As a geriatrician who sees patients from ages 18 to 99, I’ve come to appreciate aging not just as a biological process but as a deeply personal journey. My practice at Sutter Health in Novato is holistic and integrative, and my perspective on aging has been shaped by decades of listening to patients across generations. I have a “Wall of Fame” in my office — patients who have reached 90 years old and beyond. They are living proof that aging can be graceful, vibrant and full of well-being!
Menopause is also a topic close to my heart, not only because I treat it clinically, but because I’m living it myself. That dual lens allows me to connect with my patients in a unique way. We share stories, frustrations and sometimes laughter about the changes we’re experiencing. Menopause isn’t just a medical milestone. It’s a rite of passage, and one that deserves more understanding and compassion.
Typically, menopause occurs between ages 45 and 55, with the average onset around 52. It marks the end of the reproductive cycle (a woman stopping her period), driven by the decline of two powerful hormones: estrogen and progesterone. But in recent years, I’ve noticed women are entering menopause earlier, sometimes in their mid-30s. I suspect this is linked to chronic stress and the way our modern lifestyles disrupt our natural biological rhythms. We are, after all, part of nature. When we are out of sync with it, our bodies respond — sometimes with premature aging, autoimmune conditions or hormonal imbalances.
Around age 50, many women begin to seriously reflect on aging. They notice slower recovery from injuries, sagging skin, fatigue and a general sense that their bodies aren’t bouncing back the way they used to. These changes are often more pronounced in women than men, and that’s no accident. Up until menopause, women benefit from the protective effects of estrogen and progesterone, or what I call “female superpowers.”
Estrogen is life-giving. It supports skin elasticity, bone density, brain function, cardiovascular health and emotional well-being. It’s the hormone that prepares the body for reproduction, but its benefits extend far beyond fertility. Progesterone, on the other hand, is the quiet hero. It regulates mood, promotes restful sleep and helps women tolerate stress and multitasking. When these hormones decline, many women feel like they’ve lost their edge. I’ve had spouses tell me, half-jokingly, “She’s turned into a different person!” I call it the “crankiness index” — a humorous but real reflection of how hormonal shifts can affect personality and relationships.
So what can women do to age well? It starts with the environment, both internal and external. The internal environment includes everything that enters your body: food, air, cosmetics and the information you consume. The external environment is where you live, the people around you and the energy you surround yourself with. These factors shape your health in profound ways.
But even with the best lifestyle choices, our bodies need support. That’s where the HPA axis — the hypothalamus-pituitary-adrenal system — comes in. It’s the command center for hormonal balance and well-being. When it’s functioning well, it helps us process stress, regulate mood and maintain health. But when it’s overwhelmed, everything suffers.
That’s why I strongly advocate for menopause hormone therapy, or MHT, for my female patients as part of a comprehensive anti-aging strategy. MHT isn’t just about easing hot flashes; rather, it’s about preserving the hormonal advantages that support longevity and vitality. When used thoughtfully and under medical guidance, hormone therapy can help women maintain bone density, cognitive function, cardiovascular health and emotional stability. Nature gave women the gift of reproduction, and with it, the gift of longevity. Estrogen and progesterone are more than reproductive hormones — they’re life-sustaining forces. By understanding their roles and supporting their balance, we can help women not just survive menopause but thrive through it.
Aging is inevitable. But how we age is a choice. With the right tools, support and mindset, women can embrace this chapter of their life with dignity, strength, grace and confidence.
Dr. Adaeze Udezue (Dr. Dezzy) is a geriatrician with Sutter Health.
