you really want? Tracey Gee to the rescue.

This is an exclusive excerpt of The Magic of Knowing What You Want: A Practical Guide to Unearthing the Wisdom of Your Desires by Tracey Gee

People I looked up to had told me that midlife was something to be excited about. They used phrases like “fabulous forties” and talked about how freeing it was to live truer to oneself when age gives you the gift of caring much, much less about other people’s opinions. And I believed them. I had started to taste some of that freedom, and I anticipated more.

On the other hand, I do not recall any mention of life-changing inciting incidents that could leave you questioning yourself and everything you ever thought you knew about where you were headed. Nobody talked about being blindsided. Or maybe they did, and I simply tuned it out.

However, when I hoped for a promotion and got a rejection at work instead, it triggered a mid-life spiral I didn’t even know was possible. Suddenly, my experience of being in my 40s felt more freefall than fabulous.

It was during this time in my life that I was drawn to think about what I wanted.

And not only to pay attention to how I related to my own desires but also to trust that this clarity would lead to a more fulfilling and meaningful life. I wasn’t looking to be selfish, but I sensed that finding my way back would somehow be connected to paying attention to what I really, truly wanted. I’ve never been the gambling type. It’s probably because I’m no good at it, and I always lose. But this was a bet I wanted to take.

Fast forward many years later, the gamble paid off. Paying attention to what I wanted led me away from the organization I thought I’d retire from and toward starting my own thing as an entrepreneur, which was a dream job for me, even if it was challenging at many points. In this capacity as a leadership coach and consultant, I had the opportunity to have thousands of hours of conversation with people about their unique strengths, aspirations, and challenges. Over and over, I noticed that the real issue wasn’t about finding one perfect solution—it was about figuring out what they truly wanted. But I was taken aback by how that turned out to be surprisingly difficult for many people to express and define.

What do you want?

It’s an age-old question but one that we may never outgrow. Inner and outer transitions can cause this question to come back repeatedly, even if a past version of you had it all figured out. It’s a big question, but one that affects the very smallest elements of our lives. It’s a question that’s everywhere, but we aren’t taught where to go to find answers for it. Based on the countless conversations I’ve had with others, as well as my own story, “What do you really want?” is only a simple question until you try to answer it meaningfully.

Shouldn’t it be easy to know what you want? Isn’t it as natural and unconscious as breathing? Listening to people’s stories has shown me that our desires aren’t always obvious and easy to decipher. There’s a lot more to them, and sometimes, we need help to uncover and understand them. Uncovering and understanding our true desires can be challenging, and not discussing this reality makes it much harder to navigate.

These repeated conversations showed me how the simple question of what you want can go from straightforward to complex fast. When you are lost about how to answer, that confusion feels like a crushing wave of confusing emotions. I call this desire fog, and it is frustrating, stress-inducing, and tricky to navigate.

How to know what you really want

On the other hand, some things help combat desire fog and see more clearly what we truly want.

They are:

1. Calibrating your inner compass

We all have an inner compass, but sometimes we haven’t taken the time to pay attention to it and notice what uniquely makes us come alive and what doesn’t, what we’ve learned about ourselves that we want to bring into the future, and what we need to leave behind. Sometimes, when we don’t know where we want to go next, it’s because we don’t yet know enough about who we are.

2. Reprioritizing the roles of clarity and action

Most people assume that they need clarity before they can act. This is logical and makes sense. But there are thinking questions, and there are doing questions. Sometimes, you can find the clarity you’re looking for through reflection and being thoughtful. And sometimes, you can only find the clarity you’re looking for by taking action. Instead of waiting for clarity before you can act, I help people see that action leads to clarity.

3. Viewing outcomes as invitations

Lastly, most people don’t tend to be curious enough about the outcomes of their desires. If I get the job, that’s success. If I don’t, that’s failure. That’s definitely how I saw things. However, there are many more layers and nuances to the things we will encounter as we experiment with our desires, and we need to learn how to interpret these outcomes for our desires to become reality.

4. Not minimizing your desires

Many of us have wants, but we try to downplay them and make them as small and convenient as possible. Often, this is because we don’t want to open ourselves up to the possibility of being disappointed, so it feels safer to settle. But I find it essential to engage with what we want with more creativity and expansiveness.

I’d like to invite you to take a moment to pause to try a quick exercise that can help you get in touch with what it feels like to intentionally choose to be expansive with what you want. It won’t take you too long, I promise. Grab a pen and a piece of paper and set a timer for three minutes. For this brief amount of time, I want you to write down everything that you want. Don’t get caught up with what is and isn’t realistic. Instead, just allow yourself to be open and honest with whatever you find. Author Emily P Freeman talks about how you want what you want whether you admit it to yourself or not. So, this is an exercise in naming what is there, even if it feels a bit vulnerable to do so. You can even pause right now to do this before reading on. In fact, I think that is great.

Because when you take just a brief three minutes to try to be as expansive as you can be with what you want, you’ll learn so much. When I did this recently at a workshop, I found the responses so fascinating. One person said, “I found myself trying to come up with a good reason for everything I wrote down like I had to justify this to someone else. But I’m doing this only for me, and no one will even look at this, so why am I doing that?” Another person said, “It sounded so simple but surprisingly hard. I’m not used to thinking this way about myself. I do this for other people in my life — my kids, my loved ones — but not me.” Other people found it lovely and enjoyable, and it helped them get even more in touch with their true desires. The point is what you write down, and it’s also what it’s like to be more curious about your desires and let yourself flex your dreaming muscles.

When we do this kind of inner work in our lives, it builds a positive relationship with our desires, much like that of a good friend who wants what is best for us, sees beautiful possibilities ahead, and helps us become who we’re meant to be in the world. I’ve seen this time and time again in my life and the lives of the people I am privileged to work with. It’s why I’ll never not be passionate about helping people uncover what it is they truly want.

Recently, I was talking with a client of mine who had recently retired at the age of 65. He had been successful by most of society’s measures — a family, a successful career in finance, and a respected member of his community. When we were talking about what lay ahead in this new chapter of his life, he was asking a lot of questions. “I know what others want me to do, and I also know what I want to be doing, what lights me up the most, and what brings me joy. I’ve noticed how those aren’t usually the same thing these days. My question is — does that difference matter?”

I’ve thought a lot about this conversation and his questions. I believe the inquiries were his way of seeking permission to focus on what his life showed him he wanted most. I knew that deep down, he already knew the answers. That his desires matter and that leaning into them would help him continue to grow and evolve in a thriving and joyful way. I was so grateful for the courage and honesty of his inquiries and how he reminded me there is no wrong season of life to ask these deeper questions.

This book excerpt was originally published here on the-midst.com.

About the author

Tracey Gee is the author of The Magic of Knowing What You Want: A Practical Guide to Unearthing the Wisdom of Your Desires.

She became a certified coach and consultant because she wanted to be the best she could be at helping people amplify their authentic leadership genius. Gee holds degrees from UCLA in Anthropology and Business and an M.A. in Leadership.

She is certified in four frameworks — Gallup StrengthsFinder, Cultural Intelligence, the Enneagram, and Working Genius — and am a member of the International Coaching Federation.

𝗧𝗵𝗲 𝗹𝗮𝗿𝗴𝗲𝘀𝘁 𝘀𝘁𝘂𝗱𝘆 𝗼𝗻 𝗛𝗥𝗧 𝘀𝗮𝗳𝗲𝘁𝘆 𝗷𝘂𝘀𝘁 𝗱𝗿𝗼𝗽𝗽𝗲𝗱. 𝗜𝘁 𝗰𝗵𝗮𝗹𝗹𝗲𝗻𝗴𝗲𝘀 𝗲𝘃𝗲𝗿𝘆𝘁𝗵𝗶𝗻𝗴 𝘄𝗲'𝘃𝗲 𝗯𝗲𝗲𝗻 𝘁𝗼𝗹𝗱 𝘀𝗶𝗻𝗰𝗲 𝟮𝟬𝟬𝟮.

By Verity Fotheringham

For over two decades, the 2002 Women's Health Initiative cast a shadow over hormone replacement therapy. That single study (16,608 women) changed prescribing overnight and left an entire generation afraid to treat their menopause symptoms.

The BMJ just published something that puts WHI in perspective.

Danish researchers tracked 𝟴𝟳𝟲,𝟴𝟬𝟱 𝘄𝗼𝗺𝗲𝗻 for a median of 𝟭𝟰.𝟯 𝘆𝗲𝗮𝗿𝘀 using nationwide registries. That's 53 times larger than WHI, with 𝟰𝟳,𝟱𝟵𝟰 deaths analysed.

Women using HRT had 𝟰% 𝗹𝗼𝘄𝗲𝗿 𝗺𝗼𝗿𝘁𝗮𝗹𝗶𝘁𝘆 𝗼𝘃𝗲𝗿𝗮𝗹𝗹.

The longer they used it, the stronger the benefit! - 𝟯 𝘁𝗼 𝟱 𝘆𝗲𝗮𝗿𝘀 𝘀𝗵𝗼𝘄𝗲𝗱 𝟭𝟬% 𝗹𝗼𝘄𝗲𝗿 𝗺𝗼𝗿𝘁𝗮𝗹𝗶𝘁𝘆, 𝟱 𝘁𝗼 𝟭𝟬 𝘆𝗲𝗮𝗿𝘀 𝘀𝗵𝗼𝘄𝗲𝗱 𝟭𝟭% 𝗹𝗼𝘄𝗲𝗿.

Women who'd had their ovaries removed surgically and started HRT had 𝟮𝟳-𝟯𝟰% 𝗹𝗼𝘄𝗲𝗿 𝗺𝗼𝗿𝘁𝗮𝗹𝗶𝘁𝘆.

No increased cardiovascular death. No increased cancer mortality. The dose-response went the opposite direction of what WHI suggested.

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A love letter to myself after eating disorder treatment

By

The sharp, familiar outlines of anorexia and bulimia came into view when I met T. I was 52 years old, two years separated from my husband of 25 years, and still grieving the sudden death of my mother. T. wasn’t the cause of the resurgence of this decades-long disease. He didn’t create the cliff that I had been hurtling toward—but he certainly encouraged me to jump.

We met on a dating app. I was dating for the first time in decades, as an older person, which triggered a whole new set of insecurities. I felt as if I was living in an old body that no longer told the story about myself I wanted to tell. I wanted to feel younger, fresher, as if I wasn’t hauling the weight of a lifetime of trauma. I found it difficult to step into or see the courage and strength I’d worked so hard to develop.

I couldn’t imagine how anyone would find me physically attractive. I couldn’t imagine how I would connect with another man on the level at which my ex-husband D. (the father of our two children) and I had connected. I couldn’t imagine a man looking at my stretched belly that had carried two pregnancies to birth and one miscarriage and find it anything other than repulsive. I didn’t know how I would ever rebuild a life of love and stability and joy and connection like the one I’d experienced with D. and our children.

The stories I told myself were tired and written, in part, by my eating disorder voice. The problem is, while I had battled disordered eating throughout my adult life and had swerved solidly into some murky territory over the years, sometimes starving myself and other times purging, I worked hard to hide it from everyone, including myself.

When I met T., a retired firefighter who had invested early in Seattle real estate and was therefore able to live a life of relative leisure at that point, I was taken by his physical presence. I am barely 5’1’‘. He was 6’3’‘, with graying blond hair, and a sly smile. He was strong and smart and funny as hell. He could pick me up and toss me around like a stuffed animal. We found familiarity over our shared childhoods in New York and New Jersey, the sarcasm we loved to lob, and that both of us moved to Seattle in the nineties during the height of the grunge era.

Initially, he made me feel beautiful and desired. He wanted to delete his dating profile a week after meeting me; two weeks in, he told me he could see us married. He invited me to his beach house — an A-frame cabin separated from the ocean shore by a small thicket of woods — a month into our relationship.

Sitting on the back porch one evening, drinking wine, I joked, “I wish someone would pay me to sit on this porch, gazing at the trees, smelling the saltwater air.”

He replied, “Well, if we got married you could quit your job and just do this. So, in a way you could.” I smirked and said nothing in response.

I had no idea what I was doing but the dopamine was spiking, and it was addictive. Rather quickly, he opened up to me about his life, his family, and his background.

It’s easy for me to berate myself now. Why didn’t I pay attention to the red flags? Among the most glaring was the anger he felt for most of the people who had helped shape his life, from his parents to his college-aged son to his son’s mother, and his former colleagues in the fire department. No one was safe from his contempt. But I thought I could change him — a cliché of epic proportions.

Predictably, he started to unleash his bitterness at me as well. One morning at breakfast, in a restaurant near the beach house where we had spent the weekend together, he asked, “Do you want your 22-year-old body back?”

I shot back, “Of course not. I love my body now.”

But he pressed on and suggested I “could lose ten pounds and look even more beautiful.”

I was primed and ready. The eating disorder grew from there, propagating and germinating its seeds, rooting and preparing to ripen inside me.

First, I stopped eating dinner.

That was a typical disordered eating behavior I’d employed a few times over the years. I ran every day, in rain or shine, sickness or health, another disordered behavior that had infiltrated my adult life under the guise of exercise for health. This wasn’t exercise to feel good, to feel strong, to care for myself. I had one goal: to lose weight. One glaring clue was the obsessive-compulsive thoughts — the only thing that mattered day to day was exercising. I simply couldn’t miss it.

I started to count calories, calculating every morsel that touched my lips. I refused dinner invitations and began to check myself in the mirror relentlessly. Each day became a twisted game. I “won” by going to bed hungry, buzzing with deprivation. It was exhilarating. And gutting.

Eventually I broke up with T., walking away with memories of evenings spent in his hot tub, arguments as we walked his old Australian shepherd, and his nonsensical tantrums that would erupt whenever I’d reveal the slightest vulnerability.

But the biggest thing I left with was a raging eating disorder.

I immediately slid into another relationship with B. within a month. While B. was kinder and gentler, he battled his own demons. I spent a few months pretending this relationship was what I wanted. He also asked me to marry him. “Let’s go to Vegas! I’ve never met anyone like you,” he pressed. I said no many times. I simply wanted distraction, and he provided it. I floated through my days dissociated and fell deeper into denial that I had a problem.

My adult kids — my son E. and my daughter A. — came to visit Seattle from Brooklyn, where they lived at the time, and while they didn’t yet know I had an eating disorder they sensed my just-under-the-skin deep discomfort. They knew something was wrong. They may not have been able to define it, but they knew my essence was being slowly smothered by something. I had lost too much weight. I was barely eating. I made excuses all the time for why I wasn’t eating breakfast, lunch, or dinner.

My skin felt like the itchiest of wool blankets. I wanted to fly away and beg for forgiveness at the same time. My brain buzzed with alarms that told me when to exercise, what to eat, and when to stop eating. My ever-shrinking body made me feel a certain kind of fleeting power, but my tolerance for anyone and everyone waned sharply. I was quick to anger; it was the only emotion I seemed to be able to feel.

