Dr. Malia Swanson

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Dr. Malia Swanson Welcome! I’m a board-certified family medicine physician and a certified menopause expert with The Menopause Society. https://linktr.ee/dr_malia_swanson

I’m passionate about educating and supporting women during the perimenopause transition and beyond.

Let's talk about collagen supplements. How much of the hype is backed by data?Consuming hydrolyzed collagen does have so...
09/25/2026

Let's talk about collagen supplements. How much of the hype is backed by data?

Consuming hydrolyzed collagen does have some benefits. Type I benefits skin a little, and Type II helps joints a little- but it takes 10-20g of collagen daily, for months, to see a modest improvement. And it's still not as effective as other options. Vitamin C, retinol, and sunscreen do far more for skin health, and lifting heavy weights and consuming enough protein will make a bigger difference in joint health.

When you consume collagen, your body breaks it down into amino acids, which are the building blocks of protein. In this way, it's beneficial. But it won't rebuild your knees or your skin in a specific, targeted way.

Collagen isn't useless. But in my opinion, it's overhyped.

09/21/2026

We've seen a 40-60%r rise in colon cancer rates in those under 50, and that rise continues to increase annually by 2-3%. If you were born in the 1990s, your risk of colon cancer is far higher than someone who was born in the 1960s.

The biggest drivers of this increase are:
- Processed, packages foods
- Obesity
- Red meat
- Processed meats (this includes deli turkey!)
- Sugar-sweetened beverages
- Smoking + alcohol

What we eat in childhood likely contributes to our colon cancer risk later in life.

Colon cancer has become the #1 cause of cancer-related death in men under 50, and the #2 cause of cancer-related death in women under 50.

09/16/2026

What is my ideal workout schedule for women in perimenopause?

- 3 x/ week: heavy lifting. Think compound lifts (exercises that use multiple muscle groups at the same time) and progressive overload.

- 2x/ week: sprint interval training. 30 seconds of all-out effort, followed by 2-4 minutes of total recovery, for 4-6 rounds. This should take 15-20 minutes in total.

- Daily: 8,000-10,000 steps, to keep your basal metabolic rate up.

- 1x/ week at least: jumping, plyometric exercises, or heavy loaded carries, all of which help build bone.

Make sure you get enough sleep and protein after your workouts, otherwise you won't be building the muscle and bone you're striving for.

09/14/2026

Sprint interval training (SIT) is one of the best things you can do to support your long-term health, longevity, and quality of life in menopause. VO2max predicts how long you'll live more accurately than almost any blood test. Here's the fastest way to improve it in menopause.

Sprint interval training is 30 seconds of all-out effort for 4-6 sets. Between sets, aim for 2-4 minutes of complete recovery, where you let your breathing and heart rate return to normal. The goal is to do this 2-3x a week.

SIT produces significantly greater improvements in VO2max than moderate cardio, and VO2max is one of the strongest predictors of all-cause mortality — more predictive than most labs we order!

SIT improves insulin sensitivity, reduces visceral fat, and increases mitochondrial biogenesis. In menopause specifically, SIT has been shown to help alleviate symptoms, like hot flashes and night sweats.

The best part? You can do this anywhere. On a bike, on the treadmill, on a trail, on a rowing machine.

Let's talk about breast cancer screening guidelines.1) Standard breast cancer screenings begin with an annual mammogram ...
09/05/2026

Let's talk about breast cancer screening guidelines.

1) Standard breast cancer screenings begin with an annual mammogram when you turn 40.

2) Dense breast tissue changes the screening recommendations. About 40% of women have dense breasts. Mammography misses 20% of cancers in dense tissue, unlike MRI. Ask your doctor: "What's my density?"

3) Annual breast MRIs are indicated for women who:
- have ensity Class C or D (look at your mammo report for this)
- BRCA1/2 positive (or high-risk family)
- Prior chest radiation (Hodgkin's)
- Lobular carcinoma in situ (LCIS) history
- 20%+ lifetime risk (Gail/Tyrer-Cuzick)
- Personal history of breast cancer

4) MRI does not replace mammogram. MRI is supplemental, not standalone. Combine with mammography for best detection.

5) Talk to your doc about YOUR risk profile. Dense tissue? Family history? Personal history? That changes the plan.

Get screened. Stay informed.

