What are the HRT Effects on Exercise Results?

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It's made by a trusted family-owned company that we all can feel good about. Third-party tested for purity and potency. And if you're interested, you too can try a sample for just $6. But even better, you can get 30% off forever with discount code FLIPPING50. That's FLIPPING50. Just go to flipping50.com/blueskycbd. We'll put that link in the show notes and you'll find it everywhere on Flipping 50 at My Favorites. What are you waiting for? Good night. Okay, before we even jump in, this can be a heated topic. I realize this is a little bit like talking about animal versus plant protein, a little bit about talking about how much protein should you consume, and it's really something that is each woman's personal choice and decision. What I want to make sure of is that, that's how you're taking it. So I think there is some old science that you may be under the spell of that. I just want to bring your awareness to the point that old beliefs about hormone replacement therapy may need an update for you. So there once was a time when we believed that hormone replacement actually led to higher risk of cancer, including breast cancer for sure.. And there are actually now a very limited and much smaller percent of people who actually have had breast cancer or at risk for it that may actually still be able to do HRT and may benefit from doing it in terms of their risk. So some of old science has been thrown out, but remember how easy it can be to, once you get an idea in your head about what is healthy, what is true, what is right, often our beliefs about those continue. They linger on. They're true even when the, the science has changed, retracted statements. And that is the case in terms of hormone therapies. It's also the case in terms of, say, cholesterol. Foods with high cholesterol in them do not elevate blood cholesterol levels, but you're still finding old advice lingers, right? So that too is retracted. Things like eggs, even saturated fats, not tied to heart disease and high cholesterol levels as they once were. But I'm not gonna dive into that one particularly in a packet, but I do wanna just give you this. This is in this episode, a little based on some science and an equal base on personally, professionally, what I've seen in 40 years. Not me personally, my own results, but what I witnessed with my clients who are on HRT. Now, back in the day, in the '90s, anybody who was on HRT, it was either they were trying to do it 100% naturally and they were using things like black cohosh, and that's still recommended by, say, Christiane Northrup still recommends that on her website today as either an alternative for someone who wants to try and get as much naturally, as much support naturally as they can, or chooses not to do HRT but is doing everything they can. Another great support is our friend Magdalena Schalocki, Hormones Balance, and Cooking for Hormone Balance, and learning about the supplements that you may take that can help your own comfort level, health, and offset things, diseases, instances of signs or symptoms post-menopause or during it due to the fact your hormones are declining. You can learn a lot, and I will put those links to that, links to previous shows we've had, as well as to the resources in the show notes today. I'm Debra Atkinson. You're listening to Flipping 50, where I address your top struggles and concerns, the The things that we really hope to do here though are inspire you, elevate your glass ceiling and your expectations so you demand better service, better products that really are about positive aging. We're all going to get older, but whether— or we're all going to age, maybe I should say it that way— but how you get older, maybe instead you're getting bolder, you're getting stronger, you have better conviction, more confidence in what you're doing. And when we have wisdom now, we couldn't have had except for the life experience that we've got. For some of us, that means we're more calm. Maybe we are more strong. We are more comfortable in our own skin. And if you're not right now, and that's because of bodily changes that you can't control, hopefully this episode will be a little bit of help to you so that you are set for that second and better half. Okay, so what are the HRT, hormone replacement therapy, effects on exercise. What are those results? What do they say? So again, we're using science, and I'm going to be actually quoting from some science, and you'll see it in the post if you really want to visualize it. It will be there. So some of our podcast show notes actually function as a blog as well. And what I want to do is make sure that you understand, first of all, when we talk about HRT, it is hormone replacement therapy, but I want to make this distinction. Not talking about synthetics, not talking about the old way of the 1990s when it was just, you know, hormone therapy and it was, you know, equine urine. I'm talking about bioidentical hormones that are much more like humans. They're grown in a lab to be like humans. Okay, so the difference is your body accepts them, uses them utilizes them far better. So do HRT effects