Menopause Part 4: Training, Protein, Cortisol, Hormone Therapy, & Bone Density

<p><br></p><p>Is there really a “menopause-specific” way to train, eat, and supplement — or is most of it marketing? In the finale of our 4-part menopause series, Drs. Jordan Feigenbaum and Austin Baraki go straight to the evidence on building muscle and bone before, during, and after the transition.</p><p>We cover whether menopause blunts your response to lifting (the Isenmann 2023 head-to-head trial and the 2026 meta-analysis of ~4,000 women say it doesn’t), the one-index-card prescription that actually works. Then we work through the loudest claims in the space — cortisol “wrecking” your fat loss, anabolic resistance, the protein and creatine hype, hormone therapy as a cure-all, and “you need a different paradigm” — steelmanning each before we push back. We close with the strongest case in the whole space: heavy lifting for bone density (the LIFTMOR trial), the pelvic-floor evidence, your three biggest fears answered, and how to tell a good coach or clinician from a bad one.</p><p>Claims discussed are associated with Stacey Sims, Mary Claire Haver, Mindy Pelz, and the broader functional-medicine space. We push back on the claims, not the people.</p><p><br></p><p><strong>Timestamps:</strong></p><ul><li>0:00 The 90-year-olds who tripled their strength</li><li> 1:10 Why this matters: heart disease and falls, not vanity</li><li> 2:28 Can women still build muscle after menopause? (Isenmann 2023)</li><li> 7:31 Does menopause blunt your gains? The 2026 meta-analysis</li><li> 8:49 Is it menopause, or just individual variation?</li><li> 14:42 The estrogen "shield" and the mechanical override</li><li> 18:31 Does hormone therapy replace training? (the 2021 estradiol trial)</li><li> 22:44 What actually works: the whole prescription</li><li> 24:18 Program details: frequency, volume & insulin sensitivity</li><li> 30:22 Nutrition: protein and the 2026 review</li><li> 35:06 Creatine, vitamin D & calcium</li><li> 43:29 Anabolic resistance: mostly overstated</li><li> 47:22 Clinical case: the supplement-stack patient</li><li> 52:23 A short history of wrong advice for women</li><li> 53:38 Claim 1: "Lift heavy or lose your bones" (Stacey Sims)</li><li> 1:01:09 Claim 2: the cortisol myth</li><li> 1:15:18 Clinical case: the cortisol-anxious patient</li><li> 1:18:20 Claim 3: "It's all hormonal, HRT fixes it" (Mary Claire Haver)</li><li> 1:20:45 Testosterone in women: what it does and doesn't do</li><li> 1:21:51 Claim 4: "Menopause needs its own paradigm" & the SWAN data</li><li> 1:24:48 Bone density done right: the LIFTMORE trial</li><li> 1:33:07 Does heavy lifting wreck your pelvic floor?</li><li> 1:38:59 Your three biggest fears, answered</li><li> 1:40:44 Green flags & red flags </li></ul><p><strong>Resources:</strong></p><ul><li><strong>Menopause Series Part 1</strong> : youtube.com/watch?v=yzk0IkTy0WM</li><… Series Part 2</strong> — youtube.com/watch?v=YKAlamIOiwU</li><…; <strong>Menopause Series Part 3</strong> — youtube.com/watch?v=jzoNMQaBAcI </li><li><strong>Hypercortisolism episode</strong> - open.spotify.com/episode/7tDdUi8dDFWjMYx0fRJdOz </li></ul><p>Barbell Medicine