Muscle, Hormones & the Menopause Transition with Carla DiGirolamo, MD, PhD (Episode 253)
As active women, muscle is the engine that powers us through our lives, no matter what sport we love. When we hit midlife and menopause, it can feel like that 8-cylinder engine drops to six—less punch when we hit the gas, even though we’re still training. We may notice less muscle and more body fat when we look in the mirror. Muscle and strength loss during the menopause transition is multifactorial. It’s hormonal changes and estrogen decline. It’s inflammation. It’s symptoms like poor sleep, joint pain, and fatigue. It’s body fat gain. It’s how we recover and fuel. And, of course, it’s aging itself, as both women and men lose muscle with age. Our approach to making and maintaining it has to be multifactorial as well. This week we talk all about muscle and menopause–from basic science to menopause symptoms to hormone therapy–to understand what’s going on under the hood and help keep that engine strong.Carla DiGirolamo, MD, PhD, is a Double Board Certified Reproductive Endocrinologist and Obstetrician/Gynecologist specializing in infertility and menopausal medicine. She is also a Crossfit Level 1 trainer, Certified Nutrition Coach, and member of CrossFit Health. She is a MedFit Care provider and provides weekly workouts and medical updates at her Substack Athletic Aging. She is an Endocrine Consultant for Wild Health and Women’s Health Director at Eternal Health. Most recently, she has launched her own private practice specializing in helping active and high-performing women reach their performance potential from puberty through menopause. Dr. DiGirolamo is now seeing patients for virtual consultations for menopausal care and performance optimization. Visit her website www.drcarlad.com to learn more about her services and schedule an appointment.ResourcesAthletic Aging with Dr. Carla DiGirolamo on SubstackFor a full list of articles referred to in this episode, head to this linkSign up for our FREE Feisty 40+ newsletter: https://feisty.co/feisty-40/Learn More and Register for our 2026 Tucson Bike Camp: https://feisty.co/events/gravel-camp-x-bike-mechanic-school/ Follow Us on Instagram:Feisty Menopause: @feistymenopause Hit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099 Support our Partners:Cozy Earth: Use Code HITPLAY at https://cozyearth.com/ Midi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/Nutrisense: Go to nutrisense.io/hitplay and use code: HITPLAY to get 30% offPrevinex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/ Wahoo KICKR RUN: Use the code FEISTY to get a free Headwind Smart Fan (value $300) with the purchase of a Wahoo KICKR RUN at https://shorturl.at/maTzL
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The Bone-Building Blueprint with Lisa Moore, DPT (Episode 252)
The menopause transition is a critical tipping point for bone health. Bone loss accelerates rapidly in late perimenopause and continues for roughly 3 to 5 years after menopause begins–a window in which some women lose up to 20% of their total bone mass. For too long, society accepted this decline as inevitable. That fragility is our fate. That as women, our stature–and our lives and our worlds–just shrink as we age. Dr. Lisa Moore, DPT, founder of Brick House Bones, is on a mission to change that. After a surprise osteopenia diagnosis of her own, she rebuilt her bone density by 3% in a single year. Now she’s helping tens of thousands of women reclaim their skeletal strength, too, including those navigating uniquely challenging circumstances like cancer recovery. She shares her recipe for maintaining and building strong bones this week.Dr. Lisa Moore, DPT, is on a mission to help over one million people with low bone density turn fear into action—and build the strength to do the things they love with the people they love! She’s a Doctor of Physical Therapy, a certified yoga and mindfulness educator, and a BoneFit™ Trained Healthcare Professional specializing in evidence-based exercise for osteoporosis. Lisa is the founder of Brick House Bones, a global movement helping women build stronger bodies and stronger bones. She also runs her own clinic, Strong Bones Physical Therapy, just outside of Seattle, Washington. With degrees from the University of Maine, the University of Washington, and the University of South Dakota, Lisa brings together science, movement, compassion, and community to help her clients thrive at every age.ResourcesBrick House Bones with Dr. Lisa Moore, DPT, hereHigh-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial, hereStronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women, hereSkeletal site-specific effects of jump training on bone mineral density in adults: a systematic review and meta-analysis, hereWeighted Vests in Midlife: Hype? Help? Harm?, hereFRAX fracture risk calculator Sign up for our FREE Feisty 40+ newsletter: https://feisty.co/feisty-40/Learn More and Register for our 2026 Tucson Bike Camp: https://feisty.co/events/gravel-camp-x-bike-mechanic-school/ Follow Us on Instagram:Feisty Menopause: @feistymenopause Hit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099 Support our Partners:Cozy Earth: Use Code HITPLAY at https://cozyearth.com/ Midi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/Nutrisense: Go to nutrisense.io/hitplay and use code: HITPLAY to get 30% offPrevinex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/ Wahoo KICKR RUN: Use the code FEISTY to get a free Headwind Smart Fan (value $300) with the purchase of a Wahoo KICKR RUN at https://shorturl.at/maTzL
