Joué
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We’ve been led to believe weight is a simple equation: energy in versus energy out, which implies it’s all in our control. We’re in charge. We just need the right diet, exercise, and willpower. And while nutrition and physical activity matter a lot, and some maintain their weight through those means, others feel like their bodies have a mind of their own, which is actually true, as this week’s guest, obesity medicine scientist, educator, and policy maker Dr. Fatima Cody Stanford explains. That’s because the central nervous system, which is governed by the brain, ultimately regulates weight. We dive deep into all the factors that influence how much fat we store, where menopause comes in, and what having a healthy weight really means. It’s all a whole lot more complicated than we’ve been led to believe.
Fatima Cody Stanford, MD, MPH, MPA, FAAP, FACP, FTOS is an obesity medicine physician scientist, educator, and policy maker at Massachusetts General Hospital and Harvard Medical School. She is a national and international sought-after expert in obesity medicine who bridges the intersection of medicine, public health, policy, and disparities. In 2022, The National Academy of Medicine named her a Scholar in Diagnostic Excellence. You can learn more about her and her work at harvard.edu/faculty-staff/fatima-cody-stanford
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We’re back! And we’re kicking off the New Year with the perfect introspective conversation with former pro athlete turned entrepreneur and life adventurer, Nicole DeBoom. Nicole recently turned 50 and is in the thick of perimenopause, which for her has manifested in brain fog, night sweats, body composition changes, and more. She’s also recently had spinal fusion for spondylolisthesis, a spinal condition that causes instability and slips in the vertebrae in the spinal column, which is as awful as it sounds, all while navigating her perimenopause journey. We have a deep, wide-sweeping conversation about all of it, including her internal debate about hormone therapy, how our identities evolve during this time of life, and much more.
A world-class swimmer as a teen, Nicole turned pro as a triathlete in 1999 and won Ironman Wisconsin in 2004 wearing a prototype of the first-ever running skirt. Three days later she incorporated Skirt Sports Inc, which she sold in 2020 before launching her new company Aesop, where she records interviews with people to create audio memories for loved ones. She also has a podcast, including a menopause series, called Run This World. You can learn more about her, her enterprises, and her life’s journey at www.nicoledeboom.com
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Dr. Google is often our first stop when we want to understand a symptom we’re experiencing and find out what we can do about it. But the internet is a bottomless well of information–and disinformation. Even when we dig into actual research studies, the conclusions aren’t always reliable or consistent, which is why it’s hard to get a straight answer on complex issues like hormone therapy. It can be frustrating and confusing, but there are ways you can evaluate the information you find to determine how much confidence to put into any given conclusion, which is where this week’s guest biostatistician Leslie McClure, PhD, comes in. Leslie explains how to do your own research and how to assess the information you find, including what makes a good study, causation versus correlation, features of information you can trust, and much more. Leslie also talks about her own menopause experience, which started when she was 39 and has continued for 9 years and how it has impacted her own training and fitness.
Leslie is the Chair of the Department of Epidemiology and Biostatistics at Drexel University's Dornsife School of Public Health, where she works with other scientists to help them better formulate, design, analyze, and present their science. She is currently the Director of the Coordinating Center for the Diabetes LEAD Network, and the Director of the Data Coordinating Center for the Connecting the Dots: Autism Center of Excellence. Dr. McClure is a Fellow of the American Statistical Association, the Society for Clinical Trials, and of the American Heart Association.
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At age 42, off-road triathlete Deanna McCurdy was crushing it, including clocking the fastest female amateur time at XTERRA National Championships, and was ready to turn pro when—perimenopause. Out of the blue, her performance tanked and she found herself in tears through a key race. Deanna, who’s also a mom of a special needs daughter, was forced to rest, research, reset, and make some training and lifestyle changes. It worked and she roared back to racing as a pro by age 45, winning XTERRA Fruita and getting second at XTERRA Quebec. But those ups were followed by more hormonally-driven downs, as she became plagued by symptoms including aches and injuries, sleepless nights, and headaches earlier this year as she was preparing for Breck Epic, a six-day mountain bike stage race. With the help of hormone therapy, she got back on track and crushed the race. This week she shares that journey and how, though the path is still rocky, and training isn’t perfect, she has found the tools she needs to navigate this challenging time.
