Perimenopause Long Term Health To Build a Stronger Future

Are you in perimenopause? Do you wonder if you're in perimenopause? Did you miss perimenopause? And then all of a sudden here you are postmenopause and nobody ever gave you the word perimenopause in your vocabulary when you were there. Either way, any of those, this is for you. So I am interviewing Dr. Jennifer Rowlands. We are talking about the premise of a book she wrote, but really we're talking a lot about what What's the current status of women and their awareness of what it is they want and need when it comes to hormone therapy? When they're raising young daughters asking questions, what's the best way to prepare them to grow as they participate in sports and athletics and feel good doing it no matter what? What is it that they need to know? We talked about all of the things and I think you're gonna love this one. So So here we go. You're in perimenopause, menopause, or postmenopause, and you're not slowing down. You're just getting started. But the old rules don't apply anymore. The workouts that worked before, they're working against you now. The advice you've been given, incomplete at best. I'm Debra Atkinson, and I'm the founder of Flipping 50. The pioneer in fitness for women in midlife. For more than 40 years, I've been in the trenches with women just like you, and for the last 12, right here on this podcast. And and the founder of Flipping 50: The Stronger Way app and membership. Welcome to Flipping 50: The Stronger Way, where science meets strength, where you'll find the tools, research, and real talk to build the body and the life you want in your second half. Each week, you'll get evidence-based exercise and nutrition strategies, conversations with leading experts, and honest answers to the. questions your doctor didn't get answers to in medical school and doesn't have time to answer in an appointment. This is your show. Let's get stronger. You're Not Crazy: Pivot, Your Perimenopause Playbook. I'm interviewing the author of that new book coming out November 13th, 2026, depending on when you're listening. Still probably gonna be a great one to pick up. If you are in perimenopause, not yet in it but want to be prepared, or don't even realize you're in it but you haven't hit that 12 months since your last period, and even if you're postmenopausal, this one is still for you. Dr. Jennifer Rowlands is my guest. She's a double board-certified OB-GYN and integrative medicine physician specializing in perimenopause, hormone optimization, and women's longevity health. She earned her medical degree at UC San Diego, completed completed her OB-GYN residency at Duke University and a fellowship at the Andrew Weil Center for Integrative Medicine. She is the founder of Precision Health MD and creator of the Midlife Upgrade Academy, reaching over 35,000 subscribers through evidence-based education on hormones and midlife health. A few of the questions that we answer in today's episode: How is it that OB-GYNs still get about an hour of menopause training during their entire residency? A lot of our listeners who are already on the other side of menopause still have opinions about being on HRT, and they feel, why bother? What's your answer to that? We also talk about our mutual agreement that strong does things skinny doesn't even dream about. I ask her why she feels so strongly about this, and you'll hear us talk about a mutual kind of flirtation or evolution from an endurance runner to a multi-sport athlete in each of our 40s, one at the beginning, one at the end. But it's very interesting that that happened. We also finish with a little chat about something that may be a new and upcoming book about puberty, but in a whole different light than Are You There, God? It's Me, Margaret. I think you're going to love this conversation. I hope you stick around and I hope that you reach out on Instagram in DMs and let me know that you listened. This is also a great one to share with potentially your daughters, daughter-in-laws, or someone who might be raising a— Teenager. Pre-puberty or pubescent young girl. Welcome to the podcast, Dr. Jennifer Rowland. Thanks for being here.

Thank you so much. I'm honored to be with you.

Well, yes, and we should let everybody know we were just together. So as we do this in real time anyway, and I wanna ask a few questions. So you have so much goodness behind you and we'll get to a recent book you've published and one that I really wanna ask you about as well. For all of our listeners and for all of their daughters and daughters-in-law and the ones coming behind that and that. But I love busting this, and I don't remember who it was in the last few years. Maybe it was Mary Claire Haber. Some of the New York Times bestseller book authors really blew this up, and I think this was a shock to every woman learning. How could this be true? That You, double board-certified OB-GYN, have had what, an hour of training on menopause in your entire OB-GYN residency? Yes. How did that gap actually look like for you? I mean, did you even think about that yourself? Because I'm sure as you go through things, and we go through things doing what's always been done, we don't necessarily know enough yet to stop and ask or look. But did it strike you as odd at that point, or when did it hit you that, wait, there's a gap?

Yeah, no, at the time it didn't, 'cause, you know, I'm 29 or 30. So, you know, you're invincible at 30. None of these things are breaking down. You don't even really think about it. And so at the time, when I remember distinctly my attending at the time said, well, you don't need to memorize hormone replacement therapy. You're never gonna prescribe it. And I was kind of like, well, what are we learning? Like, well, you're learning that Your cycles stop after 1 year, it's called menopause, and then women just are in a new phase, right? A new stage. So I was like, okay, you know, I'm 29 or 30, I don't know any different. It doesn't really come to me until I'm in private practice and seeing my own patients and they're getting to be in their 40s and 50s and they're like, yeah, but this is not great. Like, what are you gonna do for me? Like, I can't sleep, I don't like my husband, I'm gonna get fired from my job. Like, what are you going to do, Dr. Rollins, to help me? And I was kind of like, well, you know, aging is normal. The standard answer that I was taught, it's all normal to lose your ovarian function, and it's normal to become wiser at this age. But I really didn't have anything for them besides, I can give you a birth control pill till age 55, and then I got to take you off of it. And that was kind of it. I mean, it was really that small and superficial. Yeah. I mean, you learn so much when you're In resi— when you're a private practice and you're seeing your own patients and you're aging with your patients, right? Especially when I hit my 40s and I was like, WTF, what is this?