I lived alone, so the metamorphosis wasn’t as obvious. I stopped seeing most people except for B. But I had a large community of friends and a committed family who knew me well. A few months after my kids visited, I took a trip to Brooklyn to see my brother and his family, my kids, and their partners.

It turned out to be the first stop on the intervention highway. At the end of the trip, in my brother’s apartment, he told me we needed to talk.

“Are you okay? You look really gaunt. Like, something is wrong. We’re all worried about you,” he pleaded.

As I packed to head home the next morning, I silently wondered whether I could just flee then and there. His worry was overwhelming. My brother and I are very close. When he pulled me aside that evening, it had been five years since our mother died in a car accident. I didn’t want to cause more concern.

I launched into my automatic response, honed over years of people-pleasing: “I feel great. I’m totally okay. I swear. Really, I promise.”

I did think I was fine. Or, more accurately, my eating disorder brain told me I was fine, and I chose to believe it. I thought to myself, I’m the most beautiful and healthy I’ve ever been. Sure, I didn’t have the physical strength to close the trunk of my car. I couldn’t get up in the middle of the night to pee without feeling dizzy and lightheaded, grasping the edge of the mattress so I didn’t fall.

But look at me, I thought, ‘am a physical specimen. I can run for miles a day. I’m a nonprofit executive, helping to direct a multimillion-dollar human services organization. I’m a published writer. I jump out of airplanes and rappel down waterfalls. I hike mountains. I write poetry, goddammit.

My brother didn’t buy my empty explanation and plastic smile. He was already talking to my son and my daughter, my ex-husband, and my closest friends, to figure out how to address what they all saw. I wasn’t well, and I needed help.

I flew home to Seattle thinking I’d bought myself more time to…what? Starve myself? Lock myself away in the prison of this powerful mental illness? Isolate my body, heart, and mind from anyone and everyone who loved me?

I resumed my starving and purging and compulsive exercising back home.

But two weeks later my ex-husband pulled me aside at a bar where we gathered to watch a friend’s band play and confronted me: “I’m — no, we — are all scared. I want you to know I’ve talked to the kids and your brother, and we need you to get help. You’re not eating. You avoid everyone in your life. Please. Don’t tell me everything is okay.” Sitting side by side, on stools, the bartender mere feet away, I was humiliated and caught off guard. I tried to fight it.

“What?! I’m totally okay. I swear. I truly promise you. I’m fine,” I lied. I felt exposed, like those dreams where you find yourself naked at work or in school. Why is everyone making such a big deal out of this? He may as well have told me he believed the moon was made of cheese. I was shocked and didn’t know how to process any of this confrontation. I had kept this a secret for so long. My house was burning.

None of my tricks, none of my lies, were working any longer.

D. said they found a place where I could get help. I lied and told him I’d call to find out more. I didn’t.

My boyfriend B. came over to the house one evening to make dinner and watch a film. He was a good cook but I, of course, would make an excuse, as always, for why I wouldn’t eat the food he’d made. I wasn’t feeling well. I had eaten late. Or else I would pick at the food on the plate, pretending to eat and then spitting it out in my napkin as surreptitiously as possible. Halfway through the movie, he turned to me and said, “Hey, let’s go to Mexico City. I’ve never been there, and I’ve always wanted to go.”

Why not? I thought. I decidedly chose not to answer myself.

We landed in Mexico City in August 2023. Mexico City is a high-altitude city. If you’re not used to it, it’s best to take a few days to acclimate your body by hydrating well, limiting alcohol intake and strenuous activity. Me? I could hardly wait to put my gear on and go for a run the day we arrived. After the run, we spent the rest of the day exploring the area around our Airbnb without drinking nearly enough water. That evening, we made dinner (which I didn’t eat), drank wine, and watched a movie. I did exactly everything I shouldn’t have done. And when I walked downstairs to our bedroom that night, I felt woozy and lightheaded and flopped into bed. B. stayed upstairs to clean up.

Almost immediately, nausea overtook me. I remember standing up to walk to the bathroom. The next thing I recall I was on the cold tiled floor, B. standing over me, frantically asking if I was okay. I was too shaky to walk so he picked me up and carried me to bed.

The next morning, I awoke to a massive, red, and very painful bump on my forehead. I tried to lift my head to find the world spinning off its axis. I had to be carried into a taxi and taken to see a doctor at a nearby clinic who told me I had a mild concussion. I sent a lighthearted text to my family group chat (“Ha! I fainted last night. I’m so silly. I have a concussion but I’m fine!”). No one got the joke.

My kids each called me one after the other. My son was furious. He’d had enough and he told me there was nothing funny about fainting. My daughter called me crying. They each implored me to get help. While they didn’t have all the details (not eating + over-exercising + drinking in a high-altitude city = fainting), they knew I wasn’t well. They knew the eating disorder was the fuel for this episode.

Something broke inside of me that day. I laid in bed, thousands of miles from home, listening to each of my children practically beg me to stop hurting myself. These were the humans I grew inside me, the ones whose eyes I gazed into moments after pushing them from my body and with whom I fell in love in a way that’s impossible to put into words. These are the people I would die for if it meant saving them.

And they were asking me now to save myself.

I flew home the following week and called the treatment center. I took leave from my job and, with the help of my community of friends and family, entered a two-month partial hospitalization program. My kids and my brother attended virtual family therapy with me every week. My ex-husband and closest friends worked from my house to stay with my senior dog and take her for walks. They attended Zoom sessions organized by the treatment center to help them learn more about eating disorders.

I made it through each day peeling back one more layer of pain and grief, bearing loving and compassionate witness to the experiences of those who were in the program with me, so that I could see myself within the same orbit of love.

I opened to the possibility that having an eating disorder — even in my fifties —wasn’t shameful. I allowed myself to feel strengthened by my courage to be as vulnerable as I could be and to admit to everyone, including myself, that I was sick.

That was two and a half years ago.

I started writing about my experiences to understand myself and this decades-long disease. I reached out to other women in midlife who have struggled with eating disorders and am collecting their stories as well. It can be hard to find the self-love you need to get through trauma like this but somehow, we often find it for others. Let me hold you so that I can hold myself, I often think.

T. reached out a couple of months ago, out of the blue, saying he wished he had been more sensitive when we were together, apologizing for what he said to me about my body back then and asking if he could see me. I waited a few days, wondering if I wanted to respond. I finally emailed him in response: “I appreciate the email and the kind thoughts. Seeing each other isn’t a good idea. You hurt me while we were together, and I’m now in a strong place. I don’t want to jeopardize my health. I wish you a good life, T.”

Recovery from an eating disorder is a bumpy road and while I wish I could wrap this up in a neat bow, I have slowly understood that this is and will be a lifelong process.

My eating disorders aren’t just about my relationship to food or to my body; they’re about my relationship to myself. So, I sit here, on my couch, and write this essay as a love letter to myself and to those I love. I find strength in this love. Love for the woman I was when I was deep in the grips of anorexia and bulimia. For my children, my friends, and family who put themselves in belly of the beast to pull me out. For the little girl who was harmed by parents who didn’t understand how to metabolize their own body issues. This is a love letter, also to those who struggle in the throes of active eating disorders and for those who are in recovery. Most of all, this is a love letter to the woman I am today: messy, vulnerable, unique, courageous, and stubborn as hell.

This story was originally published here in Open Secrets.

More about Amie Newman

I live in West Seattle, by the water, where I’m teaching myself to play the guitar and co-leading women’s circles on rituals, myths, and story sharing for perimenopausal and menopausal women. I’m the proud mother of two brilliant humans, and in my spare time, I am an abortion doula, a certified yoga teacher, a lover of music, films, nature, and most of all, my beautiful community of friends and family.

In my day job, I serve on the executive team and as the head of communications for a large Seattle-based nonprofit human services organization that provides food, financial assistance, and housing to individuals and families in need, as well as support for survivors of domestic violence, refugee resettlement, and other critical services.

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“You can buy them in bulk, honey.”

By Lauria Locsmondy

The woman behind the Dairy Queen counter pointed to the pre-made ice cream sandwiches in the fridge. Oh, my god. Did she know that I puked them up, too?

I was an unsuccessful bulimic — my binges surpassed my purges — and I was overweight, having gained 30 pounds since I started college the year prior. The trauma from date rape (is the passive modifier “date” still used these days?) left my 19-year-old mind seeking control over my body. Food was an obvious choice to spike my dopamine and reclaim my power — although it took me years to realize that’s what I was doing.

I can’t remember the details of this time in my life with clarity, but my writing helps memories resurface — and I am reminded of how I could “see” again after the Dairy Queen herself shamed me to seek out Overeaters Anonymous (OA) meetings. (Despite its name, OA helps people recover from eating disorders like anorexia, bulimia, and of course, compulsive overeating.) It was as if a veil fell from my eyes — I saw the sky and the colors in the flowers: I wasn’t (as) consumed with food and weight and secrets and control.

What people don’t know — often including people suffering — is that eating disorders are a disease of the mind: An eating disorder is a serious, complex, mental health issue that affects someone’s emotional and physical health. And like being an alcoholic in recovery, being a bulimic in recovery is very much the same — there are triggers and maintenance, and it never really goes away.

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Can you burn more calories ruck-cleaning than jogging alone?

By Stella Tamul

For most of my adult life, I did fitness the “right” way. I ran. I trained. I signed up. I remember sitting in my car at 5 a.m. to meet my friend Kerri for bootcamp. We were 22 years old. We both commuted an hour to work after that workout every week. Writing this now makes me smile. Kerri and I had all the time in the world — we were fresh out of college and still living with our parents.

In my late 30s, the early mornings, late-night yoga classes, and long training plans stopped feeling sustainable. Not because I stopped caring about my health, but because the structure of my life changed. I was working. Raising kids. Managing a household. My body also felt different. Workouts that once energized me began to feel like another demand.

Talking with women in midlife, I know this experience is common. Structured exercise often fades quietly. Not out of laziness, but because of fatigue, other responsibilities, time pressure, and bodies that no longer respond the same way to intensity. I started walking laps in parking lots during my son’s hockey practice with other moms. We talked. We worried. We laughed. It was movement born of necessity and connection, not a plan.

What struck me most was that my movement did not disappear. It just stopped being labeled as exercise. Research supports this shift.

When exercise becomes invisible

Studies comparing physical activity patterns across generations show that modern adults perform significantly less occupational and lifestyle movement than previous generations, largely due to labor-saving technology. Daily movement has declined by roughly 30 minutes over the last century, not because people stopped moving, but because movement became “invisible.”

Our bodies, however, have not changed — they still respond to effort, duration, and consistency.

Why energy expenditure matters more than fitness labels

I’ve always trusted evidence more than fitness trends, which is why I rely on measured energy expenditure rather than narratives about what counts as exercise.

Compendium of Physical Activities is the scientific framework I use to calculate chores energy expenditure in the ChoreFit app. Developed by exercise physiologists to quantify everyday movement, the Compendium assigns metabolic equivalent of tasks values (METs) to hundreds of activities. The Compendium of Physical Activities started in the early 1990s to give researchers a consistent system for measuring the amount of energy used in various activities.

Before the Compendium existed, studies often used inconsistent values, making it difficult to compare results. Since its first publication in 1993, the Compendium of Physical Activities has been updated several times (in 2000, 2011, and more recently in 2024) to include new activities and better data. Over the past 30+ years, it’s become a widely used tool in research, public health guidelines, and even apps and tech that track physical activity (Ainsworth et al., 2024).

One MET represents the energy cost of resting quietly. Activities are scaled relative to that baseline.

Calories burned from daily activities (MET-based estimates)

Calories burned during daily activities can be estimated using MET values from the Compendium of Physical Activities.

While one MET represents resting metabolic rate, activities at 3.0 METs or higher are classified as moderate intensity, according to the U.S. Department of Health and Human Services Physical Activity Guidelines (2018).

Weighted vest exercises around the house: METs from common household activities

• Vacuuming: ~3.3–3.5 METs

• Mopping or scrubbing floors: ~3.5 METs

• Carrying laundry upstairs: ~4.0 METs (or higher depending on load weight)

• Snow shoveling: Often exceeds 5.0 METs

How calories are calculated

Calories per minute can be estimated using the standard formula:

Calories/minute = MET × 3.5 × body weight (kg) ÷ 200

Because calorie burn depends on body weight and duration, two people performing the same task will burn different amounts of energy.

Public health guidelines define moderate-intensity activity as ≥3.0 METs. Many everyday household activities meet or exceed this threshold. When an activity raises heart rate, increases muscular effort, and requires sustained energy, it qualifies as moderate-intensity physical activity under established guidelines.

Chores without load versus chores with load

Here is where the science becomes especially interesting: Without added load, many household activities already meet moderate-intensity thresholds. Vacuuming requires continuous walking and pushing. Mopping and scrubbing involve sustained upper body force, trunk stabilization, and leg movement. Carrying laundry increases lower-body and core demand.

By adding external load (such as a weighted vest), the physiological response increases without changing the movement pattern.

Adding load increases muscular recruitment, particularly in the legs, hips, and trunk. It raises oxygen consumption and overall energy expenditure while preserving low-impact, joint-friendly motion. Research on wearable resistance shows that even modest added weight significantly increases metabolic demand during walking and daily activities, especially in midlife and older adults (Macadem P et al., 2017).

In practical terms, the same chore performed with a weighted vest requires more effort from the same body. Heart rate rises modestly. Muscles work harder to stabilize and move. Over time, this contributes to strength maintenance, bone loading, and cardiometabolic demand without requiring additional time or structured workouts.

This is not about making chores harder for the sake of it — it’s about recognizing that load changes the stimulus.

The body adapts to load and repetition, not to whether movement happens in a gym.

Why accumulated movement counts as fitness

One of the most persistent myths in fitness culture is that activity must happen in long, intense blocks to matter. But that’s not always true.

The U.S. Department of Health and Human Services research shows that accumulated moderate-intensity physical activity improves cardiovascular health, metabolic function, and mortality risk, even when performed in short bouts across the day.

Household movement is inherently accumulative. A few minutes here. Ten minutes there. Repeated daily. When tracked accurately, these sessions often meet or exceed recommended activity thresholds across the week.

The problem has never been the movement. The problem has been visibility.

The benefits of wearing a weighted vest in everyday life

Weighted vests are simply a tool to increase load during movement you already do. A practical starting point is 5 to 10% of body weight. Movement should feel steady, not strained. Breathing should remain controlled.

Examples include vacuuming with upright posture, carrying laundry upstairs, tidying rooms with repeated squats and reaches, and making beds using lunging and pulling motions. These movements are multiplanar and functional. With light load, they often cross moderate intensity thresholds without impact (Ainsworth et al., 2011).