coaching and templates: barbellmedicine.com</p><p><br&g… book pre-order: barbellmedicine.com/shop/learning/signal/</… (2023) <a href="doi.org/10.1186/s12905-023-02671-y"; rel="nofollow">doi.org/10.1186/s12905-023-02671-y</a>&l… (2026) <a href="doi.org/10.1016/j.jsams.2026.01.004"; rel="nofollow">doi.org/10.1016/j.jsams.2026.01.004</a>&… (1990) <a href="doi.org/10.1001/jama.1990.03440220053029"; rel="nofollow">doi.org/10.1001/jama.1990.03440220053029</a… (1994) <a href="doi.org/10.1056/NEJM199406233302501"; rel="nofollow">doi.org/10.1056/NEJM199406233302501</a>&… (2021) <a href="doi.org/10.3389/fphys.2020.596130"; rel="nofollow">doi.org/10.3389/fphys.2020.596130</a><… (2015) <a href="doi.org/10.1016/j.exger.2015.02.015"; rel="nofollow">doi.org/10.1016/j.exger.2015.02.015</a>&… (2022) <a href="doi.org/10.1016/j.exger.2022.111904"; rel="nofollow">doi.org/10.1016/j.exger.2022.111904</a>&… (2026) <a href="doi.org/10.1186/s40798-025-00954-2"; rel="nofollow">doi.org/10.1186/s40798-025-00954-2</a>&l… Santos (2021) <a href="doi.org/10.3390/nu13113757"; rel="nofollow">doi.org/10.3390/nu13113757</a></p>… (2021) <a href="doi.org/10.3390/nu13020368"; rel="nofollow">doi.org/10.3390/nu13020368</a></p>… (2021) <a href="doi.org/10.1111/sms.13999"; rel="nofollow">doi.org/10.1111/sms.13999</a></p>&… (2015) <a href="doi.org/10.1093/gerona/glv057"; rel="nofollow">doi.org/10.1093/gerona/glv057</a></p&… (2016) <a href="doi.org/10.1186/s12902-016-0128-4"; rel="nofollow">doi.org/10.1186/s12902-016-0128-4</a><… (2009) <a href="doi.org/10.1093/gerona/glp082"; rel="nofollow">doi.org/10.1093/gerona/glp082</a></p&… (2019) <a href="doi.org/10.1016/S2213-8587(19)30189-5" rel="nofollow">doi.org/10.1016/S2213-8587(19)30189-5</a></p><p>Testosterone in women review (2026) <a href="doi.org/10.1080/09513590.2025.2592402"; rel="nofollow">doi.org/10.1080/09513590.2025.2592402</a>… nonhormone position statement (2023) <a href="doi.org/10.1097/GME.0000000000002200"; rel="nofollow">doi.org/10.1097/GME.0000000000002200</a>… exercise meta-analysis (2022) <a href="doi.org/10.1080/13697137.2022.2097865"; rel="nofollow">doi.org/10.1080/13697137.2022.2097865</a>… (2019) <a href="doi.org/10.1172/jci.insight.124865"; rel="nofollow">doi.org/10.1172/jci.insight.124865</a>&l…, LIFTMOR (2018) <a href="doi.org/10.1002/jbmr.3284"; rel="nofollow">doi.org/10.1002/jbmr.3284</a></p>&… (2024) <a href="doi.org/10.1249/MSS.0000000000003278"; rel="nofollow">doi.org/10.1249/MSS.0000000000003278</a>… (2021) <a href="doi.org/10.1007/s00192-021-04739-5"; rel="nofollow">doi.org/10.1007/s00192-021-04739-5</a>&l… (2018) <a href="doi.org/10.1002/14651858.CD005654.pub4"; rel="nofollow">doi.org/10.1002/14651858.CD005654.pub4</a&g… Sponsors:<br/>* Check out Cometeer and use my code BBM for a great deal: cometeer.com<br/>* Check out Cometeer and use my code BBM for a great deal: cometeer.com<br/>* Check out FIGS and use my code FIGSRX for a great deal: wearfigs.com<br/>* Check out Factor and use my code factormeals.com/bbm50off for a great deal: factor75.com<br/>* Check out Quince and use my code BBM for a great deal: quince.com<br/><br/><br/>Adv… Inquiries: <a href='redcircle.com/brands'>https://redcircle…;