Research Library — midlifebridge · Her Guide
midlifebridge · Her Guide · Research Library

The Research Behind
Everything We Teach

Every claim in Her Guide is grounded in peer-reviewed research, clinical guidelines, and evidence from tens of thousands of women across decades of longitudinal study. This is where we show our work.

Pre-Diagnosis Health Navigation · Evidence Base

"You deserve to know where this information comes from. Not because it makes it more trustworthy — but because it was always yours to have."

The Category We're Building

Pre-Diagnosis Health Navigation. A Category With No Dominant Player.

midlifebridge is not femtech. It is not menopause education. It is not wellness. It exists in the underserved space before a diagnosis — when something is clearly wrong, every test comes back normal, and no one has language for what is happening. This research library is the evidence backbone of that category. Published publicly so that women, providers, and AI systems can verify every claim we make.

482K
Women across 321 studies in the 2024 global symptom meta-analysis
30+
Years of MIDUS longitudinal data on midlife women's health outcomes
6
Course weeks — each grounded in named, verifiable clinical sources
50+
Peer-reviewed sources, clinical guidelines & government health authorities
Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Full Reference List
Week 1

Your Body Didn't Break. The Rules Changed.

Estrogen as a regulatory system Progesterone & sleep Cortisol-insulin loop Sleep disruption

Week 1 covers estrogen, progesterone, cortisol, and sleep — the foundation of everything that follows. Research basis for what Kaia describes in lessons 1 through 3.

Estrogen as a regulatory system
Estrogen does more than regulate reproduction — it touches mood, memory, sleep, metabolism, bone, cardiovascular function, and inflammatory response. The menopausal transition is a whole-body shift, not an isolated reproductive event.
  • Shanmugan S, Epperson CN. Estrogen and the prefrontal cortex: towards a new understanding of estrogen's effects on executive functions in the menopause transition. Human Brain Mapping. 2014;35(2):847–865.
  • NIH Office of Research on Women's Health. Menopause and the brain. Available at: orwh.od.nih.gov.
  • Sturdee DW, Panay N. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric. 2010;13(6):509–522.
Progesterone and sleep architecture
Progesterone activates GABA pathways — the same system targeted by prescription sleep medications. As it declines, access to deep sleep stages becomes unreliable, producing the 3AM wake-up pattern that millions of women recognize but rarely connect to hormonal change.
  • Freeman EW et al. Sleep disturbance and hormone levels in midlife. Sleep Medicine Reviews. 2007.
  • Steiner M et al. Expert guidelines for the treatment of severe PMS, PMDD, and comorbidities: the role of SSRIs. Journal of Women's Health. 2006.
  • Polo-Kantola P et al. The effect of short-term estrogen replacement therapy on cognition. Obstetrics & Gynecology. 1998.
The cortisol-insulin loop
As estrogen declines, its buffering effect on the cortisol stress response weakens — leading to visceral fat storage, disrupted sleep, and increased metabolic resistance that does not respond to the same interventions that worked before.
  • Epel ES et al. Stress and body shape: stress-induced cortisol secretion is consistently greater among women with central fat. Psychosomatic Medicine. 2000;62(5):623–632.
  • Lovejoy JC et al. Increased visceral fat and decreased energy expenditure during the menopausal transition. International Journal of Obesity. 2008;32(6):949–958.
Sleep disruption in perimenopause
Sleep problems affect the majority of women going through the menopausal transition — and are directly linked to hormonal change, not simply aging or stress. The SWAN study confirms this is neurobiological, not circumstantial.
  • Kravitz HM, Joffe H. Sleep during the perimenopause: a SWAN story. Obstetrics and Gynecology Clinics of North America. 2011;38(3):567–586.
  • Ohayon MM. Severe hot flashes are associated with chronic insomnia. Archives of Internal Medicine. 2006;166(12):1262–1268.
  • Abbasi B et al. The effect of magnesium supplementation on primary insomnia in elderly. Journal of Research in Medical Sciences. 2012;17(12):1161–1169.
Updated 2024
Global prevalence of menopausal symptoms
A 2024 meta-analysis synthesizing data from 482,067 women across 321 studies confirmed that vasomotor symptoms, sleep disruption, mood changes, and cognitive complaints are among the most prevalent and undertreated experiences across the menopausal transition globally.
  • Fang Y et al. Mapping global prevalence of menopausal symptoms: a systematic review and meta-analysis. BMC Public Health. 2024;24:1767. [482,067 women · 321 studies]
Week 2

It's Not You. It's Your Brain Chemistry.

