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

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. 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. 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. Timestamps: 0:00 The 90-year-olds who tripled their strength 1:10 Why this matters: heart disease and falls, not vanity 2:28 Can women still build muscle after menopause? (Isenmann 2023) 7:31 Does menopause blunt your gains? The 2026 meta-analysis 8:49 Is it menopause, or just individual variation? 14:42 The estrogen "shield" and the mechanical override 18:31 Does hormone therapy replace training? (the 2021 estradiol trial) 22:44 What actually works: the whole prescription 24:18 Program details: frequency, volume & insulin sensitivity 30:22 Nutrition: protein and the 2026 review 35:06 Creatine, vitamin D & calcium 43:29 Anabolic resistance: mostly overstated 47:22 Clinical case: the supplement-stack patient 52:23 A short history of wrong advice for women 53:38 Claim 1: "Lift heavy or lose your bones" (Stacey Sims) 1:01:09 Claim 2: the cortisol myth 1:15:18 Clinical case: the cortisol-anxious patient 1:18:20 Claim 3: "It's all hormonal, HRT fixes it" (Mary Claire Haver) 1:20:45 Testosterone in women: what it does and doesn't do 1:21:51 Claim 4: "Menopause needs its own paradigm" & the SWAN data 1:24:48 Bone density done right: the LIFTMORE trial 1:33:07 Does heavy lifting wreck your pelvic floor? 1:38:59 Your three biggest fears, answered 1:40:44 Green flags & red flags Resources: Menopause Series Part 1 : https://www.youtube.com/watch?v=yzk0IkTy0WM Menopause Series Part 2 — https://www.youtube.com/watch?v=YKAlamIOiwU Menopause Series Part 3 — https://www.youtube.com/watch?v=jzoNMQaBAcI Hypercortisolism episode - https://open.spotify.com/episode/7tDdUi8dDFWjMYx0fRJdOz Barbell Medicine coaching and templates: https://www.barbellmedicine.com Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/ Isenmann (2023) https://doi.org/10.1186/s12905-023-02671-y Isenmann (2026) https://doi.org/10.1016/j.jsams.2026.01.004 Fiatarone (1990) https://doi.org/10.1001/jama.1990.03440220053029 Fiatarone (1994) https://doi.org/10.1056/NEJM199406233302501 Dam (2021) https://doi.org/10.3389/fphys.2020.596130 Markofski (2015) https://doi.org/10.1016/j.exger.2015.02.015 Orsatti (2022) https://doi.org/10.1016/j.exger.2022.111904 Walter (2026) https://doi.org/10.1186/s40798-025-00954-2 dos Santos (2021) https://doi.org/10.3390/nu13113757 Myung (2021) https://doi.org/10.3390/nu13020368 Dote-Montero (2021) https://doi.org/10.1111/sms.13999 Ravussin (2015) https://doi.org/10.1093/gerona/glv057 Cadegiani (2016) https://doi.org/10.1186/s12902-016-0128-4 Greising (2009) https://doi.org/10.1093/gerona/glp082 Islam (2019) https://doi.org/10.1016/S2213-8587(19)30189-5 Testosterone in women review (2026) https://doi.org/10.1080/09513590.2025.2592402 NAMS nonhormone position statement (2023) https://doi.org/10.1097/GME.0000000000002200 Vasomotor exercise meta-analysis (2022) https://doi.org/10.1080/13697137.2022.2097865 Greendale (2019) https://doi.org/10.1172/jci.insight.124865 Watson, LIFTMOR (2018) https://doi.org/10.1002/jbmr.3284 Skaug (2024) https://doi.org/10.1249/MSS.0000000000003278 Skaug (2021) https://doi.org/10.1007/s00192-021-04739-5 Dumoulin (2018) https://doi.org/10.1002/14651858.CD005654.pub4 Our Sponsors: * Check out CovePure and use my code CovePure.com/bbm for a great deal: https://covepure.com * Check out FIGS: https://wearfigs.com * Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com * Check out Quince and use my code quince.com/BBM for a great deal: https://www.quince.com Advertising Inquiries: https://redcircle.com/brands