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Rethinking the Rules: Peak Performance in a Menopausal Body with Becky Croft (Episode 251)
Unpredictable cycles. Sleepless nights. Mood swings. Body composition changes. And performance that mirrors all of it. During the menopause transition, you never quite know which body will show up on any given day. As this week’s guest menopause run and strength coach Becky Croft explains, you can still get stronger and faster, but it won’t come from constantly pushing through or grinding it out. It takes smart planning, a different kind of periodization, and recovery that respects your shifting hormones and the cumulative stress that comes from this time of life. We dive into all of it: hormones, nutrition, hydration, strength, load management, and much more. Becky also opens up about her struggles with endometriosis, surgical menopause, and younger women in menopause can feel left out of the conversation.Becky Croft is a certified running and strength coach who specializes in guiding masters and menopausal athletes through the complex intersections of performance, hormones, and identity. After years of battling endometriosis and undergoing a full hysterectomy at 38, Becky entered surgical menopause as a younger, recreational competitive athlete—and quickly realized the resources she needed didn’t exist. So she became the coach she was looking for. She is a Game Changers Coach and Mentor, holds certifications as a RRCA Run Coach, Girls Gone Strong Menopause Strength Coach, and Chi Running & Walking Instructor. Becky is the founder of hustle.run.thrive., where she helps runners of all ages, stages, and identities push performance boundaries without abandoning their bodies. Follow her work at Instagram: @coach.croft or website: https://hustle-eat-thrive.myshopify.com/Sign up for our FREE Feisty 40+ newsletter: https://feisty.co/feisty-40/Learn More and Register for our 2026 Tucson Bike Camp: https://feisty.co/events/gravel-camp-x-bike-mechanic-school/ Follow Us on Instagram:Feisty Menopause: @feistymenopause Hit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099 Support our Partners:Cozy Earth: Use Code HITPLAY at https://cozyearth.com/ Midi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/Nutrisense: Go to nutrisense.io/hitplay and use code: HITPLAY to get 30% offPrevinex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/ Wahoo KICKR RUN: Use the code FEISTY to get a free Headwind Smart Fan (value $300) with the purchase of a Wahoo KICKR RUN at https://shorturl.at/maTzL
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Active Release Techniques, Massage & Musculoskeletal Health in Menopause with Jan Wanklyn, LMT (Episode 250)
Our ligaments, tendons, and overall musculoskeletal system can take a real hit during the menopause transition, making injuries more frequent and recovery slower. Too often, practitioners still overlook common issues like tendinopathies—leaving women to live with unnecessary pain before getting an accurate diagnosis and effective treatment. This week’s guest, former pro triathlete and licensed massage therapist Jan Wanklyn, dives into the unique musculoskeletal challenges active menopausal women face, the soft tissue therapies (like ART) and exercise strategies that can help, and why she wishes hormone therapy had been an option back in her day.Jan Wanklyn, LMT, has been a massage therapist for 34 years. She is an Active Release Techniques® (ART) instructor and practitioner (1998–2025) and former professional triathlete with five Ironman wins (Germany, New Zealand ×3, Australia) and two Philadelphia Marathon victories. She holds a Human Movement Studies degree (University of Queensland) and a Graduate Diploma in Teaching, taught PE for eight years, and has coached triathletes online and in person. Jan’s clinical toolkit spans Contemporary Medical Acupuncture, K-taping, DNS, SFMA, Smart Tools/IASTM, and extensive wet-lab/cadaver and running biomechanics training. She practices at Northside Chiropractic Clinic in Brisbane, QLD and has a private practice on the Sunshine Coast -North of Brisbane you can contact through Active Release Australia / Jan Wanklyn on Instagram.Resources:Active Release Techniques at Physio-PediaSign up for our FREE Feisty 40+ newsletter: https://feisty.co/feisty-40/Learn More and Register for our 2026 Tucson Bike Camp: https://feisty.co/events/gravel-camp-x-bike-mechanic-school/ Follow Us on Instagram:Feisty Menopause: @feistymenopause Hit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099 Support our Partners:Cozy Earth: Use Code HITPLAY at https://cozyearth.com/ Midi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/Nutrisense: Go to nutrisense.io/hitplay and use code: HITPLAY to get 30% offPrevinex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/ Wahoo KICKR RUN: Use the code FEISTY to get a free Headwind Smart Fan (value $300) with the purchase of a Wahoo KICKR RUN at https://shorturl.at/maTzL