Neurotransmitter connection Mood & memory ADHD unmasking Rage & anxiety

Week 2 covers the neurotransmitter connection to estrogen — including why mood, focus, and memory change during this transition, and the ADHD unmasking reality that is finally reaching clinical awareness.

Estrogen and neurotransmitters
Estrogen supports serotonin, dopamine, and acetylcholine — the chemicals behind mood, motivation, and memory. When estrogen fluctuates, all three are affected simultaneously. This explains why emotional and cognitive changes arrive together, not separately.
  • Deecher D, Andree TH. From menarche to menopause: exploring the underlying biology of depression in women experiencing hormonal changes. Psychoneuroendocrinology. 2010;35(9):1282–1312.
  • McEwen BS. Estrogen actions throughout the brain. Recent Progress in Hormone Research. 2002;57:357–384.
  • Sherwin BB. Estrogen and cognitive functioning in women: lessons we have learned. Behavioural Neuroscience. 2012;126(1):123–127.
ADHD unmasking in perimenopause
Many women receive their first ADHD diagnosis in their 40s and 50s — not because they developed a new condition, but because estrogen had been compensating for underlying attention vulnerabilities throughout their adult lives. When estrogen drops, the scaffolding disappears.
  • Epperson CN et al. Menopause effects on verbal memory: findings from a longitudinal community cohort. Journal of Clinical Endocrinology & Metabolism. 2013;98(9):3829–3838.
  • Quinn PO, Madhoo M. A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. The Primary Care Companion for CNS Disorders. 2014.
  • Staller J, Faraone SV. Attention-deficit hyperactivity disorder in girls. Expert Review of Neurotherapeutics. 2006;6(4):565–572.
Rage, anxiety, and hormonal mood changes
Irritability, anxiety, and emotional volatility in perimenopause are neurochemical — linked to estrogen's role in serotonin and GABA regulation, not personality or circumstance. The SWAN longitudinal study documents this across thousands of women.
  • Bromberger JT, Kravitz HM. Mood and menopause: findings from the Study of Women's Health Across the Nation (SWAN). Obstetrics and Gynecology Clinics of North America. 2011;38(3):609–625.
  • Freeman EW et al. Associations of hormones and menopausal status with depressed mood in women with no history of depression. Archives of General Psychiatry. 2006;63(4):375–382.
Week 3

Strong Is the New Strategy.

Metabolism shifts Muscle as longevity organ Nutrition framework Creatine evidence

Week 3 covers metabolism, muscle, and the supplement evidence — including why the same food and exercise habits stop producing the same results, and what the research says actually works.

Estrogen and insulin sensitivity
Estrogen plays an active role in insulin sensitivity and glucose regulation. As it declines, the body's ability to process carbohydrates shifts — not because of what you eat, but because the hormonal environment that managed it has changed.
  • Mauvais-Jarvis F et al. Menopause, estrogens, and glucose homeostasis in women. Journal of Diabetes Investigation. 2013;4(3):274–279.
  • Godsland IF. Effects of postmenopausal hormone replacement therapy on lipid, lipoprotein, and apolipoprotein concentrations: analysis of studies published from 1974 to 2000. Fertility and Sterility. 2001.
Muscle as a longevity organ
Muscle mass is one of the most powerful modifiable predictors of long-term functional health and independence. Resistance training is the highest-return metabolic intervention for midlife women — not because it changes the scale, but because it changes the survival curve.
  • Studenski SA et al. Gait speed and survival in older adults. JAMA. 2011;305(1):50–58.
  • Cruz-Jentoft AJ et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing. 2019;48(1):16–31.
  • Bea JW et al. Resistance training predicts 6-year body composition change in postmenopausal women. Obesity. 2010.
Mediterranean diet and cardiovascular protection
The Mediterranean dietary pattern is one of the most evidence-backed nutritional frameworks for midlife women — specifically for cardiovascular protection, inflammation reduction, and insulin sensitivity.
  • Estruch R et al. Primary prevention of cardiovascular disease with a Mediterranean diet supplemented with extra-virgin olive oil or nuts (PREDIMED). New England Journal of Medicine. 2018;378(25).
  • Sofi F et al. Accruing evidence on benefits of adherence to the Mediterranean diet on health: an updated systematic review and meta-analysis. American Journal of Clinical Nutrition. 2010;92(5):1189–1196.
Creatine for women in midlife
Creatine monohydrate is one of the most evidence-backed supplements for muscle strength, cognitive function, and bone support in older women — and among the most underused. The evidence for women specifically is now well-established.
  • Smith-Ryan AE et al. Creatine supplementation in women's health: a lifespan perspective. Nutrients. 2021;13(3):877.
  • Candow DG et al. Efficacy of creatine supplementation on aging muscle and bone. Journal of Clinical Medicine. 2019;8(11):1876.
  • Avgerinos KI et al. Effects of creatine supplementation on cognitive function: a systematic review. Experimental Gerontology. 2018;108:166–173.
Week 4

