When I started thinking about writing about menopause in my mid-forties, I had no idea how quickly time would go and how quickly the void would be filled by other GenX women. I couldn’t keep up with these amazing women, and I couldn’t keep up with myself. I had so many things planned out in my head that I wanted to write about and share. But before I knew it, I found myself unknowingly navigating my way through this challenging time, and significant years of my life had gone by. I now find myself a bit shocked to be turning 55 this year. These are precious days my friends, and I do not want to lose any more ~ nor do I want you to. So here I am ready to begin again in this space and share all my experiences and knowledge about menopause, because I can confidently say that I have become a ‘subject matter expert’.

The hardest part has been navigating from not only one menopause transition challenge to the next, but life challenges as well. What most disappoints me is how much time I have lost because of both how little I knew, and where life took me. You only get one go-round and to feel like you missed years figuring things out and dealing has been extremely disappointing. I am disappointed in myself a bit, but really I am most disappointed in how little I knew because of how little information there was to help me.

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I distinctly remember thinking in my forties that I never wanted to be one of those ‘sad older women’, but wow I got there.

First of all, I had no idea when it started the tumult late perimenopause would cause in my life, especially as an athlete, because I had no idea what late perimenopause was or would be like. And then just as I was getting on my feet, my back took me on a journey I never could have predicted. And just as that got better, I lost my furry best friend Inge, my Dad, my job, and stumbled through a year navigating it all alone while my spouse has been working overseas. Before I knew it I lost a lot of precious time and it feels like I am still digging out.

Not only did the Wheels Fall Off, but metaphorically I completely lost the bike.

I have been so immersed in the challenges of this time of life, and so tired of thinking about and dealing with menopause that taking the time and focus to write has been hard. I found myself trying to get through, and then just wanting to move on. I found that my initial desire to write and share went to a mental space of not wanting to deal. I can see why when GenX women have asked their mothers what menopause was like for them, their mothers typically can not recall. Rather than letting a challenge define your life there is a definite instinct to forget and move on. To not become defined by one moment in your life. Menopause at points really became all too consuming for me, punctuated by an all-consuming back pain. And after two years of constant medical visits I have wanted nothing more than to get myself and my time back.

But if menopause has taught me anything, it is that I will never get myself or my time back and that I will never be the person I was before. Before the menopause transition, before back surgery, before my body changed, before one hell of a year that quite nearly broke me. So in an effort to have a lot fewer ‘sad older ladies’ in the world, including myself, I feel it is important to acknowledge, accept, and share in order to move forward.

My intent with this space is to now catch up with myself and to begin (again) sharing my GenX/Menopause journey in hopes it helps to bring some humanity and understanding to what for many is a misunderstood and under-understood time of life. I am confident that with the work my generation is doing that the path ahead will be easier for those that follow and who chose to address changes with eyes wide open and a good knowledge bank in place.

I have just made it through what has been the most challenging five years of my life. But rather than sitting down and writing a book about my experience, I will let the story unfold. I am finally going to write about all those ideas in my head after what has been year after year of making it through one difficult moment to the next. Because here I sit on what feels a bit like the other side, and an understanding with myself that I cannot get those years back so I better make the most of where I am now and what lies ahead.

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In retrospect, my body has repeatedly forced me to have unachievable goals at every attempt to reach a goal the last three years. At the end of the day, the goal has always been the same ~ to feel more like my active cyclist self and be able to regularly workout again. Yes I would like to be where I was at when I was 47, 49 (I am now 54)… but as the goals kept getting averted, my expectations eroded and I tempered them to accept less. Doing nothing was never the goal, but my body has had much different plans than my head and heart ~ eventually pulling those down with it.

First there was the goal to ‘fix my iron’ issue.

If you have been following along, my ‘iron issue’ became a bit of a side note to what became my next goal…

The next goal was to get the MPT (menopause transition) ‘under control’. Spoiler alert, it doesn’t really get ‘under control’ (but it definitely can get better with the right partners and solutions).

The next goal was to at long last, after getting through all that (and a cabin build) ~ get back ‘in shape’.

Well, life took a long winding detour on that one. That goal seems more like a lofty dream right now, but I remain hopeful.

About that detour…

After many valiant efforts, to get myself ‘better’, I now sit here 5 days after back surgery officially in ‘recovery’. But for me the question has become, what is recovery to someone who has never ‘recovered’ as an athlete (remember I did not call myself one until the age of 51)? What is recovery to someone who has literally never been treated for any health issues in their life, not spent time in a hospital or with health professionals other than for an annual exam? And what is recovery in the end really ~ will I ever be ‘recovered’?

My lesson in life over the last 3 years has been if there is one thing for sure, it is that it is likely I will never reach my specific athletic goals, because things change along the way. And although it is good to have that end goal in mind, it is likely to be different than I envisioned it. And as an athlete living the path of life, I think what is most important at this stage is to accept the goal changing, rather than to be disappointed when I can’t make it. It is likely that this one ‘fix’, at this point back surgery, is going to make things better for sure ~ it already has, but it is likely things are also going to be different than they were pre MPT and pre surgery.

After 3 years of what has felt very off-track, and a bit over a year of living in excruciating pain, I will say however, I am going to set my sights on my recovery goal ~ with recognition things are likely to alter the direction along the way. What is my goal now? To get my body, and my mind, in a better place. Because when the body falls apart, I have learned the mind follows.

So what exactly has happened to me? The short story: a pinched nerve in my spine (L4-L5) resulting in radiating leg pain that landed me in surgery on May 23, 2025 for a decompression. The long story? There are three parts really:

1. When things went sideways

2. What I did to try to get back in-line

3. Surgery and Recovery.

I am going to write about each of these separately so they are more digestible and easily referenced for anyone else dealing with a similar issue.

