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Welcome to Menopause Research Review! Now that menopause has hit the mainstream, we’re swimming in a steady stream of studies, which is great and can also be overwhelming. So for 2025, we’re introducing a regular segment called Menopause Research Review where we break down key research as it comes out with resident reproductive endocrinologist and menopause performance specialist Dr. Carla DiGirolamo. This week we kick it off with a study published in Menopause: The range and variation in serum estradiol concentration in perimenopausal and postmenopausal women treated with transdermal estradiol in a real-world setting: a cross-sectional study. We dive into hormone testing, what it tells us (and what it doesn’t) as well as what it means (or not) to have therapeutic levels.

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. 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.

Resources

The range and variation in serum estradiol concentration in perimenopausal and postmenopausal women treated with transdermal estradiol in a real-world setting: a cross-sectional study, Menopause 

Hormone replacement therapy (oestradiol-only preparations): can the laboratory recommend a concentration of plasma oestradiol to protect against osteoporosis?, The Association of Clinical Biochemists 

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Spikes, crashes, excursions, and elevated numbers. Blood sugar is on a lot of active midlife women’s minds. But what do we really know about what this all means…and what it doesn’t, especially when it comes to long term health? This week’s guest Oxford nutrition scientist and globally recognized type 2 diabetes expert Dr. Nicola Guess helps sort through all things elevated glucose and helps separate what we need to worry about with what we don’t. 

Nicola Guess, RD, MPH, PhD, is a dietitian based in London specializing in the prevention and management of type 2 diabetes. She is currently an associate professor at the University of Westminster, Research Fellow at King’s College London, and Head of Nutrition Research at the Dasman Diabetes Institute in Kuwait. She also runs her own private clinical practice. Her primary research interests are in the prevention and management of type 2 diabetes, including the effects of nutrients on the underlying pathophysiology of type 2 diabetes. Dr Guess is a National Institute of Clinical Excellent (NICE) scholar investigating meal provision for inpatients with diabetes; a member of the NICE expert committee; a member of the Diabetes UK Clinical Study Group, and previously a Winston Churchill Travel Scholar investigating approaches to type 2 diabetes prevention in the UK and China and a Diabetes UK Academic Health Partnership Fellow investigating the role of diet in the prevention of type 2 diabetes. You can learn more about her work and follow her research at drguess.substack.com/

Resources

Erratic glucose in normoglycaemic athletes: insufficient protein? blog

How useful are CGMs for athletes? blog

Blood Glucose Levels of Subelite Athletes During 6 Days of Free Living, Journal of Diabetes Science and Technology (JDST)

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Women are often accused of being “too emotional”, whether it’s PMS, perimenopause, or just plain life. Worse, we’re made to believe those emotions make us weak. What if the opposite were true? What if our emotions were our super power, a force we could channel to give us strength in and out of the gym? This week’s guest Aimee Anaya Everett is living proof we can do just that, as she has channeled her own emotional turmoil into a world class Olympic coaching and lifting career. Now she helps other women in midlife and menopause do the same. 

Aimee Anaya Everett is the co-owner of Catalyst Athletics. She has devoted the last 29 years to the sport of Olympic Weightlifting as an athlete and a coach. In her time as a coach, Anaya Everett became the second female International Coach in USA Weightlifting, and the first American female coach to coach at the Olympics. Aimee is also the head lifting coach for Mat Fraser’s HWPO Training. Aimee coaches Olympic Weightlifting athletes across all levels, including a multiple American and Pan Am record holder, World Championship multi-medalist, and a Youth World Champion. She also loves coaching beginners and garage lifters with no desire to compete. Aimee has a passion for mental training and toughness, and has a Masters Degree in Human Behavior Psychology. You can learn more about her and her work at

www.aimeeanaya.com

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For the longest time, endurance athletes avoided the weight room, afraid unwanted muscles would weigh them down, while strength athletes all but kicked cardio to the curb. Now we know that no matter if you’re running an ultra or competing in a CrossFit competition, the right blend of cardio and strength is the secret sauce for success–especially once you hit midlife and menopause. This week, renowned exercise physiologist Dr. Alyssa Olenick dives in on how our hormones impact our muscles, metabolism, and general physiology, and how the right blend of hybrid training can help you stay strong, fit, healthy, and injury free during and beyond the menopause transition.