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Smart Glucose Management for Active Midlife Women with Liz McKinney, CNS, LDN (Episode 249)
Grazing. Chronic stress. Poor sleep. Rushed meals. Sitting for long hours. Underfueled workouts. Estrogen decline. There’s a lot more behind our fasting glucose and A1C than how many carbs we eat. This week we return to one of the most consistently requested topics: blood sugar meaning and management with Liz McKinney, CNS, LDN. We explore what glucose spikes really mean, why time-in-range and variability matter more than a single peak, and how stress, sleep, and even eating speed affect your numbers. We cover carb timing, meal sequencing, post-meal walks, creatine, why under-fueling can make exercise spikes worse, and much more so you can keep glucose working for your performance and overall health.Liz McKinney, CNS, LDN, heads up the clinical nutrition team at Nutrisense. Liz holds a Master of Science degree in Clinical Nutrition and Integrative Health and is a board-certified nutrition specialist (CNS) as well as a licensed dietitian nutritionist (LDN). In her time as a nutritionist, Liz has educated and counseled hundreds of clients in areas such as weight loss, hormonal imbalances, and gastrointestinal diseases. Her approach is rooted in the tenets of functional medicine, and she strives to identify the root cause of the issue instead of simply treating the symptoms. She realizes there is no one-size-fits-all approach to achieving optimal health and feels it is crucial to be in an equal partnership with her clients. Resources What to Know About Prediabetes and Menopause with Val Schonberg, RDN, CSSD (Episode 202)Sign up for our FREE Feisty 40+ newsletter: https://feisty.co/feisty-40/Learn More and Register for our 2026 Tucson Bike Camp: https://feisty.co/events/gravel-camp-x-bike-mechanic-school/ Follow Us on Instagram:Feisty Menopause: @feistymenopause Hit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099 Support our Partners:Cozy Earth: Use Code HITPLAY at https://cozyearth.com/ Midi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/Nutrisense: Go to nutrisense.io/hitplay and use code: HITPLAY to get 30% offPrevinex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/ Wahoo KICKR RUN: Use the code FEISTY to get a free Headwind Smart Fan (value $300) with the purchase of a Wahoo KICKR RUN at https://shorturl.at/maTzL
Perimenopause and menopause hit active women differently. We have a different lifestyle and different goals. And we know our bodies. Whether you run and hike or do CrossFit and ski (or a little of everything!), you’ve had a way of eating and exercising that worked…until the menopause transition, when it all goes out the window as body composition changes, fatigue, body aches, sleepless nights, hot flashes, brain fog, mood swings, and low mojo blindside you out of the blue—despite doing everything right. Your doctor may (or may not) help with hormone replacement therapy. But what about all the active stuff you love? You’re already exercising and eating well. What you want is to feel and perform like you used to. That doesn’t mean fasting, swearing off carbs for life, or just slowing down. It means adjusting your nutrition, training, recovery, and mindset to work with your changing physiology as you hit this phase of life. And we’re here for it.
At Hit Play Not Pause, we know the potential of women in their 40s, 50s, 60s, and beyond, because we talk to elite athletes and everyday active women who are still hitting personal bests along with world-renowned sports dietitians, researchers, medical and menopause specialists to help you understand what’s happening under the hood during the menopause transition and more importantly, what you can do about it—from hormone therapy to heavy lifting and everything in between—to feel and perform your best.
Host Selene Yeager is a health and science journalist with 30 years’ experience and more than two dozen books to her name. She also lives an active life as a former Ironman triathlete and professional mountain bike racer who still rides, runs, paddles, hikes, lifts, and through her work at Feisty Menopause helps others do the same.
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