As I publish this today, I am finally in week six of a restricted activity six week recovery. On July 9th I have my post-op appointment that I am literally counting down the days for (I have a calendar on my refrigerator I have been crossing the days off on) until I can get clearance to return to exercise and lift more than a gallon of milk. I wait with cautious optimism, and metered excitement, for direction on the next phase of my recovery. And I look forward to sharing my experience with you.

For the majority of my adult life going to the doctor was never about being sick, and really not about taking care of myself. Essentially as an adult I went to the doctor so I could get a renewal on my birth control prescription. And I have been lucky to have never had to spend time in a hospital or take medication. But I knew things were going to change and I should take charge before they did. So I set out to find a doctor who would be my partner in aging as a woman.

So let’s talk about my relationship with a doctor starting with early adulthood…

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Primary Care

I always had a primary care doctor, a doctor who was a woman (my choice), and that is who gave me my annual exam. ObGyn’s in my viewpoint were for women who had babies, or wanted to, and neither of those was me. That honestly is pretty much still my opinion ~ not because of how I thought in my 20’s, 30’s, and 40’s, but because as a now menopausal woman I have learned a thing or two. [Side note, I did go to an OB’s office once for an annual exam at the recommendation of a mom friend and most of what I remember about the experience was nearly passing out and being taken to a room to lie down. I always say the sight of all those pregnant women in the waiting room made me almost pass out!].

Women-Centered Care

But I did start to think in my late 40’s that advancing from a primary care physician to someone who had expertise in women-centered care for the ‘someday I would be in menopause’, and as I ‘aged’ would be important.

There was no information at the time on how to find a doctor to help me with this goal, so I intuitively did my best and sought out a well-regarded female doctor who treated women. I literally searched the internet and looked up bios and pictures and did my best. A method today I am glad other women shouldn’t have to resort to (more on that below).

So in 2018 when I was 47 I started looking for a new doctor. I found one at the M Health Fairview Women's Clinic and scheduled myself an appointment.

2019 ~ My New Doctor

My new doctor was an ObGyn who had a special interest in menopause. On February 27, 2019, when I was 48, I had my first visit with my new doctor. I really liked her and she seemed knowledgeable, but we had very little time together (which I believe was entirely not her choice, but the reality of healthcare today).

What I did not understand at the time was that I already WAS in LATE perimenopause, which meant I was in the menopause transition (what I call the MPT). I had specific notes for this visit that I wanted to discuss, one of which was ‘refill birth control’, but also other things I will talk about in another story. Specifically something that I now know to be a symptom of menopause (that I had been having for 3 years by that point!). I did get a new prescription for this menopausal issue, because I believe my new doctor knew exactly what was going on with me. But the problem is, because she was allotted so little time to spend with me, I didn’t really realize how important this prescription was for me and what exactly was going on with me ~ again, the MPT.

2020 ~ A Pandemic Pause

So off I went with my new prescription that I only used for awhile. I dutifully scheduled my next annual exam for 2020 and then, Covid 19. I was unable to keep my 2020 appointment and would not make it in to my new doctor again until 2021. I see now that having a global pandemic hit at exactly the same time you are going through the menopause transition did me absolutely no favors. But I also know that when I finally made it to my next doctor visit in 2021, I wasn’t much further along with my care, in fact I missed some critical moments.

My 50th Birthday was March 17, 2020. By the end of that week my celebratory dinner reservation had been cancelled. And around this time I noticed that all of the sudden I had a ‘belly’. My wedding ring also no longer fit (which it still doesn’t and I don’t understand why), and my fingers hurt (I thought it might be arthritis). Because of the lack of information available on menopause, I attributed this weirdness to pandemic stress and cortisol (which I had never heard of until the Pandemic). These things bothered me, but as the Pandemic wore on I just accepted them more as hopefully a temporary situation than the long-term one it has become. [If anyone can tell me why my wedding ring still doesn’t fit ~ I would love to know!]

2021 ~ A Maroon Folder

By September of 2021 I finally made it back to my new doctor. Clearly she knew I was in the menopause transition, but I absolutely still did not grasp what that meant in our brief time together. We discussed if I wanted to stay on birth control as that was a good option to continue to take and then she mysteriously mentioned considering progesterone ‘next year’. The doctors notes from that visit were:

Continue OCPs for contraception/HRT, refill ordered today

Offered FSH level at the end of placebo week, consider at next appointment if interested

Resources given: menopausal folder, NAMS website

I still have no idea what the FSH level note is about so looked it up, here is more info if you are interested. Again, the doctor was not given enough time to explain this to me.

And this menopausal folder… It was a maroon folder filled with informational packets and pages with what I am sure were all the things she didn’t have time to tell me. I looked through it, but that is not the same as having a conversation with someone to be sure. Did I grasp what all of it meant? Still, not really because wasn’t menopause mainly about hot flashes and just happens one day? No.

I can confidently say that my doctor absolutely knew what she was doing. But the fact that she didn’t have time to explain it, or ask me to schedule a separate appointment to discuss it all (which I will discuss below), was not advantageous to my MPT journey.

GenX Women Speak Up

And then GenX women started talking and there was an explosion of information not only about menopause, but late perimenopause and the menopause transition. Most importantly, I found the Hit Play Not Pause Podcast (HPNP) and it opened up my world. And it was from this podcast that I started to understand I needed to find another doctor and make a different kind of appointment. This was thanks to two main guests on HPNP:

• Dr. Heather Hirsch. In this episode Dr. Hirsch spoke about other symptoms than just hot flashes (which I have never had).

