When Stanford was recruiting Dr. Karen Adams, she talked about menopause, and her interviewers kept talking about healthy aging.
Dr. Karen E. Adams is a clinical professor of obstetrics and gynecology and the Farwell Family Director of the Stanford Program in Menopause and Healthy Aging. She presented 'From pillars to practice: Integrating lifestyle medicine into menopause care' at The Menopause Society 2026 Annual Meeting, held October 20 to 24, 2026, in San Diego, California. Her talk closed the opening symposium, 'Cutting through the noise: The evidence for incorporating the six pillars of lifestyle medicine for menopause.' She described how she integrated those pillars into menopause care through shared medical appointments (SMAs).
Considering what a healthy aging program for women would include, she turned to lifestyle medicine. She became board certified in lifestyle medicine and said that 'it changed the way I approach my patients ... and it actually changed my own life.'
Why lifestyle medicine may fit the chronic disease risk of menopause
Menopause is associated with increased chronic disease risk. Among women older than 55 years, 80% have at least 1 chronic condition. Dr. Adams noted that many menopause clinicians, herself included, are not primary care physicians. 'I have lifestyle medicine,' she said. 'I can prescribe these.'
The pillars, she explained, do double duty. 'They not only reduce symptom burden, but they also decrease chronic disease risk.' She presented them as a complement to hormonal and nonhormonal therapies. She also recommended the American College of Lifestyle Medicine menopause toolkit, whose sexual health chapter covers what she would argue 'should be the seventh lifestyle pillar.'
What a Stanford pilot showed about shared medical appointments in menopause
An SMA is a billable medical visit in which several patients with a shared condition are seen together. The evidence she presented associated SMAs with better outcomes, revenue, and less clinician stress. Because she gives the same counseling about 15 times in a clinic day, she finds an SMA of 10 to 12 patients more efficient.
In her pilot, 14 patients attended SMAs and 14 matched patients received one-on-one care. All visits supported billing code 99214 when documented appropriately. At 6 months, SMA vs comparison patients reported behavior change in exercise (80% vs 73%), nutrition (80% vs 82%), sleep (60% vs 18%), mental health (70% vs 27%), and sexual function (40% vs 18%). The study was small, single-site, and based on self-report. Feedback was 100% positive, centered on peer learning and reduced isolation.
'Connection is a lifestyle medicine pillar in and of itself,' Dr. Adams said. 'You are giving them a therapeutic intervention.' She concluded that menopause SMAs are revenue-enhancing and highly acceptable to patients and might improve sustained behavior change. Her suggestions for colleagues included lifestyle medicine prescriptions, goals tied to the pillars, and SMAs.
Abbreviations: SMA, shared medical appointment.