Full Transcript Introduction to Hotness and Menopause 0:03 Welcome to Hotness, the podcast that brings you practical tools to balance your hormones and rekindle connection, confidence, 0:10 and desire in midlife and beyond. 0:13 I'm your host, Dr. 0:14 Liz Lister. 0:15 Hotiness is a safe space for honest conversations about menopause, sex, identity, love, loss, reinvention,and desire, because you can embrace your hotness 0:28 at every age. 0:30 Welcome, Hot Ones, to episode two of Things No One Told You About Menopause, Joint Pain. 0:38 That's right. 0:39 If you've been wondering, why does my body suddenly feel older almost overnight, this episode is for you. 0:45 We're going to talk about your joints. 0:53 First of all, let's jump in. 0:55 Yes, joint pain can be hormonal. 0:57 I am so bummed every time a woman comes to my practice and she's spent maybe a year, maybe longer, she has seen a rheumatologist for joint pains, 1:09 an orthopedic surgeon for pain, may be even a pain doctor, when actually what's happening are those underlying hormonals shifts that we experience in midlife.
Why Joint Pain Can Be Hormonal 1:20 We'll also talk about the fact that bone loss accelerates as we approach menopause. 1:26 And we'll talk also about how we need to adapt our workouts as get older and as arrive in this awesome, wonderful phase of life that I call midlife and beyond. 1:40 So let's jump into my part that's my lane in all of this, which is the hormone balance. 1:47 So yes, joint pain can be hormonal. 1:50 Women are shocked by this. 1:51 They get frozen shoulder, hip pain, plantar fasciitis, knee pain. 1:58 That fun, exciting stiffness getting out of bed that did not used to happen. 2:04 And women say, I feel like I've gotten 20 years older in the last year or two. 2:11 What is happening hormonally? 2:13 As I've talked about in other videos and recordings and classes, et cetera, the first hormone that declines in midlife is progesterone. 2:25 Progesteron can start to decline as early as our 30s, sometimes even younger. 2:28 I'm seeing these hormonal declides earlier and earlier. 2:32 And so what we're left with by the time we get to our 40s is an imbalance between estrogen and progesterone. 2:40 Estrogen causes cells to hang on to fluid, which is a wonderful thing, until it's not balanced by progeterones, a natural diuretic. 2:50 So in the joint spaces, those cells are holding onto fluid that they can't release, and that can lead to joint pain. 3:00 Then we start to lose our estrogen. 3:02 Estrogen directly helps collagen usage by our tissues.
Hormones, Estrogen, and Joint Resilience 3:08 It affects inflammation, it affects joint lubrication, connective tissue building. 3:14 it even affects pain perception. 3:16 So as we have less estrogen, we just have more resilience. 3:21 And even also less testosterone can lead to less stress tolerance. 3:28 So the tissues themselves actually become less resilient and inflammation can increase and recovery slows down. 3:35 So a lot of women think they're falling apart, but what's actually happening is that those hormones that were supporting your tissues, 3:43 you didn't even realize that that's part of the role of those hormone. 3:49 Sometimes progesterone can just be a magic bullet to help relieve joint pain in midlife. 3:58 The second important area that is changing in our bodies in midlife is our bone density. 4:04 I talk about this a lot. 4:16 The acceleration in bone loss actually starts to happen up to two years before that. 4:23 So if a woman is just going along, she's trying to navigate all the other symptoms of perimenopause, and of course, the U.S. 4:31 Preventive Services Task Force does not recommend a bone density scan baseline until age 65, which is absolutely insane. 4:40 It must be done much, much earlier. 4:42 I like for women to have a baseline no later than age 50, maybe earlier if she's had any kind of fracture that was a low impact type of fracture. 4:54 So we see that as we start to lose our estrogen in particular, the bone-density decline can really pick up speed. 5:04 What's crucial about this is that you don't feel this. 5:07 We do not feel our bones getting thinner. 5:18 which of course can increase our fracture risk.