Dr. Alyssa Olenick holds a PhD in exercise physiology and is a certified sports nutritionist and CrossFit Level 2 Trainer. Alyssa completed her doctoral training in exercise and human metabolism, sex differences, and menstrual cycle physiology. She also completed a postdoctoral research fellow investigating the areas of menopause and metabolism. As a coach she specializes in the areas of endurance, strength, and hybrid training. She runs her online business ‘Doc Lyss Fitness’ and training programs ‘The Lyss Method’. She is also a strength athlete, ultra-marathon runner, and all-around fitness lover who is passionate about educating people on science-based fitness to get them into the gyms and on the roads/trails — or often, doing both at the same time! You can learn more about Dr. Alyssa Olenick and her programs at www.doclyssfitness.com

Resources

How to exercise for menopause with Dr. Alyssa Olenick on YouTube

Menopausal Women Need Unique Muscle Making Guidelines, Feisty Menopause Blog

Resistance training alters body composition in middle-aged women depending on menopause - A 20-week control trial, BMC Women's Health

Effect of Concurrent Training on Body Composition and Gut Microbiota in Postmenopausal Women with Overweight or Obesity, Medicine & Science in Sports & Exercise

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Supplements get a bad rap. And to be fair, there is a lot of trash out there. But there are some treasures, too, especially for midlife and menopausal women who often can use some extra help building bone, recovering from injuries, and hitting it hard during training and events. This week we break down the best ergogenic aids for active women in and beyond the menopause transition with Kristen Arnold of Sports Nutrition for Women. 

Kristen Arnold MS, RDN, CSSD is a board-certified sports dietitian, cycling coach, retired professional athlete, and team sport director for USA Cycling and professional cycling teams. Her private practice is centered around empowering women through evidence-based sports nutrition coaching and information, and she has done research on improving postmenopausal women's health through nutrition strategies and counseling. You can learn more about her and her work at sportsnutritionforwomen.com.

Resources

The JUMPFOOD study: additional effect of hydrolyzed collagen and vitamin C to exercise treatment for patellar tendinopathy (jumper’s knee) in athletes—study protocol for a double-blind randomized controlled trial here

Specific Collagen Peptides Improve Bone Mineral Density and Bone Markers in Postmenopausal Women—A Randomized Controlled Study here

How collagen could help heal your torn rotator cuff, Achilles tendon, meniscus and more here

The effects of collagen peptide supplementation on body composition, collagen synthesis, and recovery from joint injury and exercise: a systematic review here

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Here we go again with the bombardment of “New Year, New You” ads and messages to “eat this, not that,” or “do this specific workout for 30 days to get amazing abs.” You know the drill and they’re probably in your feed as we speak. 

In this first-of-its kind episode, Feisty Media podcast hosts Kathryn Taylor (Girls Gone Gravel), Sara Gross (Women’s Performance Podcast), Kelly O’Mara (If We Were Riding), and Selene Yeager (Hit Play Not Pause) unite for a candid conversation about these societal pressures of New Year's resolutions and the pitfalls of Fitness Challenges within women’s fitness culture.

Building positive new habits isn’t a bad thing, but the problem is that most of the challenges, diets, and cleanses often lead to underfueling, which can sabotage your goals as an active woman.

Sharing their own personal experiences with diet culture and disordered eating, Kathryn, Sara, Selene, and Kelly advocate for more self-acceptance and celebrating what the body can achieve, emphasizing overall health over aesthetics. Quite simply - they want you to be fueled for your 2025 goals. 

That’s why we’re launching the Feisty Fueled Challenge in January to foster healthier food and fitness dialogues. This FREE five day challenge will help you dive deeper into some of the internalized messages that we all struggle with, and feel empowered to make smart and mindful decisions about how to fuel in 2025.

Starting January 6th, you’ll receive daily emails from leading fueling & mindset experts that will reframe your mindset around fueling and cover some practical ways to fuel your 2025 goals.

With just 10 minutes each day, you’ll be ready to be your best feisty, fueled self in 2025 and redefine health and fitness on your own terms. 

To sign up for the FREE Feisty Fueled Challenge: 

https://www.womensperformance.com/fueled-challenge 

The conversation around hormone therapy for menopausal symptoms is pretty clear. Hormone therapy is the gold standard for treating hot flashes and night sweats and can help with many other common symptoms that come with the menopause transition. It’s very effective and broadly safe. But recently, the conversation has evolved past symptom management and into preventative health with many experts suggesting that hormone therapy may play a larger role in extending a woman’s healthspan, if not lifespan. That maybe we should all start taking hormones to protect our hearts and cognitive health. And there’s promising research in those areas. Yet none of the medical associations recommend hormones for those purposes. Why? That’s what we dig into this week with Professor Susan Davis, AO, who is a pioneer and leading expert in women's health as a clinical endocrinologist, researcher, and educator. She reflects on her decades of research on various forms of hormone therapy and shares what we know–and still don’t know–today regarding traditional hormone therapy as well as testosterone therapy for women’s health post menopause.