Yeah, right.

I don't want to be on the suck it up buttercup plan. I want to be on the I don't want to break a hip plan. So you learn things as you age with your patients. I think why we don't have it in training, I think OB-GYNs really focus a lot on OB. And if you look at someone's private practice, you see See, in the waiting room, most women are pregnant or gonna have a baby. We focus on this part of life. We don't really focus on that part of life. And then if you were trained since 2002, you were told the same story: it causes cancer. You're never gonna prescribe it. So that's a huge—that's 24 years of doctors being pumped out that have been told, "Don't learn this. It's not going to be useful for you." So it's an issue. I mean, it's a problem. We're still all in private practice, right? The ones that are 40 years from were trained 40 years ago. Gave all the HRT that they wanted, and they're out. They're not practicing anymore.

So

you're kind of in this phase where doctors are still not being trained yet or trained to do it yet unless they go outside of their traditional training and teach themselves. And they also have to be open-minded to be okay with learning on their own and not the stigma that's been taught over and over and over again. And so it is. We're kind of in this era where there's just not enough training yet for doctors. So people like me and Mary Claire Haver and all those other folks in this space are like, there are options. Just teach yourself, learn how this happens.

What are you finding? So what is it like? Are you doing telemedicine and seeing people in office clinical setting or?

Yes, I do both because I'm licensed in 7 states. So I see people outside my states. Yeah.

So what is it like for you on your side of the screen or the table, if it is? With social media right now, I mean, are you finding patients come in more educated or more confused or a little both? Are they knowing enough to be dangerous? How would you describe what it's like for you maybe now versus 10 years ago?

Yeah, I think it's a little bit of both misinformation and also education. They know that they don't feel good. They know that they don't feel like themselves and they can't live this way. That's Number one across the board, women go, "I just don't feel like myself. I don't feel like who I was a couple years ago." So they're definitely seeking help because they feel like I just can't. I hope I don't have to do this for thirty years. I hope this is not what I'm set up for. I think the misinformation comes out in that you know there are online there are people who kind of feel like menopause is natural. You should just go through it however you're going to go through it, and to do anything, get any help, or to getting the assistance is kind of weak. So I do feel like there's that category online that's kind of very, you know, I did it, you should do it too kind of thing. I almost feel like it's the same kind of people that tend to say that about epidurals. Like, well, I had a baby without epidural, you can do it. It's like, well, not everybody wants to.

I did till I was there. And then I was like, no, no, no. What do you got?

So it's kind of that same kind of like, it's natural, you should just deal with it kind of episode. And then I also think there's people that are Um, really kind of don't see the whole body approach to how you should take care of menopause women. And so they're like, take this supplement, take this, and magically all of this 80 symptoms associated with menopause will go away. And so I think that there's kind of that misinformation where women come in here to me and they're like, I don't know, should I take magnesium? Should I take ashwagandha? Should I sleep better? Should I eat this? So much overwhelm of like, I want things to be different. I don't even know where I should start. So I do think in some ways it's empowered women to get help, but in some ways now they have 60 different things to choose for dinner. So what do they wanna— what do you wanna pick?

Yeah, and that actually, I mean, you kind of intuitively read my mind with my next question because that is such a statement. And I browse social media posts of other people, I browse the comments. To see what are other women saying, what are their questions or their or their beliefs, and just to understand. And so often I will hear well first of all how human we all are, and we love to be right. So we almost go looking for the posts that are that's what I believe. Good, I'm glad you said that. So yay, I'm right. And we're not. As curious as I would like all of us to be, and I'm sure there's somewhere I'm— true for me too. But if we could just be a little bit more open to maybe there's 2 right answers, and we learn so much more that way when we're maybe in opposition with someone, as opposed to just looking for everybody who has the same beliefs I do. But I hear so many women say this, and I'd love your response to it. So a woman who says, you know, you know, she's boasting about, here's my lifestyle, and I lift and I eat well, and I'm not on HRT, I feel great. And so she thinks, why bother? Why do I need to be on HRT? And you say—

I never want to discourage someone if it's working for them. If it's working, and they, and you know, they're dialed in, and it works great. Awesome. There's always things you can learn from other people too. Like there's from those patients, I learn things sometimes like, okay, well maybe I need to focus on this type of exercise to add for me. And we're all learning from each other. And so I don't discount that it's working for them great. I think ultimately menopause care needs to be integration of multiple things. It's certainly lifestyle, it's nutrition, it's exercise, it's stress management, it's sleep, it's medications, it's supplements. Like you kind of take little pieces Of different buckets and kind of make the plan that makes sense for you. For some women, they can be dialed in on exercise and nutrition, and other people are trying to deal with ailing parents and crazy teenagers and a work schedule that's out of control, and they just can't focus on that kind of piece. And so they need that help to sleep, and they need that help to not have hot flashes, and then they kind of gradually add those things into their life. as they can kind of make room for it, if that makes sense. So I don't discount being an integrative OB-GYN. That's the cool part, is there are patients of mine who are, give me the HRT or I'm going to hurt you. And I have patients who are like, I never want to have HRT and I just want to do everything dialed in, and I'll wear a continuous glucose monitor and I'll wear wearable tech and I'll biohack everything because this is the approach I feel is right for me. And that's what's cool about my job, is I'm like, okay, I'll support you on whichever Pathway, this makes sense for you.

And I love that too. I commonly will use the phrase like, no, don't fix it if it's not broken.

Yeah.