• Dr. Lauren Streicher. In this episode at minute 52:10 was an ‘aha’ moment for me when they start talking about how your doctor may not be the best doctor for what you need at this time.

Dr. Heather Hirsch

Heather Hirsch’s podcast became an important resource for me. This was well before she had her book, had been on Oprah, and began her own online practice. After listening to the HPNP episode with Dr. Hirsch I listened to a LOT of her episodes while doing work for the small business I had at the time. Specifically, Episode 67 Where Can I Find a Menopause Doctor had an impact on me in regard to how I approached my visits with my doctor and how I could find the right one.

Dr. Hirsch also has a YouTube Channel where I found a lot of helpful information. She has this helpful video: How to Find a Menopause Doctor and What a Good Doc Should Do! I can see from my YouTube history it looks like the first video I watched from Doctor Hirsch was on February 11, 2023 and about joint aches and pains, which I was having in my hip.

Dr. Hirsch also came out with a book, Unlock Your Menopause Type, which released in June of 2023. I checked out this book from the library and read it in August 2023 (before menopause books had long lines in the e-reader queue at the library, which is a good thing).

Dr. Lauren Streicher

I started listening to select episodes of Dr. Streicher’s podcast Inside Information after the HPNP episode I link above. Dr. Streicher can sound a bit harsh sometimes, but she knows her stuff and tells it like it is.

Dr Streicher has recently come out with an entire episode on finding a MPT doctor, How to Find a Clinician Who is Not Clueless. I listened to this podcast and thought it to be a very clear and concise resource for the end of 2024. Again, Dr. Streicher can be a bit terse to listen to, and I did not find 100% of what she said to be useful in my situation, but she knows her stuff.

A couple points I personally understand Dr. Streicher mentioned in this episode in my case I did not find relevant to me.

• Academic appointment at a medical school. The doctor I found in 2019 was part of a university medical system and an associate professor, which although I have no doubt made her extremely knowledgeable I did not feel lent to us having what could have been beneficial conversations and were missed opportunities to guide and educate me (especially during a time of very limited resources for the average woman about the MPT).

• A doctor who isn’t like you. Although Dr. Streicher is completely right about the fact that you do not need a female doctor, personally I would never go to a male doctor (and never have as an adult). I ultimately believe no one knows a woman’s body better than a woman (outside and in). But along those same lines… My 2019 doctor I believe is a bit older than me and either had gone through or was going through the MPT transition. My current doctor is younger than me and although has not been through the MPT I feel very comfortable with the additional education and interest she has in menopause.

I not only wanted, but deserved, more. Finding My Next New MD

Thanks to the increasingly good resources available to me (I always say I was getting my MPT PhD), I learned so much ~ specifically how to make the right kind of appointment to actually talk to a doctor about menopause, and how to find that doctor.

For my new doctor search I learned three key things (at the time):

• Look for a NAMS Certified Practitioner (The North American Menopause Society) website where you can search by zip code. [NAMS is now called The Menopause Society]. There are a number of Menopause Society requirements a doctor needs to have in order to be listed on the website. Dr. Hirsch explains this very clearly on her podcast, Where can I find a menopause doctor? Starting at minute 7:20.

• That Doctor should be licensed and board certified. Dr. Streicher explains this clearly on her substack.

• Make your first appointment for a ‘Menopause Consultation’, NOT your annual exam. This was so critical as this is likely why I was not getting the time and conversation I felt I needed from my first doctor. I wish she would have told me, but at least through my resources I learned this.

After looking on the NAMS website by zip code I narrowed down my search to three people. And then I sat on doing anything for quite awhile ~ months. It was not until I had the Summer of 2023 where I was dealing with extreme fatigue and poor exercise performance that I finally decided to make an appointment with one of these three doctors. What it really came down to is where I could get in and when (from what I recall).

My Menopause Consultation with my new doctor was scheduled for August 23, 2023.

The Menopause Consultation

I knew from the MPT PhD I was getting to come well prepared with notes, and that I sure did! I had a two page document arranged accordingly so I was sure to remember everything I needed to:

• Overall visit goal

• Symptoms I was having

• Supplement list (because I had been working with Rasa)

• Dr’s Visit Notes since 2019

• Period History (I had been documenting this for the last couple of years when I was noticing a change in regularity)

To my pleasant surprise at this visit for the first time in a long time I did not feel rushed at this appointment. My new doctor spent a FULL HOUR with me!

• Conversation: First we had a full conversation. This included my long list, but also filling her in on my bloodwork and working with Rasa, as well as discussing the other MPT medication I was on (that I will discuss in another story).

• Exam: I was given an exam.

• The Plan: Most importantly after having the conversation and the exam, my doctor discussed a go forward plan with me. We agreed it was time to stop birth control and begin hormone therapy (MHT or HT) [Which I was well educated on by this point and felt very comfortable taking. More on MHT in an upcoming story].

• Resources: I loved that my doctor included additional resources in her after visit notes such as:

  • This article from the New York Times is also a good one: Women Have Been Misled About Menopause - The New York Times (nytimes.com) [I had already read this article and agree, it was groundbreaking at the time. This link is a gift link so you can read it].

  • Good books: Menopause Manifesto by Jen Gunter, MD, You Are Not Broken by Kelly Casperson, MD (also has a podcast of the same name). Estrogen Matters by Avrum Bluming, MD. Good Books on desires and sexuality: Better Sex Through Mindfulness by Lori Brotto, PhD, Anatomy of Desire by Gina Lake, Mating in Captivity by Esther Perel, MD, Come As You Are by Emily Nagoski, PhD, She Comes First by Ian Kerner, PhD. [I immediately checked out the Menopause Manifesto from the library and read it].