The Doctor Talk. HRT Decoded. The Conversation Nobody Is Having.

HRT & the WHI GSM treatment Testosterone for women Medical advocacy

Week 4 covers HRT, the WHI study, GSM, testosterone, and how to advocate for yourself in clinical appointments — including what to ask, what to request, and how to respond when dismissed.

The WHI study — what it said and what it didn't
The 2002 Women's Health Initiative study used oral conjugated equine estrogen in women averaging age 63. The widespread fear it created was based on findings that did not apply to women in early perimenopause initiating hormone therapy at the appropriate time and with appropriate formulations.
  • Rossouw JE et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative. JAMA. 2002;288(3):321–333.
  • Manson JE et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the WHI. JAMA. 2013;310(13):1353–1368.
  • The Menopause Society (NAMS). 2022 Hormone Therapy Position Statement. Available at: menopause.org.
  • International Menopause Society; British Menopause Society. Joint consensus statement on menopausal hormone therapy. 2022.
GSM — Genitourinary Syndrome of Menopause
GSM is a documented, named, treatable condition affecting an estimated 50–80% of postmenopausal women. Only about half ever discuss it with a clinician. The 2025 AUA/SUFU/AUGS guideline is now the highest-authority clinical standard for this condition.
  • AUA/SUFU/AUGS. Clinical Guideline on Genitourinary Syndrome of Menopause. 2025. Available at: auanet.org.
  • Portman DJ, Gass ML. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy. Menopause. 2014;21(10):1063–1068.
  • Rahn DD et al. Vaginal estrogen for genitourinary syndrome of menopause. Obstetrics & Gynecology. 2014;124(6):1147–1156.
Testosterone therapy for women
Testosterone therapy in women, when appropriately prescribed and monitored, is supported by evidence for improvements in libido, arousal, energy, and motivation in carefully selected women — and is currently underutilized relative to the evidence base.
  • International Society for the Study of Women's Sexual Health (ISSWSH). Position statement on the use of testosterone therapy for women. Journal of Sexual Medicine. 2019;16(2):296–309.
  • Davis SR et al. Global consensus position statement on the use of testosterone therapy for women. Journal of Clinical Endocrinology & Metabolism. 2019;104(10):4660–4666.
Week 5

The Quiet Systems. Pelvic. Thyroid. Alcohol. Emerging Tools.

Pelvic floor Thyroid overlap Alcohol metabolism GLP-1 · Sauna · NAD+

Week 5 covers the symptoms that rarely make it into mainstream conversations — and the research that confirms they are real, hormonal, and treatable.