But I hate to use this term in this moment we're in, and if we release this soon, everybody will understand informed consent, um, and what that means. But that's part of potentially the challenge there is that do women know their options and understand that it's not just symptom management anymore? Yeah. Which used to be the only reason to do HRT when somebody was miserable. But it's also the long game. Is this helping her protect her bones more? And/or is it helping protect her brain more, or her risk of heart disease? And I get, in a course of 43 years, I would promote that the exercise is definitely helpful, but it can't do all of it. It can't do everything. Right. And we, we all know Jim Fixx died of a heart attack 40 years ago. And, you know, he was the author of the world's— one of the world's foremost running books. But that happens to a lot of people who are outwardly healthy and have all the lifestyle things. What about the longevity game? How much do you educate a woman? You know, that's a great choice. Just want you to be sure that, you know, there are other things that Not just your day-to-day and symptoms or being asymptomatic, that you might want to consider. Do you want to hear more? How do you approach that?

Exactly. So in the consult, I always say, are you open to the conversation about hormone replacement therapy? Because if they outright are not interested at all, that's where I'm like, okay, we'll support you in other ways. But when I had the HRT conversation, it is specifically about HRT is FDA approved for symptoms, right? Severe hot flashes, dry vagina. Like, they have indications, but it does so much more. So you can think of hormone replacement therapy as an option for symptom relief, but really it's a longevity tool. How do we keep your brain healthy? How do we keep your muscles healthy, your bone healthy, all these other aspects? So I even use that when I talk about how I manage hormone replacement therapy with patients. I'm like, well, I'm not just going to put you on a patch and your hot flashes go away and that's the end of that. I want to actually monitor you because now we have clinical trials that say here's the estradiol level that's There's the cardiovascular benefits. So, you know, the, you know, the indications for HRT doesn't include those because we're not kind of progressive and forward-thinking quite yet in medicine. But that's what I discuss with patients because often I'm like, if you're going to do this, let's do it. Like, let's make sure that, you know, your DEXA scan comes back good in 2 years.

Isn't it somewhat true, if not entirely 100% yes, we'd both say, That we are the first generation that will be proving longevity potentially is better in those who've done HRT versus those who didn't. We'll be the first generation with adequate enough, you know, critical mass to study in both of those cases. Mineral replenishment is one of the most overlooked aspects of wellness, and Beam Minerals makes it super easy to incorporate into your day. I confess, until recently, I've been overlooking the big role small minerals play in my total health. I've spent years working on my own and clients' diets, paying attention to the macros— protein, fats, carbs— but giving far less thought to the minerals that make the macros work. I take half capful of Beam Minerals Electrolyze and their Micro Boost Daily. That's it. So easy. It tastes like water and you can drink them alone, but do like I do. I add them to that glass of water waiting for me on the counter every morning. No extra time, no extra effort. Beam Minerals has become one of those daily habits that I genuinely miss when I skip it. I feel it. It's like a subtle upgrade to physical energy and Mental focus. Head to beamminerals.com/FLIPPING50 and use code FLIPPING50 for 20% off your first order. That's beamminerals.com/FLIPPING50, code FLIPPING50. Give Beam Minerals a try and discover why mineral replenishment could be the missing piece of your wellness routine.

I think, you know, there are definite things that came outta the WHI study back in the day about decreasing colon cancer risk, decreasing cardiovascular risk if you're using, you know, not using the synthetics. So, there's definitely some data that's underrepresented that we have for the last 20-something years. But, when you're talking about putting someone on it and enough women on it to say, okay, what happened to their bones 20 years from now?

Yeah.

I think that's where this is going to be helpful. And, especially if we can get, you know, more research and money into it. I mean, kudos to Melinda Gates, man, for getting out there and saying, we got to have some money behind women's health research. So that, you know, we have ways of saying, even if it's not a randomized clinical trial, which is the gold standard, at least an observational study to say, oh, here's 5,000 women who took it for the next 10 years. Who ended up with a broken bone? Who ended up with loss of muscle? Who ended up— you know, we can have these sort of studies that are really about what— why it should have other indications besides just severe hot flashes and dry vagina, you know?

Yeah. So true. We have a saying here around these parts at Flipping 50 that strong does things skinny doesn't even dream about. And you're on board with that for your patients, you know, train for strength, not skinny. How does that go over in your visits with patients? Because let's just agree, we're both women here. We've always been praised our whole lives on looking good, and that always leaned toward looking slim and looking, you know, trim and fit and being smaller, not bigger. And I mean, it's been a part of us, I would say, for most women in this generation, their entire lives.

Yeah. I mean, I think Vonda Wright is a perfect example with Strong Is the New Skinny, right? Like, it's not about— and I talk to patients, I frame it like this. What do you want to do when you're 80? What do you see? You know, I don't want to mention his name because none of us like him anymore in this space who invented this longevity Olympics. But the concept of, you know, what do you want to do when you're 80? Like, I want to be able to take groceries out of my trunk and I want to get off the floor without somebody helping me. So I have to build that for the next 30 years. It's not going to just happen at age 80. I have to do the things. things, the movement, the nutrition, the agility, balance, all the things that I don't want to do necessarily, because I got to build it to do it at 80. And so this is my opportunity to take that and say, what are my goals? Maybe your goal is to travel around the world at 80. And you got to be sitting on an airplane for 14 hours. Maybe like, what are the goals that you have to be able to do at 80 and now build the body for it to do it? And that strength is what you're looking for, that sort of ability to live is what you're looking for. Not am I 110 on the scale or am I 115 or 120 or maybe 140, close to mine. Like, what is the— is it the DMV weight or is the real weight? What are we referring to? Because, you know, I did my first triathlon this year at 49 and I had been a marathon runner forever. And let me tell you, when you switch it up, it's like Wait, what thing? Like, what, you want me to sit on this thing for hours? Like, but I did it because I wanted to prove to myself the body I still have is capable of doing something different than what I'm used to. And I learned so much about balance, about just, uh, having to actually take my exercise down and focus on lifting to be able to do the things I had to do for the race, which was like—

Mm-hmm.