Walking, stair climbing, sit-to-stand transitions, wall push-ups, and gentle carries can also be performed with or without a vest depending on comfort and joint health.

No jumping. No rushing. No turning life into training. Just letting effort count.

Why everyday movement is supported by research

The evidence is clear. The body responds to mechanical load, muscle activation, and sustained energy demand. Moderate intensity activity improves health markers regardless of where it occurs. Wearable resistance increases metabolic demand during everyday movement. Accumulated activity contributes meaningfully to long term cardiovascular and metabolic health (Macadem P et al., 2017; U.S. Department of Health and Human Services, 2018).

Household work has always met the physiological criteria for real fitness — it was just never acknowledged until now.

Why I built a way to measure my effort with ChoreFit

As I approached 50, feeling stuck and unseen in my own effort, I built an app to measure what was already there. ChoreFit tracks household work using Compendium-based energy estimates and integrates with Apple Health. Not to gamify life. Not to optimize every minute. But to validate the movement that already supports our health.

This story was originally published here on the-midst.com.

When the call comes: How end-of-life planning rewrote my definition of success

By Marni Blank

I was standing in my studio in SoHo, surrounded by a room full of women entrepreneurs having a curated dinner, when my phone rang. It was 2018, and Blank Studio NYC was thriving. My sister and I had built this beautiful rental photo studio and creative space, and I was hosting exactly the kind of event that made me feel like we’d made it.

Then my stomach dropped.

My mom had been in a serious accident. In the span of maybe three seconds, I went from present and engaged to a thousand steps ahead: How do I get to the Berkshires from Brooklyn without a car? Who’s going to manage the studio? What if she dies? Why did my parents have to get divorced so this now all falls on me? I’m the eldest daughter — of course it’s on me.

I don’t remember what I said to everyone in the room. I just remember the immediate, crushing weight of logistics mixed with dread, and the realization that I had absolutely no idea what I was walking into. All I knew was that some of her key paperwork was on my desk, I was supposed to have notarized something…and I hadn’t. I’m smart, I’m a lawyer, I know the importance of this type of paperwork…and I’d let it collect dust. Talk about an emotional block.

My sister, also my business partner, was incredible. Over the next few months, we took turns managing the studio and helping our mom. But there were still so many parts of the business that only I knew how to do. So I’d sit in a hospital room, then rehabilitation center, or at my mom’s house, laptop open, trying to keep everything from falling apart while also trying to figure out how to transport two animals back to Brooklyn, how to pay bills I couldn’t access, how to navigate insurance I knew nothing about.

My mom had recently moved — to a new home, in a new state, with no real friends or community to show up for her. I didn’t even have keys to her house at that point. She’d gotten a kitten a week before the accident and had a deeply attached dog named Harriet with the longest lashes that always made us laugh. I had zero understanding of how to navigate the system I was suddenly thrown into and felt completely overwhelmed.

The rehab facility is what still gets me. That smell — I can still smell it though I’d rather not describe. I stood there, completely ashamed and horrified that my mother was in this place, and I couldn’t figure out the bureaucracy fast enough to move her somewhere better. I tried. I made calls, I visited other facilities in New York closer to my sister and me. I asked questions, I pushed. I couldn’t make it happen — and I felt like I’d failed her.

And she looked at me and said she could handle anything for six to eight weeks.

And she did.

My mom is fully recovered now, walking, self-sufficient, and living her life. But in that moment, standing in that facility, I realized how completely unprepared I was, not just for the logistics of caregiving, but for the emotional weight of it. I wanted to curl up under my gravity blanket, but everyone needed something from me.

What scared me most wasn’t just the immediate crisis. It was the realization that I couldn’t get out of my business, even when I was sitting bedside at a hospital. I was tethered to it — knowing if something happened to me, or if I needed to step away to care for someone I loved, what would happen? I had no continuity plan. No documentation or SOPs. No way for someone to step in and keep things running. My sister and I had very different roles in the business, and I carried a lot of my knowledge in my brain, not accessible to anyone.

I found my calling as an end-of-life planner

The experience with my mom’s health changed the trajectory of my entire career. I wanted to feel more prepared for caregiving, death, and grief, and I saw what everyone in my age bracket was going through: health challenges ourselves, our parents aging or dying, the messy sandwich generation reality of what they’re carrying emotionally, financially, logistically, physically.

When the pandemic shut down our studio for several months, I finally took time to pursue training as an end-of-life doula and pore over as much education and resources I could around caregiving and loss. It felt like everything fell into place — I wanted to create a business that helped people face these realities with more support.

I found my calling by taking something that started in a fearful state and turning it into something meaningful. I built a business that gives me flexibility and freedom so I can care for others while still living my life on my terms. That’s the real shift. Not just preparing for a crisis, but building a life that has room for the messy, unpredictable reality of loving people who age, who get sick, who need you. And having room to take time I need when I need it for myself, not having to ask someone else’s permission to take time off or risk getting fired. I’m creating the support I wished I’d had for myself.

A few years later, my father started going through his own health challenges. And it confirmed what I already knew: this wasn’t a one-time crisis, this was the new normal. My parents were aging — and I needed to be ready, not just logistically, but emotionally. I needed to build a life that had room for this reality.

End-of-life planning checklist

That crisis with my mom, and later my dad, is why I originally created the Plan Well Organizer. I had felt completely blindsided by what I didn’t know, what I thought I should have known. Both my parents have now filled it out, so I have the information I need as they continue to age and need us for more support. But it also showed me that as a small business owner, I needed to create a proper plan so that if I need to step away and care for myself or someone else again, I’m not leaving my business to flounder. Creating a simple business continuity plan isn’t sexy, but it’s essential.

I used to measure success by how fast the business was growing, our P&L, how many bookings we had, how impressive our client list looked (and it was impressive). And those things mattered, don’t get me wrong. But caregiving forced me to ask different questions. If I only have 10 good summers left with my parents, how do I want to spend them? If I have 40 good summers left myself, how do I want to spend them? What do I want to prioritize? What am I willing to let go of?

The shift of how much a parent or other loved one needs you begins to creep in and all of a sudden, it’s hard to balance the life you’ve been creating for yourself, and a feeling of responsibility to others. Not everyone has the resources to outsource help, which means that you need to get really discerning with how you spend your time and energy.

The last four winters, I spent a month in upstate New York being a backup caregiver for my nana, who passed this past spring at 102. I prioritized that time over networking or pushing my business forward. It was hard and lonely and exhausting and I also loved most minutes, learning more about her, connecting on a new level. It was the best of times, and sometimes the worst of times…and I wouldn’t change a thing. This winter, I decided to continue the tradition, spend a month upstate to work remotely and be in the place that my grandmother loved, and it feels just right, and something I will incorporate into every winter from now on.

Health scares put everything into perspective — it’s no longer a hypothetical. Even though I’m fully immersed in the end-of-life space for work, it’s still unfathomable to me that my parents or those I love will no longer be here. I don’t think it’ll ever quite sink in. So I do little things to honor the time I do have, to not waste it. I started calling my parents more during covid. I still do, even if it’s five minutes on the way to the subway or when I’m walking my dog, Penny. I prioritize experiences with the people I love over things, over certain types of ambition. I choose quality time. I show up differently in my friendships because I know I’m not guaranteed anything. I’ve let myself redefine what success looks like, because on my deathbed, I truly believe it won’t be how many hours I worked in my business, it will be the connections I created within my community and those I love.

Life is long or short — we don’t know how long we’ll get. What I do know is that my phone will ring again; it did last week, in fact, and off to the ER I went at 4 am. And whenever it does, I want to be ready. Not just with the right paperwork and the right systems, but to be ready emotionally as best as I can, knowing that no one can ever be fully ready. I crave a life that has space for caregiving without losing myself completely. And prioritizing the things that actually matter, so when I look back, I don’t have regrets about how I spent my time.

My work in end-of-life care, this pivot, this whole third chapter of my career exists because I stood in that rehab facility and realized I had no idea what I was doing. Because I sat in hospital waiting rooms trying to manage a business remotely and felt completely alone. Because my mom looked at me and said she could handle anything for six to eight weeks, and I wanted to be able to say the same.

And when the next call comes, because it will, I’ll be as ready as anyone can be.

This story was originally published here on the-midst.com.

Marni Blank, ESQ., is the founder of Begin With The End, where she helps people navigate end-of-life planning, caregiving support, and the overwhelming administrative reality that follows a loss. A former attorney and co-owner of Blank Studio NYC, Marni pivoted to this work after her own experience as a caregiver showed her how unprepared most of us are for what’s coming. She’s trained as a death doula, mediator, certified in grief coaching, and after loss support.

Marni holds a BA from the University of Rochester and a JD from Brooklyn Law School. She completed her doula training through Going with Grace and INELDA Bridge Training Program, mediation training through New York Peace Institute and Elder Decisions, grief training with Living Through Loss Counselling Society and From Grief to Gratitude Certification Program, and is NEDA proficient. She also completed her After Loss training through PALS (Professionals of After Loss Services).

Marni works with individuals and families navigating some of life’s most complicated terrain, and facilitates programming for companies and organizations seeking meaningful educational opportunities for their HR and talent teams.

Wednesday, March 11, 2026 • Free

If you’re unsure about how to plan care for elders and loved ones, this workshop is your starting point.

4 pm PT • 6 pm CT • 7 pm ET • Live streaming on Substack

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Tonight! Wednesday, February 25
& Thursday, February 26 • Live in Chicago

Hosted by Midlife Upgrade

I’m flying into Chicago to see The [M] Factor 2: Before The Pause on Thursday, February 26, 6:30–9:30, at The Chicago Arts Club. Tamsen Fadal, Dr. Sameena Rahman, and other menopause awareness leaders will be there. I hope to meet you at The Midst table. Order your ticket here. — Amy Cuevas Schroeder

You can also attend the screening tonight (Wednesday, February 25) in Highland Park, Illinois. Order your ticket here.

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My year on Wegovy: How semaglutide changed my perimenopausal life

The author chose to share her story anonymously • Originally published in February 2025

I’ve spent the last year in a pretty exclusive club. In February 2024, I began weekly doses of Wegovy (semaglutide), which I injected into my belly. As a Gen X gal a few years into perimenopause, I’ve gained a ton of weight — to the point that my labs were screaming at me in all caps: YOU IN DANGER, GIRL.

How I got started on semaglutide: On the struggle bus

I received the Wegovy prescription from my regular doctor in November 2023, after asking if she would prescribe it to help me lower my skyrocketing A1C levels. I’d been over 200 pounds (around 233) for a few years, without any luck of shaking it through exercise or diet changes. My blood pressure was high, along with my A1C which was at the top of the “pre-diabetes” range. She agreed, but it wasn’t that easy. I still had to navigate the wild waters to obtain the drug, which was unavailable anywhere.

I spent months calling a handful of local pharmacies — ranging from national chains as well as a few mom-and-pop options. I’d hear the same thing over and over: they didn’t have Wegovy in stock but they could attempt to get some for me if I went through the process of transferring over my prescription to their pharmacy. But there were no guarantees.

At one pharmacy, the pharmacist legit laughed at me over the phone when I asked how possible it was to get the drug. I was heartbroken. I even called the pharmacy benefit manager associated with my insurance to see if they could recommend any other options — like running for the border in Canada. But they said neither was a viable solution for me.

The weighting game

I waited and even considered joining one of the growing number of “medical spas” in my city, which offered their own cocktail of GLP-1 drugs with a hefty “membership fee” tacked on each month. But what would cost just a few hundred dollars with my insurance at a normal pharmacy would cost thousands through a med spa — with no guarantee that their elixir (called “compounding” in pharmacy speak) would do the trick.

I hemmed and hawed and waited it out a little longer. At the end of 2023, Novo Nordisk, the company that makes Wegovy as well as Ozempic, promised that they would be ramping up production in early 2024. I had hope.

“I remembered those days of my own dieting so well – and I realized how diet-charged our existences had become. And how toxic diet culture permeated everything.”

But January came and went. My doctor was out on maternity leave, so I met with her fill-in for a check-up — and my labs were even worse from the holidays. But this time, the substitute doctor had new ideas for sourcing my prescription: mail order. Low-and-behold, CVS Mail Order Pharmacy had the injections, and I was able to get my first “starter” doses of Wegovy in February 2024.

I continued with CVS as I ramped up my dosing, and now I get Wegovy at my local pharmacy. (Since last spring, CVS Mail Order Pharmacy stopped carrying Wegovy completely, citing costs.) Finding doses locally has now become easier, partly due to increased production — partly as initial Wegovy users discontinued their medication.

Scaling down: How Wegovy works and feels

Because Wegovy (like other GLP-1 inhibitor drugs) works to make your stomach empty slower, it can be a bit of a shock to your system. Patients start on a very low dose — just .25 mg each week for the first month, administered via epi-pen injection. It’s then increased (if you’re tolerating it well) to a .50 mg dose.​​ Then 1 mg, 1.7 mg, and finally 2.4 mg as the final dosage. In normal circumstances, this takes five months, but sometimes patients repeat a month or go slower per doctors’ instructions on individual tolerance.

First, almost immediately, I felt a physical fullness creep into meals. Especially when eating later in the day. I wouldn’t say that I had cues to stop eating all the time, but if I took it slowly and served myself less, I would hit the end of a meal having eaten less than I used to. In fact, that was the one overarching tip my doctor gave me: put half of what you’d normally eat on your plate. It was the best advice I received on managing the effects so I wouldn’t feel like I had to throw up. This worked well to make me feel satisfied and “normal,” even while suddenly consuming less food.

The silence of “food noise”

The problem with eating habits are, well, they’re habits! And by the time you hit your 40s, you’ve definitely gone on autopilot with food. Food was and still is pretty tied to emotions. The biggest change I experienced at the start of taking Wegovy was a turning down of the “food noise” in my head.

I never heard a name for this emotional eating that fit so well as this phrase. It’s almost like I didn’t realize how loud or constant it was until it was gone. (Like tinnitus suddenly lifting.) No more did I feel like I had to go and raid the pantry for something salty or sweet at certain times of the day. And I didn’t even want dessert now? (Who was this person?)

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Ozempic: Weighing the pros and (often hidden) cons

By Emily Ornberg

“Nothing tastes as good as skinny feels.”

That refrain has been repeated since Kate Moss popularized it in the 2000s. And if you are like me, the 1 in 3 adults in the US who are overweight, it reminds you of the stigma that is often tied to fatness: you’d rather indulge yourself with food than opt for the skinny life, a life you may never get a taste of. As though body size is solely a reflection of discipline, and not a result of a demanding, sedentary, junk-food-filled society.

Yes, obesity is a health crisis. But our nation’s weight issue is not only a medical concern, but a cultural one, too. Study after study validates that overweight people, especially women, face stigma and discrimination that result in favoring the fit. That’s been socially acceptable for decades.

