The Most Kick Ass Menopause Performance Tips from 2022

Here are the golden nuggets of wisdom from nearly 50 episodes of Hit Play Not Pause this year.

By Selene Yeager

It’s that time of year when we look back at what we’ve learned over the past 12 months and look forward to how we’ll apply that wisdom in the year ahead. And this past year of Hit Play Not Pause was jam-packed with wisdom we all can use as active menopausal women.

So, I perused the past 50 episodes and pulled out some common themes that can help us optimize our health and performance in 2023. In no particular order, here they are:

Make and Maintain Your Muscle

If you haven’t started strength training yet, make 2023 the year you do. Guests from researchers to doctors to athletes unanimously agree, muscle is essential not just for physical performance, but also quality of life and good health through menopause and beyond. Higher muscle mass levels improve your odds of both vitality and longevity, lower your risk for heart disease, and are negatively associated with vasomotor symptoms like hot flashes and night sweats. It’s also good for your brain. As neurophysiologist Louisa Nicola explained during episode 87 Better Brain Health, 80 percent of your brain’s gray matter is modifiable by physical activity. She also told us about new research showing that when you strength train you get a rapid release of the hormone irisin, which is so powerful for brain health, research suggests it could be an effective therapy for treating deficits in the brain that occur from Alzheimer’s disease. Put strength training on the top of your resolutions list.

Stay Curious

The menopause transition can rattle your performance and athletic identity. During patches where you’re just not feeling the joy for your current sport or activity, it can help to get curious and explore other outlets for your athletic expression. Adina O’Neill shared how helpful this mindset has been for her as she’s navigating the challenges of menopause and midlife: “With my hormones going crazy and emotions off the charts as my son starts college and teenage daughter is navigating through her own hormones, I’ve gained weight and slowed down in a lot of ways. After months of crying, I tried estrogen and so wanted it to help, but it didn’t really do anything for me. Soooo…I changed my perspective. I’m embracing where I am and celebrating anything and everything I can do that feels good. I have been using my extra insulation to explore cold water swimming and even climbed up to dive off the ice…What a rush! I guess my point is: be patient with yourself, love who you are right now, and don’t wait until you figure this stage of life out to do something that lights your heart on fire." There’s no way I could say that any better.

Treat Mobility Like Preventative Medicine

Most of us, even if we’re very active, are not moving our bodies the way nature designed them to move. We might exercise plenty, but we generally also sit plenty. Or we move in a limited range of motions as we run, bike, or even lift, but don’t regularly take our joints through their full movement capacity. That can set the stage for aches, pains, and injuries, especially during this time of life when our joints are more vulnerable.

Poor ankle mobility, for instance, can impair your ability to flex and extend your foot, which can hinder your running form and lead to strains and injuries like Achilles tendonitis and shin splints. It also makes it hard to perform a squat with the proper distribution of weight on your forefoot, causing you to compensate by rounding your back or pushing your shoulders too far forward to get the weight where you need it to be, increasing your risk for injury. And that’s just your ankles! Treat your mobility practice like preventative medicine and you’ll not only avoid injuries, but also optimize your performance because you’ll be able to fully access the strength and power in all your muscles. Mobility is most effective when done regularly. 2022 podcast guests Dr. Julie Angel and Petra Fisher both offer excellent programs for active menopausal women.

Eat to Stay Healthy...and Heal

Eating enough was a big theme in 2022 and one we should carry into 2023. As Dr. Vonda Wright told us in episode 105 Healthy Pain-free Joints Through Menopause. How Regenerative Medicine Can Help, “You will never heal unless you’re eating enough protein.” Ideally, that’s about 30 grams per meal and 15 to 20 grams per snack spread throughout the day to support your training and maintain healthy muscle mass. You also need carbs to fuel your activity and prevent low energy availability. As Heidi Skolnik, CDN, said in episode 103 Less Fuel, More Problems. Why Menopausal Athletes Need to Eat More, most athletes need 5 to 8 grams per kilogram of body weight. “But you may even need upwards of 10 grams per kilogram depending on your sport.” Nailing your carbs, especially your complex carbs, will also help you achieve your fiber needs, which go up to 30 grams a day during menopause, explained Dr. Kathleen Connell during episode 82 Vaginas, Vulvas, and Pelvic Organ Prolapse. Fiber is a heavy hitter when it comes to preventing constipation, keeping your pelvic floor healthy, and preventing a host of diseases including heart disease, diabetes, and cancer.

Foster Your Relationships

More than diet, exercise, genes, and the money in your checking account, having strong, positive relationships keep you healthier and happier, explained gerontologist Zora Benhamou in episode 107 Find Your Menopause Five-The Power of Human Connection in Menopause. “People's level of satisfaction with their relationships at age 50 was a better predictor of physical health than their cholesterol levels were. Those people who are most happy in their relationships at 50, were the healthiest at age 80.”

Prioritize Your Pelvic Floor

A lot of women accept [urinary] pads as their destiny, explained the Vagina Coach, Kim Vopni during episode 109 Get a Buff Muff with the Vagina Coach. “Then they get to menopause and have really strong urges or complete loss of their bladder and realize they can’t live with it. Women wait on average 6 ½ to 7 years to address these problems. A man would probably wait 6.5 seconds if something was wrong with his penis.” Amen to that. For far too long it has been considered normal and women were to just accept that they would have to wear pads, stop doing the activities they love, and just live with it. That’s not true. You don’t have to suffer. You can exercise and do the things you love. There are many therapies and tools available to help remedy prolapse, incontinence, and other pelvic floor issues. A pelvic floor therapist can help. If there are none in your area, working through therapies online with an expert like Vopni at vaginacoach.com is a great place to start. 

Be Open-Minded on Hormone Therapy

There’s a lot of polarized thinking around hormone therapy. Some experts promote it as the first line of preventive care. Others maintain that it should be a last resort. Women are left in the middle wondering what to do. Numerous 2022 guests told me they “broke down” and went on hormone therapy as if it were a personal failing. I’d love to see hormone therapy be considered just another tool in a menopausal woman’s toolkit in 2023, and not necessarily the last one she reaches for after years of soaking sheets and disrupted sleep. Hormone therapy, especially in the 10-year window surrounding menopause for women without known risk factors, is safe and very effective against vasomotor symptoms like hot flashes and night sweats. We also really need to move away from the notion that menopause symptoms are just “bothersome”. As we’ve learned through guests like NAMS Medical Director Dr. Stephanie Faubion in episode 101 The State Of Menopause severe vasomotor symptoms (VMS) like hot flashes and night sweats don’t only hurt performance, but also have been tied to heart disease, mood disorders, and other negative health conditions They’ve also been linked to weight gain. Do not just suffer through or “tough it out”.

It’s also important to recognize that it doesn’t work the same for everyone. We’ve had guests who tried it and didn’t find it helpful or even made them feel worse. And, of course, not every woman can take hormones. That’s why, as Dr. Faubion mentioned, there’s a big push to also raise awareness of existing nonhormonal VMS treatments like Swedish pollen extract, the active ingredient in Bonafide’s Relizen, as well as the new non-hormonal pharmaceuticals in the pipeline like fezolinetant (FDA approval pending, anticipated in Feb 2023) that work by modulating specialized neurons in the hypothalamus region of the brain, which helps regulate temperature control. 

And of course, some women do well with cognitive behavioral therapy (which comes up a lot on the show) and employing mindfulness and other techniques, which is how guest Kirsten Lewis ran her fastest 5K time post menopause at the age of 57, which she talks about in episode 77 Rewilding Menopause.

Thanks for being part of our community in 2022, and here’s to a happy, feisty new year!