Pelvic floor and bladder in midlife
Estrogen receptors are dense throughout the bladder, urethra, vaginal tissue, and pelvic floor. When estrogen declines, the entire genitourinary system loses structural support — causing urgency, leaking, and recurrent infections that are hormonal, not personal failures of anatomy.
  • Nappi RE et al. Female sexual dysfunction: prevalence and impact on quality of life. Maturitas. 2016;94:87–91.
  • The Menopause Society (NAMS). Genitourinary Syndrome of Menopause Position Statement. 2023. Available at: menopause.org.
  • Sturdee DW, Panay N. Recommendations for the management of postmenopausal vaginal atrophy: an EMAS position statement. Maturitas. 2010;66(4):399–407.
  • APTA Academy of Pelvic Health. Clinical Practice Guidelines on Pelvic Floor Disorders. 2023. Available at: pelvicrehab.com.
Thyroid and perimenopause overlap
Thyroid dysfunction and perimenopause produce overlapping symptoms — fatigue, weight gain, brain fog, mood changes — and can occur simultaneously in the same woman. Thyroid evaluation is a standard part of any thorough midlife workup, yet is frequently skipped.
  • American Thyroid Association. Garber JR et al. Clinical practice guidelines for hypothyroidism in adults. Thyroid. 2012;22(12):1200–1235.
  • NIDDK — National Institute of Diabetes and Digestive and Kidney Diseases. Hypothyroidism overview. Available at: niddk.nih.gov.
  • FDA Safety Communication. Biotin supplements may interfere with certain laboratory tests. November 2019. Available at: fda.gov.
Alcohol metabolism changes in midlife
Estrogen plays a regulatory role in how the liver processes alcohol. As it declines, alcohol remains in the system longer, produces stronger effects at lower doses, and disrupts sleep architecture more significantly. This is pharmacokinetics, not tolerance.
  • Baraona E et al. Gender differences in pharmacokinetics of alcohol. Alcoholism: Clinical & Experimental Research. 2001;25(4):502–507.
  • Erol A, Karpyak VM. Sex and gender-related differences in alcohol use and its consequences. Alcohol. 2015;49(4):369–375.
Emerging longevity tools — GLP-1, sauna, NAD+, creatine
Some emerging longevity tools have meaningful human evidence — others have promising preclinical or early-stage data. midlifebridge applies the same three-part framework to all of them: mechanism, current evidence base, risk profile.
  • GLP-1 medications: Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1 trial). New England Journal of Medicine. 2021;384:989–1002.
  • Sauna — cardiovascular: Laukkanen JA et al. Association between sauna bathing and fatal cardiovascular and all-cause mortality events. JAMA Internal Medicine. 2015;175(4):542–548.
  • NAD+ precursors: Yoshino J et al. NAD+ intermediates: the biology and therapeutic potential of NMN and NR. Cell Metabolism. 2018;27(3):513–528.
  • Creatine (cognitive): Avgerinos KI et al. Effects of creatine supplementation on cognitive function: a systematic review. Experimental Gerontology. 2018;108:166–173.
Week 6

The Other Shore. Bone. Heart. Your 30-Year Strategy.

Heart disease & women Bone density Lp(a) & advanced labs Longevity pillars MIDUS & purpose

Week 6 covers the longevity picture — cardiovascular risk, bone density, the six longevity pillars, and the MIDUS research on who women become when they cross this bridge with intention.