But this anti-obesity boom is only just beginning. As worldwide obesity rates continue to rise, drugs like Ozempic and Wegovy (powered by a molecule called semaglutide) and Mounjaro (which uses tirzepatide) became the first pharmaceutical brands to reach celebrity status across social media. While Ozempic is currently prescribed for those who have type 2 diabetes, each of these appetite-suppressing drugs have proven to be effective in promoting weight loss, including menopausal weight gain. And future versions of these glucagon-like peptide-1 (GLP-1) medicines could be game-changers: In clinical trials, they’re showing to not only stave hunger, but improve the way your body breaks down sugar to boot.

From possible side effects like “Ozempic personality” to potentially curing addictions, here’s the skinny on the lesser known side effects of weight loss drugs (before you start to feel seduced by these injectable hormones).

There are two sides to every story

Pharma marketing in the digital world is not new. For decades, drugmakers have jumped through strict, regulated hoops to market their medicines. The FDA does this so that consumers aren’t misled about a drug’s potential benefits versus its potential risks. Unlike company drug advertisements, unpaid social media posts don’t have to describe a drug’s side effects or tell people to ask for their doctor’s perspective. Influencers sharing their newfound Ozempic bods – veiled as an authentic vignette of How Much Better Your Thinner Life Could Be if You, Too, Scored a Prescription – only paints part of the picture. They don’t share how much this drug may have caused them severe stomach pains, or poorly impacted their mental health.

For example, influencer Karen Evans’s video sharing tips for taking Ozempic, including for managing nausea, reached nearly 500,000 views. After posting, she had to stop taking the drug because the vomiting became so bad, she told the Wall Street Journal. But that detail is not shared in a follow-up video – it can only be learned if you read the fine print of the caption. The virtual word-of-mouth can come across as authentic and accessible, but remember, things on social media are not always as they appear.

Potential for treating other conditions

While GLP-1 drugs will continue to evolve in weight loss treatment, studies have also shown promise in treating Alzheimer’s and Parkinson’s, possibly as a result of these drugs’ ability to regulate insulin levels and calm inflammation. Plus, this shows that these drugs could be beneficial for other conditions made worse by chronic inflammation.

Then there are meaningful mental health benefits. Some studies have found decreases in the risk of depression and anxiety after taking these medicines. They could be useful as treatment for schizophrenia and neurological dysfunction, as insulin-like hormones like GLP-1 play an important role in the central nervous system and semaglutide helps to reshape the brain’s reward system. It might even redirect compulsive behavior, too, like alcoholism and drug addiction, compulsive shopping and gambling, nail biting and skin picking, and sex addiction and smoking.

Long-term effects are still unknown

There was “Ozempic face,” the term people used to describe how the weight loss after taking the drug resulted in increased wrinkling or hollowing of the face. Then “Ozempic butt,” drooping and sagging of the skin. And now, “Ozempic personality?”

Among the online chatter of the semaglutide’s unknown side effects, some are reporting increased anxiety, depression, and even suicidal ideation.

“I have minimal passion for anything, very monotone, and no enthusiasm,” one person wrote on Reddit. “I hear good news, I respond with ‘okay.’ Things I enjoy seem to be a chore.”

While this is not an officially documented side effect, Prevention says the most commonly reported symptoms of “Ozempic personality” are a result of the change in dopamine in the brain, resulting in:

• Worsened mood

• Increased feelings of anxiety and depression

• Lacking an interest in previously enjoyed activities

• Decreased libido

It’s not entirely clear how GLP-1 drugs are interacting with dopamine, especially as others have seen positive mental impacts. It could be as simple as: eating less, losing weight, and giving up foods you love is hard.

What we do know: Treatment for obesity has been years in the making. All of a sudden, we have several, and this is just the beginning.

This story was originally published here on The Midst Substack in April 2024.

This week is gonna be good! ⁠

🧵 I’m producing What Linkedin Doesn’t Say About Wendy Mullin, founder of Built By Wendy. Wait til you see what she’s doing now!

⁠👯‍♀️ Hosting a meetup with The Midst Founder network! During which, I’ll teach my first SEO workshop.

⁠🍊 Planting a mandarin tree and a grapevine ⁠

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It took 25 years to diagnose my endometriosis. Here’s what I wish I’d known

By Nicole Moore, LMFT

It’s 3 a.m., and I’m on the bathroom floor, cold from sweat. I focus on the weight of my body pressed against the cool tile, the only thing distracting me from the waves of nausea and ripping pain inside my belly. My little dog rests his head in the arch of my foot. If a tree falls in the forest, does it make a sound? He’s the only witness.

I’m a licensed psychotherapist. It’s my job to help people with the mind-body connection and decode somatic messaging from within their bodies. Yet I spent 25 years not knowing what my own body was trying to tell me.

What is endometriosis?

Endometriosis is a condition in which tissue from the uterine lining implants itself on organs outside the uterus, according to the American College of Obstetricians and Gynecologists (ACOG). Most commonly, endometriosis affects the ovaries, fallopian tubes, bowel, and bladder — but has been found in nearly every organ in the body, including the diaphragm, lungs, and, in rare cases, the brain. The growth of endometriosis is related to levels of estrogen in the body and can cause inflammation and adhesions (bands of scar tissue that can fuse organs).

ACOG estimates that endometriosis affects approximately 1 in 10 women of reproductive age. According to a 2025 systematic review published in BJOG: An International Journal of Obstetrics and Gynecology, the average time in the United States to diagnose endometriosis ranges from 5 to 8 years, with some women waiting much longer. The researchers note that diagnostic delay is often due to physicians not being educated about endometriosis and they call for increased awareness and targeted interventions.

For me, getting an endometriosis diagnosis took a quarter century.

The medical gaslighting started early

When I was a teenager, I’d miss school because the pain was so intense that I couldn’t get out of bed. One morning, at 17, I took a bath hoping for relief, but I fainted as I got out of the tub to put on a robe. My dad found me on the bathroom floor. I lived with my single father, and we never talked about my period. It was understood that it happened, the way the weather happens. That morning, I had to say the shameful thing out loud so I could stay home. We never spoke about it again.

At school, I reached out to my gym teacher, thinking surely, she would know how to help with this. “You just need more exercise,” she said. “The pain will go away.” I believed her and thought that somehow the pain was my fault for being too lazy. I became obsessed with working out, convinced it would cure me. To this day, I still box, do yoga, dance… I became someone who could power through anything. Exercise did not cure the pain. In fact, the pain became worse over time, and, eventually, my capacity to power through failed.

What are some of the symptoms of endometriosis​?

Looking back, the signs were clear. Here’s what I wish someone had told me to watch for:

• Pain that interrupts your daily life
  Not just discomfort, but pain that keeps you home from work, school, or an inability to participate in routine activities.

• Pain beyond your period
  Endometriosis can cause pain during ovulation, sex, bowel movements, or just… all the time. If your pelvic pain isn’t confined to your period, pay attention.

• GI symptoms that sync with your cycle
  Bloating, constipation, diarrhea, or nausea that gets worse around your period.

• Heavy or irregular bleeding
  Soaking through a pad or tampon every hour, or bleeding between periods.

• Chronic fatigue
  If you’re tired all the time and can’t figure out why, this could be a part of the picture.

• Infertility
  Many women don’t discover they have endometriosis until they struggle to conceive.

What doctors often miss about endometriosis and what to do about it

I had the same gynecologist for 15 years. I complained to her countless times. I rushed to her office in crisis on multiple occasions, doubled over, unable to function. She gave me shots of narcotics to manage the pain. She never once said the word “endometriosis.” When I asked her what was wrong with me, she said, “You have painful periods. Have a baby. That will help resolve the issue.”

I’ve learned that many doctors, even OB-GYNs, are not adequately trained to recognize or understand endometriosis. The symptoms overlap with other conditions (IBS, ovarian cysts, pelvic inflammatory disease, SIBO), and there’s a long history of dismissing women’s pain as psychological.

What finally worked for me

I went to my internist in tears and told him, “I think I have cancer.” I truly believed this to be the case since there was seemingly no other explanation for my pain. He listened. He examined me and immediately referred me to an endometriosis specialist. “I think this is reproductive-related,” he said. After one meeting with the specialist, he suspected what 15years of visits to the same gynecologist missed.

If you suspect you have endometriosis, here’s what I recommend:

• Find a specialist: Not just any OB-GYN, but a doctor who specializes in endometriosis.

• Document everything: Track your pain, your cycle, your symptoms, and bring the data to the appointment with the specialist.

• Don’t accept, “it’s just bad cramps.” If your pain is severe enough to disrupt your life, that’s not normal.

• Ask about imaging: While a definitive diagnosis requires confirmation from pathology after surgery, a skilled specialist can sometimes detect endometriosis via transvaginal ultrasound or MRI.

• Trust yourself: You know your body. If something is wrong, keep advocating until someone listens.

What chronic pain does to the nervous system

When I finally got diagnosed, I was put on medication to manage chronic pain leading up to surgery. My doctor explained that my nervous system had been in a prolonged activated state, running on survival mode for decades due to the unaddressed pain. It validated the years of difficulty managing stress, the heightened anxiety, and the way I had learned to function in a constant state of hypervigilance because I had been told the pain could not possibly be that bad.

As a therapist, I see this pattern in my clients, too. When your pain is repeatedly invalidated by doctors, by family, by a culture that tells women to just deal with it, you start to question yourself. You stop trusting your own body, your own feelings.

Getting the positive report back from pathology, confirming the diagnosis of endometriosis, validated 25 years of wondering if I was being dramatic.

Endometriosis can be a dangerous disease

In 2014, seven years before my endometriosis diagnosis, I was hiking when I developed sudden, severe abdominal pain. I ended up in the ER, needing emergency surgery for a twisted bowel caused by an adhesion. The surgeon saved my life, but because no one had ever suspected endometriosis, he wasn’t looking for it. He fixed the obstruction and sent me home. It wasn’t until years later that I connected the dots: That adhesion was almost certainly caused by the same disease that had been growing inside me since I was a teenager. The cramps I was told to exercise away had migrated to my intestines and put me in a life-threatening situation.

This disease is not a minor inconvenience. It can affect your fertility, your organs, and your quality of life. And the longer it goes undiagnosed, the more damage it can do.

You’re not making up the pain

If you’re reading this on your own bathroom floor, or powering through another day of pain that no one seems to take seriously, I want you to listen to your body. You deserve answers, and you deserve to stop wondering if the pain is that bad. It’s real. I spent too much of my life learning the hard way.

This story was originally published with sources here on the-midst.com.

About the author

Nicole Moore, LMFT, is the founder of The Center Method, a trauma-informed group therapy practice in Los Angeles. She specializes in working with professionals, creatives, and high-achievers who have built impressive lives on the outside but are quietly struggling with anxiety, burnout, and a persistent sense of disconnection.

Nicole also works extensively with neurodiverse couples and women navigating the biopsychosocial and spiritual complexities of midlife, particularly those doing so without a partner.

A personal crisis in her mid-30s became the catalyst for her clinical philosophy. Rebuilding her own life and identity after a significant loss, Nicole rediscovered the healing power of somatic practices; such as yoga, dance, and movement alongside therapy. That experience influenced The Center Method: an integrative approach that addresses not just the mind, but the body’s role in healing.

Nicole’s own 25-year journey to an endometriosis diagnosis has deepened her understanding of medical trauma, chronic illness, and the psychological toll of not being believed. She is licensed in California, New York, Texas, and Arizona, and is currently writing The Single Woman’s Midlife Metamorphosis, a book exploring identity reconstruction when life doesn’t follow the expected script.

Nicole Moore on YouTube: @becoming_centered
Instagram: @becoming_centered
TikTok: @becoming_centered

Cold or cold, I’m flying into Chicago to see The [M] Factor 2: Before The Pause on Thursday, February 26, 6:30–9:30, at The Chicago Arts Club. Tamsen Fadal, Dr. Sameena Rahman, and other menopause awareness leaders will be there. I hope to meet you at The Midst table. Order your ticket here.

If you can’t attend the Thursday screening in Chicago, our friends at Midlife Upgrade are hosting another screening the day before (Wednesday, February 25) in Highland Park, Illinois. Order your ticket here.

Buy tickets

What’s stopping sexy time?

Join this free webinar for women 40+ who want intimacy and pleasure without pressure, performance, or fixing themselves.

Intimacy isn’t broken. The myths around it are.

Most women were taught that intimacy and sex should be spontaneous, effortless, and orgasm-focused. But midlife bodies don’t respond to pressure. They respond to safety, presence, and sensation.

When those pieces are missing, intimacy feels hard.

By the end of this webinar, you’ll discover:

• Relief instead of self-blame

• Less pressure around sex and orgasm

• Curiosity about pleasure again

• A sense that intimacy could actually get better with age

Hosted by Daydree Horner, RMT CLC

Friday, February 20, 11 am–noon PST

Register here

The Midst Founder Meetup on February 10

Attention Founding MidstHers! We’re excited to see you at our second Zoom meetup on February 10 at 4 pm PST (5 pm MST, 6 pm CST, 7 pm EST). We’re discussing social media and content marketing that actually works for your business (and what wastes your time). If you didn’t receive the invite, please email amy@the-midst.com.

Learn more about The Midst Founder community here.

Of course this was coming: Big M, a new book of essays about the modern menopause experience, edited by Lidia Yuknavitch. Contributors include some of today’s best and brightest: Roxane Gay, Cheryl Strayed, Nguyễn Phan Quế Mai, Reyna Grande, Joey Soloway, Nana-Ama Danquah, Gina Frangello, Monica Drake, Lan Samantha Chang, Julia Alvarez, Darcey Steinke, and Pam Houston.

The Big M explores themes of freedom and mortality, sexuality and the patriarchy, with each writer navigating the profound changes in their bodies and lives in their own “fiercely individual” way. We can’t wait to dig in.

Buy The Big M

Your February 2026 horoscope

Think flow over force

By Mandy Wilde

After the push of the new year, February encourages pacing, asking us to move with intention rather than urgency. Several key transits shape the tone. Saturn’s return to Aries, followed closely by its conjunction with Neptune, opens a longer chapter around disciplined action and realistic vision. Later in February, Mercury turns retrograde, slowing communication, clouding decisions, and bringing a familiar mix of reflection, rerouting, and nostalgia.

From a wellness perspective, February highlights how energy moves through the body. Astrology links each zodiac sign to specific physical areas, and as the Sun moves through the signs, we collectively feel these shifts. Aquarius season draws attention to the calves, shins, ankles, and circulation, areas tied to balance and adaptability. As the Sun enters Pisces later in the month, focus turns to the feet and lymphatic system, supporting rest, release, and emotional processing.

February favors flow over force, reminding us that steadiness often brings the clearest direction.