  • I LOVE the "You Are Not Broken" podcast by Kelly Casperson, MD. Episode 222 is an interview with Avrum Bluming, MD, auther of Estrogen Matters. [I remember listening to this driving around the gravel roads by the Crash Pad].

• Ongoing Conversation: My doctor urged me to reach out to her with any additional questions and we did have an ongoing conversation via MyChart (the messaging system my medical providers have all used for a number of years).

• Follow Up: Because I was starting out on MHT, a follow up was required to see how I was doing and if any adjustments were needed. I was offered in-person or virtual but wanted to do in-person. I will talk more about what was decided at the follow-up in my story on MHT.

• Cost: I should mention that this visit for me was not really covered by my insurance (don’t get me started). We had high deductible insurance and I ended up paying a few hundred dollars out of pocket for this visit (one of the MANY hidden costs of menopause that I will be writing about). But I will say it was 100% worth it and I would do it again. I would strongly urge you to maybe pass on some other non-essential needs in your life and use that money for this crucial visit if you also have to pay out of pocket.

  Luckily subsequent (‘regular’) visits have been covered by my insurance as you would expect.

The Value of Finding THE Right Doctor

It has now been 1 1/2 years, and three in-person visits, since I started seeing my new doctor. I absolutely have made the right decision to switch doctors and am so glad I found her. In November of 2024 I again came with a list of things I wanted to discuss, we had a conversation, my doctor spent around an hour with me again, and I left knowing if my mind changed on something we discussed, or things changed with my body, or I had questions ~ I could always reach out and get an answer and we could make educated decisions together (which we have).

I really like my new doctor. She is most of all kind and equally well-educated on menopause.

Critical Referrals

As it turns out menopause for me has resulted in needing all sorts of recommendations for other medical professionals. I have really had to lean on my Doctor for quality referrals and am very thankful for them. Turns out I have needed a village to get through this time of life, and I am glad I am finding it with the help of my doctor, and all under the same medical system (in my case HealthPartners. I switched systems when I switched doctors and am so glad I did!).

I have been very clear with my doctor about the type of person she is referring me that I want: I want a woman, an athlete (someone who works with cyclists), and someone who is knowledgeable about menopause. My new doctor has given me stellar recommendations, such as my current physical therapist (a now critical part of my MPT team that I will be writing about), and other professionals to help me with needs outside of her treatment area; these people have become a crucial part of my MPT medical team, or I have the names of when I am ready (i.e. potentially working with a mental health pain specialist who works with athletes).

Conclusion

I would highly suggest finding a doctor through the Menopause Society website. Then check out their bio and picture and see if there is enough information there to think you will ‘click’ with them. I always like to read about what they do in their free time, if they are an outdoors person and athletic, that goes a long way for me. Make yourself an appointment not when you are in menopause, but when you are in perimenopause (for me I now realize that would have been in my early 40’s). Having someone to essentially walk alongside of you during one of the most challenging times/transitions of your life is incredibly valuable. Don’t underestimate the value of a good partner/doctor during this time. You deserve the best care, find it.

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In November I had my annual exam, during which I told my doctor I wanted to have bloodwork done for my ferritin and vitamin D. Ferritin to see if I was still in Rasa’s target range of 50-80, and vitamin D because Rasa told me my test in June was low.

My doctor also put in requests for other tests that she wants to get data from, so this is the bloodwork I had done last week:

The short summary is that my doctor said all the results were good, but I wanted to dive into a couple of them further.

I had hoped to regroup with Rasa, but the expenses I have incurred this year due to menopause (another story), including care for my pinched nerve (another story), have been unexpected, and a lot. So I need to lean on my doctor to help me navigate the results at this time.

Vitamin D

After my June bloodwork Rasa said “Typically we try to be above 50 for optimal, but maybe this is your normal”. To recap: when I started taking my Omega 3, it has 1000u Vitamin D, so I had adjusted for that and decreased my Thorne Vitamin D3 pills to 1 pill at 1000u, for a total of 2000u Vitamin D between the two pills. But after my June bloodwork, I added back the 2nd Thorne Vitamin D3 for a total of 3000u between all 4 pills I take daily (2 Thorne Vitamin D after breakfast, 2 Omega 3 with Vitamin D after lunch).

I was disappointed to see with my most recent bloodwork that my Vitamin D level is still in the 30’s (it went from 34 to 37 in 6 months). My doctors comments on the result were “Vitamin D is still on the lower end of normal so I would still take a supplement (D3 2000 IU) daily.”

I discussed previously how my Vitamin D levels have been low for years and I started taking supplements after moving to Minnesota. I also know from all the information I have gathered about menopause that Vitamin D is very important.

Vitamin D is essential for muscle function. Research shows that Low vitamin D status is very common in postmenopausal women, and that correcting vitamin D deficits in postmenopausal women can help boost their muscle mass.

~Source, FeistyMenopause

Listen/Watch at minute 5:20: Nutritional Supplements for Active Menopausal Women with Katie Linville, MS, RDN

Heather Hirsch discusses Vitamin D: The Best Supplements and Vitamins for Menopause from a Menopause Expert Physician

Ferritin and Iron

If you have been following my journey with the MPT you know that I found out thanks to my nutritionist that I had low iron and have been specifically monitoring my Ferritin levels. The goal was to get between 50-80, which I achieved after many months of taking a supplement called Ferrasorb daily (2 capsules).

In June I sent my results to Rasa and she advised an adjustment to switch to taking two capsules every other day.

My December test showed my ferritin level over the target range, but still well in the acceptable range.