Not toning anymore. It was like, no, Jen, you need to be strong. Like you're going to do all these things. And by the time you get to the swimming part, you got to not drown. Like you got to keep going. You got to build these muscles. Right. So, you know, and running is very different. You think that you can ride a bike if you're a runner, but that is not true. Even though it's using those big muscle groups in your legs, very different type of exercise. So you have to sort of train differently. So I think that's what I like to do with my patients is like, what do you think you want to do at 80? Let's build that body. To do that. That's what's important, not whether or not you got in your size 4 dress, you know?

Yeah, right. You in 20 years is being built today. Exactly. You know, I think that evolution of being a runner is something— I will compliment us both— wise women do shift to multi-sport because I did the same thing at 40 and had dreamed about it and trained that way when I was 20 but didn't have time. Between those 2 gaps. And, you know, so that's when I transitioned also to multi-sport, but I also did it because it's a better use of your body.

Yeah.

Right? So you are a much more well-rounded athlete using the top of your body, the bottom of your body, doing it with no impact versus lots of impact. The biggest challenge is the longer that race gets, the more unweighted time you spend on a bike or in the pool. And that's not great for bone density. That's true.

That's true. Yeah, I mean, lifting is what I do for bone density because I did get diagnosed with osteopenia at 46, which was shocking given I was a runner my whole life.

Oh, that's not shocking because you're a runner. Running doesn't promote bone density.

No, but you know what I did is I looked back into some of the data now that's coming out with birth control pill users for 30 years, right? That was me for 30 years. And the lack of of estrogen, progesterone to my bones for, you know, I had a minimal amount because I was on a low-dose birth control pill. So

yeah,

it's kind of interesting, some of this data coming out now with sort of like not having women have spontaneous cycles and the impact of their bones too.

Yeah, true. But I want to point this out to everybody. So if you're a runner, what you're doing is not any more minimal effective stress. So as soon as you can run a mile with your your body weight, running 2 miles does not give you more bone density. You've run it, you've done it, you've adapted to it, and you won't lose that, but you're not going to gain more because you put in more miles, more days. That's a very big distinction, and a lot of women still drive that home. So yeah, um, so talk a little bit about, uh, the SHEEO. We both love this term. So SHEEO, I use it in business as my title, as opposed to CEO, which sounds a little stuffy. Um, but you call it CEO of your health, which also love that one. And what does that look like in your doctor's appointment with most women? You know, I always ask this question of physicians because I think this is the biggest obstacle with a lot of women unable to maybe make a program stick. You know, and feel like they're constantly starting another one or another one and they got disrupted, interrupted for some reason, is potentially the belief that they can change the way they ate, that they have the capacity to, through their habits, make a difference. So we know that as epigenetics. But talk about someone becoming a CEO of her own health. How's that conversation go in your office?

Yeah, I think you know doctors or whoever you nurse practitioners or whoever whatever provider that you're seeing, it's really about helping someone guide them. Not I think medicine is built very much like we tell patients what to do. Like here, take this. We'll see you in six weeks. Here, take this. So when I say the CEO of your appointment or CEO of your health is like you are the pilot here. I'm the copilot. You're the person making these decisions that make sense for you. And so, I often sometimes use this example in clinic. I was like, if I told you that the best thing for menopause is broccoli, and you ate broccoli every single day, and you hate broccoli, it's useless. Like, why am I, you know, like, if I was like, that's the best thing, it'll cure everything, and you hate broccoli, you're never gonna do it. So, what's the point of me kind of spouting out, this is what you need? I need to understand what are the obstacles that you have for your health? What are the low— In my mind, I always think about low-hanging fruit with patients. Like, what's the low-hanging fruit? What's the thing that you and I can start now to kind of move that direction, as opposed to maybe giving you a Microsoft Word document about the 10 things you should do? And for someone that— women that might be eating a little bit better, for some women that might be getting to bed before midnight, for some people it might be having some stress management plan, some people might be going to the gym for the very first time. Like, there's so many little low-hanging fruits where working with those first to kind of say, hey, we need to start with what's easiest for you to add. You know, I don't know if you read the book Atomic Habits, but I think about that book a lot.

Yeah.

How you have to add these little things into your daily routine so that it doesn't become a thing. It becomes a habit, a normal thing, part of your day. Like, for example, my mother-in-law, she doesn't like to go to the gym. She doesn't like to lift weights. So she actually puts 2 5-pound hand weights in front of her coffee pot. And she will not do anything until her coffee is made in the morning. So she goes in while her coffee is being made and she does these little arm weights. She's 75, skinny little thing, no muscle. And like, that's her way that she incorporates it in her daily life because she's like, I need to start something, but I just don't— I want to do something that's part of my day that I'm gonna have to do anyway. So she waits for her coffee. Now, is that the best plan for a 77-year-old? Probably not. She needs to do things a little bit more, but It's the first low-hanging fruit for her.

Yeah.