Key astrology dates in February 2026

• February 1: Full Moon in Leo brings attention to self-expression and confidence,

• February 11: Mercury conjoins the North Node in Pisces emphasizing ideas with long-term impact

• February 13: Saturn enters Aries initiating a new cycle of disciplined action and self-leadership

• February 17: New Moon and Solar eclipse in Aquarius marks a major shift in future direction

• February 19: Sun moves into the sign of Pisces shifting focus toward intuition

• February 20: Saturn conjoins Neptune in Aries redefining how vision becomes action

• February 22: Venus in Pisces trines Jupiter retrograde in Cancer supporting emotional growth

• February 25: Mercury retrograde in Pisces slowing decisions and encouraging reflection

Aries (March 21–April 19)

Early in the month, there’s a strong focus on your role within larger systems, work environments, communities, or shared responsibilities. Aries, you may realize that some obligations you’ve taken on no longer reflect who you are becoming. This awareness is useful, even if it feels mildly disruptive at first.

As the month progresses, attention turns inward. Pisces season invites rest, reflection, and emotional processing, which may feel unfamiliar for a sign that prefers forward motion. Your body may signal this through fatigue in the feet or a sense of being “unplugged.” These are cues to slow your roll!

Saturn’s shift into your sign on February 13, begins a longer chapter of redefining self-leadership. You are learning how to act with intention. For you, February supports decisions that build authority over time.

Taurus (April 20–May 20)

Taurus, February offers an opportunity to realign your long-term goals with what truly matters to you when attention turns toward public roles and responsibilities. This helps you refine your ambitions so they better reflect your values.

As Venus, your ruling planet, conjoins the North Node in Pisces on February 17, relationships and community spaces come into clearer focus, highlighting where support flows easily and where deeper connection is available. As the month unfolds, emotional belonging becomes a source of steadiness and reassurance.

Subtle conversations feel meaningful, guiding you toward what resonates on a deeper level rather than what simply appears impressive. On February 22, Venus in Pisces trines Jupiter retrograde in Cancer, encouraging a renewed sense of safety within close relationships. February supports patient progress, helping you release outdated expectations and make room for goals that genuinely nourish and sustain you.

Gemini (May 21–June 20)

February brings a noticeable shift in perspective for you, Gemini. Early in the month, your attention turns toward bigger questions about meaning, direction, and what you’re building toward. You may feel pulled to reconsider plans that once excited you but now feel slightly off. As the month unfolds, the energy becomes more introspective and asks you to listen beneath the surface of conversations and ideas. You may realize that some answers arrive through feeling rather than logic. This can feel uncomfortable for a sign that thrives on mental clarity, but it’s deeply useful now. February supports releasing the need to explain everything. When you give yourself space to process privately, your words regain their precision. By month’s end, clarity returns with more depth and confidence.

Cancer (June 21–July 22)

This month invites emotional honesty, Cancer. You shine in this area naturally, but what February asks is that you do so without overwhelm. For you, attention may turn to shared resources, emotional agreements that require trust. You may notice where you’ve been carrying more than your share. Acknowledging this helps you reset boundaries without guilt. Towards the middle of the month, the energy softens and becomes even more supportive for you. This is a time to reconnect with your intuition and allow rest to play a more central role. Emotional stress often settles in the body for you, especially when feelings go unexpressed. Hydration and warmth help your system process and release. This month reminds you to honor what you feel as decisions become clearer and relationships more balanced. February supports emotional recalibration that strengthens you for what comes next.

Leo (July 23–August 22)

Leo, February begins with heightened awareness around relationships and visibility. You may feel seen in ways that are both affirming and challenging, especially within one-to-one dynamics. This is a time to notice how you show up when attention is shared rather than centered solely on you. The New Moon in Aquarius mid-month supports a reset in perspective, inviting you to reconsider how connection, recognition, and mutuality intersect.As the month progresses, focus shifts toward emotional depth and shared experiences. You’re encouraged to look beneath surface interactions and reflect on where intimacy feels balanced and reciprocal. Fatigue around the middle of the month can be a useful signal to step back and restore your energy rather than push through. February asks you to redefine confidence. When you allow yourself to be fully present instead of performing, connections deepen and your sense of purpose steadies.

Read all horoscopes here

The art of letting go

A yoga-inspired path to freedom, backed by science

By Lauria Locsmondy

My body resisted the deep twist, my breath was shallow, and my mind was fixated on holding the pose — on doing it right.

“Find steadiness and ease,” my instructor reminded us. “Flow … let go.”

Let go? I had always believed strength meant pushing through, enduring. But as I exhaled and softened, something unexpected happened — my body realigned, my breath deepened, and instead of falling, I found stability. I found balance.

That moment taught me something profound: clinging creates tension, while release creates space. And this isn’t just yoga philosophy — it’s neuroscience.

Read more

Wish we could have met this filmmaker! Martin Scorsese described her as “one of the Gods of Cinema”.

If you want to live a long life, move to the Aloha state

Unless you dislike sunshine, who wouldn’t want to live in Hawaii? Too bad the average home sale price is $973,555 and a gallon of milk costs like $9 there.

According to a study by MoneyGeek, the state Americans choose to live in shapes how long and well they’ll live. The study looked at healthcare across the U.S., with one of the variables being the average life expectancy.

Hawaii consistently leads in life expectancy, often followed by Massachusetts, Connecticut, New Jersey, New York, Minnesota, and California, though exact rankings vary slightly by data source and year, with Southern states generally having lower life expectancies.

Recent data from the CDC for 2021 shows Hawaii at 79.9 years, Massachusetts at 79.6 years, and Connecticut at 79.2.

Where do Americans live the longest?

Top 10 states for quality healthcare

1. Hawaii

2. New Hampshire (also considered the “healthiest state”)

3. Massachusetts

4. District of Columbia

5. Minnesota (we’re sending you all the love right now)

6. New Jersey

7. Washington

8. Colorado

9. Rhode Island

10. North Dakota

These 10 states share several strengths: high insurance coverage, primary care capacity, competitive premiums relative to income, and lower mortality rates.

Should I use the estradiol patch for night sweats?

By

This is not a story about how an estradiol patch will fix everything. This is about how confusing perimenopause still is and how easy it is to mistake hormonal chaos for a menopausal hormonal decline. This is especially true in a moment when menopause advice is louder, more confident, and more commercial than ever.

When I was the youngest in my group of mom friends, the older women talked about something they called “the change before the change.” It sounded ominous and vague, and I didn’t fully grasp what they meant.

Twenty-some years later, we have a name for that mystery shift: perimenopause. It’s the stretch of years when hormones start behaving unpredictably, often long before periods stop. It can look like waking up at 2 a.m., replaying something that happened yesterday — or decades ago. It can also look like heavier periods. Bigger mood swings. PMS that feels dialed up to eleven. And night sweats that seem to come out of nowhere.

Now I’m 51, with four kids, picking up my fourth grader as the “old mom” at school. I think back to myself at 35, when I first sensed perimenopause looming, and realize I didn’t take my older friends seriously enough. Since then, life has been one long hormonal upheaval: pregnancies, babies, teenagers, and my own steady march through perimenopause. I’m still cycling at 51. It’s still intense.

Even though I knew “the change before the change” could last for years, I still wasn’t prepared for how it would actually feel or what to do about it. And judging by the questions I hear now, many millennial moms entering this phase aren’t either. The difference today is that instead of too little information, there’s too much, especially when so much of it is just marketing dressed up as medical advice.

One of the biggest sources of confusion is what perimenopause actually is. But also: How long does it last? What symptoms count? How do you know when it starts or when it’s over?

What is perimenopause?

Perimenopause is the span of years leading up to natural menopause, when the ovaries begin changing how much estrogen they produce and how regularly they release an egg. Most women enter perimenopause in their mid-40s, though hormonal shifts can begin earlier.

But this sounds a lot simpler than it feels, and so many women are navigating this largely on their own. Recently, a late-30s mom with young kids asked me if hormone therapy might help her night sweats. Would an estrogen patch calm the “meno monster”? Hot flashes mean menopause, right?

Not necessarily.

At what age do women enter perimenopause?

While menopause can occur before 45, it’s pretty uncommon. Around 5% of women enter menopause between 40 and 45, and it’s even less common before 40. And night sweats have many causes that have nothing to do with menopause, or even chronically low estrogen.

In my late 30s, my night sweats were tied to the natural estrogen drop that happens just before a period. The issue wasn’t too little estrogen; it was estrogen volatility. I still had regular cycles, but my hormones were swinging wildly. PMS often worsens after 35, and ovaries can pump out higher peaks of estrogen followed by sharp crashes. Those rapid shifts, not sustained deficiency, can trigger night sweats.

This is why there’s no single blood test that can effectively diagnose perimenopause. Hormone levels fluctuate daily. Testing is usually done to rule out other causes like thyroid issues, anemia, early menopause, or to investigate heavy or painful periods. Clinicians rely on age, symptoms, and cycle patterns, and tracking your periods and symptoms can be far more helpful in understanding the full picture than a snapshot that a lab provides

So back to the night sweats question.

Will the estradiol patch help with night sweats and hot flashes?

If you’re still cycling (in your early perimenopause or late reproductive years), will a menopause estradiol patch help with night sweats or hot flashes?

Sometimes hormone therapy can be prescribed to premenopausal women, but the more important question is whether it will actually help. Menopause hormone therapy (typically referred to as HT or MHT) contains relatively low doses of estrogen, too low to suppress ovulation. If your ovaries are already producing erratic surges of estrogen, adding a small, steady amount may not smooth the ride. In my case, it likely wouldn’t have helped much at all.

That’s why, for women who still cycle and are struggling with symptoms like heavy periods, mood instability, and night sweats, low-dose combination birth control is often prescribed instead. Birth control suppresses ovulation, preventing the hormonal rollercoaster in the first place, and replaces it with a more consistent level of estrogen and progestin. Menopause HT, by contrast, is designed to replace estrogen that the ovaries are no longer making, not to override them when they’re still active.

This isn’t a popular message on social media — or among the many for-profit companies cashing in on the menopause market — but the estrogen patch is not a one-size-fits-all solution. It has an important role for some women with specific symptoms, but years before menopause, fluctuating estrogen, not low estrogen, is often the real issue.

Birth control has another benefit: pregnancy prevention. Contrary to what you may have been led to believe, perimenopause doesn’t mean infertility, and until menopause is confirmed, contraception still matters if you don’t want to get pregnant, even though fertility is less predictable at this stage.

If pregnancy is something you are hoping for, time matters. The late reproductive years can close quickly, and early conversations with a clinician or reproductive endocrinologist can be invaluable.

Whatever path you take, the most important step is finding a clinician you trust, preferably someone who is experienced with this life phase and up-to-date on current research and FDA-approved options. Hormone therapy isn’t mandatory, and it isn’t for everyone. It also requires ongoing conversations, since risks, benefits, and bodies change over time. I’ve found my midwife to be my most helpful guide hormonally, alongside regular care from an internist.

Appointments can feel daunting, but preparing helps. Track your cycle and symptoms. Bring family history when possible. Ask direct questions: What else could be causing these symptoms? What tests make sense? What kind of hormones, at what dose, and why? And don’t forget to discuss fertility goals or contraception.

And after bursting the estrogen-patch miracle bubble, here’s the least exciting truth: all the boring things that have always helped still matter — maybe more after 35. Sleep. Hydration. Whole foods with enough protein, fiber, calcium, and iron. Strength-building movement. Less smoking, alcohol, and late-day caffeine.

None of us does this perfectly. I certainly don’t. One of my biggest health goals now is less perfection, more pleasure. Mental health is health and it’s often the most overlooked part of perimenopause.

Creative outlets, therapy, faith, and real connection have helped me through mood swings and panic attacks. If anxiety, sleep, or mood are disrupting daily life, that’s a reason to seek help, not something to white-knuckle through alone.

Finally — and this should probably come first — find community. Some days you might feel better than ever. Other days you’ll be exhausted and deeply uninterested in “menopositivity.” On those days, being around someone who gets it matters. No wonder creators like @JustBeingMelani resonate so widely.

Community is what pulled me into writing as a second career, starting with my first pitch to The Midst. Amy Cuevas Schroeder didn’t just encourage me to write — she provided the kind of support that turns intention into action.

We’re all on the same path, just at different points. Women supporting women, sharing what we’ve learned, and asking for help when we need it, and that’s a cycle I plan to keep repeating long after my menstrual cycles finally end.

It’s amazing the knowledge you gain being the “old mom.”

This story was originally published here in Meet Me at the Medcart. Learn more about The Midst’s syndication program here; we partner with physicians and health experts to produce and publish their thought leadership about 40+ women’s health and wellness.

Daphne Berryhill is a freelance writer and pharmacist, practicing in oncology infusion and behavioral health pharmacy. Her writing has appeared in GoodRx Health, Forbes Health, the MedShadow Foundation, and The Midst, with additional projects including needs assessments, content strategy, and health outreach for Those Nerdy Girls. She writes two Substack newsletters: Meet Me at the Medcart and Daphne Discloses. She lives near Madison, Wisconsin, with her husband and kids, three at home and one nearby.

“In psychology there’s something called the spotlight effect.

We overestimate how much everyone is watching and judging us.

In reality, we’re far less visible than we think.

Simply put: no one cares.”

— Colette Jane Fehr, LMFT, LMHC

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Let us not forget why we honor Martin Luther King Jr. Day.

Winter blues? 21 self-care ideas to prevent Seasonal Affective Disorder

By Gretchen Kalwinski

Winter is here, but you already knew that. ‘Tis the season of shorter days, longer nights, and, if you live in a northern climate, six months of dirty snow and grey skies.

For those of us who suffer from Seasonal Affective Disorder (aka “Winter Blues,” a type of depression that revolves around recurrent seasonal patterns), the winter months can include a disconnected, depressed mood, low energy, weight gain, overeating and craving carbohydrates, sleeping much more than usual, lack of focus, and other mood changes.

After many years spent learning to survive (even thrive) during the winter months, I’ve learned that it’s most important for my SAD-affected self to: move/exercise, get extra Vitamin D, catch some rays, connect with others, and stay engaged with my senses and body. In general, I try to maintain a sense of well-being and coziness.

Looking for winter wellness and self-care? Here are some go-to SAD-combatting ideas.

Light up your life with light therapy happy lamps for Seasonal Affective Disorder

Catch some “rays” with a full-spectrum light lamp or box. Some researchers link seasonal depression to melatonin, which causes sleepiness and fatigue. Because light affects the biological system in our brains that regulates circadian rhythms, it’s possible that less sunlight in winter can affect our psychology and cause mood changes — and this natural or “full-spectrum” light can have an antidepressant effect.