Deanna McCurdy is a USAT Level I and USAC Level II certified coach. She is also the founder and head coach of Team Miles for Smiles-Wings to Fly Racing. Miles for Smiles is a training team created to help raise funds for the Foundation for Angelman Syndrome Therapeutics (F.A.S.T.), a not-for-profit whose sole purpose is to fund research, and ultimately a cure for, Angelman Syndrome (AS). USA Triathlon awarded Deanna Off-road Triathlete of the Year honors in 2017, 2018, and 2021. You can learn more about her and F.A.S.T. at cureangelman.org/fast-athletes and her USA Triathlon blog.
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Women have been taught incontinence is our destiny–that we should just accept it and wear pads. Pelvic floor issues like prolapse are often normalized–we should just stop running, jumping, and lifting heavy sh*t. This week’s guest The Vagina Coach, Kim Vopni, is having none of it, and she dives into all the therapies and tools available to help remedy prolapse, incontinence, and other pelvic floor issues so you can continue doing the activities you love. And she should know, Kim has dealt with her share of pelvic floor issues, including experiencing a stage 2 uterine prolapse, which she ultimately resolved through a series of special pelvic floor exercises.
Kim is the founder of Pelvienne Wellness Inc - a company offering pelvic health programs, products, and coaching for women in pregnancy, motherhood, and menopause. Kim also certifies other fitness and movement professionals to work with women with core and pelvic floor challenges through her Core Confidence Specialist Certification and Pre/Postnatal Fitness Specialist Certification. She is the author of the best selling book, Your Pelvic Floor. She also runs Buff Muff Challenges to help women learn and get in the habit of training their pelvic floor. You can find her on-line at www.vaginacoach.com and on social media @vaginacoach.
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Ultrarunner Kamm Prongay is clear: she did not sign up for the Menopause 200. Her ovaries did. And when they did, she eventually found herself on the start line, unable to run. Kamm has been chronicling her journey through menopause in a series of essays in Ultrarunner.com, including one titled the Menopause 200, in which she shares her anxiety, brain fog, drenching night sweats, and ultimately performance decline and lack of drive to do the sport she loved. And this week, she shares that journey with us, as well as how she turned it around to regain her mojo, tame her symptoms, and get back on the trails.
Kamm Prongay is a writer, ultrarunner, and veterinarian whose essays intertwine science, nature, people, and place. A child of the South, raised in the Pacific Northwest, Kamm spent time at sea as a Naval Surface Warfare Officer before coming ashore to pursue veterinary school, clinical practice, teaching, and research. She has contributed to four books, along with essays published in scientific journals and UltraRunning magazine. When not running or supporting trail races, Kamm lives with her wife, Liz, and two curious cats in Portland, Oregon.
Resources
The Menopause 200, and Kamm’s other essays at ultrarunning.com
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More than diet, exercise, the money in your bank account, your cholesterol levels, or even your genes, it’s your relationships that matter most when it comes to being happier and healthier in midlife and into old age. That’s important because midlife and menopause are inextricably intertwined, and how we experience one impacts how we experience the other. We dig into all of that and so much more with this week’s guest, gerontologist Zora Benhamou, who encourages women in midlife to find positive, nurturing people–their menopause five, if you will–to share their journey through menopause and beyond.
Zora is a gerontologist passionate about aging and longevity. She is on a mission to disrupt ageist stereotypes in social media and is host of the Hack My Age podcast and the website HackMyAge.com focusing on biohacking for women over 50. She is the author of the Longevity Master Plan and the Eating For Longevity cookbook. Zora is also a certified sports nutrition coach and an Oxygen Advantage Advanced Breathwork Instructor. She is a digital nomad who has traveled to over 50 countries, has lived in 8, and speaks 6 languages. You can learn more about her and her work at https://hackmyage.com/
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Research links:
Harvard article on the Study of Adult Development
Adult Development Study website
Social Isolation and Loneliness In Older People Pose Health Risks
Human Development In The Second Half Of Life - Gene Cohen
Demography of Menopause
Menopause - Related Symptoms and Influencing Factors in Mosuo, Yi and Han Middle-Aged Women in China
Menopause in Cultural Context
Perception of Menopause Among Women of Sarawak, Malaysia
Menopause Is A Natural Stage of Aging : A Qualitative Study
Premature Menopause...
