37: Midlife & Menopause: The 2025 Report
Ep. 37
In this episode of Reset Recharge, Dr. Komal Patil-Sisodia highlights the transformative year of 2025 in women's health, focusing on menopause care. Key topics include the FDA's rewording of black box warnings on hormone therapy, breakthrough non-hormonal treatments, and the American Heart Association's new cardiovascular guidelines.
The podcast also covers advances in weight management, bone health, and preventive screenings, along with the elevation of lifestyle medicine and the growing field of fem tech.
Listen to the full episode:
By Dr. Komal Patil-Sisodia | Reset Recharge Podcast | December 23, 2025
2025: The Year the Trajectory of Women’s Health Changed Forever
As we close out 2025, we aren’t just looking back at another year—we are celebrating a historic turning point. For decades, menopause care was driven more by fear than by data. Women were told to "wait it out" or accept debilitating symptoms as an inevitable part of aging.
But as Dr. Komal Patil-Sisodia explains in the latest episode of Reset Recharge, the science has finally caught up to the lived experience of women. From FDA breakthroughs to revolutionary shifts in heart health, 2025 has redefined what it means to age with vitality.
1. Breaking the “Black Box” Barrier
Perhaps the most significant clinical shift of the year was the FDA’s move to remove or substantially reword the "black box" warnings on many hormone therapy (HT) products. For years, these warnings—based on the outdated 2002 Women’s Health Initiative (WHI) study—created a culture of hesitation among both patients and clinicians.
Why this matters: Decades of follow-up data now confirm that for healthy women under 60 or within 10 years of menopause onset, the benefits for heart health, bone density, and cognitive protection often outweigh the risks. We have officially moved away from the "lowest dose for the shortest time" mantra toward individualized duration, where the length of treatment is a shared decision based on your specific health goals.
2. A Non-Hormonal Revolution: Elinzanetant
For women who cannot use hormone therapy due to breast cancer history, clotting risks, or personal preference, 2025 delivered a massive win. The approval of elinzanetant marks a new era in non-hormonal treatment.
Unlike previous medications that only targeted one receptor, this is a dual-action medication that works centrally in the brain’s thermoregulatory center.
The Result: Not only a substantial reduction in "vasomotor symptoms" (hot flashes), but improved sleep quality independent of those flashes. This is the first time a non-hormonal medicine has been proven to tackle both simultaneously.
3. Menopause as a Cardiovascular Milestone
One of the most sobering yet empowering updates of 2025 comes from cardiology. The American Heart Association (AHA) now formally recognizes the menopause transition as a female-specific cardiovascular risk factor.
We now know that frequent, persistent hot flashes are biomarkers, not just "noise." Women with ongoing symptoms have a significantly higher risk of cardiovascular disease, which remains the leading cause of death for women.
The 2025 Intervention Standard: Dr. Patil-Sisodia notes that doctors are moving beyond basic cholesterol panels. They are now looking at APO-B (Apolipoprotein B) and Hemoglobin A1C to catch insulin resistance and heart risk years earlier than before.
4. The Metabolic Edge: GLP-1s and Estrogen
In a fascinating update for weight management, 2025 research highlighted the "synergy" between hormones and metabolic medication. Data showed that women using a combination of Hormone Therapy and a GLP-1 agonist (specifically Tirzepatide) experienced:
20% weight loss when used together.
16% weight loss when using the GLP-1 alone.
The Clinical Insight: Estrogen appears to enhance the body's metabolic responsiveness to these therapies. For women navigating the "menopause middle" or metabolic shifts, this dual approach is now within the scope of standard, evidence-based care.
5. Protecting the "Silent" System: Bone Health
We often wait until age 65 for a DEXA scan, but 2025 data confirms that is often too late. The most rapid bone loss—up to 10%—occurs one to two years before the final menstrual period.
Because bone turnover is regulated by estrogen, the decline in hormones leads to immediate deterioration. Dr. Patil-Sisodia has shifted her practice to screen women at the onset of menopause, aligning with the Endocrine Society’s advocacy for earlier screening at age 50 for those with risk factors.
6. FemTech and the Data-Driven Visit
Gone are the days of trying to remember how many hot flashes you had three weeks ago. In 2025, Menopause-specific FemTech—including smart rings and watches—introduced tracking modes for core temperature and heart rate variability (HRV).
This allows you to take objective data to your physician. It transforms the clinical visit from a "guessing game" into a data-driven conversation, ensuring your treatment plan is as precise as possible.
A New Chapter, Not Just an Aging Process
The message of 2025 is unmistakable: Midlife care has changed, and it needed to. We now have the evidence that lifestyle interventions are powerful medicine, and hormone therapy is safer and more flexible than we were once taught.
You don’t need to wait until your symptoms are debilitating to seek care. This phase of life is your opportunity to reset your health trajectory for the decades to come.
Dr. Komal Patil-Sisodia is a triple board-certified endocrinologist and women’s health expert. For more insights, subscribe to the Reset Recharge podcast.