To start. And it's something that she'll do because she just will— she wants her cup of coffee. So she's going to work for her cup of coffee. So I think it's about trying to advocate for women getting the care they need. I mean, you and I talked— start this conversation about how they just don't have the time in doctors' offices and they don't have the education. So we need women to go in with a plan that's like, here's what I think is right for me. Help me figure out the solution. So that's kind of being the CEO of your health, to say, here's what I think is right, here, help me kind of narrow this down to a solution that makes sense for me.

Amazing. So I'm going to hold this up. So you shared with me your book. So Pivot— this is You're Not Crazy: Pivot Your Perimenopause Playbook. Talk a little bit about perimenopause, because perimenopause is having a moment this year. And, you know, there are so many summits And books and, you know, why perimenopause versus postmenopause? Why this book?

Yeah, you know, I don't— I mean, in, in residency, no one said the word perimenopause at all. It was just like, you can have babies and then one day you can't, and then you're menopausal. Like, that's basically how it was sort of taught to me, right? And I lived that way for a long time. And then this sort of term perimenopause, although it was in OB textbooks, we never Talked about it ever. And this concept of like, yeah, women who are coming to you in your late 30s and early 40s and mid-40s who are like, I can't sleep, I'm getting hot, I'm ragey, like all these things that are starting to happen, they get dismissed a lot in healthcare because they're told, well, you're not in that one year without a period and you don't want to have a baby. So what do you want me to do with you? Yeah. I feel like now it's starting to have this momentum where women are realizing like, Oh yeah, this is going to happen for 4 to 10 years where I'm starting to transition. These symptoms are very similar to what I'm going to go through when I get to menopause, but yet I need to have a plan. Otherwise I might burn my house down and walk away. Like, I need a legit plan. That's why I wanted to focus on perimenopause, because I feel like it's an area that's very much dismissed in this category. And my book is different than other books because I do take that longevity angle. I talk about— I start the book by saying what we've been, where we need to go, and I use something called a longevity cascade, which is talking about all the systems that change. Perimenopause is the one time when everything starts to just catalyst change, right? And postmenopause, you're already on the other side where you have kind of a consistency in how much your bone loss goes away, your muscle loss, your cardiovascular risk goes up. It kind of becomes a little bit like every year is the same. Perimenopause is where things are just like completely catalyzing there. So the highest rate of bone loss is in this time. The 4 times the risk of depression. Can we just say it can be? Yes,

we can mitigate that shit.

Okay, but it's a roller coaster, right? It's the time when things change, and it's the time when, you know, 4 times the risk of depression, anxiety. Women lose their jobs because they can't stay focused and keep They are, they don't know what's happening to them. And so I feel like it needs to be a conversation about, it's really a moment to pivot. That's why I call it Pivot, but it also has a pivot protocol, but I call it that because it's this moment when women need to go, you know, I need a different plan. I need to shift to a life I want for the next 40 years. So I do talk about in the book how to become the CEO of your health, how to get the right labs, the right testing. Don't wait till you're 65 for a bone scan. There's nothing more irritating to me in medicine that we make people wait till they would break a hip. Right.

Right.

And then we're like, oh yeah, by the way, go get it checked. Like, what?

Yeah.

I mean, we need to have CART tests. We need to know why we have these tests available. Why can't we tell— have women know what their heart looks like and their vessels look like? We need to understand their balance, like what is going on with their overall, so they can build a plan of nutrition and movement that makes sense for them to do the things at 80. So it's really not just about this moment. And I think a lot of perimenopause books are about that moment. How do we put you on HRT? And then very traditionally trained where it's like, here you go, you know, now you'll have a perfect life. And I sort of say, that's not the way it goes.

Okay, princess. Okay.

Yeah. You know, where people were, I think a lot of those books in that space, and I love those doctors that write those books. I think they're fantastic, but I see things from an integrative longevity standpoint and not just this moment in time. So I want women also to know they have to, this is a transition. So what you do now may not be the same you're doing in 2 years.

Yes.

Well, and it— Flipping things up, right?

That is so true. And I would also say, you know, having been in this space in fitness for 43 years, and we have dedicated in everything we've been doing for 12 years has been with women over 40. I mean, to your point, you know, not going to be doing the same thing in 2 years. Sometimes a woman is not going to be doing the same thing in 3 months. Because, you know, her symptoms or the midlife just lifing that happens to a woman, you know, filling her buckets, not just hormonal changes. Like, okay, now there's, you know, the empty nest or the full nest again because you've got aging parents living out in the back, you know, or you've got, you've got so much going on that it's like it's a juggle entirely. And I'm going to say something that will shock the women who are going through it, but I want to say that, like, with back to your point about bone loss, and I did not mean to be disrespectful there, but I always want every woman to hear bone loss doesn't have to happen. And likewise, so many fitness professionals, physicians as well, will say women lose 3 to 8% of muscle every decade after 30. We never finished that. Sentence with unless you're mitigating it and paying attention to what you should measure and do. It doesn't have to happen. It does not happen to everybody. It just will if you sit on your hands and think, I don't need to work out because I look fine. That's not going to do it. But I want to say that for a lot of women, the loss of their bone or the loss of their muscle Does happen because they're asymptomatic.

Yes.