ACR guidline update:

https://linkinghub.elsevier.com/retrieve/pii/S1546-1440(25)00498-3

09/03/2026

As an integrative physician, I focus on preventative cardiology, rather than waiting to treat symptoms. This is because cardiac disease begins long before symptoms appear, making early intervention far more effective. Heart disease is usually decades in the making!

I look at my patients' LDL, cholesterol particle size, lipoprotein-a, apolipoprotein-b: these lipid markers that can show me the risk of heart attack and stroke. Based on what I see in lab results, we may do imaging, like a CIMT (an ultrasound of the carotid arteries), or a calcium score of the heart, which looks for hard plaque, or even a CCTA with Cleerly, which looks for soft plaque.

There are many ways to assess someone's risk for heart disease before symptoms manifest.

08/31/2026

If you're doing the same workout you did at 35, we need to talk.

The weight you're lifting needs to feel heavy. In menopause, light weights and high reps are not the move for building muscle or protecting bone.

Estrogen is a potent anabolic signal — when it drops, you lose that baseline muscle protection. You need progressive overload: the weight must increase over time or you're maintaining, not building. Compound lifts — squats, deadlifts, hip hinges, overhead press — recruit the most muscle and load the most bone.

Mechanical loading of bone (impact + resistance) is the stimulus for osteoblast activity — cardio alone does not do this!

Aim for 3–4 sets of 6–10 reps at RPE 7–8 — you should be working hard!



08/28/2026

As an integrative physician, I work intensively with my patients on lifestyle and diet, but sometimes people can benefit from extra support. I love to stay abreast of the latest research in longevity medicine, and I'm particularly excited about two medications.

Retatrutide is slated for FDA approval in early 2027, and it's another medication that affects the GIP, GLP, and glucagon receptors. But compared to other GLPs, the retatrutide data is remarkable! With a small dose of 0.5mg, we see a 5% reduction in fat mass, specifically in visceral belly fat, which presents the most disease risk. In higher doses, a 4mg dose reduces fat mass by 15%, an 8mg dose reduces fat mass by 26%, and interestingly, a 12mg dose only reduces fat mass by 23%, so more is not automatically better.

The second medication I'm excited about is Lipfendra. Similar to Repatha, it reduces LDL ("bad" cholesterol), which helps prevent heart attack and stroke, but it's an oral medication instead of an injection. Repatha has historically been difficult to get, and now we have hope that Lipfendra may be a great alternative to statins. More research is needed, but I'm excited about the potential of both Lipfendra and Retatrutide as longevity medications.

08/24/2026

Estring: the v*ginal ring most people have never heard of. Think of its use as comparable to v*ginal estradiol cream. It's a flexible silicone ring, about the size of a diaphragm, that you insert yourself and forget about for three months. It delivers a steady, low dose of estradiol straight to the v*ginal tissue—treating dryness, painful in*******se, and cutting the risk of recurrent UTIs—without raising estrogen levels enough to need progesterone alongside it.

It won't touch hot flashes or night sweats, since it's built to stay local, but for genitourinary symptoms it's one of the lowest-effort options available. Ask your doctor if it's covered before you commit; insurance coverage is hit or miss, and the cost tends to be higher than patches/gel.

There's an unexpected connection between gut bacteria and mental health.Trillions of gut bacteria communicate with the b...
08/20/2026

There's an unexpected connection between gut bacteria and mental health.

Trillions of gut bacteria communicate with the brain through neural, endocrine, and immune pathways. The gut biome shapes cortisol receptivity, and gut bacteria can produce GABA, serotonin, and dopamine, linked to neurotransmitter production.

Patients with mental health conditions including PTSD, bipolar, schizophrenia, autism, Alzheimer's, Parkinson's, anxiety, and depression, show distinct microbiome signatures.

A Mediterranean diet has the strongest human data for mood of any microbiome-related intervention, including alongside antidepressants.
Fermented foods (kombucha, kefir, sauerkraut) and prebiotic fibers (leeks, asparagus, onion, chicory, banana) are also great food sources.

(sources: Butler MI, Mörkl S, Sandhu KV, Cryan JF, Dinan TG. The Gut Microbiome and Mental Health: What Should We Tell Our Patients? Can J Psychiatry. 2019;64(11):747–760)

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