As a native Chicagoan, I definitely find happy lights to have an energizing effect in the winter. After a brief light therapy session, I’m more alert and the cobwebs in my brain are swept away. Placebo or not, I’ll take it. Here are the full-spectrum lights I’ve grown to love in my home.

Philips SmartSleep Wake-up Light, Colored Sunrise and Sunset Simulation

This alarm clock gradually brightens my room with soft light in the minutes leading up to my set wakeup time. The Phillips SmartSleep personalizes your wake-up and wind-down time with a simulated sunset and sunrise, 20 brightness settings, and choice of five natural wake-up sounds.

Verilux HappyLight Lucent

I use the Verilux desk lamp to bask in fake sunlight over my morning coffee. I love that the ultra-thin tablet design and detachable stand make HappyLight Lucent portable.

Verilux SmartLight Full Spectrum LED Modern Floor Lamp with Adjustable Brightness

This floor lamp on my wish list, just to round out my full-spectrum light options.

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New Hampshire is the healthiest state in America

Would you move to a different state just because it’s the healthiest place to live?

For the fourth year in a row, New Hampshire is considered the healthiest state in the U.S., according to America’s Health Rankings 2025 Annual Report, which analyzes 99 measures of health and well-being drawn from 31 data sources to provide a comprehensive portrait of health at the national and state levels.

Why is New Hampshire so healthy?

• Low non-medical drug use

• High secondary school completion rates

• Nearly 10% drop in homelessness

• Positive socioeconomic factors like low unemployment and food insecurity

What are the other healthiest states?

2. Massachusetts: Scores high on health outcomes, economic stability, and access to healthcare providers.

3. Vermont: Strong in social/economic factors, behaviors, and education.

4. Connecticut: Benefits from low premature death rates and e-cigarette use.

5. Utah: Known for low excessive drinking, fewer chronic conditions, and good physical environments.

6. Hawaii and Colorado: Also frequently cited for healthy lifestyles, with Hawaii leading in some indexes and Colorado for outdoor activity.

What are the least healthy states?

46. West Virginia

47. Alabama

48. Mississippi

49. Arkansas

50. Louisiana

Read the report

Non-alcoholic cocktails and drinks that taste better than the real thing

By

Are “mocktails” still a thing? With non-alcoholic — simply called “NA” — booze and beers now available at mainstream retailers like Target, the current trend of not drinking is considered common and, dare I say it, cool. Unlike the cigarette-and-beer stance of our youth, those healthy Gen-Zers show less interest in drinking alcohol than previous generations, perhaps finally normalizing life without the sauce — and its socially acceptable sobriety terms.

For us Gen-X GALs who put down our cosmos for fewer headaches, this news directly benefits our health as well. During perimenopause, our livers, in charge of breaking down alcohol and metabolizing hormones, may be less effective, therefore eliminating alcohol at a slower pace — and also causing more intense menopausal symptoms like hot flushes, night sweats, and mood changes.

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‘Nobody else has issues with food after they get sober, right?’

By

Enjoy this exclusive excerpt of Humble Pie: Sober Menopause, Sugar Addiction, and the Sweetness of Recovery.

And then, for a long time, sobriety got a lot easier. But after a while, sugar started to get harder. It’s complicated.

Here is an example: It’s been a stressful day. I’d started having issues with sleeping. My husband leaves for a work trip, so at around 5 p.m. I decided to call him to check that he didn’t die in a fiery plane crash. If he’s on a work trip and I have not heard from him in a few hours, my brain does this: “It must be a fiery plane crash. That’s why he hasn’t called. The boys and I are going to end up in a van down by the river.” Also, even if he hasn’t died in a fiery plane crash, I know that Brian doesn’t love me as much as I love him because he hasn’t called first. So, either way, I’m screwed. I finally trudge through all my neuroses and give him a call, and he picks up after two rings. I am not a widow. But now I’m resentful. It’s confusing.

Brian says, “Hey, babe! How’s my sweetie?” His words are buoyant, and I narrow my eyes. From across the miles, I can hear it. Brian has a beer voice. Now I’m more resentful. First of all, I was almost a widow. Second, I love him more than he loves me. And now, he has the audacity to drink when I cannot.

Food. Food was my second thought after the plane crash. “Well,” my brain says, slapping my knees, “Who’s hungry?” And right there, that’s when the thinking stops. Anxiety and addiction are dysfunctional siblings. Anxiety stands at the starting line of my mind, waiting for a feeling to fire the starting gun. That night, it was this conversation with my husband that pulled the trigger. My friend, Mindy, who is thirty-seven years sober, always tells me, “First thought wrong.” I do have to congratulate myself that after hearing Brian’s beer voice, my first thought was not, “Let’s drink at this. You are uncomfortable and stressed. Bring on thirteen glasses of wine.” That thought did not happen.

Instead, my first thought was “Well, let’s go for food. Nobody else has issues with food after they get sober, right?”

My binge starts in my brain. It has nothing to do with my stomach. There is no hunger, only feelings. The brain starts to feel stress and shifts in its seat, muttering, “Uh, I’m getting uncomfortable. Could we have some dopamine over here? I don’t do stress.” Ben and Jerry, camped out in the freezer, laconically raise their hands and say, “Dude. We’re here for you.” And my brain, always willing to go for the quickest option because it hates waiting, says, “Ah yes! That has always worked in the past! I have been grooving to this for ages. It is super effective.” Somewhere, buried deep in my prefrontal cortex, a bit of tired mumbling says, “Um, actually not so much really,” but after the first hit of sugar, my brain turns off. Like an old TV, it just clicks and the screen shudders to a pinprick of light, then black. Sugar pulls the plug. When the Snickers bar or the ice cream or the bagel hits my system, I don’t even get a groan of pleasure. There’s . . . nothing.

This, incidentally, is an enormous relief.

And this is why a binge is so very difficult to ward off. I would like to think my brain is super attentive to me and all my needs, but in this case, my brain zones out like when I drive for twenty minutes and then realize I have no recollection of how I got to my destination.

Oh, and willpower? It’s useless.

Sugar. It fires up my brain very much like a glass of wine does. The alcohol took all feelings of inadequacy, shame, and dread, and switched them off.

Sugar does the same. My brain likes a repetitive groove.

Let’s say you take a rat, name him Ralph, and feed him a lot of sugar. This rat lives in a small square cage with fluorescent lighting. Ralph’s dwelling has no ambiance. It’s pretty unpleasant, even if you are a rat. The most fun for Ralph is his wheel. If Ralph wants to work out, he can whirl himself around on it a couple of times, which is a bit of a thrill, but it’s short-lived. If he’s super bored, he can chew up a toilet paper roll. Ralph also only gets crunchy brown pebbles for lunch and dinner. Since Ralph is vastly more intelligent than anyone ever gives him credit for, Ralph knows his circumstances are less than ideal. So, when presented with a Ring Ding, Ralph takes a bite and immediately stops caring about the harsh lighting, his lack of a nice couch or cozy throw pillows, or that the water in his dispenser is never chilled. He is hit with a dopamine surge that makes his little paws scrabble for more Ring Ding. He wants only the Ring Ding now. If presented with the option to move out of his cage to a nice three-bedroom with a fireplace, he only wants the Ring Ding. He can’t remember what it feels like not to want a Ring Ding.

By the way, we did this exact experiment when I was in third grade, minus the three-bedroom cage. We had two rats, and all the kids brought junk food from home to give to the lucky rat. Our teacher fed the healthy rat a lot of lettuce. We treated our soon-to-be very obese rat to Cookie Crisp cereal, and we cheered when one day, a kid offered his lunchtime Twinkie. We named the junk food rat Templeton, and I am still haunted by whatever happened to him.

It was 1977, and I guess eight-year-old kids could mess up rats back then in the name of science. It was a different time.

So, am I the rat in this scenario? My cage has a lot more accent lighting because that’s important, but other than that, I think I’m the rat. I want the Ring Dings. When presented with the Ring Dings, I will forget about the last time I ate the Ring Dings, and I felt so gross and shaky afterward. I’m just a rat, looking at a Ring Ding, asking it to love her.

This book excerpt was originally published here on the-midst.com.

10 years of sobriety later, I want to share my story with the rising number of women alcoholics

By Laurie White

A few months after I got sober from alcohol in 2013, my sister pointed out the endless alcohol advertising as we drove through a town not far from our homes in the D.C. suburbs.

“Until you got sober I just never noticed before that alcohol signs are everywhere,” she said, pointing to the nearest roadside sign, mentioning billboards, every restaurant sign, and delivery trucks, not to mention television and the internet.

At the time, I was keenly aware of the absence of alcohol in my life after 25 years of progressive, destructive drinking, and its persistent presence everywhere while I tried not to drink it anymore. I was aware for decades that I could not stop putting alcohol in my body, and thought constantly about where I could get it, how much of it I needed, how much I did or didn’t have, how miserable it made me, and most of all, that I couldn’t quit it.

Like many American college students, I started drinking to fit in socially. It helped me to cope with the academic and social stressors of college, and then the personal and professional demands of early adulthood. By the time I realized that it was harming my life, I also knew that I couldn’t stop even when I wanted to, like the other estimated 1 in 8 American adults with alcoholism.

For years I was a binge drinker who could go some period of time — although never long — without consuming alcohol, although I frequently obsessed about it, whether I was drinking it or not. By my late 30s, following the implosion of a serious long-term relationship, I was a daily, drink-to-get-drunk drinker. By 42, I had given away my career in education, most of my relationships, and my physical and mental health to an increasing, and increasingly damaging, compulsion to drink.

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Feng shui interior design tips for abundance and peace of mind

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As a naturally messy creative type, I’ve studied feng shui out of necessity to help refine my sometimes chaotic instincts, starting when I was a teenager. Back then, I ran a small jewelry business, and beads were everywhere in my room, making it difficult to focus on schoolwork.

Now that I have my own kids and am in the midst of life, I rely on feng shui to maintain a sense of calm more than ever. I’ll take peace of mind any way I can get it, especially if it’s as simple as moving a piece of furniture to a better spot — a cornerstone concept of feng shui.

The philosophy of feng shui is about how subtle shifts in your environment can dramatically enhance your life’s abundance. When you have a balanced and supportive home and feel secure, you are relaxed and grounded, says Susan Chan, certified a feng shui consultant, in Architectural Digest. “A feng shui adjustment can be as simple as making sure your artwork is at the right height. Hang it too high and your attention, and therefore your energy, goes upward, which can leave you feeling ungrounded.”

What is feng shui and how does it help create abundance?

Feng shui is an ancient Chinese practice that beautifies your space and aligns it with the natural flow of energy to bring prosperity and harmony.

Proper feng shui is purposefully arranging the stuff around you to affect you positively, says feng shui expert Karen Rauch Carter in her book Move Your Stuff, Change Your Life. “What stuff, you ask? All stuff your worldly possessions, your desk at work, your toothbrush, your underwear. Just as that Chunky Monkey sundae affects your body when you eat it, each object you place in your living environment affects you as well. You also affect each environment you encounter.”

What are the primary principles of feng shui?

Feng shui principles can transform spaces in ways that might seem subtle but have a profound impact. Whether you’re looking to boost your creativity, attract wealth, or simply create a more harmonious living environment, feng shui offers practical and effective solutions.

By applying these feng shui principles, you can turn your home into a sanctuary that supports your goals and enhances your quality of life.

1. Declutter

Clutter blocks Chi (energy), so it’s critical to clear messiness everywhere, especially entryways and under the bed, to allow good energy to circulate.

2. Clear pathways
Keep doors and hallways open and free of furniture to ensure smooth energy flow.

3. Balance the elements
Incorporate wood (plants), fire (candles), earth (rocks/ceramics), metal (fixtures), and water (fountains) in moderation for harmony.

4. Maximize light and air

Open windows and curtains to bring in fresh air and natural light, keeping spaces bright.

5. Fix anything that’s broken

Feng shui for your home office

Want to make your workspace a powerhouse of productivity and creativity? Here’s how:

Position your desk to face the door

One of the most fundamental principles of feng shui and office design is the placement of your desk. This arrangement is the “command position” because it allows you to see who is entering the room, enhancing your sense of control and clarity. It also helps to reduce stress and increase your overall productivity by creating a more balanced and harmonious environment.

Kill the clutter

A clutter-free desk is another crucial element in feng shui interior design. Clutter can be a significant drain on your mental energy, leading to distractions and a lack of focus. By keeping your workspace tidy and organized, you promote clear thinking and a more efficient workflow. Consider using organizers, drawers, and shelves to keep essential items within reach but out of sight.

This simple practice can make a significant difference in your ability to concentrate and stay productive throughout the day.

Plants!

Incorporating plants into your home office is a fantastic way to improve air quality and add life energy to your workspace. Plants not only purify the air but also bring a sense of vitality and freshness to the room.

Choose low-maintenance plants that thrive indoors, such as snake plants or spider plants, to avoid the stress of constant care. Position them in areas that receive natural light, and consider placing a small plant on your desk for a personal touch. The presence of greenery can enhance your mood and creativity, making your home office a more enjoyable and productive space.

Cue calming colors

Feng shui interior design emphasizes the importance of choosing hues that foster focus and creativity. Calming colors like blue and green are particularly beneficial in a home office setting. Blue is known for its ability to promote concentration and stability, making it ideal for tasks that require deep focus.

Green is associated with growth and renewal, which can inspire creativity and innovation. Consider painting one of your walls in a soft blue or green, or adding decorative elements like cushions, rugs, or artwork in these colors to create a serene and inspiring environment.

Mirror mirror on the wall

To enhance the positive energy of your home office, consider hanging a mirror. Mirrors are powerful tools in feng shui and can expand the sense of space and invite more opportunities and abundance into your life.

Place a mirror strategically so that it reflects a pleasant view, such as a window or a plant. Avoid positioning a mirror in a way that reflects the door directly, as this can create a sense of unease. A well-placed mirror can make your home office feel larger and more inviting, contributing to a more positive and productive work environment.

Feng shui for entryway

Your entryway sets the tone for the entire home. Make sure that it invites positivity and abundance with every step.

A welcoming doormat is a simple yet powerful feng shui tool. It serves as a physical and symbolic threshold, inviting prosperity and good fortune. Choose a doormat with a positive message or a design that resonates with you. This small touch can have a big impact on the energy of your home.

Additionally, keeping the area around the doormat clean and free of clutter is crucial. A cluttered entryway can block the flow of positive energy, so make it a habit to regularly sweep and tidy this space.

Light up your entryway

A well-lit entryway is essential in feng shui as it symbolizes clarity and the welcoming of positive energy. Natural light is ideal, but if that’s not possible, consider using warm, inviting light fixtures.

Avoid harsh, fluorescent lighting, as it can create a sterile and unwelcoming atmosphere. Soft, ambient lighting can make a significant difference in how you and your guests feel as they enter your home.