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Since we started this podcast, many women have gone from being afraid to take hormone therapy to being afraid not to take hormone therapy, as some in the menopause field are saying that menopause is really a “hormone deficiency” and we can’t age well without it. This week we dive in on what hormone therapy is; what it can do (especially for performance and health); what it can’t do, and what we’re still learning about all of it with Dr. Carla DiGirolamo.
Carla 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 runs an online personal training and nutrition coaching business, FitforLifeMD, specializing in the care of women in all age groups, but with a special interest in the comprehensive care of peri/postmenopausal women. She also writes a regular blog on Athletic Aging. Carla has the distinction of being the only repeat (and now threepeat!) guest on Hit Play Not Pause.
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The good news: we are finally talking about menopause! The not so good news: we still have a long way to go, especially in the realm of research, says this week’s guest Dr. Stephanie Faubion, who is on the tip of the spear leading the way forward as the Medical Director of The North American Menopause Society (NAMS). When it comes to dealing with menopause openly in our culture, especially in the workplace, Dr. Faubion believes we are where we were with pregnancy 30 years ago. And she has some ideas on how we can all help accelerate progress and bring our doctors and culture up to speed.
Along with her role as Medical Director of NAMS, Dr. Faubion is Professor and Chair of the Department of Medicine at Mayo Clinic in Jacksonville, Florida, and Director of the Mayo Clinic Center for Women’s Health. Her expertise is in women’s health, clinical research, education, and clinical practice. You can learn more about her and her work at mayo.edu.
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Want to challenge yourself without the pressure that comes with traditional competition? Feel like trying something new that won’t have you comparing your former self to your current self? This week’s guests Teri Smith and Dana Katz suggest trying an FKT, or fastest known time, a challenge where you run, hike, or in some cases bike or “multi-sport” along a route as quickly as you can to try and set an FKT. When perimenopause upended Teri’s competitive identity as an ultrarunner, her friend Dana coached her to complete an FKT—nearly 190 miles of traversing the Olympic Peninsula of Washington—and it transformed her life, as you’ll hear in her own words in this week’s show.
Dana is the owner and coach at UltraU in Portland and also coaches with Women who FKT. Teri is an avid backpacker, trail runner, cross country skier, and mom. They are both part of the Women Who FKT Project, a group of women who are on a mission to help more women and underserved minorities have meaningful adventures in the outdoors. You can learn more about them and their work at Women Who FKT.
Resources
Fastest Known Time Official Website
Women who FKT Instagram
Teri Smith and Stacey Lee’s FKT story
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Nothing stops you in your tracks like chronic pain and nagging, seemingly endless injuries, both of which can become more common during the menopause transition and beyond. The sports medicine world is brimming with cutting-edge, regenerative medicine treatments promising relief, but it can be hard to cut through the marketing jargon to figure out what really works. This week we sat down with sports medicine-certified orthopedic surgeon Dr. Vonda Wright of the Hughston Clinic for detailed explanations of TenJet rehabilitation, platelet-rich plasma (PRP), stem cells, orthobiologic injections, and other regenerative medicine treatments, as well as the impact of diet and lifestyle on joint health.
Dr. Wright is a double board-certified orthopedic surgeon, researcher, and team doctor. Her pioneering research in mobility and musculoskeletal aging is changing the way we view and treat the aging process, and her passion for advancing her field is evident in her expertise with cutting-edge orthobiologics techniques, including PRP for arthritis. She has experience caring for athletes and active people of all ages and skill levels, including the Division I Georgia State Panthers, Penguins Elite developmental hockey teams, University of Pittsburgh Division I athletes, World Rugby 7’s, Olympic track and field athletes, and the Atlanta Ballet. You can learn more about her and her work at https://www.surgeon.drvondawright.com/
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Body image issues. Wrecked sleep. Struggling with slowing down. Midlife and menopause can send us into some seriously turbulent waters. This week’s guest, Lisa Alfano, manages to keep from going under by riding the waves–literally. Lisa is a surfer and triathlete who has married her passions in her business Tri2Surf, a community for women ages 50+ who want to reset or discover their active selves and claim their power and passion.