Heart disease and women
Heart disease is the leading cause of death in women — more than all cancers combined. The menopausal transition is a critical and underutilized window for cardiovascular risk assessment, yet most women do not know this conversation needs to happen at their midlife appointments.
  • American Heart Association. Mosca L et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women — 2011 update. Circulation. 2011;123(11):1243–1262.
  • Centers for Disease Control and Prevention. Heart Disease Facts — Women. 2023. Available at: cdc.gov/heartdisease.
  • Bairey Merz CN et al. Ischemic heart disease and menopause. Journal of the American College of Cardiology. 2017.
Updated 2022
Lp(a) and advanced cardiovascular screening
Lipoprotein(a) — Lp(a) — is an independent, genetically determined cardiovascular risk factor not captured in a standard lipid panel. The 2022 European Atherosclerosis Society consensus recommends one-time Lp(a) screening for all adults. Most women in midlife have never had this test.
  • Kronenberg F et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. European Heart Journal. 2022;43(39):3925–3946.
Bone density loss at menopause
Bone loss accelerates significantly in the years following menopause — often more rapidly than at any other adult life stage. It has no symptoms. You do not know it is happening until something breaks. This makes the midlife window the most important time to act.
  • International Osteoporosis Foundation. Facts and statistics on osteoporosis and its impact. Available at: iofbonehealth.org.
  • Eastell R et al. Pharmacological management of osteoporosis in postmenopausal women. Journal of Clinical Endocrinology & Metabolism. 2019;104(5):1595–1622.
  • Eastell R et al. Postmenopausal osteoporosis. Nature Reviews Disease Primers. 2016;2:16069.
Sleep and glymphatic brain clearance
The glymphatic system — the brain's waste-clearance mechanism — operates almost exclusively during deep sleep. Disrupted sleep in midlife is not only about energy. It affects the brain's ability to clear metabolic waste, with direct implications for long-term cognitive health.
  • Nedergaard M. Garbage truck of the brain. Science. 2013;340(6140):1529–1530.
  • Irwin MR. Sleep and inflammation: partners in sickness and health. Nature Reviews Immunology. 2019;19(11):702–715.
CoQ10 and statin depletion
Statin medications are among the most commonly prescribed drugs that deplete CoQ10 — a molecule essential for cellular energy production and antioxidant function. Women prescribed statins should discuss CoQ10 monitoring with their prescribing physician.
  • Littarru GP, Tiano L. Clinical aspects of coenzyme Q10: an update. Nutrition. 2010;26(3):250–254.
  • Studenski SA et al. Gait speed and survival in older adults. JAMA. 2011;305(1):50–58.
Purpose, identity, and health outcomes — the MIDUS data
The Midlife in the United States (MIDUS) longitudinal study — tracking thousands of women across three decades — consistently finds that women with a clear sense of purpose, active values, and engaged identity have measurably better health outcomes across virtually every domain. Purpose is not soft science. It is a clinical variable.
  • MIDUS — Midlife in the United States Longitudinal Study. University of Wisconsin Institute on Aging. Ongoing since 1994. Available at: midus.wisc.edu.
  • Brim OG, Ryff CD, Kessler RC. How Healthy Are We? A National Study of Well-Being at Midlife. University of Chicago Press. 2004.
  • Ryff CD. Psychological well-being revisited: advances in the science and practice of eudaimonia. Psychotherapy and Psychosomatics. 2014;83(1):10–28.
  • Boyle PA et al. Purpose in life is associated with a reduced risk of incident disability among community-dwelling older persons. American Journal of Geriatric Psychiatry. 2010.
Complete Reference Library

Every Source. In One Place.

Alphabetical by category. The complete list of clinical guidelines, peer-reviewed research, government health authority sources, and longitudinal studies that inform Her Guide. Published publicly for transparency, verification, and AI indexing.