Place a mirror in a positive position

Mirrors are known to reflect energy, so positioning one in the entryway can help reflect positive energy back into your living space. However, avoid placing the mirror directly opposite the front door, as this can cause energy to bounce right back out of your home.

Pick up the shoes!

Shoe piles can disrupt the flow of positive energy. Designate a specific area for shoes, such as a shoe rack, closet, or a storage bench, and encourage family members to use it.

Keeping the entryway free of clutter not only makes it more visually appealing but also ensures a clear path for positive energy to flow into your home. A tidy and organized entryway sets the stage for a harmonious and abundant living environment.

Feng shui kitchen

The kitchen is the heart of the home, and with a few strategic feng shui adjustments, you can pulsate with even more warmth and vitality. In feng shui and traditional Chinese metaphysics, the kitchen is associated with health, wealth, and family well-being. It’s where energy is transformed, much like how ingredients are transformed into nourishing meals.

Clear your counters

You knew this one was coming. Clutter-free kitchen countertops are essential for promoting smooth energy flow and maintaining good health. Clutter can obstruct the flow of chi, leading to stagnant energy and potential health issues.

Regularly clear your countertops of unnecessary items, such as mail, appliances, and other clutter. This not only makes the space more functional but also creates a cleaner, more organized environment that supports a healthy lifestyle. Consider using drawer organizers, shelves, and storage solutions to keep everything in its place and out of sight.

Place the stove away from the sink if possible

Considered the heart of the kitchen, the stove is one of the most important resources as it represents nourishment, success, and igniting wealth and opportunity. Respecting the stove is an essential element in kitchen feng shui — keep it clean and working properly.

Because the stove represents fire and the sink represents water, keep them separate if you can.

More feng shui for bedroom, kitchen...

The art of letting go

A yoga-inspired path to freedom, backed by science

By Lauria Locsmondy

My body resisted the deep twist, my breath was shallow, and my mind was fixated on holding the pose — on doing it right.

“Find steadiness and ease,” my instructor reminded us. “Flow … let go.”

Let go? I had always believed strength meant pushing through, enduring. But as I exhaled and softened, something unexpected happened — my body realigned, my breath deepened, and instead of falling, I found stability. I found balance.

That moment taught me something profound: clinging creates tension, while release creates space. And this isn’t just yoga philosophy — it’s neuroscience.

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By Laura Brigance, MS

What are the best anti-inflammatory winter foods?

Winter has a way of asking the body to slow down. Shorter days shift our hormones. Colder air calls for deeper warmth. Our physiology naturally moves toward rest, repair, and recalibration.

But winter can also make inflammation flare.

Cold temperatures, less movement outside, holiday stress, richer foods, blood sugar swings, and disrupted routines can all nudge the body into an inflammatory state.

The good news is that Winter is full of healing foods that work with your body’s seasonal rhythm: warming, grounding, nourishing foods that calm inflammation and support your immune system, digestion, hormones, and energy.

Here are 21 winter foods that decrease inflammation, grouped into three categories your body loves during the cold months.

• Vegetables and fruits (grounding, colorful, antioxidant-rich)

• Herbs (silently powerful inflammation fighters)

• Spices (warming, circulation-boosting, digestive support)

Let’s explore the abundance winter offers for healing, repair, and warm nourishment.

Anti-inflammatory winter vegetables and fruits

1. Leafy greens

Even though leafy greens (think: kale, collard greens, and Swiss chard) start their appearance in the summer, winter leafy greens follow with even more flavor since many greens lose their summer bitterness in the cold, becoming sweeter and more comforting.

Rich in vitamins A, C, K, folate, minerals, and antioxidants, they support:

• immune function

• detoxification pathways

• inflammation regulation

They shine in soups, sautés, warm salads, and casseroles

2. Cruciferous vegetables

Vegetables in the cruciferous family include Brussels sprouts, cauliflower, and cabbage, and are chock full of vitamins like folate, K, C, and A, as well as phytonutrient compounds that lower inflammation.

They also have the benefit of less bitterness during colder weather, like the leafy greens of winter.

• Cauliflower: low-carb, gut-friendly, and endlessly versatile (makes it an amazing substitution for anything from rice to pizza dough to mashed potatoes.)

• Cabbage: packed with anthocyanins (especially the purple variety); Not only is it a great way to have a winter version of tacos with slaw, but it goes spectacularly raw in salads or cooked in soups or casseroles. If you’re not sure which color to choose, just know that purple cabbage’s vitamin A content is eleven times higher than green cabbage.

• Brussels sprouts: loaded with fiber, C, K, and folate; Try roasting them or shaving them into hearty winter salads.

3. Pumpkins

Their orange flesh signals high beta-carotene (vitamin A), along with vitamin C, vitamin E, and fiber. Pumpkins offer:

• antioxidant protection

• blood sugar stability

• gut-supportive fiber

Pumpkins can be roasted, pureed into soups, or added to warm breakfasts. They also can be stored for a long period of time (in a dry pantry or frozen) without going bad.

4. Mushrooms

One of the most healing and warming foods during winter, mushrooms should top your list of required eating during the cold weather.

Mushroom health benefits:

• B vitamins for energy

• potassium for circulation

• naturally occurring vitamin D

• beta-glucans to calm inflammation

Mushrooms’ nutrient-dense properties qualify it as a superfood with antibacterial, antioxidant, and anti-inflammatory properties that also happens to add that coveted ‘umami’ flavor to any culinary dish.

5. Beans

Beans are an amazing add-in for winter meals for several reasons.

1. First, they’re bursting with fiber and resistant starches, and they’re full of antioxidants → both of which give them anti-inflammatory superpowers.

2. Although their carb content is higher than other vegetables, they’re considered a ‘slow carb’, which means they absorb at a much slower rate. This helps prevent a blood sugar spike and gives healthy carbohydrate energy over a longer period.

3. Beans are also super hearty and perfect to add on as a side dish, or in soups, stews, or chilis.

6. Colored potatoes

Although white potatoes are full of fiber, resistant starches, and essential minerals, studies have shown that their colored versions pack way more of a punch when it comes to inflammation and blood sugar levels.

Studies have shown that purple and yellow potatoes contain higher levels of antioxidants including phenols, anthocyanins, and carotenoids shown to:

• lower inflammatory markers

• improve insulin sensitivity

• support metabolic health

Purple potatoes in particular pack the strongest anti-inflammatory punch. What’s great about colored potatoes is there’s no special preparation aside from how you would prepare regular white potatoes (except, don’t fry them!). Baked, roasted, steamed, and added into soups is great. And I wonder how fun it would be to have purple mashed potatoes!

7. Beets

Beets are vibrant winter medicine. They contain:

• betalains (anti-inflammatory + anticancer)

• folate

• manganese

• gut-supportive fiber

Even better: beet greens are nutrient-dense and delicious in soups and sautés.

8. Cranberries

Cranberries are loaded with vitamin C and polyphenols that reduce inflammation and oxidative stress.

Their tartness makes them perfect for:

• warm sauces (sweetened naturally)

• baked breakfasts

• vinaigrettes

• winter grain bowls

Choose unsweetened dried cranberries if using dried.

9. Citrus fruits

Citrus is winter’s bright, fresh, antioxidant powerhouse.

Citrus fruits offer:

• vitamin C (an especially potent antioxidant that fights free radicals and inflammation.)

• flavonoids

• fiber

Citrus like lemons, limes, oranges, and grapefruit are super versatile and can be used in anything from flavoring water and cut up in salads, to being used as a dressing, in a snack, or as dessert.

They also do an amazing job brightening savory dishes with meats while tenderizing as marinades, as well as pairing beautifully with herbs in dishes and cocktails!

10. Pears

Pears are gentle, soothing, and high in fiber.

Their skin contains quercetin, a potent anti-inflammatory and antihistamine bioflavonoid — great for allergies, immunity, and inflammation.

Soft, sweet, and winter-friendly, pears work well in salads, breakfasts, and warm desserts.

11. Pomegranates

These little jewels are rich in polyphenols that decrease inflammation and oxidative stress in the gut, brain, and cardiovascular system.

They add brightness and crunch to:

• salads

• yogurt bowls

• roasted vegetables

• winter mains

Anti-inflammatory herbs for winter

Herbs are tiny but mighty anti-inflammatory healers — perfect for winter, when flavor and warmth matter most.

They’re also SO EASY to add to any dish for extra flavor, including throwing fresh sprigs into salads. Here are my favorite anti-inflammatory herbs for fall.

12. Tarragon

Although tarragon is more commonly used in French and English cooking, it’s a delicious herb that—like most—contain powerful flavonoids that fight inflammatory cytokines. It also contains B vitamins, folate, and vitamins A and C.

Tarragon is particularly helpful for:

• digestion

• blood sugar balance

• immune support

Add tarragon at the end of cooking for maximum flavor.

13. Rosemary

Rosemary is full of iron, calcium, and vitamin B-6, and is also native to the Mediterranean — fitting for an anti-inflammatory diet rooted in the Mediterranean diet.

Benefits of rosemary:

• digestion

• helps to alleviate muscle pain

• improves circulation and memory

• boosts the immune system

Aside from its fragrant and mouthwatering culinary powers, studies have proven rosemary’s anti inflammatory, anti-oxidant, and neuroprotective properties.

This means that even though it can fight free radicals and harmful bacteria, it can also be used in mood disorders, enhanced learning, anxiety, and sleep disorders.

14. Sage

Sage not only adds delicious earthy notes to fall and winter dishes, but also can be used in teas and as an essential oil. Sage is high in Vitamin K and vital minerals, but also contains antioxidants. What’s so amazing about sage is that it’s been shown to relieve or cure illnesses like obesity, diabetes, heart disease, cancer, depression, dementia, and lupus.

But sage also has been used for centuries in traditional medicine for inflammation, bacterial, and viral infections, which makes it high on the list for cold and flu season.

15. Thyme

Thyme (another herb native to the Mediterranean) can be used as a treatment for anything from acne to GI disturbances to menstrual cramps (and a ton of stuff in between!)

But it’s actually an extremely versatile culinary addition. It has an earthy flavor but can waver back and forth between savory or sweet dishes like:

• stocks and stews

• roasted vegetables

• teas

• desserts

Anti-inflammatory winter spices (warming and healing)

Although spices can generally be used year-round, these warming spices are winter’s natural healers, supporting circulation, digestion, and inflammation reduction.

16. Black pepper

Being a staple ingredient in most kitchens, black pepper can blend into the background and largely be overlooked.

However, studies show it increases absorption of antioxidants — especially curcumin — by up to 2,000%.

It contains piperine, which supports metabolism, insulin sensitivity, and anti-inflammatory pathways.

It’s also been shown to increase absorption of other key minerals and antioxidants, making it an absolute must in literally any savory dish you cook from now on.

This alkaloid compound gives a distinct bite flavor and has been shown to reduce insulin resistance as well as exhibit anti-inflammatory effects.

17. Ginger

Ginger contains over 400 bioactive compounds that support:

• immune function

• gut health

• inflammation reduction

• blood sugar balance

Fresh ginger is especially soothing in winter teas, soups, and stir-fries.

It’s best to use fresh, and ginger root can be cut up and put in the fridge or frozen to last even longer.

18. Turmeric

Turmeric is used traditionally in Asian dishes, but has been widely recognized the last few years because of its use as an amazingly effective nutritional supplement.

Turmeric’s active compound, curcumin, is one of the most studied anti-inflammatory nutrients.

Combining turmeric with black pepper dramatically improves absorption.

Use in warm drinks, curries, broths, and roasted vegetables.

19. Cinnamon

There can be a lot of confusion over the type of cinnamon that’s best to use. Ceylon (known as ‘true’ cinnamon) and cassia (what you buy in the grocery store) are equally delicious and contain a compound called cinnamaldehyde that’s thought to be responsible for its health and metabolism benefits.

Cinnamon has been shown to contain more antioxidant activity than any other in a study against 26 other spices, is a potent anti-inflammatory, and has been shown to reduce insulin resistance (among other benefits).

It’s perfect for winter breakfasts, teas, and warm desserts.

20. Cloves

Cloves have surged in popularity for good reason.

They’re one of the highest antioxidant foods on the planet, containing eugenol, a compound shown to:

• reduce inflammatory markers

• support digestion

• soothe pain

• improve immune function

Their warming, slightly sweet flavor shines in teas, warm cereals, baked goods, broths, and spice blends.

21. Pumpkin pie spice

Honestly my favorite spice for winter is a combination of several spices: Pumpkin Pie Spice. If you’re all in on the anti-inflammatory diet, and it’s finally fall, then Pumpkin Spice Mix definitely needs to be one of your pantry staples.

This mixture obviously enhances pumpkin flavor, but can be used in a variety of recipes in fall and winter (usually around the holidays.)

The components of pumpkin pie spice include cinnamon and ginger, which we already covered. The other ingredients are nutmeg, cloves, allspice, and black pepper.

What’s so great about the blend in pumpkin pie spice is that all the ingredients have powerful anti-inflammatory and antioxidant compounds just like the other spices mentioned.

So as long as you use healthy sweeteners and anti-inflammatory ingredients for whatever pumpkin spice recipe you’re making, you essentially have a superfood recipe with powerhouse ingredients for winter!

A winter of nourishment, not restriction

Winter isn’t a season of deprivation — it’s a season of warmth, comfort, and deep nourishment.

These foods are here to:

• support your immune system

• calm inflammation

• stabilize blood sugar

• soothe your digestion

• bring grounding warmth into your meals

Think of them as winter’s way of taking care of you.

This article was originally published here on The Balanced Body Brief Substack. Subscribe to Laura Brigance’s Substack here.

Laura Brigance, MS, CHC, is a Certified Health Coach and Nutritionist with a passion for helping women with chronic conditions to reduce inflammation, eliminate pain, and balance blood sugar.

With more than 12 years of experience and a Master of Science in Nutrition, her constant mission is to empower women to take control of their health to reverse their symptoms by understanding their bodies and creating a personalized approach to diet and lifestyle.

Subscribe to Laura’s Substack, The Balanced Body Brief.

The science of why you become less of a people-pleaser with age

By

You’re in a meeting. Someone says something objectively wrong. And instead of doing your usual dance — the soft correction, the diplomatic phrasing, the careful preservation of everyone’s feelings — you just… say it.

“That’s not accurate.”

No cushioning. No apology. No emotional labor to make your truth more palatable.

And everyone looks at you like you’ve grown a second head.

Welcome to what I call the Great Unfuckening — that point in midlife when your capacity to pretend, perform, and please others starts shorting out like an electrical system that’s finally had enough.

You might think you’re becoming difficult. Impatient. One of those “bitter older women” you were warned about.

But here’s what’s actually happening: your brain is restructuring itself. And thank god for that.

The biology of not being able to fake it anymore

Let’s start with the science, because this isn’t about you becoming a worse person. It’s about your brain finally doing some overdue maintenance.