Bone Loss and Why It Matters in Midlife 5:21 Okay. 5:22 Now, the good news is that as we build muscle, we're also helping our bones. 5:29 So we'll talk about that in just a moment. 5:32 But the point I want to emphasize right now is the bone is living tissue. 5:38 Your body is constantly making bone and remodeling it based on the signals and the nutrients that you give to your body. 5:50 Let's now say a little more about how do you need to update those workouts? 5:56 I did fun cardio workouts all through my, well, really starting in my teens, but definitely in 20s. 6:04 That was the high impact aerobics, which then later became low impact, aerobic. 6:09 But nonetheless, it's really an emphasis on cardio and a lot of fun. 6:14 However, those workouts don't work as well for us in midlife, depending on our goals, okay? 6:22 Great for balance, great for fun, but not so much for building muscle or helping our metabolism. 6:30 You also might notice more soreness or slower recovery or more fatigue after the same fun cardio workouts you've been doing all this time. 6:43 You also might notice, and we talk about this in a lot of other videos, increased weight despite your very best efforts and all the efforts that up until
Updating Workouts for Midlife 6:54 now have worked just fine. 6:55 You might also be getting injured, so that's incredibly important. 6:59 We must avoid injury as absolutely much as we can at this point in life. 7:05 Other hormonal changes are happening in our body. 7:08 For example, our cortisol response, insulin sensitivity, With less estrogen, we have more resistance to insulin. 7:18 So all these underlying hormonal changes. 7:21 And by the way, I link to this in every episode, but I wrote a midlife guide just for you. 7:28 We talk about all of this and more. 7:32 How do we need to update our workouts in mid-life? 7:39 For one thing, this is something I often try to do, and that is to reframe exercise. 7:44 Sometimes I call it the E word because it might be off-putting, especially if someone has not really exercised a lot in her life. 7:53 And now she wants to get stronger, which is exactly the goal that I want you to have in midlife. 7:59 So the gold has to shift from calorie burning to preserving muscle and also building muscle, and building bone strength. 8:12 We're going to protect our bone. 8:14 And this is also going help in the area of metabolism. 8:20 What do I want you to update with your workouts in midlife? 8:26 In addition to the other segment that will be on this podcast with an exercise fitness trainer, where we will get her expertise, 8:36 let me share with you the gist as we talk about joint pain in particular in this episode. 8:44 We need to focus in midlife more on strength training, we've talked about that, mobility, recovery, giving our bodies enough recovery time. 8:57 This is actually very important from a hormonal standpoint. 9:02 When you workout intensively days and days in a row without a recovery day for your system, you are actually decreasing the hormonal benefits of the exercise 9:17 that you're doing. 9:18 For example, growth hormone.
Recovery, Protein, Sleep, and Hormone Support 9:20 We release growth hormone after doing a really good workout, but not right away. 9:25 It's really over the course of the next 24 to 36 hours. 9:29 So you need to have something alternating with the intense workouts that you might be doing. 9:36 Walking, of course, is very underrated and we want to be doing that. 9:41 In making sure we have a lot of protein intake, making we protect our sleep. 9:48 I talk about this a LOT and it's really sort of priority number one before we can do anything else with our health. 9:56 And of course, the right hormone replenishment, right? 10:00 We talked about that a little bit earlier. 10:02 And so that's one of my missions in life is for women not to be afraid of the. 10:08 Right types of hormones, given the way can make a huge difference in particular in the area of joint pain. 10:18 Again, a couple more points about the workouts. 10:21 Really avoiding overtraining. 10:25 This is some of my toughest women that I work with who love their intense workouts and they're doing six days a week. 10:33 Not sure I've had anyone do seven, but even I'm trying to have them dial back from six a days week, that's a lot. 10:39 That does not give the body the recovery time that it needs. 10:45 Also, this is sad for me to say because I love cardio, I loved my Zumba. 10:50 I still go to one Zuba class a week because it's fun and I enjoy it and cardio is good for us. 10:57 But I'm understanding that it is not really helping my muscle building and it not helping with my metabolism. 11:04 It's helping me in other ways. 11:07 Another really important reframe is your relationship to your body. 11:13 Your body in midlife is not betraying you. 11:16 It is changing and we need to adapt. 11:22 I recently was at a hormone conference and a lot of focus was paid to muscle. 11:28 We've all heard about lifespan and then the new word that went in there is health span.
Mindset, Muscle Span, and Closing Thoughts 11:34 How long are we in good health? 11:36 And the newest word on the scene is muscle span, how long we are maintaining good, strong muscles is also really important for longevity. 11:48 And so it's very important from the mindset standpoint that we're cooperating in a loving partnership with our bodies, not trying to punish them into submission, 12:00 trying get our body to respond the way they used to. 12:05 Again, we are working out. 12:09 Smarter, not harder, that's a phrase lots have used. 12:14 We're building strength, we're getting stronger as we get older. 12:19 Were not punishing our body, were are supporting our bodies. 12:25 If this episode has helped you realize that your body has been changing in ways that you didn't know about, you are not alone. 12:36 Your body isn't weak, it is adapting and it needs new support for this new phase of life. 12:47 In midlife we become very powerful in many ways and we need to work in, like I said, loving partnership with our bodies to have our body's keep up in that 13:01 strength so we can live long, wonderful, healthy lives free of joint pain. 13:06 Take care and see you soon. 13:09 Thanks for listening to Hotness. 13:11 Help more women find these practical tools by liking, sharing, and following the show, as well as leaving a review. 13:18 As a gift for listening, go to drlizmd.com forward slash hotness for your free midlife guide filled with powerful support for you mind, 13:29 body and soul because you can embrace your hotnes at every age.
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