This episode originally dropped on: June 2, 2025

When some of the biggest names in menopause medicine want to learn to lift heavy, they turn to this week’s guest, Nike Master Trainer and midlife fitness advocate Holly Rilinger, founder of the LIFTED Method. Because Holly gets it. She’s been through her own journey with damaging diet culture, body image issues, and a challenging perimenopause that has left her navigating sheet soaking night sweats, brain fog, and fatigue. Through a midlife-specific training plan and tailored hormone therapy regimen (including testosterone), she’s been able to reclaim her energy and power and is devoted to helping others do the same. This week we dive into the science and strategy behind Holly’s Lifted Method and her Blueprint programs designed specifically for women in midlife, as well as for those using GLP-1 medications. This conversation is packed with insight, honesty, and a lot of muscle. You can learn more about Holly and her programs at www.theliftedmethodcoaching.com

Holly Rilinger is a Nike Master Trainer, author, and founder of the LIFTED Method: An in-person and virtual platform with the focus of empowering people at all levels to strength train. Holly is dedicated to delivering innovative, science-backed training methods in an environment that prioritizes growth, resilience, and a lifelong passion for fitness. Holly coaches in her East Hampton studio and on her virtual platform. She is also the founder of LIFTED Blueprint, formerly Menopause Bootcamp, a program designed specifically to help women in midlife get stronger, feel more energized, and gain confidence as they navigate this powerful phase of life. She is also the creator of LIFTED’s newest program for SLP-1 patients–GLP-1 Blueprint in partnership with Dr. Alexandra Sowa of So Well.

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As we wrap up 2025 and start dreaming about our goals for the New Year, this week’s guest, ultracyclist Paula Ralph, has one simple message: Just go for it. We often wait until we’re 100% ready—which usually means we never start. But whether you succeed or fall short, you’ll be better for having tried. Paula knows this firsthand. She set out to break a world record riding solo from Cape Town, South Africa to Nordkapp, Norway. Sponsors pulled out. Mechanical issues piled up. She got heat stroke…and hit by a truck. Safety concerns forced reroutes. The record slipped away. But she didn’t stop. She kept going—ultimately riding 12,290 km across 17 countries in 126 days. And what she gained was far bigger than a record: proof that she’s stronger than she ever imagined, and a reminder of what midlife women can do when we dare to go big.

Paula Ralph is a solo endurance cyclist who rode unsupported from Cape Town to Nordkapp, Norway — a 12,290 km journey across 17 countries in just 126 days. What began as a world record attempt quickly turned into a raw test of resilience. Navigating relentless challenges, both on and off the bike, Paula had to let go of the record and hold on to something more powerful — the will to keep going. Her journey is one of survival, courage, and what it means to find freedom at the edge of your comfort zone. She was recently named a "sporting hero" as one of the top 100 female cyclists by CyclingUK. You can learn more about her and her mission @thelongrideglobal on Instagram.

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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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