on exercise results give you an advantage, or do they hold you back? I've addressed this in podcasts and interviews before, but it's been asked again. It's probably an evergreen topic we'll keep coming back to, so let's discuss it. For the Cliff Notes, yes, it makes a difference. It makes a positive difference. I mean, that if you want the Reader's Digest condensed version, There you go. You may go on about your day, but I think you're going to want some details. There are things to consider about why and how it makes the difference, what it does, doesn't do, and no matter what your choice is, what's possible for you. So research reports that HRT effects on exercise are this. So I quote, hormone replacement therapy has significant beneficial effects on skeletal muscle mass, strength, and protection from damage in older women. HRT seems to improve muscle power, regulation of muscle contraction— that's the strength that you're able to create from movement— and muscle composition. HRT is linked to the reversal of both menopause-related obesity and loss of lean muscle mass without overall change in body weight. That means you may weigh the same as you do in high school, but I guarantee you— I would, I would almost bet my life on this— that if you're not lifting weights or haven't, and haven't been aware of high protein intake needing to happen, that you are not the same body composition that you were in high school, even if you weigh the same, right? And what we're after is making sure that you are maintaining that lean muscle mass so that you stay strong, you stay independent later in life. We need it for reaction skills, for balance, for just simply living on our own. Getting up and down off a toilet, and let alone a chair, can be super important to us later as we age. So HRT, by the way, will be in literature often referred to as HT or just hormone therapy, quote unquote. The increase in lean body mass during hormone replacement therapy is likely explained by muscle anabolism. And anabolism is growth, beneficial increases in muscle, which in turn prevents disease in the elderly. The more lean muscle mass you have, the less likely you are to have blood sugar issues, diabetes, heart disease. And more benefits of hormone therapy are seen in younger postmenopausal females and those who initiate hormone replacement proximal to menopause, meaning if you, before you actually hit that menopause transition, you started, go you. And I will tell you, true confessions, I resisted that. I, you know, my lab tests, my Dutch test showed when I was— oh gosh, it's probably 53, 54 when I first was testing and looking at where am I, what am I doing. And, you know, I went on and I didn't feel any different. I mean, I didn't feel bad. I gotta say this, I didn't feel bad when I went in, but I was just doing a lot of additional training. I was training for some long endurance events, and I knew, obviously, you know, as I talked to you about the risk of lean muscle mass and bone density changes that can happen right at this point, right, when even if I'm not experiencing hot flashes or night sweats I've got to be close to menopause. The average age is 51. So at 53, 54, I began testing, and I was testing my own— had already done that for the book You Still Got It, Girl, self-directed tests and interpretations, learned and taught myself how to do that. And then I started working with a longevity institute in Boulder, and You know, they put me on HRT and it was like, okay, you know, 6 months later, I don't know, I'm not feeling any better, not noticing any change in anything. And I was like, you know, this is great, but I just don't feel the need. And so I went off. Uh, you know, hindsight now, I might not have done that because that actually could have given me an edge with even better bone density. And I'm talking in 10 and in 20 and at 30 years. Now, will I ever know what, what I could have done, what I could— what edge I could have given myself? Not exactly, no, right? So I won't know that. But that's what I would be thinking now if someone were wondering, I don't know if I should go on it or start it. And a lot of doctors— you're going to get controversial advice— will say, well, you don't need it yet, you're not in menopause, or I'm not even going to look at that because you're not in menopause. And I I think that's just not being proactive. So I think you want to be able to push back and say, how do I want to approach it? And then find somebody who will work with you, because there are plenty of people out there who have a different opinion and have witnessed different things in their practice. They're not shooting blanks and just operating by opinion. They're operating based on science. Okay. Positive association of bone mass and density with estrogen in older women has has been well established in scientific literature. Bone mineral loss accelerates following menopause in women, and this accelerated bone loss is prevented by hormone replacement therapy. It may not be entirely prevented, but it certainly is slowed down or reduced. The other thing you got to do— two things— resistance training. If you're not resistance training, you're going to hear me say that again and again