My doctor also ran other tests for iron and specifically the iron result was alarming to me because it got flagged as ‘high’, as was another result that I honestly don’t know what it tells (% saturation, calculated).

My doctor always sends comments in my chart on lab results and this is what she said:

Your ferritin is in a great range. The other iron studies are likely due to iron supplementation. If you are supplementing daily, decrease to every other day; if taking every other day, decrease to 2-3 times weekly.

Since I am already on the every other day regimen, I am moving to every third day right now. I asked my doctor if I should switch to 1 tablet, but she said:

Usually the 50-80 range is the "don't go below" range; a lot of people struggle to even be in that range. Anything above the 50-80 range and below the upper limit of normal is just fine; no downside to this.

We will check again when we next meet to make sure it is still in an appropriate range.

So I now feel OK with where my iron levels are at. And remember, it took me over two years to get to this point. I started taking Ferrasorb in August 2022.

Guidance

The above shows how important it is to work with your doctor on guidance. The results above were a bit alarming to me, but knowing my doctor is reading the results and evaluating based on my situation is extremely helpful. I wish I could afford to work with Rasa again to hear her opinion, but it is helpful to know from when we worked together what her targets were for me.

Am I Better?

As I have stated before, I always hope when I enter into a challenge (low iron, low vitamin D, MPT, or now a pinched nerve) that there is a quick fix. I have learned that patience, perseverance, and having a team to support you for the long-haul are all important. Our bodies are ever changing, which means constant monitoring and care.

Do I still fill fatigued? Much less! Do the Ferrasorb and Vitamin D supplements help? Absolutely!

As a 53 year old menopausal athlete, the last three years, particularly this year, have felt interrupted and incredibly isolating.

I think back to 2022 when the Crash Pad was becoming a reality and the Summer of cycling I ‘missed’ because of it, and then the hip pain that started to present that Autumn.

I think back to the gravel ride in May of 2023 where I couldn’t stay with the group, later realizing my hormones were in major fluctuation during the MPT causing all sorts of chaos in my body. And in turn my mind. I felt alone, very alone.

I think back to the times over the last three years where the MPT made me fall off an exercise cliff stopping me in my tracks as I tried to climb my way back into fitness, again and again and again, thinking ‘okay, that sucked but this time I’m back’. Until the next time…

I think back to that hike in Arizona in February when I decided something had to change, and it meant dropping out of group fitness class indefinitely and going it alone. Very alone.

I think back to all the solo trainer rides I have been doing, some very good. But alone.

And all the solo gravel rides I have been doing, so many were very, very good. Physically and mentally.

Yet I still feel interrupted and alone.

And then there is now.

This week I found out that I have a “L4-L5 disk herniation impinging on the nerve root”. THIS is the reason the last 7 months have been so difficult. THIS is why all the physical therapy I was doing stopped working. THIS is why yet again I fell off the exercise cliff.

After almost two weeks at home, most of it standing, or on my stomach, once again I feel very very interrupted and very very alone.

I expected menopause to disrupt my life in some way, I just never expected it to disrupt my life in the ways it has.

As an athlete, when you find your self time and again unable to do the things you love one of the biggest challenges becomes your mental state of mind. For me, this has been completely unexpected.

The options are to give up, or to keep going. In the darkest of moments of pain in the wee hours of the morning, I now understand how some people give up. But I know that I have to keep going.

Keeping my head screwed on in the right direction the last few years has not been easy. Especially this year. But I know I have the tools to work through the challenges, deal with the reality, and keep going.

And also what I know from my menopause class with other women going through the MPT, is that although it feels like I am alone, I am not alone.

In the coming months I will go in depth more on this experience and share what I have learned.

Although the doctor told me this week my disc issue is not necessarily age related (“it can happen to 15 year olds”), and cyclists are prone to herniated disks, I can not help but think it just might be partly menopause related.

The loss of estrogen changes EVERYTHING and I do find it coincidental that when my body began to dive deeply into the MPT, this issue started to present in subtle ways. Is there anything evidenced based to say definitively? No. but could it be related, my hunch says yes. I will talk a bit more about this when I write my story.

Meanwhile…

More immediately I plan to share my healthcare journey and how I found ‘my’ MPT doctor. That decision has made all the difference in my current web of extended healthcare for my spine. And I know that with all these people by my side, and the people I have yet to meet, I will continue to not be alone.

And maybe, just maybe, if I keep going ~ the cliff’s I keep finding will turn into rolling hills.

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In August I received an email that I couldn’t believe I was the recipient of:

Hi DeAnn!

It’s Selene from Navigate Menopause and Hit Play Not Pause.

I’m putting together a podcast where I interview a few women from the Navigate Menopause cohorts and just talk about the experience.

…

Just thought you’d be great to include.

…

The honor of the lifetime to be asked! Of course I said YES! And on September 5, while we were up at the Crash Pad, I sat down to chat with Selene.

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Today the Podcast released and I could not be more honored to be part of this episode. Selene is a great interviewer who made me feel like I was talking to a friend, and she did a great job of creating a podcast I am extremely proud to say I was a part of.

Listen to The Episode

Here is a little behind the scenes of what it looks like to do a podcast at a cabin you are building so you can ride gravel (gravel always comes first…):

Thank you Selene, and all the women at Feisty for this amazing opportunity to share my journey and be part of this wonderful community!

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And yes, I will be writing more about the class, Navigate Menopause, in a future story. The next cohort starts soon. You can sign up now (if you are wondering if you should, the answer is yes!).