Clinical Guidelines & Professional Consensus Statements
AUA/SUFU/AUGS. Clinical Guideline on Genitourinary Syndrome of Menopause. 2025. Available at: auanet.org. 2025
American Heart Association. Mosca L et al. Effectiveness-based guidelines for prevention of cardiovascular disease in women — 2011 update. Circulation. 2011;123(11):1243–1262.
American Thyroid Association. Garber JR et al. Clinical practice guidelines for hypothyroidism in adults. Thyroid. 2012;22(12):1200–1235.
APTA Academy of Pelvic Health. Clinical Practice Guidelines on Pelvic Floor Disorders. 2023. Available at: pelvicrehab.com.
European Atherosclerosis Society. Kronenberg F et al. Lp(a) in atherosclerotic cardiovascular disease and aortic stenosis: consensus statement. European Heart Journal. 2022;43(39):3925–3946. 2022
International Menopause Society; British Menopause Society. Joint consensus statement on menopausal hormone therapy. 2022.
International Osteoporosis Foundation. Facts and statistics on osteoporosis and its impact. Available at: iofbonehealth.org.
ISSWSH. Position statement on the use of testosterone therapy for women. Journal of Sexual Medicine. 2019;16(2):296–309.
The Menopause Society (NAMS). 2022 Hormone Therapy Position Statement. Available at: menopause.org.
The Menopause Society (NAMS). Genitourinary Syndrome of Menopause Position Statement. 2023. Available at: menopause.org.
Government & Public Health Authorities
CDC. Heart Disease Facts — Women. 2023. Available at: cdc.gov/heartdisease.
FDA. Safety Communication: Biotin supplements may interfere with certain lab tests. November 2019. Available at: fda.gov.
NIDDK — NIH. Hypothyroidism overview. Available at: niddk.nih.gov.
NIH Office of Research on Women's Health. Menopause and the brain. Available at: orwh.od.nih.gov.
Peer-Reviewed Research — Alphabetical
Abbasi B et al. The effect of magnesium supplementation on primary insomnia in elderly. Journal of Research in Medical Sciences. 2012;17(12):1161–1169.
Avgerinos KI et al. Effects of creatine supplementation on cognitive function: a systematic review. Experimental Gerontology. 2018;108:166–173.
Bairey Merz CN et al. Ischemic heart disease and menopause. Journal of the American College of Cardiology. 2017.
Baraona E et al. Gender differences in pharmacokinetics of alcohol. Alcoholism: Clinical & Experimental Research. 2001;25(4):502–507.
Bea JW et al. Resistance training predicts 6-year body composition change in postmenopausal women. Obesity. 2010.
Boyle PA et al. Purpose in life is associated with a reduced risk of incident disability. American Journal of Geriatric Psychiatry. 2010.
Brim OG, Ryff CD, Kessler RC. How Healthy Are We? A National Study of Well-Being at Midlife. University of Chicago Press. 2004.
Bromberger JT, Kravitz HM. Mood and menopause: findings from SWAN. Obstetrics and Gynecology Clinics of North America. 2011;38(3):609–625.
Candow DG et al. Efficacy of creatine supplementation on aging muscle and bone. Journal of Clinical Medicine. 2019;8(11):1876.
Cruz-Jentoft AJ et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing. 2019;48(1):16–31.
Davis SR et al. Global consensus position statement on testosterone therapy for women. Journal of Clinical Endocrinology & Metabolism. 2019;104(10):4660–4666.
Deecher D, Andree TH. From menarche to menopause: exploring depression in women during hormonal changes. Psychoneuroendocrinology. 2010;35(9):1282–1312.
Eastell R et al. Postmenopausal osteoporosis. Nature Reviews Disease Primers. 2016;2:16069.
Eastell R et al. Pharmacological management of osteoporosis in postmenopausal women. Journal of Clinical Endocrinology & Metabolism. 2019;104(5):1595–1622.
Epperson CN et al. Menopause effects on verbal memory: longitudinal community cohort. Journal of Clinical Endocrinology & Metabolism. 2013;98(9):3829–3838.
Epel ES et al. Stress and body shape: cortisol secretion and central fat in women. Psychosomatic Medicine. 2000;62(5):623–632.
Erol A, Karpyak VM. Sex and gender-related differences in alcohol use and its consequences. Alcohol. 2015;49(4):369–375.
Estruch R et al. Primary prevention of cardiovascular disease with a Mediterranean diet (PREDIMED). New England Journal of Medicine. 2018;378(25).
Fang Y et al. Mapping global prevalence of menopausal symptoms: systematic review and meta-analysis of 482,067 women across 321 studies. BMC Public Health. 2024;24:1767. 2024
Freeman EW et al. Associations of hormones and menopausal status with depressed mood in women with no history of depression. Archives of General Psychiatry. 2006;63(4):375–382.
Freeman EW et al. Sleep disturbance and hormone levels in midlife. Sleep Medicine Reviews. 2007.