and again. And I don't know when you're listening, but inevitably some kind of program is open. So if you're not lifting, you don't feel safe lifting, you don't know that, that a trainer who's, who you're working with has your back or understands what it's like to be in midlife or in menopause, and your program is really not reflecting something that is heavyweight, that is stimulus enough to gain strength and bone density, you wanna look at that closely. Don't waste any more time checking to make sure you're doing the right thing. Bone mineral loss accelerates following menopause. Know that I've talked about this for years now prior to the pandemic, but then in the pandemic, what would have happened to a woman who was in that couple of years right before hitting menopause, 12 months without a period, and those 2 years if she was in that window of 2 years after, 2 years before? Muscle loss does accelerate, bone loss accelerates because your estrogen is taking a nosedive. And we're in a pandemic with a dumbbell shortage and no access to gyms. If you weren't lifting then, that means right now you have nothing more serious on your plate if you care about your health and those who love you so they don't have to take care of you. You want to get that muscle and the bone density back on track because you can still make a huge difference and mitigate any losses in strength or lean muscle mass or bone density that to have. Exercise and hormone replacement— this is quote unquote— may also independently and additively mean if you're not doing HRT, you can't but do resistance training. If you're doing HRT, fantastic, you're getting some benefit there. But if you are doing both together, they additively help maintain bone mineral density in aging females. So that is all coming directly from the literature, and in most cases, studies that I have included were a review of literature. So do you know what that means? Just in case you're not sure, that means that there were multiple studies included. So now we're talking of large numbers of women included. So it's not just one study where you have to say, well, how many women were studied? And it wasn't just 14 people, was it 38? That's really not many, but we're talking thousands of people, some of which are longitudinal studies. That means a long time over time, like we looked at what were they doing and then how did it come out when they were 70, right? And they're going to be in a point where osteoporosis is much more common. So what is exercise for menopause optimization? It can't just be any exercise. Whether you're on HRT or not. Like, not just like, I'm very active, I love you, but it's not enough. Now we want to start getting a little more specific. Is it really addressing your highest priority on your needs? An ineffective exercise program designed, say, for men, based on research featuring men or mice or even young women, or just everyone— this program's for everyone, you can all come— I mean, that has a small chance of working for a midlife woman. And I would say really for anybody. Like, the same is true for a young woman or for a man, but the difference is that young men respond to almost anything. Younger women will respond better to almost anything. But you, if you're a woman in midlife, I mean, and you're trying, oh, I'm gonna do this challenge with my daughter, I'm gonna do that— it's not— if both of you respond, you're not getting as much, you're not getting as specific for your own personal personal needs. So it's like the difference between going to your GP and getting, you know, run-of-the-mill 15-minute talk and check versus going to an executive physical, you know, examination at Mayo Clinic. Which one's going to give you more in-depth information, right? So think about that. Okay, so for exercise to have the most benefit on body composition and bone density, it must have adequate volume volume of intensity level. So what that means is adequate volume of intensity doesn't mean just increase the number of days or the duration of the exercise that you do. That's not it at all. It is how breathless do you get? Do you actually reach it where you've got to bend over and stop, put your hands on your knees? Do you actually get to a point muscle fatigue at the end of every set. And if you don't, well, you may not be reaching where you need. Volume comes from heavy weight and fewer repetitions rather than increased frequency. And I have to tell you this, we think we know but we don't. So a little tale I'm telling out of school, we recently released a program in, inside of our membership that is testing proactively something that we'll use for an app And I suggested that probably this program is best for women who are very comfortable with exercise technique, that are very familiar with exercise protocol, and otherwise wait until you've got some more experience under your belt. You're used to, you know, structuring workouts and creating them for yourself, and you understand progression and protocol. So you're pretty comfortable around a gym. Great. Okay, well, I have intelligent women in our membership. However, just got a question from a woman in her first week of starting that program, and it was very clear. She