Building an ‘MPT Team’ (I call the menopause transition ‘MPT’) takes time, and takes work.  For me my ‘team’ was not built all at once, it was an evolution over time.  Finding a team skilled in what they do, and who you trust, is incredibly important ~ but knowing that you have indeed found ‘your’ team might take awhile.  I consider the core of my ‘MPT Team to be my doctor, my coach, my nutritionist, and most recently my physical therapist ~ all of whom I will be sharing my journey’s with separately.  On the heels of ‘Is Steak the Answer?’, let’s start with the Nutritionist.

Why Did I start working with a Nutritionist?

It has been just over two years since the idea of working with a nutritionist was introduced to me.  When I first started working with a nutritionist, it was to ‘fix’ the fatigue issue/iron problem I had, not to learn how to eat ‘better’ or what to eat, or to deal with menopausal weight gain (because initially menopause in general was not on my radar 100% as a reason to work with a nutritionist), and most certainly supplementation (other than vitamin D) was definitely not on my radar.  

I worked with a nutritionist on a regular basis from July 2022 - May 2023.  I learned a lot in the process, and continue to learn from the process.  

One of the biggest things that I have learned from working with everyone on my ‘team’ is that there is never just ‘a fix’ ~ usually multiple things are going on in your body that overlap and improvement is a continual evolution.  Especially as a peri/menopausal athlete.

How I found ‘my’ nutritionist

As I discuss in ‘When the Wheels Fell Off’, my nutritionist was recommended to me by my coach, Sophie.  I had never in my life thought about working with a nutritionist, and I definitely was not thinking about working with one for my fatigue issue.  But I was desperate to figure out a solution.  After yet another not so great bike ride, I made the call.

Who is my nutritionist?

The nutritionist I worked with during 2022 and 2023 is Rasa Troup.  Rasa is a former Olympian, has worked with the Minnesota Vikings, is an immigrant to the US, and much much more.  Those are all great parts of her story, but why I chose to work with her is the personal referral from my friend and coach Sophie, as well as the conversation we had on that first call I made.

The Call

Immediately during that first phone call with Rasa (July 18, 2022) I knew I was talking to someone who listened, who understood my issues, who was knowledgeable and made very good suggestions, and who would help me.  I discuss in ‘Is Steak the Answer’, on that first call Rasa made suggestions on what bloodwork to get done before we even had a first meeting.  That was the beginning.

First Meeting

After I received the results of my bloodwork, Rasa and I met virtually for our first visit on August 8, 2022 (even though Rasa is local to me, it was still ‘covid times’).  We talked a lot about my iron deficiency (see ‘Is Steak the Answer?‘), but we also began to talk about other things, like how much I exercised (and what type), if I was eating enough to support the exercise I was doing (hmmmm, never thought about it), the importance of protein, my stage of life, hormones, supplements, and moving differently (which will come into play in a later story).  

I learned a lot of new things.  And although I was still pretty laser focused on that ‘iron issue’, some new ways of thinking and eating started to slowly settle into my brain and then my daily practices.

Let’s back up here a second

If you will recall, I did not call myself an ‘athlete’ until I was 51 years old.  That was early in 2022, shortly before I started working with Rasa.  Nutrition around exercise was never something I paid attention to, I knew Kurt did ~ but he was a bicycle racer ~ I wasn’t.  So drinking electrolytes, eating before/during/after exercise, paying attention to protein ~ absolutely none of that was going on until quite late in my lifestyle as an athlete.  When I was younger and started cycling more seriously, I drank water on my bicycle rides, I didn’t ever worry about food around exercise, and I certainly never ever had a protein shake (that was for serious athletes).  My advice to myself now would be ~ get there sooner.  You ARE an athlete, you need to think about what you put into your body and why; because it matters.  But you don’t know what you don’t know, until you know it ~ and then fortunately, you can’t unsee/un-know it.

I did change those habits, eventually beginning to drink Skratch in my water bottles on cycling rides.  But I didn’t start thinking much about eating around exercise really until my late 40s, particularly when I started doing virtual training with The Fix Studio in late 2020 and started to think more about eating around my training and drinking protein shakes after a workout.  So I was starting to head in the right direction…

Let’s also remember, I am a selectarian, so that alone means I was typically not getting the nutrition I needed through the food I was eating pretty much most of my life, especially my adult athletic life.

And I am a ‘light’ eater.  I eat, but not a lot.  And I eat only when I am hungry.  I love vegetables, so I eat a lot of them, but having protein on my plate wasn’t something I thought about.  I got away with my way of eating, until I didn’t.  Hello MPT.  Hello Rasa education.

My Goals

After our first meeting, I emailed Rasa on 8/19/22:

I had some time this week to sit down and put a list together of what I feel I could use some help with.  I think it would be a good use of my time and money to do some additional appointments with you.

Attached is a list I put together of issues and goals.  Let me know your thoughts, if you feel continuing to meet is a good plan, and if this fits into your package plan, and best next steps.

1. Iron

a. Follow up on Ferrasorb progress

b. Long term strategy

2. Protein

a. Do I need to make adjustments?

b. Intake and times (i.e. in regard to #4 ~ workout fueling).

c. Using Protein Powders. Currently using this.

3. Perimenopause/Menopause transition

a. Is that affecting #1 & #2?

b. Adjusting diet accordingly

c. Belly fat emergence in 2020, how to reduce and stay healthy

4. Workout Fueling

a. How to fuel before/after workouts, depending on type of workout

b. Protein Balance (see #2)

5. Diet

a. This summer I have noticed an increase in appetite, which leads me to believe I

am not getting what I need out of my current diet. I am frequently hungry, which

leads to ‘b’.

b. Snacking.