Professor Susan R Davis AO, MBBS, FRACP, PhD, FAHMS is a clinician researcher with expertise in the role of sex hormones in women across the lifespan. She is Head of the Monash University Women’s Health Research Program and holds a Level 3 NHMRC Investigator Grant. Susan is a Consultant Endocrinologist and Head of the Women’s Endocrine Clinic, Alfred Hospital Melbourne and a consultant at Cabrini Medical Centre. She is a Fellow and Council Member of the Australian Academy of Health and Medical Sciences. She is a past President of the Australasian Menopause Society and the International Menopause Society. She has over 435 peer-reviewed publications and has received numerous national and international prestigious research awards. Susan was appointed an Officer of the Order of Australia for distinguished service to medicine, to women's health as a clinical endocrinologist and researcher, and to medical education. You can learn more about her and her work at Monash University.

Resources

2023 Practitioner’s Toolkit for Managing Menopause here

Menopausal Hormone Therapy and Cardiovascular Disease: The Role of Formulation, Dose, and Route of Delivery here

Use of MHT in women with cardiovascular disease: a systematic review and meta-analysis here

Studying Studies: Part I – relative risk vs. absolute risk by Peter Attia, MD, here

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A healthy lifestyle doesn’t mean you won’t suffer during peri or postmenopause. Many women are led to believe that if they exercise, eat healthy, and practice all the right lifestyle habits that menopause won’t really affect them. Nothing could be further from the truth. Even if you’re doing “everything right” you can still be blindsided by hot flashes, sleepless nights, joint pain, mood swings and/or other symptoms, and if you are, pharmaceutical tools like hormone therapy are there for you. That’s the message that award-winning lifestyle medicine physician Dr. Laurie Marbas–who was in that very position herself–wants all women to know. This week, we talk about her journey and how women can use both lifestyle and conventional medicine to feel and perform their best through perimenopause and beyond.

Laurie Marbas, MD, MBA, is a menopause-certified practitioner and double board-certified family medicine and lifestyle medicine physician who has been utilizing food as medicine since 2012. She holds medical licenses in all 50 states and Washington, D.C., and operates a concierge practice at drmarbas.com. You can join her free webinar, Master Menopause and Feel Fabulous, where she shares her exclusive 5-step blueprint to thrive during this transformative stage of life at drmarbas.lpages.co/menopause. She is also the co-founder of The Healing Kitchen with Brittany Jaroudi, blending culinary expertise with medical guidance to create a recipe for health. A veteran of the United States Air Force, Laurie served in the Middle East and South America. She is also a wife, mother of three grown children, author, speaker, and an avid hiker and runner, dedicated to inspiring health and vitality through lifestyle medicine. 

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If you’ve ever felt stiff and stuck like the Tin Man in the Wizard of Oz after being left out in the rain; have tight, sore knots that restrict your mobility, or have battled issues like frozen shoulder, this show is for you. We’re learning all about fascia–the unsung connective tissue that holds our muscles in place, facilitates healthy, dynamic movement, and transfers energy throughout the body. When it gets stuck–which it's more likely to do during peri and postmenopause–we do, too. This week’s guest, performance physical therapist Nicole Armbrust, guides us through a special presentation on fascial health and mobility so we can feel and play our best, injury and pain free for life. (As a bonus, Nicole gives a visual presentation, which you can watch on our Feisty Menopause YouTube channel.)

Nicole Armbrust is a performance physical therapist with 24 years of experience, a masters runner with 17 Boston Marathon finishes, and a UESCA certified running coach. She also has completed a Fellowship in Applied Functional Science (FAFS) through the Gray Institute. While years of clinical practice and patient care gave her vast experience, Nicole is pivoting her business/expertise away from “traditional PT” and into coaching, courses, and speaking engagements using a hybrid model of in-person and online offerings. You can find her on www.jumpstartrunning.com and Instagram under the same name. 

Resources

Jumpstart Running Mobility Video Playlist

The musculoskeletal syndrome of menopause review article 

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