said, the repetitions here make absolutely no sense. I quote, she said, why would you have a beginner doing more repetitions than someone advanced? This makes no sense at all to me. And I was like, oh, my response that I said in my head was, you probably shouldn't be in this program. I don't think you have as much experience as you think, but I could be wrong on that. So if you too would have been confused about why a beginner has a high repetition range, an intermediate experienced lifter has a kind of moderate number of repetitions, and someone who's advanced has the least number of repetitions. And the reason for that, if you're confused, is because as weight increases, you do fewer repetitions. Ultimately, if we're going to give you a really hard workout, I might have you do 5 sets of 5 repetitions. And that means you're reaching fatigue at 5. 4 is getting hard. That's, that's a strong workout, but only for somebody advanced who's got joints and ligaments and connective tissue that can handle it, that has strength and foundation and recruitment and muscle patterns that have been ingrained for not just weeks but for months, if not years. Now, if that's confusing to you, that's not your fault. If you've got a long relationship with exercise, you have not been given the real tools that you need to take charge. So I just want to point that out. And we sometimes think we know, we think we've got great experience, and we're saying, yes, well, that's me, I'm very comfortable with exercise, I know it. But you're only as limited as your awareness of limitations, right? So we don't know what we don't know, and that was just a huge eye-opener for me. So it just reaffirms what I'm doing, why we're here. So I hope this makes very good sense, but I'm going to say that last sentence again: volume comes from heavyweight, fewer repetitions, rather than from increasing the number of repetitions or increasing frequency or duration, namely because of one of the risk factors of muscle breakdown or catabolism is elevated cortisol levels. So if you're just adding distance, you're just adding multiple days per week, you're not allowing yourself to relax and recover in between, you're elevating your cortisol levels over and over and over again. With heavy strength training, you lift, you do those 5 repetitions, you put them down. What happens Rest, right? And in between those heavy lifting sessions, you actually need those 2 days between, 72 hours, 72 hours full rest between. You earn it and you want it and you take it, and that is important. You can't get results without it. So while endurance exercise like running, long bike rides, etc., it's known to contribute to a rise in cortisol with negative influence on muscle as adults age, particularly women in menopause. So too can high frequent high-intensity exercise like high-intensity interval training. If it's done too frequently, it's done for too long a period of time, like you're going for an hour trying to do high-intensity interval training, or you confuse and muddy the purpose of a workout. Let's say you go for, you know, an hour or 2-hour bike ride and you say, well, I'm going to intervals in the middle of this. Is that good? I would say no, it's terrible. Like, because what's the purpose of your workout? If it's supposed to be a long one, it should be very low intensity and a base building and/or a recovery ride just to get blood flow going and build the base that is the foundation you build the rest of your fitness on. If it's going to be interval training, great. Make it about a 30-minute ride and then get off. And that's it. You don't want to combine them. So it's important for you to think about what's the purpose of my workout today. And very few of us maybe have thought about that. There's kind of this go hard all the time kind of thing. I remember when I was training for triathlon and, you know, I'm a strength and conditioning coach anyway with years of experience, and I would ride with my significant other at the time, you know, and he would always challenge me, you know, and be kind of a hard driver in intensity. It's like, you know, you need more intensity. I'm like, I know on certain days I do, but today is meant to be, you know, it's a 3-hour ride. We're going 50 miles. Today is not the day to add intensity. This is base. I'm like, you're bad influence, you know? And so So it got really— I mean, I would get angry on rides with him because he would taunt me with wanting to beat him or race him. And I was like, oh, I'm not supposed to be doing this today. And so mentally it was really a struggle. And I think even within ourselves, it's really easy to say I should be working harder because I really want to burn more calories. And you use your tracker and your tracker is stupid. I'll say that again. Your tracker is stupid. Your tracker does not know your goal, your stress level. And I know they will beep at us and say, your stress level is extremely high today. Think about taking a deep breath. Mine says that to me all the time, but I'm here. I am in, in the middle of a strength training workout, or I'm in the middle of a HIIT workout. I'm like, yeah, it's supposed to be right now. You know, it just just doesn't