I. I try to snack on nuts, prepare healthy muffins for a mid-morning snack, etc. But this Summer I have often felt like I am starving, which is frustrating when I am hoping not to have a big weight gain as I head into menopause.

ii. What are good snack options?

c. We eat mostly a vegetarian diet, so I may not be getting everything I need. How

to adjust?

6. Hip Soreness. Is my diet contributing to this issue? What can I do to improve.

a. I can’t find when exactly this started, but I have been talking to Sophie most of

this year about trying to improve. We have been trying to address through

exercise, which does help ~ but not 100%

b. Could this be a dietary issue?

7. Vitamin D

a. I currently take typically Oct - April. My levels were good in my blood test, but in

the past I tested low (a number of years ago).

b. Any adjustments that need to be made?

8. Fatigue

From this point I bought a package of six visits with Rasa that was discounted, and refundable if I did not use it all (I used it all).

What I learned working with a Nutritionist

Protein

I am sure I read about protein in Next Level, but I think I stopped reading that book around the time the Crash Pad work started getting pretty intense, and as I got consumed by ‘fixing the iron issue’ (I will talk about that book in another story).  What I began to learn from Rasa is that protein is important, especially for an athlete. And as I now know, especially for my stage of life.  And not just protein, many things.

I was definitely not incorporating enough protein into my diet, and it is still a struggle as someone who doesn’t eat much meat and doesn’t like many sweet things.  Rasa really helped me with putting together a list of protein food options for my palette.  We looked at what I was generally eating on a daily basis, how much protein certain items had, and discussed ways of incorporating more protein into my day.

Kurt and I have the same diet, and he exercises more than me, so he has been super open and interested in increasing his protein as well.  We realized we were frequently eating meals without any protein (like pasta) and have made an effort to ensure our plate is more balanced at each meal.  We also try to have better protein snacks around so we aren’t always grabbing chips when we want a snack (still working on that one).

Next Level has good baselines for MPT women to start with your protein guidance, but I would also suggest working with a sports nutritionist to fine tune for your specific needs.

LEA (Low Energy Availability)

It was highly likely that I had been under fueling my daily activities for years.  And for many years I got away with it, but things amp up and change in the MPT and suddenly you may realize what you have been doing no longer works.  Rasa and I discussed that part of my fatigue issue might likely be because I was not giving my body what it needs for the level of activity I was doing.

Just two years later LEA is being discussed much more and athletes are having to accept that to perform better they need to eat better (here is a good recent article). Changing how you eat is likely to lead to body composition changes that have been culturally denigrated for women for decades (particularly GenX women who grew up with diet and exercise culture where looking thin was more important than feeling good and performing at your best).  Layer LEA and cultural perceptions on to an already changing body during the MPT and it’s a bit of a perfect storm. 

I do not think that LEA was my only issue with fatigue, I also think it was my iron issue, hormone fluctuations, and sleep issues.  I still have a higher fatigue level than I used to, so keep trying to figure that one out (if it can be ‘figured out’). You will also hear the term ‘Red-S’ used in the LEA conversation, I certainly heard that from Rasa and that was the first time. Red-S is discussed a lot with the MPT I have come to learn.

LEA was a tricky one for me. Because I was having such a hard time with cycling, I created the perfect storm for myself. I started eating more (like Rasa said I should), BUT I began exercising less (because I was desperate to feel better and felt I had been overtraining). I put on far too much weight for me and had to realize I had gone too far. In my desire to get an ‘A’ in LEA, I was eating too much fatty proteins while I was not exercising much. So a word of caution, really understand what you are doing. Eating more is not in itself a bad idea for an athlete, but what you are eating and what is going on with your exercise is important to monitor. I don’t think I ever have fully lost that weight because of my continued struggles the last few years with exercise (more on that later), but I did lose quite a bit of it. Unnecessarily putting on weight I didn’t need during an already difficult time mentally and physically made the whole MPT weight shift more complicated for me. I think more could be written and researched about LEA and menopausal athletes for sure.

Exercise Diversification

For years cycling 4-5 days (sometimes more) a week was my norm.  I have mixed in periods of yoga during my adult life, but it has ebbed and flowed.  Until I started working out with the Fix in 2020, I did not do any strength work or weight training.

At my first session Rasa said I might want to consider moving differently with shorter and more intense exercise sessions (this is well researched and discussed for MPT women, particularly by Stacey Simms), and that I might have to think about other ways of exercising that would bring me joy.  I remember feeling pretty devastated when she said that and didn’t really listen to that advice until I couldn’t cycle as much as I wanted to.

The last couple of years as I have struggled through my various challenges, I have realized how important mixing it up is to my recovery and ability to have good rides consistently.  I am thankful that I was already incorporating yoga and core + strength classes, as well as walking, into my routine; I have been trying to be consistent with these activities and use them as tools to recovery.  I have had to reduce the number of days I cycle, but it gives me more time for these other activities.  I have also set a goal this winter to do an additional day of weight training every week.

SUPPLEMENTS

Rasa and I had talked about vitamin D in our second session, but it was not until our fourth session we talked more about other supplements to aid in some of the issues I was having.  I did not grow up taking vitamins or supplements.  In my 20s I took a multivitamin for a time, but at some point stopped that.  In working with Rasa I began to understand the benefits of taking certain supplements to help me in some of my challenge areas ~ recovery and sleep.  Because I am a selectarian it is difficult to get a lot of what I need from food (ideal source), in which case supplements are helpful (as I found out with the Ferrasorb for my iron deficiency).

This is the list of supplements I began to take (and am still taking):

• Ferrasorb

• Vitamin D

• Omega 3

• Magnesium

I will discuss each of these separately.

Ferrasorb (see Is Steak the Answer?)

