What is new in menopause care

Jessica L. Fiorelli, MD, FACOG, MSCPWomen’s Health of Greenwich

I recently attended The Menopause Society’s 2026 Annual Meeting in San Diego, joining leading scientists, researchers, and physicians dedicated to advancing women’s health in midlife and beyond.

The collaborative energy was inspiring, reflecting tremendous momentum in menopause medicine, particularly at the intersection of hormone health, metabolic health, and longevity. I returned with new insights and a renewed commitment to providing individualized, proactive care at Women’s Health of Greenwich.

One of the strongest conference themes was the importance of lifestyle medicine in comprehensive menopause care. Midlife offers an opportunity to look beyond symptom management and focus on long-term cardiovascular, metabolic, bone, and brain health.

Particular emphasis was placed on preserving muscle mass and bone strength through resistance training, aerobic activity, and weight-bearing exercise. Hormonal changes during menopause can accelerate age-related declines in muscle and strength, affecting metabolism, mobility, and independence.

Presentations also explored how hormonal fluctuations, disrupted sleep, and midlife stressors affect mood and well-being, while highlighting the importance of resilience and meaningful social connections.

• Nutrition
• Physical activity
• Restorative sleep
• Stress management
• Social connection
• Avoiding risky substances

The six pillars of lifestyle medicine are interconnected and influence how women feel and age.

Key takeaways

• Prioritize strength trainingIncorporate resistance exercise at least twice weekly to preserve muscle and bone health.
• Move regularlyAim for 150 to 300 minutes of moderate aerobic activity weekly, including weight-bearing and balance exercises.
• Support metabolic healthFocus on nutrient-dense nutrition and sustainable habits.
• Protect sleepRestorative sleep supports metabolic, cognitive, and emotional health.
• Manage stressBuild resilience through mindfulness, physical activity, and supportive relationships.
• Invest in relationshipsSocial connection and community are important contributors to longevity.
• Individualize careLifestyle goals should be realistic, achievable, and tailored to each woman.

Sleep was another major conference focus, with research emphasizing its connection to menopause symptoms and long-term health.

Hormonal fluctuations, hot flashes, and night sweats frequently disrupt sleep, but menopause is also associated with increased risks of insomnia, obstructive sleep apnea, and restless legs syndrome.

• InsomniaTrouble falling or staying asleep
• Obstructive sleep apneaBreathing pauses during sleep
• Restless legs syndromeAn urge to move the legs at night

Look beyond hot flashes: menopause raises the risk of all three.

Importantly, sleep quality matters as much as quantity. Frequent awakenings can affect metabolism, cardiovascular health, mood, concentration, and cognitive performance, even when total sleep duration seems adequate.

Key takeaways

• Sleep disruption is commonApproximately 40 to 60% of women experience sleep disturbances during the menopause transition.
• Quality mattersFrequent nighttime awakenings can affect physical and cognitive health.
• Aim for at least seven hoursConsistent sleep and wake times are also important.
• Protect your circadian rhythmMaintain regular sleep hours, seek daytime light exposure, and limit disruptive nighttime light.
• Look beyond hot flashesPersistent sleep problems may warrant evaluation for insomnia, sleep apnea, or restless legs syndrome.
• Treat insomnia effectivelyCognitive behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment for chronic insomnia.
• Consider menopause treatmentsHormone therapy and nonhormonal medications may improve sleep by reducing nighttime symptoms.
• New treatment optionsNeurokinin pathway antagonists, including Veozah and Lynkuet, reduce hot flashes and night sweats, potentially improving sleep.
• Use supplements thoughtfullyEvidence supporting many sleep supplements remains limited.

Women’s sexual health was another important focus, including changes in desire, arousal, orgasm, and pelvic floor function during midlife.

Sexual function is influenced by hormones, physical health, medications, emotional well-being, and relationships. Menopause-related changes may include decreased desire, reduced sensitivity, difficulty with orgasm, vaginal dryness, and painful intercourse. These concerns are common but often underrecognized. Importantly, they are not inevitable consequences of aging, and effective treatments are available.

Key takeaways

• Sexual health mattersChanges in desire, arousal, and orgasm deserve attention and appropriate care.
• Low desire is treatableHypoactive sexual desire disorder involves persistently low desire causing personal distress. Diagnosis is clinical, not based on hormone levels alone.
• Treatment options existMedications including flibanserin, bremelanotide, and appropriately prescribed testosterone therapy may help selected patients. FDA-approved indications vary.
• Testosterone has a specific roleEvidence supports carefully monitored, physiologic-dose testosterone for postmenopausal women with low desire causing distress.
• Pelvic floor health mattersDysfunction can cause painful intercourse, urinary symptoms, and reduced pleasure. Specialized physical therapy can help with both strengthening and relaxation.
• Care should be individualizedVaginal hormone therapy, pelvic floor rehabilitation, sexual counseling, and targeted treatments can improve sexual function.

This update shares general information from The Menopause Society 2026 Annual Meeting. It is not medical advice, and the treatments mentioned are not right for everyone. Talk with your provider about your own health.