know. And so you've got to factor in that you're the human here. Let's just be a little more human. All right. In 2015, I wrote about the uniqueness of recovery period needs in You Still Got It, Girl. It's the active— or the fitness formula that we created for women. So You Still Got It, Girl is the book. You'll find it These were elite individuals. That's what I talked about. But they're just for illustration purpose. It would go across the board if you were comparing you to, you know, 50 other menopausal women in the same exact status as you. So elite athletes, you will have to say, will recover faster compared to beginners. You know, in a 20-year-old will recover faster than a 60-year-old. You know, in general, I think we could agree, well, of course that makes sense. But listen to this. The study of individuals taken through a significant overreaching period of training— now it wasn't just like one single workout, but it was a long stretch of training, maybe months long. They were all given the same protocol. They all started with similar status and health prior to it, then went through this period of training, and then they allowed them to to de-train, stop and recover. And they looked at what did it take to get them back to full recovery. So their, their VO2 was recovered, their lean muscle mass was recovered, there was no breakdown in muscle. The difference was like 1 day to 180 days. Crazy, right? Crazy difference. 180 days, that's like half a year. But they had overreached so much. This is not unlike women who suffer with adrenal stress, driving themselves into the ground. Like, I want to do a half marathon. I have experienced this, so I hate to tell tales out of school, so I won't mention any names, but I worked with private clients who want to do half marathons, and they love the endurance and they love the training. And, and mentally, I think we also have to acknowledge the fact we think if we do more training, we will lose more weight. We're suddenly gonna look like the COVID of the magazines. And gotta tell you, those are airbrushed. You all know that, right? I don't care if it's Sports Illustrated bikini issue or it's Shape magazine or Fit Woman— I don't even know if that's magazine— but they're airbrushed, even those, probably especially those. So just don't go crazy. I went to a photographer, local, um, several years ago, and I got back back my photos and I'm like, I don't look like that. Like, I would love to look like that, but this is a little too much, you know? And so I had to send them back and say, whoa, whoa, don't do this. I know this may be what gets you your photos on covers of magazines, but this is not who I am and who I'm talking to. So You know, I just— please remember that, you know, that this is really, really important, but your recovery rate— and you, you know, personally can't, you know, allow yourself to throw yourself under the bus. My clients who have sometimes done that overreaching, like training for a half marathon under that disbelief, but we still— it still lingers, you know, have then gained weight. And then can't lose it. That's the bigger one, right? So if you're in your 50s and your 60s, you gain 10 or 15 pounds training for some kind of endurance event, it may be hard to get it off because you've decreased that lean muscle mass. You lost a significant portion of that. You've increased your cortisol and your stress level. We're, we're struggling. You've decreased your testosterone levels. They suffer when you do a lot of endurance training, you know. And even if you're strength training while you're doing it that— what are we doing? More exercise. And yes, I would say strength training is important, but while you're training for something, your strength training has to change significantly into a— this is for decreasing injury risk. You can't be going really heavy and powerfully as you're trying to train for something with endurance, or you're kind of doing yourself a disservice. Like yin-yang, your right hand doesn't know what the left is doing. So a little side note on that. Now, will you recover better from any exercise if you have support through hormone replacement? Likely yes, as you've got estrogen and progesterone to help offset your stress. And if the insulin and cortisol are in better balance, there's less inflammation and more anabolism, more maintenance of muscle that is there, or maybe gain. But probably if you're doing a lot of endurance, you're probably not gaining lean muscle. You're just trying to hold your own and not lose it. Keep that in mind as well. So it may be a bucket list thing for you to do something long distance, but you're probably not gaining lean muscle mass, and you may in fact not be losing any fat either. Anecdotal HRT effects on exercise. So in 40 years of training thousands of participants, clients, and supervising thousands more of my staff members, having had, you you know, almost two dozen, at least 20 trainers at one time. There's a notable difference since hormone replacement therapy became more mainstream and more common. Women on bioidenticals are less restricted, one, by the lack of sleep and fatigue that often is true for women in menopause transition. So they're