And it's potentially those women who are symptomatic who have to sit up and pay attention. And they actually have the motivation to look at what should, what should I do, Dr. Jen? What do I change my game plan? And they may win in the long run because they have greater symptoms. Can you elaborate on that? Did you know 3 out of 4 US homes have toxic chemicals in their tap water? I did. I've lived it. And surprisingly, standard fridge and pitcher filters do little to remove most contaminants, and bottled water contains microplastic. So what's the solution? For me, it's AquaTru, the countertop water purifier tested and certified to remove 84 contaminants, including chlorine, Lead, and forever chemicals and microplastics. Join 98% of customers who say their drinking water is cleaner, safer, and healthier. And look, I love all that, but I love immediate gratification. It's the best tasting water ever. Go to aquatru.com now for 20% off your purifier using promo code FLIPPING50. AquaTru even comes with a 30-day best-tasting water guarantee. That's Aquatru, aquatru.com, promo code FLIPPING50. I'm

gonna be controversial because I don't think people should wait to get a DEXA scan. Yeah, I honestly think that they should be getting them, you know, early 30s. Yeah, I mean, well, great if you had a baseline. I mean, there's a lot of things we should do in our 30s, right? We should have a baseline testosterone level, baseline DEXA scan. Maybe that's the next Book instead of puberty. I don't know, but it's really about like getting the data right because you shouldn't just wait till you think there's a problem. You should definitely get your dexa to understand what is your now you've had forty years of impact on the bones. What does that mean? Where are you at? And then how do you then build that plan to go forward? And yeah, I think there's a lot of things that we need to test and do that's well before we hit that transition to what medicine. And would say that now is the time to check, right? I think cholesterol should be checked before age 50. Like, there's a lot of things that I think are proactive. I was going to say also one thing about— I also put in that book that's conversations about sex because they don't— nobody talks about sex. And I think that's one of the things when I post videos on my YouTube channel, it's like the number one thing on comments is do more videos on how to talk to my partner about how I really do like him, but I don't want to be with him. Like, it's like—

I don't want him to touch me. Yeah,

it's a big part. Like, there's a whole chapter that's like, when sex is meh, like, because it's true. Like, that happens. And I talk a lot about community and like relationships and like finding your people. Like, your community is amazing because it's about not feeling like you're alone. I think that's— for my own perimenopause struggle, I think that's been the hardest. I didn't realize the depression and the just like feeling Like alone that you feel when your partner doesn't understand why you feel crazy. You know, other people don't understand why you feel this way. And I think that part has to be part of menopause care too, because it's so valuable to be like, oh, Debra said too, she didn't like her husband today. You know what I mean? It feels good to feel like, okay, I'm not the only one that wants to like smother him with a pillow sometimes. Like, you know, I think that's important. And I think that's why you're seeing the momentum of menopause. Yeah. also changed is because women are like, whoa, you feel that way too? Like, okay, like, great, you know?

You know, and I'm gonna throw this out there, it feels a little like this may be random, but I think somehow this, in the context of where we're at, is everybody's experience may be similar like this, but it also can be so very different.

Yeah.

And I want to— there are a lot of fitness professionals, health and fitness professionals, and And so just to give people some relativity, my mother told me never to do this, but I've been doing this now for 15 years. I have to ask how old you are because it's so relevant. Can I ask you?

Yeah, 49.

Okay. Oh, that is such a great age. Eventually you'll be one of us. We'll send you a little card when you're 50.

In April, I'll be there.

And I'm 62. So having walked through it. I realized I thought I knew. I mean, when I was a 22-year-old, I thought I was an old soul because I was raised by older brothers and sisters, older parents, and I could communicate really well with the faculty and the staff that I ended up training. But of course, you know, then you get there yourself and then you realize, I knew nothing then. I thought I knew things I didn't know. It's probably good to have that false sense of confidence because you can operate a little better sometimes. But then, you know, I was a fitness professional and I was relatively asymptomatic. And I was asymptomatic as far as menopause goes for so long. You know, I was in my early and mid-50s and I'm like, this is not going to happen to me. Like, I'm not going to have any symptoms. I have figured this out. And I had by then written the framework, and I was busting all the rules because I loved endurance training. So my triathlons kept getting longer and longer, and I did eight Ironman. And I knew this was the nemesis of everything I was telling every other woman, but I loved it. And so there's a thing there. And the eighth one, somebody said, "We're going to teach you a lesson." So you can teach this better. And it really kicked me. And so it took until 56. I hear right now, I'm hearing some other perimenopausal age fitness pros say, you know, I've had all these people ask me, how come you look so good in perimenopause? And the answer she gave is, well, we figured this out. And I'm like, just come back to me in 10 years. 'Cause I'm like, I'm not wishing it on you. But I do think no matter who you are, at some point there is that critical mass happens and you do notice changes and you're a little less cocky and you're a little more open to, okay, still learning. Yeah.

Yeah. You know, or even, I mean, I'm 49 and last year I had a frozen shoulder. That's when I started estrogen. I didn't have any hot flashes, but I started it and I went to PT and the whole deal and was like, what the heck? And then I find my— so I'm a hot yoga runner kind of gal. That's my— and lifting weights. Those are my things.

Are you still swimming with triathlon or?

Yeah, I swim. I was— I went to college with a college scholarship for swimming. So like swimming to me is like my— I can do it all day forever and ever and ever, you know? And, but I suddenly had the frozen shoulder. I was like, oh my gosh, like I can't do hot yoga. I can't do a lot of— I can't swim. Like I'm in so much pain. So I ended up in like I would say in the nicest way, the older lady yoga class, right? Where like, it's not hot, it's not stressful. But I was like sitting in this class going, dang, this is actually hard. Like you have to hold the posture for like a long time. My legs were like burning. I was like finding myself kind of humbled by the experience of like, oh, I've always thought of this as like an old lady yoga class, but like legit, this is a hard class.

Right. Yeah.

