Why Community Matters for Women in Midlife and Menopause

Hi, welcome to the podcast. For those who don’t know me, I’m Dr. Tracy Page, and I’m a functional medicine physician, and I’m very passionate about helping women expand their education and knowledge and really understand how to age well and have longevity. I’m so glad you’re here, and today’s topic is why community matters for women in midlife and menopause. Let’s get started.

So this episode and topic is pretty dear to my heart, because I’m an introvert and I have a tendency to be introverted. So I can fill my time pretty easily with reading, learning, working out, and finding things to do that I enjoy and exploring topics and things. I’m very much a nerd; that’s how I describe myself, but I’m also an introvert nerd—so I can find lots of things to keep my brain busy. And what I’ve learned is midlife isn’t really meant to be lived alone.

And I have some wonderful girlfriends and friends who have really helped me see that as I’ve gotten older, because I’d say probably the first part of my life, I really spent a lot of time alone. Spent some time with my doggies, but just a lot of time with non-humans. And it wasn’t healthy — it’s not healthy. And so I want to talk about this topic. And on my podcast cover, I have some really wonderful people on that cover, because I spend time with them — every time I spend time with them, I always have a good time. I never regret it. And I always have to remind myself of that when I start to, like, back out, or say, “oh, I’m too busy,” or “I’m tired,” or, you know, “I have other more, quote, important things to do.” But actually spending time with people is important. And, you know, in reason, of course, we all have the things we have to get done. But I think this time of our life, it’s even more important. And I’m going to talk to you about why.

It’s really interesting to know that isolation is one of the biggest health risks for midlife women — it’s comparable to smoking; that’s how much risk it causes. So if I told you, staying in your house and hanging out by yourself and not having friends and doing things in isolation gives you the same health risk as if you start smoking, you’d probably look at me with big eyes and be like, “What are you talking about?” But they’ve actually studied this, and loneliness increases mortality risk by up to 26%. So your chances of mortality and dying early increase by 26% just by isolating yourself. And I hate to say it, I see it in patients who don’t have a lot of community and friends, and it’s hard, you know, and I’m always encouraging them to find someone to walk with—find a buddy, find a book club, like, find something. It’s so important.

You know, here’s the myth: we need to retire; strong women don’t struggle alone. I think we have to get rid of that, because strong women, they build support around them. As I said, I have some wonderful friends — friends from book club, friends that I go to dinner with, people I work out with. It’s so important to build this community of support for yourself, because as we age, we tend to have a little more time on our hands, and being isolated is not good. So we’re going to talk about that more today, because I feel like a lot of women enter midlife feeling unexpectedly alone. Even when they’re surrounded by family, colleagues, and responsibilities, they sometimes don’t have those close relationships.

And the truth is, midlife was never meant to be navigated in isolation. This is an interesting time in our lives — our bodies are changing, our priorities are changing, our purpose is changing. And it’s so important to have, you know, that close set of confidence — and I think I call it quiet confidence, where they’re your friends, they have your best interest in mind, but there’s no competition. That’s so important in life. You need that amongst the people that you’re with.

It’s funny, because some of my older patients play pickleball, and some of you who listen to this might not agree, but some of them don’t like how competitive it can be. They’re like, “Hey, I love the camaraderie, I love getting together with other couples, I love playing, I just don’t really like the competition” — like it feels like it makes it stressful and it doesn’t feel as enjoyable. So it’s interesting—being with others doesn’t always have to be adversarial and competitive; it can just be fun. So I think that’s an important point to make, because I’ve heard that more than once. So I’m definitely all for collaboration and not competitiveness.

We often dismiss the social structures that previously kept women connected. So life changes, and we reshape our network. I thought it was hard to make friends as I got older, but I realized I just wasn’t putting in any effort. I think your effort shows in what you do, and by putting effort into it, we can all have a close group of friends and avoid isolation. But in reality, we have less daily contact with others; we have less daily contact with our parents; we shift our identity to meet different needs; we don’t need constant stimulation—what we need is different from what we get from our family. Our career demands can isolate us. We can have leadership roles that take a lot out of us — and actually, this is kind of me. Like, I started with the Wisconsin Institute of Functional Medicine, and, you know, that became a beast on its own and has gobbled up all my time, to the point that I wasn’t spending time with anyone else. I wasn’t even spending time with my husband. It’s amazing how easily a career can take over your life, and then we start knocking off casual socialization. We just stop doing it because we don’t have time.