Lisa has battled body image issues her whole life. Menopause and midlife magnified them, and also ushered in poor sleep, anxiety, hot flashes, and a host of symptoms that were pulling her under and threatening to upend her sense of self. At age 50, she found salvation in triathlon, which gave her a sense of community and turned her life around. At age 57, she gave herself another midlife boost by taking up surfing, which she says brings her “joy and peace no matter what is happening.” We talk all about surfing, triathlon, and finding passion in menopause and beyond. You can learn more about Lisa and Tri2Surf at https://www.tri2surf.com/
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Eat less. How many times have you seen and heard that message? As a generation that grew up steeped in diet culture, most of us have it deeply internalized…often to our detriment. Underfueling among active women is extremely common and puts us at risk for low energy availability (LEA), which can lead to relative energy deficiency in sport (RED-S), a condition that not only hurts performance, but also can cause irreparable negative health consequences. LEA/RED-S can be especially difficult to spot in midlife women because the symptoms mirror those we experience during perimenopause. We dig into all of it this week to help you avoid LEA/RED-S and get the fuel you need to feel and perform your best with Heidi Skolnik, MS, CDN, FACSM of Nutrition Conditioning, LLC, and author of The Athlete Triad Playbook.
Heidi is a sports nutritionist, exercise physiologist, and thought leader in her field. She has been part of The Women’s Sports Medicine Center at Hospital for Special Surgery for over 20 years and oversees the nutrition program at The Juilliard School and the School of American Ballet. Heidi has sat on the Board of The National Osteoporosis Foundation for ten years and currently sits on the Medical Advisory Committee of The National Menopause Foundation. She is also the co-author of the NYTimes Best Selling The Whole Body Reset (Simon & Schuster and AARP). You can learn more about her and her work at heidiskolnik.com
Resources:
https://athletetriadplaybook.com/
https://www.frontiersin.org/articles/10.3389/fnut.2021.640621/full
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Need glasses for the first time in your life? Contacts suddenly feel too tight? Are your eyes dry and itchy? Menopause and midlife can usher in a cascade of vision and eye health changes. Thankfully there are many ways you can sharpen your sight and keep your eyes healthy (and more comfortable!). We dig into all that and more with this week’s guest, Christine Begley, OD.
Christine is an optometrist with Marion Eye Center in Carbondale, Illinois. She’s been treating eyes for more than 20 years and specializes in diagnosing, treating, and managing diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identifying related systemic conditions affecting the eye. She’s also a longtime listener of the show and wants to help us keep our eyes healthy and functioning well so we can keep enjoying our active pursuits.
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Listen in as we share about the current season we are in and how to find gratitude in the midst of loss. Sally also shares a powerful story from her teenage years that will encourage you to be grateful in the middle of a confusing and/or difficult time.
As always, thank you for listening!
Other episode highlights:
- It's all about the people!
- CS listener highlights
- Making a house a home
- The angel ornament left behind
- Reminding yourself of the Good Stories when the present gets tough
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This returning guest needs no introduction, but we will honor her with one. Today I'm joined by Sally McRae for another deep conversation, which is common for us, about the unglamorous aspects of growth, resilience, and character-building. We discuss the vital role of patience, the misconception of overnight success, and the importance of navigating through difficult seasons.
Sally and I share personal anecdotes from our toughest times, emphasizing the power of focusing on foundational habits and the often lonely, mundane work that leads to true greatness. This episode is absolutely packed with motivational insights and thoughtful reflections on life, perseverance, and enduring hardships with a warrior spirit.