more regular, they're more diligent. You know, they don't have to get up in the morning and say, I can't do that hard workout, I'm just gonna go for a walk. They can do the hard workout. Women on hormone replacement tend to have an easier time with hot flashes and night sweats as well. It's one of the key reasons that women use HRT. Diet, however, there is also a factor. High-intensity exercise, though, um, not low, uh, plays a big role in improving vasomotor issues. I'll say that again. High-intensity interval training helps reduce hot flashes and night sweats, but low-intensity exercise does not. Now, it may indirectly— I will have to say that. So blood sugar issues can trigger, be more likely to trigger, and are more related to the women that I've seen who have hot flashes and night sweats. Those women who have more hot flashes and night sweats are having more sugar in their diet, even if they don't see where the sugar is. It's not obvious to them, it's like not like dessert. But if they're having wine, alcohol, those things also increase hot flashes and night sweats. Muscle development, which is then instrumental in reducing insulin resistance, supporting weight management, is also better in clients with HRT. Bone density changes are easier improving it, though this I have less empirical evidence of, as private clients are the only reference. So it's a smaller pool, right? So my one-on-one time has been far reduced for the last 15 years. I work with a select few clients, but I can say that we have seen easier increases in bone density when someone is on HRT than when they're not. Not. So we're down to hundreds, not thousands, of private clients who I've worked with over time in a capacity where we'd share DEXA scans annually over time. So there is this to note, however: on hormone replacement therapy, women may not be as diligent— uh-oh— as those who opt not to do it for personal, financial, or genetic reasons. We tend to let a pill, cream, shot, however you're taking it, patch, do a little more of the work. We think, oh, we're on it, I'm protected. But really, your resistance training, you're eating high levels of protein of the right high-quality kind, getting good night's sleep— those are equally, if not more important, and potentially will mean your hormone replacement therapy works better. You may actually need less of it. And there's an entire domino effect I'm going to talk a little bit more about in upcoming episodes where, you know, this is all interrelated. So we can talk about, you know, the foods you're eating, how that affects your gut lining. If we're affecting your gut lining, what about the load on your liver and how is that related to metabolism? And if the load on your liver is heavy, what's happening to your cortisol, your adrenal glands, and to your thyroid levels? All of which point to your metabolism. So how do you get this show and this bus on the right track and on the right road? So if you've got questions, you can reach out to us on any social media place. You can DM me on Instagram. We don't check Messenger. PLEA is on Facebook, so go into our groups, and the Flipping 50 Insiders group on Facebook is the best place to do to do that. So if you are not started, if you're not started with strength training, resistance training, and awareness of protein, at least it's time to get going. I'm going to link to the Flipping 50 website. If you are listening in July, we open for enrollment on a monthly and annual option for our Flipping 50 membership, currently called the Cafe. And here's the deal. You can, for, for those women who don't do HRT and yet they modify their diet, their exercise and lifestyle habits for optimal menopause, they can, and they do make significant more improvements in their musculoskeletal health. The best of both worlds can be ideal. Do the work, right? Do the physical work. Maybe that for you feels like the work of lifting weights or exercising, but maybe for you it feels like the, the work of planning your nutrition a little bit more carefully along with HRT. Don't skip either and really get educated. So falling back to that message I gave you about the women starting our, you know, Stronger 8 program, the one that is a little bit more DIY, do it yourself, so they're able to look at the program and, and And yet she thought she was very experienced and she should be in that. It's very clear that what we think we know may leave gaps and holes. So for me, I've learned there's still some work to do here. So if you too still have questions, you can find the show notes at flipping50.com/ep HRT effects on exercise. You'll see it all, and you'll see the references that I've used. You'll find more references in You Still Got It, Girl, the book, by the way. All the resources are always there. Other episodes that were relative, and specifically we're going to put one in with, uh, interview with Dr. Lindsay Berkson who talked about clearing up— look, you know, If you were once told because you're at higher risk for breast cancer or you've had it that you can't be on hormones, that may or may not be true for you. So I highly encourage you to listen to that one. And what are you waiting for? Let's start Flipping 50 today.