Some of you may have career problems. Some of you may have caregiving issues where you have aging parents or ill parents. And I have many female patients who come to my office and they can hardly even take care of themselves, because they’re so busy taking care of their elderly father, or their mother who has dementia, or their dad who has Alzheimer’s, or he has Parkinson’s. And so I see this too. And then they become very isolated, because their only surroundings are work and taking care of their family and, hopefully, sleeping—that might be all they have time for.

And relationships also shift. Some people go through divorce; they become empty nesters. And like I said, as we get older, we tend not to make friends as easily. We’re not as outgoing. And so that starts to fade, because our social circle starts to shrink. So many friendships were built in the time of our lives, and in midlife, when we need it most, we sometimes don’t have the same opportunities to build the social structure we need.

Let’s talk about this — and you might be wondering, like, why is she talking about this? Like, no big deal. You know, I spend a few hours with friends, or I don’t; it shouldn’t be a big deal. But it actually is, because the science says it is, and I trust the science. And actually, as I said, I see it in my office every day. So connection isn’t just emotional; it’s actually physiological. So we make a hormone called oxytocin, and that hormone actually reduces stress in our body — it has positive effects on us. So when we have positive social interaction with others, we trigger oxytocin, which lowers cortisol, reduces anxiety, enhances feelings of safety, and improves cardiovascular health—so it can go right down to your heart. So spending time with people is good for your heart. We also see that our nervous system has a regulatory component tied to spending time with people. So when we’re around calm, supportive people, it lowers our heart rate, it reduces that feeling of hypervigilance, it improves our emotional resilience.

I don’t know how many of you have walked away from time with others and felt this — felt more resilient, felt connected. Yeah, we just had this last night — we went to dinner with some friends, some very good friends who had been with us for a long time, and then some newer friends, and we just had the most lovely evening. And I will admit, I almost thought I wasn’t going to go — it actually went longer than what I had told myself I was willing to do, because I was having such a lovely time. And it’s just the power of good conversation and sharing stories and sharing challenges — we’re more alike than we’re different in so many ways. So yeah, we left and had the best night’s sleep afterward, and we really felt connected and woke up happy. So it definitely affects our nervous system. And surprisingly, it also reduces inflammation in the body. We have higher inflammation markers when we’re isolated, we have poor immune function when we’re isolated, and we have increased chronic disease risk when we’re isolated — when we don’t have that regular connection.

So they’ve also studied this in longevity outcomes, and I think a lot of people know about the blue zones and how people live life together and do things. And we’ve also seen that, in longevity, we have better survival rates, reduced dementia, and improved recovery after illness when we have a connected group that supports us—especially social connections that focus on healthy living and exercise. But even if they don’t, they still impact those parts of our lives. So it’s easier to be healthy — that saying, “you’re probably the five people you surround yourself with.” So it’s easier to be healthy and live a healthier life, especially when you have connection with other people who are doing the same thing. I have found that to be true my whole life: surrounding myself with people who don’t have to be exactly like me, but who prioritize some of the same things — health, longevity, and wellness — really makes a difference.

Okay, so let’s talk about why you might want to isolate. Like, why do you isolate? I think this happens a lot with high-achieving women too — we tend to isolate. And I think part of it is we just tell ourselves we should handle this. We handle things ourselves; we’re independent; we’re over-functioning; we’re used to being the helper; we’re not used to being helped. So we help everyone around us. We have this—and this is me—this busyness armor. My husband sent me a podcast, “Breaking Up With Busy” — I think he was trying to help me with something. So we have this busyness armor, packed schedules, and little room for emotional connection. I would just say I was kind of like this in my younger days, where I just didn’t have time — I didn’t want to make time. I just had my goals and ambitions, and I just wasn’t letting anything get in my way.