And totally doing things that are about balance and flexibility because I couldn't really do anything that was a ton of weight on my shoulder. And so yeah, you get taught lessons even at 49 that like give you a little bink bink. You don't know everything. You're gonna, you're gonna learn, as my Italian grandma would say. Um, and yeah, that's actually T for pivot. Is the last is transcend, which is literally saying like, this is not— just because you figured it out doesn't mean from 5 years from now it's not going to be upended and change.

Yeah.

Like, this is a whole change and things will change and you will 5 years from now, maybe you have limitations now, physical limitations, or maybe you have, you know, different— you're taking care of your parents. And so your timeframe is not the same for what the type of things you were doing before. So it's not an end-all be-all. I think anyone who's— yeah, they learn.

Okay, wait, I want to finish that sentence though. Let's go the other way, just in fairness. So we might be in 5 years taking care of somebody or have a different condition or What if we're doing really well and we have pivoted and now we have a goal and we're training to climb Machu Picchu or we're doing something like your training changes and everything changes because of the thing that you said, I wanna do this when I'm 80. It changes for the better. How cool would that be?

Yeah. I mean, I'm doing farmer's carries, which I never did my whole life. Because I want to be able to grip those groceries, like those grocery bags, right? Like, never, you know.

Or children. Children.

Children. Yeah. I never had that. And those things are all, I think, yeah, your goals and your— what you want to do change. It might be to climb Mount Apichu. So you have a whole different set of movements you need to be able to do than swimming or biking. Like, there's a whole different sets of muscle groups, but also just Endurance and nutrition to train for it. It's a bit different.

Yeah.

Right. It's all different. And that's what I want women to do is I want them to think of it as like, I'm not going to be on a couch watching CNN for the last 15 years of my life. I'm going to do what I want to do.

Yeah.

And how do I do that?

This is not a book that you have out yet. So Pivot, yes. Love that. And tell me, is that out? When will it be out? Give us the details.

Yeah, so it's on Amazon now for presale and it's out November 13th on a Friday, 'cause I thought that was kind of cool to be—

Oh, sweet.

Friday the 13th. I don't know. Why not?

It is very cool. Actually, so as a little girl, my mom was a volunteer for bingo at the nursing home. So I used to, in the summertime, go help them. They all thought 13 was lucky. All of them. So there you go. Probably a bunch of witches down there, but whatever.

I called bingo too in college, man. They would be like, you're not loud enough. You need to say it more clear. I'm like, okay. Right.

I'm trying to win some Jell-O here. Let's go. But I want to ask you about the one that's not published because we were just together. So just to let everyone know a little behind the scenes, we were just together and we had the opportunity, both of us, to share an idea about a book. And the idea for the book that you shared, I think, was so intriguing and fun and And I don't have a daughter, so I was thinking about why I liked it so much. And I think it's because you get back to a moment of time where you wish maybe you'd had the book. I wish I would've had that book. I was the youngest of 4. My mom handed me the same book she handed my sister 16 years prior to me. Guess how well that went over? The pictures were so old. It was like, are you kidding me? I mean, tell us a little bit about how that evolved. You have a daughter, and I love the questions she's asking you.

Yeah, you know, being an integrative GYN, you— well, first of all, it evolved first because my daughter would— I would be driving my daughter and her friends, and they'd be asking me questions like, what's up with this? Like, what is— what does it mean by— like, what's a menstrual cup? Like, what's that? Like, they'd be asking me these type questions because they knew I was like, I, I'll— give me anything, I'm not going to be shy, anything you want to ask me. So it started where my, my daughter's friends would be asking me all these questions in the car, and I'd And then I, then my, my kid would say, you know, I'm now, um, doing flag football and I find myself kind of nauseous before the games and I'm getting headaches. And so I'm like, well, what are you eating? Like, what kind of training are you doing? Are you doing weights? Are you like, what are we doing? And she's like, I don't really know any of these things. My, my coach doesn't talk to me about these things. No one says anything about your period and what you should be thinking about related to eating and getting proper nutrition for a teenage girl. And so being a, obviously the daughter of a gynecologist, she knows all that, like luteal phase, follicular phase, ovulation. Like she uses the terms vulva and all the terms. And so realizing when listening to her friends, like they're not knowing any of these things. They don't— in the education, if you're lucky enough to live in a somewhat progressive state, you might learn a little bit. But, you know, a lot of people live in states where they don't have any education. They just basically say, hey, you're going to go through puberty and you're going to get B.O. and here's your deodorant. stick and your pad and like, good luck, right? And that's the only education that they get. And they might have a mom like mine who's a product of the '60s who spoke about puberty as this like blossom into a flower kind of thing. And I'm like, that gave me no details. Like, I don't know, what does that have to do with what's happening to me every month? Like, what's this flower thing going on? Like, so I feel like there's a lot of opportunity. And women, young savvy. Like, they pick up stuff, they learn from online. I saw a study that was done 3 years ago that 60% of women under 20 get their health advice through online— not their doctor, not their mom, but online. So they're, they're like, what is the menstrual cycle? What is this? What should you be doing? And they're learning these things online. So let's give them the proper education and teaching to what— how the body works. I mean, we tell them it's going to change, but we don't really tell them anything about how does this— how do these hormones play into leptin and ghrelin, why you want to eat chocolate at 2 AM? How does it play into your dopamine and how you want to break up with your boyfriend every 28 days? Like, how does it— how does it play into all these other things that happen in your body? And I think that they're— young women are so intuitive that they would take it. And I see a lot of younger women in my practice who don't want to be on birth control and want to learn how to make their cycle better. And their mood better and their skin better without needing to rely on those things. And I feel like this is an opportunity now to take that education to younger women and say, hey, you don't have to wait till you're 40 to sit in my office and be miserable saying, no one told me this was going to happen. You'll know well ahead of time when that happens and identify it.

