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

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/

Join the Feisty Strong Barbell Club: https://feisty.co/strong-club/

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% off

Previnex: 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