But I have to tell you, my life is so much richer and fuller since I’ve opened up that part of my life to connection with other people. I can thank my husband a lot for that — he really has brought that into my life and shown me the importance of slowing down and making time for people and experiences. It made life much richer. But I too fell into this category of busyness as armor — it kind of protects us. We don’t have to be vulnerable, we don’t have to share too much, we don’t have to, you know, let people in. Some of us isolate because we don’t want to be a burden to other people—we feel like we’re going to be. So, you know, “everyone else has problems, they don’t need to hear mine too,” or “I don’t want to complain.” Some of us fall into this category where we really want to be stoic.

Also, sometimes it’s just hard to open up—we’ve lost that safe space. Not all friendships feel emotionally safe and stable, so sometimes we have superficial connections, but that doesn’t always translate into meaningful change in our lives. And what I’m talking about — connection, changing your nervous system, changing how you feel, the oxytocin piece — because if it’s superficial, it doesn’t do any of those things. But sometimes we don’t feel safe having those deep connections. I’m trying to explain why they’re so important, and why we need to make time for them, because they change how we show up in the world and our longevity.

I just shared some statistics with you, and I want to say, especially for my high-achieving women, that strength is not self-sufficiency — strength is knowing when you need to lean on others. So I like to use myself, or my patients, as my example. Just this morning, I got a lovely text from someone — it’s my birthday month, and she’s like, “Hey, just thinking about you, wondering how you’re working on your work-life balance, because that’s been a goal of mine — is it happening for you? What can I do to support you? How can I pray for you?” Just that little text first thing in the morning, to know that somebody is looking out for me and cares for me. This is someone in my book club, and it means so much. Another text from somebody that I had dinner with last night — a long-term friend — just said, “Hey, I had a great time; we should do this again.” It was just a lovely evening. Those feel safe. And those connections didn’t happen overnight — they just took time and an investment, an investment in other people, which, you know, has been my challenge because of time management and being able to get everything in. But those who really care about you, they find a way, and you find a way.

So I want to talk to you about the types of support that can actually help you in this area. Not all support is interchangeable. So there’s emotional support — people who can listen without fixing or judging. I always joke around that everybody should have a counselor. We have a wonderful counselor that we refer our patients to, and I always say it’s just such a great place to have somebody who’s unbiased — they don’t have a dog in the fight; they’re just there to listen and really help you understand your own feelings and thoughts. And I feel like that falls under a non-fixing or non-judging component. Examples could be a friend who truly hears you and just wants to be there for you, a partner who validates your experience — I’m going to have to tell you a funny story about that — and a support group or a counselor. As I said, we have a wonderful counselor we refer patients to when appropriate, and she’s been amazing at helping patients understand themselves, which is really the goal. It’s not really to fix you, but to understand yourself, live within what matters to you, and be honest with yourself and ask yourself some important questions.

I had to giggle about the partner who validates your experience, because I’m not easy to live with — I know that. We had to go to a meeting in Vegas a couple of weekends ago, and I was a little irritable, let’s just say. And my husband — I was being irritable and maybe complaining about a few things — he said, “Honey, I understand.” And I was like, “What? What are you talking about, you understand?” He just said it so much, like, “Honey, I understand,” and I said, “Do you really?” And he’s like, “Well, I’m trying to understand, and I want you to know I understand.” And he was trying to validate my feelings. And he said, “You know, this is my new answer for you.” Because what he realized is you just need to be heard — you don’t need me to fix it, you don’t need me to tell you what you should do, you probably don’t even need my opinion. He said, “But you just need to know that I’m hearing you and that I understand.” And I had to giggle, but he was right — I just needed him to say, “I understand what you’re going through,” or “I understand why you could feel that way,” or “I understand that this is difficult for you.” And then he didn’t have to fix it. There was silence, and that was pretty powerful. So, hats off to my husband — he figured that one out on his own. So sometimes you just need somebody who’s there for you like that.