I love this. And I, I feel like the book I read was, you know, Are You There, God? It's Me, Margaret. And yet this is so much more progressive than that. I feel like your daughter, you know, and the questions she's asking, maybe representative of, of this, this that's there now. They're just so ready for more and they're gonna get it one way or another. So let's make it good. Yeah.

Yeah. Use the right terms. Let's give 'em the right education. We don't need to, to use words that they don't, they need to know about their own body. We spot, I think in, And too, we speak openly about boys and their parts and their this and that, but we don't really talk about girls. And I think that they feel— then they get in their 20s and get misdiagnosed for 5 years for their endometriosis or their PCOS or whatever the issue is, that they're dismissed because they don't necessarily have the right words to communicate, this is what's happening to me.

I'm going to ask you something that is just relevant for the moment in time we're in. And if there's anything that I ask that you'd rather not answer, please let me know. But I feel like I'd be remiss if I didn't because we're like, we're coming to the edge, but we're at this moment in time where we're talking about 7 Boys, 7 Hours and Cornell and all that's happened with a young daughter. What's happening at your house in terms of discussions you're having with her and what questions does she have?

Yeah, I'm an open book with my kids about everything. I explain consent. What does consent really mean? What does it mean to where who should see your body, touch your body? I mean, my kids know, they probably, if they were on this podcast, would be like, yeah, she starts way too early talking about this stuff. Because I, even my boys, I'm like, you guys need to respect women, you need to teach, you know, and all have literally, even when they were in high school, they all have little menstrual kits under their bathroom for girls that come over that visit so that they can give them So if they get their period while they're at my house, my sons are very well knowledgeable to be like, here you go, under the counter. My mom's made this little kit. You don't have to be embarrassed to ask her about it. Like, here, it even has a rice pack for like putting over them for periods. Like a little, like, you know, because I want my boys to even know what women go through. To get it. To get it, to understand, to be supportive. And they do. And the same thing with my daughter. I'm like, open book. Let's talk about this. What is sex? What does it mean to have consent? What does it mean to protect your body? What does it mean to go to a party together and leave together? Like, you know, like, what does it mean to be supportive of the other girl in the room, right? The other female in the room. And I also think in this day and age, you know, we have other concerns like people giving fentanyl to your kids, you know, and date rape drugs, and there's so many bigger conversations. So I talk to my kids, including my daughter, about just making sure you're protecting yourself, putting yourself in those environments with friends that are going to take you there and take you home. And, you know, it's okay to be the designated driver sometimes. Like, those are all things I talk to my kids about. And they, they like, I'll support— my sons even know, like, because they're older now, they're 19 and 17. I'm like, if you guys go to a party and someone needs a ride home, you call me. No judgment, no punishment, no nothing. I won't call their parents. I won't do anything. I will safely take them home and you have absolutely no punishment. Because at the end of the day, safety is the key. And I want my kids to know that they can trust me to help them and guide them through those things that happen under my roof and even outside my roof. I have a 19-year-old, so I've taken his friends home before from a party and that's okay. Like, I need them to understand what that means.

Relaying to anybody, home is a safe place. Your parents are safe. You can call anytime. You'll be picked up, no questions asked. And the way you're openly talking about all the things and it becomes less of an embarrassment. And I was raised by much older parents and, you know, it was a different environment. We didn't talk about it. Of course, you know, we did all the things with everybody else and we went and looked up those books. We knew where they were hiding. We would go look at them and then we would put them back.

Yeah. Yeah, exactly.

Oh gosh. Okay.

I think it's important that you have— if you're not comfortable with those conversations, maybe things like those books, like a book that we're talking about writing, that to be able to have that you can reference to them and say, maybe this is a starting point for the conversation. They're going to get the information. It's just what information do you want them to have?

Dr. Jen, thanks so much for being here. Congratulations on the release of this book, and I'm so excited about the next I think you're going to help a lot of new generation of women coming up and growing up in the right place from the very beginning. So where can listeners, number one, find you, follow you, get the book, and elsewhere that you are on social media?

Yeah, so if you want, you know, to binge some videos, I have a YouTube channel that's under my name, Dr. Jennifer Rollins. It's all about midlife, so 40 on up is the channel's about. And I have a website under my name, drjenniferrolands.com. And you can get the book on Amazon or Barnes& Noble, all the big retailers, but Amazon tends to be what everybody likes as well. And then I'm on Instagram, but mostly I spend most my time on YouTube because I love answering questions just like you. I love sort of taking that information and making videos specifically about what women want to hear. So that's important to me. And you didn't say anything about your book, but your book was fantastic about exercise in men— in midlife and menopause and how we have to actually shape it differently, right? I love that you were pitching the idea of not thinking of it just as a box, like, here's what every woman should do and this is where it should be.

It

was so much more, which, you know, I know your listeners are going to be so excited about anything from you.

Thank you so much, and thank you so much for your time. This was wonderful.

Thank you.

The information shared on Flipping 50 the Stronger Way is for educational and informational purposes only and not intended as a substitute for medical advice, diagnosis, or treatment. Always consult your physician or qualified healthcare provider before beginning any exercise program, making changes to your diet, or adjusting any medications or supplements. Individual results may vary. Debra Atkinson and Flipping 50 are not responsible for any injury or adverse outcomes resulting from information presented on this podcast.