If you're an active woman in perimenopause or menopause and it feels like your body is suddenly falling apart — new injuries, recurring pain, workouts that just aren't working the way they used to — this episode is for you. This week we sat down with Casey Francis, DPT, a performance physical therapist who works with midlife women to understand why they’re getting hurt, and importantly, what to do about it, including movement assessment, prehab, rehab, lifestyle and nutrition practices, and much more. Plus, we have a special guest appearance from our very own resident menopause specialist Dr. Carla DiGirolamo — who not only recommended Casey for this episode but is also one of her patients.

Casey Francis, DPT is a performance physical therapist and founder of MVMT MTHD. A former Penn State swimmer and graduate of the University of Florida’s physical therapy program, Casey specializes in root-cause–driven care for active individuals and athletes. Her approach integrates movement analysis, progressive strength, and regenerative therapies to help people heal from injury, build resilient bodies, and sustain high-level performance. You can learn more about her and her work at mvmt-mthd.com

Carla DiGirolamo, MD, PhD, is a Double Board Certified Reproductive Endocrinologist and Obstetrician/Gynecologist specializing in women’s performance and menopausal medicine. She is also a Crossfit Level 1 trainer, Certified Nutrition Coach, and member of CrossFit Medical Society. 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. Dr. DiGirolamo is now seeing patients for virtual consultations for menopausal care and performance optimization. Visit her website drcarlad.com to learn more about her services and schedule an appointment.

Resources:

Crossover Symmetry System

Performance Physical Therapy - An investment in your Longevity, Athletic Aging blog

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Feisty Media is proud to welcome Another Mother Runner to the Feisty Media family. Enjoy this bonus crossover AMR episode starring, Selene Yeager!

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Calling all 40+ women: This is a must-listen episode! The guest is Selene Yeager, host of the popular menopause-focused podcast called Hit Play Not Pause. Selene is the longtime health and science journalist who co-authored ROAR and Next Level with Dr. Stacy Sims. Along with hosts Sarah Bowen Shea and Tish Hamilton, Selene discusses:

• why a long run can exacerbate night sweats;
• the in’s and out’s of hormone therapy;
• dietary ways to possibly mitigate menopausal symptoms;
• realistic, actionable ways to strength train; and,
• how to keep running through midlife.

Selene joins the show around 8:25, after Tish talks about her recent “super-secret marathon” and Sarah shares that a 26.2 isn’t going to be part of her 2026. (Psst: This episode kicks off a month of Feisty crossover episodes.)

As athletic women, we often pride ourselves on grit—shoving down feelings, pushing through pain and measuring every metric in pursuit of optimization. But what does that cost us long-term? And how does it hold up in the chaos of midlife and menopause? This week, former Ironman champion and lifestyle medicine practitioner Dr. Tamsin Lewis joins us to explore the evolution from "harden the F up" culture toward bioharmony—a compassionate, context-driven alternative to the more rigid biohacking that’s popular today. Drawing from her high-performance athletic career and hard-won personal experience, she unpacks what she’s learned about female biology, hormones, and recovery. We also dig into hormone therapy, nervous system regulation, autophagy, regeneration, and embracing midlife as a "second spring"—a season for new pursuits that expand our identity, horizons, and even cognitive capacity. Prepare for a deep dive into the menopause transition through the lens of mindset, biology, and the nervous system.

Dr Tamsin Lewis, also known as Dr Tam, is a physician, longevity expert, and human‑flourishing advocate. Graduating with honours in Medicine from King’s College London and Guy’s & St Thomas’ Hospitals, with a BSc in Neuroscience and the Biology of Ageing, her work bridges psychiatry, sports & exercise medicine, nutritional and functional medicine. As Founder and Medical Director of Wellgevity®, she leads a personalised, diagnostics‑driven approach to health and emotional regulation—the Wellgevity® Method—integrating biomarkers, brain‑body synchrony, and evidence‑based recovery, while consulting at Reborne Longevity in London, where she delivers longevity medicine through a bioharmony lens. You can learn more about her and her work at www.wellgevity.com

Resources:

Progestogens and endometrial protection, BMS Tool for Clinicians

Sign up for our FREE Feisty 40+ newsletter: https://feisty.co/feisty-40/

Join us at Feisty Fest September 18-20, 2026: https://feisty.co/events/feisty-fest/

Learn More about our 2026 Feisty Events, including Bike Camps and Cycling Trips: https://feisty.co/events/

Follow Us on Instagram:

Feisty Menopause: @feistymenopause

Hit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099

Support our Partners:

Eternal - Get 15% off their services with code FEISTY15 at https://eternal.co

Midi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/

Hettas: Use code STAYFEISTY for 20% off at https://hettas.com/

Previnex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/

Wahoo: Use the code FEISTY2026 to get a free Headwind Smart Fan (value $300) with the purchase of a Wahoo KICKR RUN at https://shorturl.at/WVhdr