As I said, there are different types of support. So there’s informational support — and actually, that’s what I hope this podcast is for you: informational support to create clarity in your life, and to help you understand the things that you’re going through, that most women are going through, and how we can all talk about them openly and honestly, combat them, or travel through them and understand them, and make sure that we’re coming out on the other side, or through it, with purpose and vitality and wellness. So informational support is guidance and knowledge, and that can be, like myself, a healthcare provider. It could be a business coach — I’ve had those, and they’ve been very helpful. I had an amazing business coach who helped me understand my thoughts and feelings about managing people, reacting to how they manage people and their reactions, and how they show up. It could be educational communities and learning from others, or it could be podcasts like mine. So if you’re not in the office, you’re not my patient; hopefully I can offer some informational support through the podcast.

And then there’s also physical presence — being in the same space matters. I would say it really, truly matters, because texting — we’ve just become such a text environment; everything’s done on the computer, through the phone — we really have lost the human connection. I think, you know, we did an upgrade and remodel at the office; we added more exam rooms and some other offices, so we went to telehealth for three months, and we didn’t have patients in the office unless it was absolutely necessary, for a lab draw or a procedure. And it was really interesting — it was so nice to bring patients back into the office in January, sit across from them, see their facial expressions, see how they were feeling, really hear and listen to them, hug them, and just really be in their presence. It does matter. And if it’s not you taking care of a patient like me, it could be walking together, sharing an activity like pickleball. We’ve been playing cards, hugging someone, touching them, letting them know you’re there for them, eye contact. Those things really do matter, because — we did telehealth visits, but it’s just not the same. This whole thing about people staying at home, I just don’t know that I believe it’s really healthy for you. Human contact is so important. It has a strong physiological effect on the body, so much so.

And then there is professional support. Sometimes friends can’t meet all of our needs, and we need therapy — as I talked about, our wonderful counselor that we refer patients to — medical guidance, support groups, and even mentorships. Those are all things that can help us connect, which is super important in midlife.

So I want to challenge you to create your midlife tribe. I want you to really think about how you could reframe friendships, because midlife friendships often shift from convenience to intentionality — and that happened for me. I outgrew some friendships, and I really wanted to be intentional about the people I surround myself with. So it’s okay — like, I had a patient; she had what I think was her longtime, quote, “best friend,” or someone in her friend group, and she was telling me that every time she’s with this person, she’s like a Debbie Downer — she’s negative, she isn’t happy, she’s always complaining. And my patient said, “You know, every time I would be with her, I would feel worse; I wouldn’t feel better.” So I encouraged her — I said, “Well, maybe you need to talk to her about that and let her know how you’re feeling.” Because I was counseling my patient on managing her stress, and this was a very stressful situation for her.

And she came back and told me — she said, “You know, I told her, if you’re going to be negative, and you’re going to talk negatively and criticize everything, I’m going to create a boundary, which means I’m going to stop talking to you and being with you. And if you want to show up in a more positive light, I’d love to have a relationship with you.” Unfortunately, that friend didn’t want to change—she didn’t want to work on being positive. I don’t know that my patient wanted her friend to change, but she just wanted, in her presence, to honor what was right for her. As I told her, it’s okay to decide not to be friends with someone, because it’s not healthy for your health and for your well-being. And that’s what she decided. And she came back, and she goes, “I never felt better — I have a great group of friends, we have a super great time together, and this person, if she ever wants to be a part of that positive group, we more than welcome her, but if she doesn’t, then we’re just going to move on.” And I was really proud of her for doing that, and she seemed better — you can tell when someone’s less stressed, and she definitely seemed less stressed.

So I want you to be really intentional about your connections with people, and let go of some of those relationships — and that’s a normal process. One thing I’m going to say when you’re working on building your midlife tribe: start small. Connection doesn’t always require a large amount of people — really, honestly, just one or two meaningful relationships can be transformative. And I say that personally. We have a small group in our book club — which, crazy, I started — and I’ve probably gone to the fewest book club meetings, but I’m changing that this year, and I’m actually hosting this month, because I miss these people. These are my friends; these are the girls that I can let my hair down with and just share all the stuff, good and bad. So it doesn’t have to be a lot of people — we have a small group, under 10; I think we have like seven, eight — seven or eight total. And, as you know, that’s all you need.