Chapters
00:00 Intro
01:20 Catching Up with Sally
02:56 The Value of True Friendship
05:02 Overcoming Challenges in Racing
08:27 Navigating Life's Toughest Seasons
17:27 Balancing Ambition and Relationships
23:34 Finding Purpose and Peace
50:18 Struggles in Marriage and Personal Growth
51:00 Embracing Physical and Mental Strength
51:56 The Hardest Seasons: Relationships and Family
56:33 The Power of Solving Problems
01:00:03 Distractions and Focus in Life
01:17:45 The Importance of Foundational Principles
01:27:54 Reflections on Personal Journey and Purpose
01:33:38 Conclusion and Final Thoughts
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October is breast cancer awareness month, an annual campaign to raise awareness about the impact of breast cancer. That’s especially important for women in the menopause transition and beyond because the risk of breast cancer rises with age. Most breast cancers are found in women who are 55 and older. This week we sat down with marathon runner and breast oncologist Amy Comander, MD, at the Massachusetts General Hospital Cancer Center to discuss how we can manage our risks no matter our family history, genetic makeup, or time of life.
Dr. Comander is Director of Breast Oncology and Cancer Survivorship at the Mass General Cancer Center in Waltham and at Newton Wellesley Hospital. She is Medical Director of the Mass General Cancer Center in Waltham and the Director of Lifestyle Medicine at the Mass General Cancer Center. She is an Instructor in Medicine at Harvard Medical School. She is board certified in Hematology and Medical Oncology, and she is also board certified in Lifestyle Medicine.
Resources
Katie Couric’s article on her breast cancer.
Research on exercise and breast cancer survival.
Breast cancer risk calculator
Link to the PAVING workbook
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The good news: we are finally talking about menopause! The not so good news: we still have a long way to go, especially in the realm of research, says this week’s guest Dr. Stephanie Faubion, who is on the tip of the spear leading the way forward as the Medical Director of The North American Menopause Society (NAMS). When it comes to dealing with menopause openly in our culture, especially in the workplace, Dr. Faubion believes we are where we were with pregnancy 30 years ago. And she has some ideas on how we can all help accelerate progress and bring our doctors and culture up to speed.
Along with her role as Medical Director of NAMS, Dr. Faubion is Professor and Chair of the Department of Medicine at Mayo Clinic in Jacksonville, Florida, and Director of the Mayo Clinic Center for Women’s Health. Her expertise is in women’s health, clinical research, education, and clinical practice. You can learn more about her and her work at mayo.edu.
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How do you know if menopausal hormone therapy (MHT) is for you? What should you expect if you start hormone therapy? How long does it take to work? What should you do if you don’t feel like it’s working? We dive into the ABCs of starting MHT this week with menopause doctor Heather Hirsch, MD. This is a good one for active menopausal women whether or not you are taking or plan to start MHT because we speak to all the things we should be doing, such as taking inventory of how we’re feeling and being proactive about our care, to feel and perform our best.
Dr. Hirsch is board certified in internal medicine and completed advanced fellowship training in women’s health at the Cleveland Clinic. She performs menopause consultations at the Brigham and Women’s Hospital in Boston Massachusetts and is faculty at Harvard Medical School. Her practice has a focus on perimenopause and menopause symptom reduction, hormone therapy, genitourinary syndrome of menopause, sexual health, breast, and bone health. Her academic work centers on enhancing midlife women’s health education for fellows, residents, and medical students. Dr. Hirsch also teaches at the local, regional, and national level on various midlife topics. You can learn more about her and her work at www.heatherhirschmd.com/
Support our Partners:
Lagoon Sleep: Go to LagoonSleep.com/hitplay and use the code HITPLAY to get $25 off any pillow between now and December 2, 2024.
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We are celebrating our 100th episode…and the fact that we have surpassed one million downloads in just two years’ time! Our community is growing by leaps and bounds and you’re the reason why. So this week, we are also celebrating YOU!
Host Selene Yeager sits down with Hit Play Not Pause producer Carrie Barrett to share listener messages, talk about what we’ve learned, our hopes for the future, and to give you a little peek behind the curtain on how this show comes together week after week. We hope you enjoy it! Let’s shoot for another 100 and millions more!
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Nutrisense: Go to nutrisense.io/hitplay and book a call with a Registered Dietitian
Previnex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/
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