Are you burned out? Or just in a rough patch? Is it perimenopause, depression, or some messy mix of well, everything? In this episode, we’re joined by sports psychologist and endurance athlete Dr. Erin Ayala to unpack athletic burnout in midlife women—what it is, how it shows up, how it overlaps with perimenopause and mood changes, and how to tell it apart from being overreached, under-fueled, or just end-of-season tired. Erin also serves up some practical advice for what to do when every workout feels like a slog, how to talk to your coach, why rest, recovery, and carbs matter more than ever, and how to build a support team that actually communicates. We also dig into the grief of changing performance and body composition in midlife—and how to pivot without losing your identity as an athlete.

Erin Ayala, PhD, LP, CMPC is a Licensed Psychologist and Certified Mental Performance Consultant (CMPC) offering virtual mental health therapy for athletes aged 14 and above. She provides one-on-one performance coaching, CMPC mentorship, clinical supervision, and group workshops for teams and sport organizations. She supports athletes in injury recovery, managing performance anxiety, depression, pre-competition stress, confidence, and self-criticism. Located in Minnesota, she is licensed to work with athletes in 40 states. You can learn more about Dr. Ayala and her work at www.skadisportpsychology.com

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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.

Resources

Athletic Aging with Dr. Carla DiGirolamo on Substack

For a full list of articles referred to in this episode, head to this link

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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.

Resources

Brick House Bones with Dr. Lisa Moore, DPT, here

High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial, here

Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women, here

Skeletal site-specific effects of jump training on bone mineral density in adults: a systematic review and meta-analysis, here

Weighted Vests in Midlife: Hype? Help? Harm?, here

FRAX fracture risk calculator 

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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/

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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-Pedia

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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)

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We asked for your big questions on hormone therapy–and an avalanche ensued! This week, after 5+ years of Hit Play Not Pause, we’re doing a level set on hormone therapy. This week’s guest, nationally-recognized menopause expert Lauren Streicher, MD, digs into hormone therapy research, what it tells us and what it doesn't, why formulations matter, perimenopause versus postmenopause therapy, the cardiovascular implications of hot flashes, why hormone therapy needs to be personalized, and how every woman should approach her own care. 

Lauren Streicher, MD is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine and the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause. Dr. Streicher is a Certified Menopause Practitioner of The Menopause Society, serves on the Editorial Board of the journal Menopause, and is a Senior Research Fellow for the Kinsey Institute, Indiana University. She is a Fellow in the American College of Obstetricians and Gynecologists and The International Society for the Study of Women’s Sexual Health. She is also a best-selling author and the host of two podcasts. 

Resources:

Dr. Streicher’s Substack: Menopause: The Inside Info

Learn more about her and her work at www.drstreicher.com

Podcasts:

Menopause, Midlife and More Podcast. 

COME AGAIN Sexuality and Orgasm

Books:

The Essential Guide to Hysterectomy

Sex Rx: Hormones, Health, and Your Best Sex Ever. 

Slip Sliding Away: Turning Back the Clock on Your Vagina 

Hot Flash Hell: A Gynecologist’s Guide to Turning Down the Heat

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At 46, professional off-road cyclist and coach Serena Bishop Gordon has redefined what she thought was possible—physically, mentally, and emotionally. From second place at this year’s Unbound XL (360 miles in 22:19:56 hours) to multiple podiums at Oregon Trail Gravel Grinder, Serena shares how she’s learned to let go of limits, release outcomes, and lean into curiosity. We dive into the mental shift that unlocked her best performances, how underfueling can mimic perimenopause, and all the ways midlife women can get faster and go longer than they ever thought possible. She also breaks down what women can expect during Feisty’s Winter Training for Cyclists 16-week program she’s coaching starting this December. 

Serena Bishop Gordon is a professional off-road cyclist, coach, and community builder with more than a decade of racing at the elite level. She’s delivered standout results at Unbound XL, Oregon Trail Gravel, Cape Epic, Breck Epic, and international UCI cyclocross. Her strengths lie in technical terrain, strategic pacing, and mental toughness—skills honed over thousands of miles and many seasons. Serena founded Special Blend Gravel, a coaching and community-building organization that uplifts women through camps, coaching, and inclusive community, guided by a “person first, athlete second” philosophy that centers joy, balance, and connection. She lives in Bend, Oregon, with her husband, Ben, and their dog, Piper—and believes that with strong coffee and a strong community, she can navigate just about any challenge. You can learn more about her and her coaching at www.serenabishopgordon.com

Resources:

Sign up for Winter Training for Cyclists here

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When amateur boxer Jessica D'Abrosca entered perimenopause, she didn’t know what hit her. The exhaustion. The night sweats. The joint pain. She felt like she was unraveling. Then she found our community and studied up on this new opponent perimenopause and its hormonal haymakers and learned how she could fight back with training, diet, and lifestyle adjustments. Today, she’s still in the ring. This week we talk all about her history as an athlete and trainer, what happened when she hit the menopause transition and the adjustments she made, the benefits of doing hard things, and what it’s like to take (and give) some punches as a midlife woman.

Jessica D'Abrosca is a NASM Certified Personal Trainer, Corrective Exercise Specialist, and a GYMR Mindset Coach, with over 20 years of experience in the fitness industry. Her journey began in Rhode Island as a young gymnastics coach, where a string of injuries ended her own competitive career—but sparked her passion for helping others succeed. Since then, Jessica has worked with athletes of all ages and abilities across a wide range of sports, from recreational youth programs to adult group training and 1:1 coaching. Her athletic experience spans the spectrum from triathlons, road racing, and martial arts, where she holds her 1st and 2nd degree black belts. Now in her 40s, Jessica is still chasing new challenges—recently stepping into the ring for her first two Masters boxing bouts. You can check out On the Ropes Boxing & Fitness here.

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We’re told stress (looking at you cortisol) is the enemy in midlife—but that’s too simple. In the right dose (and with real recovery), stress is good medicine that builds resilience and makes us stronger, in sport, at work, and in life. In this episode, we dive into the “stress that helps” with Dr. Sharon Horesh Bergquist—physician, researcher, and author of The Stress Paradox. We break down hormesis (the just-enough stress plus recovery cycle), how the right doses of stress in the form of training, plant phytochemicals, hot/cold exposure, and smart time-restricted eating activates cellular defense pathways that ultimately rebuild us to be stronger right down to our DNA. We also dive into how to stack stressors without tipping into overload, which is key for active midlife women, so we can live longer, healthier, and happier lives.

Sharon Bergquist, MD, is a board-certified physician, researcher, and pioneer in lifestyle medicine. She has led $61M in clinical trials on lifestyle interventions and early biomarkers of chronic disease. Her book, The Stress Paradox: Why You Need Stress to Live Longer, Healthier, and Happier (HarperCollins, Mar 2025), unpacks how daily habits activate the body’s regenerative systems. An Emory University faculty physician since 2000, she earned a B.S. in molecular biophysics and biochemistry from Yale, an M.D. from Harvard, and trained in internal medicine at Brigham & Women’s. Her TED-Ed lesson has 8M+ views, and she’s been featured by Good Morning America, CNN, ABC News, The Wall Street Journal, and NPR. You can learn more about her and her work and sign up for her newsletter at drsharonbergquist.com

Resources:

The Stress Paradox book: drsharonbergquist.com/the-stress-paradox

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