I love watching how this book club has grown, because each person has connected with another person and created small friendships; they do things together. It’s beautiful to see a group of women from different parts of life, doing different things, but all sharing a common core theme of what they need from each other and what they’re experiencing. It’s great to see them lift each other up and talk about all the things we’re experiencing—a lot of it is very similar, and in different ways we’re dealing with it—and it’s a very safe space. It’s pretty amazing, and I do miss it, so this year is my year to get back in it and make sure I’m an active participant. Plus, we get to read a good book, so that’s why it’s good too. So, start small — we started our book club with four people, and I think our max now is seven, including myself, eight. So it’s grown to a lovely-sized group.

Schedule connection like an appointment — I say this about exercise too. You really just have to make it happen wherever it fits. So: monthly coffee dates, which I’ve seen happen with the girls in my book club; weekly walks, if you can do that; a standing lunch or a fitness class — just something where you protect the time on the calendar and make time for each other. Like for book club, instead of hosting at my house this time, I’m hosting at a restaurant, someplace that we all love, and it should be really fun. We’ve got it on the calendar; it’s coming, and I’m not missing it.

Okay, another way you can build connection — and I hear this a lot from my patients—is to join an activity-based community group. A lot of my patients play pickleball; it’s like the top of the top right now. They love it because you can rotate, and you meet other people. I would say some of them don’t like the competitiveness—I have a few patients who really love that it’s competitive —but either way, you get to meet new people and form groups. Another one for me is faith, church, and my community—you can have a spiritual community of people you’re close to. You could do volunteer work. Some people like yoga or Pilates, but you still connect with others, or some other hobbies. Two of the ladies — one used to work for me, and one still does — started crocheting together, and I love that. So they meet, they crochet, and then one of them invited the other and her husband to go to church, introducing them to their community of Christian people. So there are so many ways that you can slowly make connections that really can impact your life in ways you can’t even imagine.

And then, finally, always reconnect with existing people who have been in your life — you know, you could be the instigator: “Want to catch up? I’ve been thinking about you, let’s go for a walk sometime.” There are just so many ways that you can open that door, and it doesn’t have to be fancy — you don’t have to go to a restaurant, you don’t have to buy something. A simple walk is a great way to reconnect with somebody.

And then the last thing: always remember that no single person meets all your needs, so it’s important to have at least one or two friends who are different people, in different parts of life. I have older and younger people in my life, and I’ve noticed I learn a lot from the younger people—I learn something different from them, I gain something different, I give something different. I find I mentor a lot, and then they impart their wisdom from their perspective, which I think is really important. I think this may be the first time in our lives where we have all different generations — like five generations of people in the workforce — and I’ve seen it even in my own business. What matters to someone in their 20s is so different from what matters to someone in their 50s or 60s. So I think it’s important to have connections outside our typical frame of reference, just to help us grow as individuals. That’s a great way to connect with different people, different roles, and different ages.

So one thing I want you to remember is that connection is meaningful. Think of one person who makes you feel calmer, stronger, or more like yourself, and, you know, call them, invite them for a walk, or meet them for coffee. I was going to say text them, but I want you to actually connect—and so maybe text them to get together. But small actions really create momentum in this area, and you’d be surprised how quickly it could feel better just to expand your connections with people in your life, so that you’re not alone.

Because everyone deserves support, everyone deserves companionship, everyone deserves to be known and not just needed — everyone needs companionship. And if you’re feeling disconnected, it’s not a personal failing at all — it’s just that it happens, it’s part of life, and you just need to put a little effort into this area, because we know it’s going to make you healthier, happier. It’s going to contribute to your longevity, and connection really protects your health—it strengthens your resilience and reminds you that you don’t have to carry everything alone.

So I encourage you to reach out to that one person and make a new friend this week. Talk to you soon.