For decades, your prefrontal cortex — the part of your brain responsible for executive function, social behavior, and impulse control — has been working overtime. It’s been monitoring social cues, calculating risks, suppressing authentic responses, and managing everyone else’s emotional experience.

This is exhausting work. And it turns out, it’s unsustainable.

Research in neuroscience shows that as we age, the brain undergoes a process called synaptic pruning. Neural pathways that aren’t essential get trimmed away. Your brain is essentially Marie Kondo-ing itself, keeping what serves you and discarding what doesn’t.

And all those neural pathways dedicated to hypervigilant people-pleasing? They’re often first on the chopping block.

Dr. Louann Brizendine, neuropsychiatrist and author of The Female Brain, explains that women’s brains are particularly wired for social harmony and caregiving in the first half of life — driven partly by estrogen and oxytocin. But as estrogen levels shift in perimenopause and beyond, this intense drive to please and nurture others begins to diminish.

What replaces it isn’t bitterness. It’s clarity.

The accumulated cost of a lifetime of performance

Think about what you’ve been doing since you were old enough to understand social dynamics:

Reading the room. Adjusting your tone. Softening your language. Making yourself smaller to make others comfortable. Laughing at jokes that weren’t funny. Agreeing with opinions you didn’t share. Explaining things carefully so no one feels threatened by your knowledge.

You’ve been running complex social calculations every single day for decades.

There’s a concept in psychology called “decision fatigue”. The deteriorating quality of decisions made after a long session of decision-making. But what we don’t talk about enough is emotional labor fatigue.

After thousands of interactions where you’ve monitored and managed your authentic responses to maintain social harmony, something in your system starts breaking down. Not because you’re broken, but because the system was never meant to run this way indefinitely.

Your brain isn’t malfunctioning. It’s finally refusing to malfunction anymore.

Why women experience brain changes more intensely

Men experience aging changes too, obviously. But women tend to report this shift more dramatically, and there’s a reason for that.

From childhood, girls are socialized for social harmony in ways boys simply aren’t. Research shows that girls as young as 4 already demonstrate more awareness of others’ emotions and adjust their behavior accordingly more than boys do.

By the time you reach midlife, you’ve had 40+ years of this conditioning. That’s four decades of:

• “Don’t be bossy” (translation: don’t lead)

• “Don’t be pushy” (translation: don’t assert boundaries)

• “Don’t be difficult” (translation: don’t have needs)

• “Don’t be emotional” (translation: don’t be human)

You’ve been performing an elaborate social choreography so long it became automatic. You stopped noticing you were doing it.

Until suddenly, you can’t anymore. Or more accurately — you won’t.

What’s actually happening in your brain in midlife

Several neurological and hormonal shifts converge in midlife that contribute to this phenomenon:

Hormonal recalibration

As estrogen declines, so does its moderating effect on emotional responses and social bonding behaviors. You’re not becoming “hormonal” in the dismissive sense. You’re becoming less chemically compelled to prioritize others’ comfort over your own truth.

Prefrontal cortex changes

The same executive function region that helped you suppress inappropriate responses for decades starts operating differently. Some research suggests it becomes less reactive to social judgment and approval. You’re literally less neurologically invested in what others think.

Accumulated stress response

Decades of chronic low-level stress from constant social monitoring takes a biological toll. Your stress response system — the HPA axis — can become dysregulated. What looks like “not having a filter” might actually be a stress response system that’s finally saying “enough.”

Cognitive prioritization shifts

Your brain starts prioritizing differently. Energy becomes more precious. Time becomes more finite. The cost-benefit analysis of pretending shifts dramatically.

The social backlash is real (and expected)

Here’s the part that makes this transition so uncomfortable: other people don’t like it.

When you stop performing emotional labor, systems that relied on that labor start breaking down. And instead of examining why the system needed your performance to function, people blame you for withdrawing it.

You’re suddenly:

• “Not a team player”

• “Going through something”

• “Difficult to work with”

• “Changed” (said with concern that really means disapproval)

The same directness that would be called “no-nonsense” in a man gets called “abrasive” in a woman over 40.

This backlash is proof of concept. It confirms that your people-pleasing wasn’t optional. It was required labor that kept everything running smoothly. And when you stop providing it for free, people notice.

The discomfort you’re causing? That’s not your problem to fix. That’s information about a system that was always exploiting you.

The fear that comes with liberation from people-pleasing

But here’s what complicates this: the liberation feels dangerous.

You’ve been rewarded your entire life for being accommodating. Easy. Pleasant. Not too much. The positive feedback loop of being liked is powerful, and you’re now breaking that loop.

You might find yourself afraid that:

• You’re becoming “that woman” — the bitter, difficult one everyone avoids

• You’ll lose relationships (and you might — more on this in a moment)

• You’re being selfish or narcissistic

• You’re overreacting or being “too sensitive” (ironic, since you’re actually being less sensitive to others’ reactions)

These fears are valid. But they’re also old programming.

The woman you’re afraid of becoming? She’s not real. She’s a cautionary tale designed to keep you compliant.

What you’re gaining

Let’s be explicit about what’s actually happening when you “lose your filter”:

Authenticity

The real you — the one who’s been submerged under layers of performance — is finally surfacing. This might feel harsh because authentic humans have edges. They have opinions. They have boundaries. These aren’t character flaws.

Time

All the energy you spent managing everyone else’s experience? That’s now available for literally anything else. The return on investment is staggering.

Clarity

When you stop cushioning every truth, reality becomes clearer. Problems that were obscured by diplomatic language become visible and therefore solvable.

Real relationships

Some relationships will end when you stop people-pleasing. These were transactional relationships sustained by your performance. What remains are connections based on who you actually are.

The relationships that don’t survive

This is hard to talk about, but necessary: some relationships won’t survive your refusal to keep pretending.

Friendships built on shared complaining but not actual intimacy. Work relationships that relied on you doing emotional labor others weren’t doing. Family dynamics where you played mediator, peacemaker, or emotional manager.

When you stop playing these roles, one of two things happens:

The relationship evolves into something more authentic, or it dissolves because it was never based on authentic connection in the first place.

Both outcomes are information.

Losing relationships because you stopped performing isn’t actually loss. It’s clarity about what was never really there.

How to navigate this transition

If you’re in the thick of this shift, here’s what helps:

• Name what’s happening. “I’m not becoming difficult — I’m becoming authentic. My brain is reorganizing around honesty instead of performance.” Language matters. The story you tell yourself about this change shapes your experience of it.

• Expect resistance. When you stop over-functioning in relationships and systems, others will push back. This isn’t evidence you’re doing something wrong. It’s evidence you were doing too much before.

• Practice the pause. You don’t have to swing from people-pleasing to brutal honesty overnight. Notice when you’re about to soften/cushion/apologize unnecessarily. Pause. Choose consciously whether to add the cushioning or not.

• Find your people. Other women going through this same shift. They exist. They’re tired of pretending too. These relationships will feel different — less performative, more substantial.

• Grieve if you need to. There’s loss here too. Loss of approval, loss of being liked by everyone, loss of your identity as “the nice one.” This grief is legitimate even as the change is ultimately positive.

The unexpected gift of aging out of fucks

Here’s what no one tells you about aging out of fucks: it’s practice for being fully alive.”

Every small death of ego, every shedding of others’ opinions, every moment you choose truth over approval, you’re rehearsing the ultimate letting go.

You’re learning to exist as yourself regardless of external validation. This is spiritual work masquerading as social rudeness.

The woman who can say “that’s not accurate” without apologizing is the same woman who can eventually face her own mortality without flinching. She’s practiced not needing everyone’s approval. She’s learned that her worth isn’t contingent on being pleasant.

You’re not becoming difficult — you’re becoming free

The “you” that’s emerging isn’t a worse version. It’s the version that was always there but buried under decades of social conditioning to maintain harmony at any cost.

Your brain is finally doing triage. Deciding what actually matters. Cutting away the pretense that never served you.

The filter you’re losing wasn’t protecting you. It was protecting everyone else from your truth.

And your truth? It’s not the problem.

The system that required you to hide it was always the problem.

So when someone says you’ve changed, when they say you’re not the person you used to be, when they imply something’s wrong with you now?

They’re right. You have changed.

You’ve changed into someone who’s no longer available for performance.

And that’s not difficult.

That’s development.

This story was originally published here on Ellen Scherr’s Substack.

Ellen Scherr is a clinical mental health therapist based in the Chicago area. After years of chasing goals, overthinking every decision, and trying to “do it all,” she finally realized that alignment isn’t about doing more — it’s about slowing down, tuning in, and trusting yourself again. Now she helps women do exactly that — through calm, grounded guidance that helps you reset your energy, shift your mindset, and reconnect with what really matters. Subscribe to Ellen’s Substack, Life Branches, here.

Why does cognitive load increase during perimenopause?

TL;DR: Cognitive load is metabolic load

Every decision, every emotion you manage, every commitment you track draws on the same biological resources as physical work. In perimenopause, declining estrogen reduces the brain’s buffer against this cost. The result is not weakness. It is a real physiological shift that requires support.

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Stop being everything but yourself

How to overcome self-abandonment, by psychologists Badass Rebellion

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How to stop being a people pleaser

Real advice from therapists and women who’ve been there, done that

By Alexis Mera Damen

I used to think being nice and liked by everyone was my superpower. I’d try to smooth over tension before it surfaced and anticipate other people’s needs before they voiced them. It made me a reliable employee, a “low-maintenance” friend, and sometimes even the family mediator. But I felt exhausted, resentful, and weirdly disconnected from myself.

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For ThriveOn cofounders, marriage is stronger than ever

Learn why women may benefit from creatine more than men in some areas, particularly cognitive function.

I’ve heard part of this story before because it happened to me and many other women in my age group. You hit midlife and everything seemingly goes to sh## — insomnia, pains that seemingly come out of nowhere, lack of energy.

But the story I haven’t heard is about a married couple cofounding a wellness company to help women in perimenopause. That is, until I met Victoria and Andrew O’Hare.

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I’m striving for goal harmony

By Amy Cuevas Schroeder

I’ve long been on the fence about the “work-life balance” thing. I mean, it sounds nice in theory, but in practice it ends up feeling like more work.

Which is why I’m intrigued by a new concept called “goal harmony,” a learned skill that you can read about here in Harvard Business Review. The philosophy is that you can and should let your personal and work goals balance and enrich each other rather than compete for your attention. If you can find a way to mentally connect your goals, you’ll be happier, more productive, and less anxious.

Here’s a summary from HBD:

Life can sometimes feel like a zero-sum game, where you have to let go of some goals (like a successful career) in order to pursue others (like a satisfying social life). But chasing multiple dreams doesn’t have to mean choosing between them.

New research across 11 samples in 10 countries found that those who were able to draw connections between their goals (seeing them as complementary or mutually reinforcing) were less stressed and more resilient than people who didn’t see many connections between their aspirations.

Additionally, simple exercises (like reflecting on ways that separate—and even conflicting—goals might have things in common) helped workers feel less stressed, more productive, and less likely to burn out.

I think of goal harmony as a mental health two-fer. Here are some examples:

• “By being more relaxed, I will be able to work more efficiently” (Work–Leisure pair).

• “The healthier I remain, the more money I can save” (Health–Finance pair).

• “I could absolutely take my parents out with me to volunteer at my community center (Family–Community pair).

Read more on Harvard Business Review

How do you know it’s time to quit your ‘real job’ and go full-time into your side hustle?

Sara Blakely is one of my favorite entrepreneurs. I can’t get enough of her Spanx startup story in which she developed her product while working full-time selling fax machines door-to-door. When will this gem become a movie?

So, naturally, I was thrilled to see that she addressed one of scrappy entrepreneurs’ most pressing questions on Linkedin:

More from Sara:

I cut the feet out of my pantyhose in 1998. But I didn’t leave my corporate job until 2000. I used my paychecks to fund my idea.... I worked on it at nights and on the weekends. I took customer service calls from bed in the middle of the night. I took all of my PTO for the year to drive to North Carolina and knock on the doors of hosiery mills in hopes that they’d help me create my idea. It was a busy and stressful and grueling time. But just the fact that I was willing to put in the extra hours on top of my 40-hour a week job meant that I knew I was onto something. I had an unwavering belief in myself and my invention.

And I didn’t leave that job until I was absolutely sure I could still pay rent without it (and let’s be honest... they knew something was up anyways. I was constantly exhausted 🤣).

So if you’re still grinding it out on nights and weekends pursuing your passion.... keep at it. Trust your intuition to know when and if you’re ready to take it to the next level. But until then.... try and remember that your ‘real job’ may be giving you the ability to fund your idea. And if you believe in it enough... all the extra hours are worth it. ❤️

Thank you so much, Sara. I’ve been “grinding” on The Midst for years now and I’m still in love with it.

I entered the “Health Testing Olympics”

By Roma van der Walt in Her Long Game

Before we dive into all the testing I did recently, let’s review my DOC 2025 visit:

The biggest takeaway for me was that when you put scientists and physicians in one room, magic happens. Those two camps can be woefully separate. One is healthcare, the other is academia or “wellness”.

I was recently called “non-credentialed” compared to people with a Dr. title, despite the fact that I have a Masters degree in sports science. Rude.

Anyway, as I like to reference often: professional athletes have performance teams that span clinical, physiological and everything in-between and that’s why they excel.

It is about time we applied that playbook to the general population — especially women — and luckily data and machine learning allows for that.

I will share more about my talk at the conference soon, but for now…

Let’s get into it.

1. I’m biologically 37 — whoop!

I did a DNA test for the second time in 2 years and after being 48 last time, I am now a young 37. Awww, I remember 37. It was the age when I thought about what a great party I would have for my 40th while basking in the vitality of my mid-30s.

So you can imagine the shock when that last test came back much older and I subsequently watched a health coach sweat bullets trying to explain it to me.

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It began with one card

By MacKenzie Wilson

No collection or a launch plan. Just a wish to create something, which led to experimenting with a simple design that captured everything I was feeling at the time: the compassion, the humor, the heavy mental load so many women carry in this middle season of life. All of it unfolding against the relentless chaos of what’s happening in the world, and across our country and in our own communities.

Yet, through it all, it’s that unshakable bond between women, when we show up for one another, that always gleams above the noise.

I launched Goldhawk Paper Co. on Etsy with that one card on International Women’s Day this year. An offering of solidarity and a quiet nod to every woman doing her best to hold it all together.

Since I can remember, I’ve written letters to friends, to family, to childhood pen pals in England and France. Sending small, heartfelt notes became my way of staying connected, of saying I see you and you matter.

That’s what Goldhawk is about. Not just cards, but connection. A reminder that we’re in this together and that even a simple message can make someone feel seen and loved.

For me, the only thing that makes sense in this world is the incredible orbit of powerhouse women who give a damn!