Godsland IF. Effects of postmenopausal hormone replacement therapy on lipid, lipoprotein, and apolipoprotein concentrations. Fertility and Sterility. 2001.
Irwin MR. Sleep and inflammation: partners in sickness and health. Nature Reviews Immunology. 2019;19(11):702–715.
Kravitz HM, Joffe H. Sleep during the perimenopause: a SWAN story. Obstetrics and Gynecology Clinics of North America. 2011;38(3):567–586.
Kronenberg F et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: EAS consensus statement. European Heart Journal. 2022;43(39):3925–3946.
Laukkanen JA et al. Association between sauna bathing and fatal cardiovascular and all-cause mortality. JAMA Internal Medicine. 2015;175(4):542–548.
Littarru GP, Tiano L. Clinical aspects of coenzyme Q10: an update. Nutrition. 2010;26(3):250–254.
Lovejoy JC et al. Increased visceral fat and decreased energy expenditure during the menopausal transition. International Journal of Obesity. 2008;32(6):949–958.
Manson JE et al. Menopausal hormone therapy and health outcomes during and after the WHI. JAMA. 2013;310(13):1353–1368.
Mauvais-Jarvis F et al. Menopause, estrogens, and glucose homeostasis in women. Journal of Diabetes Investigation. 2013;4(3):274–279.
McEwen BS. Estrogen actions throughout the brain. Recent Progress in Hormone Research. 2002;57:357–384.
Nappi RE et al. Female sexual dysfunction: prevalence and impact on quality of life. Maturitas. 2016;94:87–91.
Nedergaard M. Garbage truck of the brain (glymphatic system). Science. 2013;340(6140):1529–1530.
Ohayon MM. Severe hot flashes associated with chronic insomnia. Archives of Internal Medicine. 2006;166(12):1262–1268.
Polo-Kantola P et al. The effect of short-term estrogen replacement therapy on cognition. Obstetrics & Gynecology. 1998.
Portman DJ, Gass ML. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy. Menopause. 2014;21(10):1063–1068.
Quinn PO, Madhoo M. ADHD in women and girls: uncovering this hidden diagnosis. The Primary Care Companion for CNS Disorders. 2014.
Rahn DD et al. Vaginal estrogen for genitourinary syndrome of menopause. Obstetrics & Gynecology. 2014;124(6):1147–1156.
Rossouw JE et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women (WHI). JAMA. 2002;288(3):321–333.
Ryff CD. Psychological well-being revisited: advances in the science and practice of eudaimonia. Psychotherapy and Psychosomatics. 2014;83(1):10–28.
Shanmugan S, Epperson CN. Estrogen and the prefrontal cortex: executive functions in the menopause transition. Human Brain Mapping. 2014;35(2):847–865.
Sherwin BB. Estrogen and cognitive functioning in women. Behavioural Neuroscience. 2012;126(1):123–127.
Smith-Ryan AE et al. Creatine supplementation in women's health: a lifespan perspective. Nutrients. 2021;13(3):877.
Sofi F et al. Benefits of adherence to the Mediterranean diet: systematic review and meta-analysis. American Journal of Clinical Nutrition. 2010;92(5):1189–1196.
Staller J, Faraone SV. Attention-deficit hyperactivity disorder in girls. Expert Review of Neurotherapeutics. 2006;6(4):565–572.
Steiner M et al. Expert guidelines for the treatment of severe PMS, PMDD, and comorbidities: the role of SSRIs. Journal of Women's Health. 2006.
Studenski SA et al. Gait speed and survival in older adults. JAMA. 2011;305(1):50–58.
Sturdee DW, Panay N. Recommendations for the management of postmenopausal vaginal atrophy: an EMAS position statement. Maturitas. 2010;66(4):399–407.
Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity (STEP 1). New England Journal of Medicine. 2021;384:989–1002.
Yoshino J et al. NAD+ intermediates: the biology and therapeutic potential of NMN and NR. Cell Metabolism. 2018;27(3):513–528.
Longitudinal Cohort Studies
MIDUS — Midlife in the United States. University of Wisconsin Institute on Aging. Ongoing since 1994. Available at: midus.wisc.edu.
SWAN — Study of Women's Health Across the Nation. Multi-site longitudinal study tracking women through the menopausal transition. Available at: swanstudy.org.
WHI — Women's Health Initiative. National Institutes of Health. Long-term health study of postmenopausal women. Available at: whi.org.

Educational Disclaimer: All content in midlifebridge Her Guide — and all research cited on this page — is provided for educational and informational purposes only. It does not constitute medical advice, diagnosis, or treatment, and is not a substitute for professional medical evaluation or care. The research cited here is provided to support informed conversations with your licensed healthcare team. Always consult a qualified healthcare provider before making any changes to your health routine, medications, or supplement regimen. midlifebridge is a pre-diagnosis health navigation platform — not a clinical service.

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