Vitamin D

After I moved from California to Minnesota in 2006, I learned at an annual exam I had extremely low vitamin D, so I began taking vitamin D annually October - April.  Rasa and I discussed vitamin D at our second session and that I should check my levels at the end of winter and adjust if necessary.  I was taking 2000u daily.  

When I started taking Omega 3 with vitamin D (see below), I cut down my vitamin D pills.  But in my bloodwork this Summer, Rasa noticed my vitamin D levels had gone down, she said above 50 was optimal.  I looked back at my results and saw my levels had gone down almost in half!  They had been between 54-60 consistently.  When I started taking Omega 3, I went down from taking a 2000u vitamin D tablet to a 1000u tablet because the Omega 3 has 1000u in two tablets.  So I stepped the vitamin D back up to 2000u daily (in addition to the Omega 3 with vitamin D).  I will have new bloodwork done this winter and see the impact of the additional units.

I looked back at a menopause class I took earlier this year and the nutritionist in that class also recommended levels from 50-80 (More on that class in a separate post).

Omega 3

In our fourth session Rasa and I discussed Omega 3.  Rasa told me that Omega 3 provides a fatty acid our bodies need, and it also helps with inflammation and muscle soreness.  She also told me I could have my levels tested if I wanted to and shared this article with me.  After this session I ordered the Omega 3 she recommended and have been taking two a day ever since (per her recommendation).

Not surprisingly, I have since learned a lot about the benefits of Omega 3 supplementation in the menopause podcasts I have listened to (Heather Hirsch and Hit Play Not Pause), as well as the menopause class I took.

Magnesium

I had been sleeping pretty poorly starting in my mid-40s, not knowing I was in Perimenopause and that it was a common symptom (I attributed it to work stress).  I was really not sleeping well when I started working with Rasa and she recommended taking Magnesium for that, as well as its other benefits.  The Magnesium she suggested was not in stock at the time, so she said it would be okay to take this one (I never did switch to the powder and have been taking the pill ever since).  I instantly noticed an improvement in my sleep.

I realized about a year after starting to take Magnesium that I was only taking one pill, which is 135 mg, and nowhere close to the 400 mg Rasa had suggested.  When I realized that earlier this year, I moved up to a second pill, so am up to 270 mg.  I realized later the pill recommendation for what I am taking is 1-3x/day.  I take the Magnesium pills before bedtime with other pills, so moving up to 3 pills at a time seems like a lot, but I am committed to getting there.  My goal is still to get closer to the 400 mg by either taking another pill or switching over to the powder.

Not surprisingly, I have learned in the same podcasts linked above, and in my menopause class, that magnesium is very important.

Supplement Certification

I learned from Rasa’s recommendations, and later menopause educational sources, that it is extremely important to take supplements that are 3rd Party certified; it is a flooded market without much regulation, so if you want to take an effective and tested supplement you should be sure it has had adequate certification.  I look for ‘NSF Certified for Sport’, Thorne has an info page about it).  When I learned about the importance of 3rd Party certification, I switched my vitamin D to Thorne (I had previously been buying it at Whole Foods which I noted did not have any information about 3rd party certification).

Is it Worth the Money?

Supplementation Cost

When you are trying to get the MPT under control and start learning about the things you need to do for yourself, it can add up quickly!  I’ll put together a story eventually on the cost of MPT, but for now as it relates to supplements, they are a new expense I definitely did not have before.  As I said earlier, because I need these supplements and am unlikely to get them through my diet I consider the cost both part of my medical expenses as well as my grocery bill.  

The downsides of not taking the supplements I am taking I feel are personally too great for me based on evidential research I have read and been educated by.  And if there is one thing I want to do for the next phase of my life, it is give my body what it needs so I can enjoy doing the things I want to do ~ like cycling.  And thanks to cycling, I sought out a nutritionist who helped educate me on how I could give my body what it needed.  I owe so much of my journey to cycling.

Nutritionist Cost

I bought a 6 visit package from Rasa which was $100/visit. Any unused visits were refundable, but I used them all. Each visit was 45 minutes. We have a high deductible insurance plan, so I had to pay out of pocket. But your insurance may cover an expense like this. I feel that paying the fee was worth it for Rasa, for her time and her knowledge and guidance.

I plan to continue to work with Rasa on at least an annual basis to stay on top of the inevitable changes I will go through and to make sure I stay on top of my iron deficiency. Because having a nutritionist is another expense, it can be hard to include in your budget when you have a lot of other expenses going on (for me it has been many things related to building a cabin). But I do believe the cost is a worthwhile investment. Unfortunately this year I have not been able to budget for the expense; I am hoping after my next round of bloodwork we can touch base (which will be a session I have to pay for).

Would I pay for a nutritionist again after taking the menopause class and having access to a nutritionist in that class? I would because I was having specific issues I needed help with. I learned a lot in my class that I had already learned from Rasa so it was great to have the generalized information for navigating the MPT for sure. But if I was going through the other specific challenges like I was, I would definitely work with a nutritionist to deal with my challenges.

Where your doctor fits in

What I learned is that although my doctors (I have had two during this process) may not initiate bloodwork, if you have a good nutritionist working with you requesting bloodwork and advising what testing to have done, your doctor will work with you and send in the requests for you.  And it should be a three-way conversation once you get the results, talk to your nutritionist, but also make sure your doctor knows what is going on with you and what your nutritionist is advising.  My new doctor has been great with having an ongoing conversation with me and sending in the tests I request, keeping a record in my files, and keeping an eye on the results and offering feedback. In my experience, as with so many things ~ you do need to be your own best advocate.  No one knows your body like you do.  Your doctor is relying on you to be in tune with your body and also having conversations with your nutritionist if you are monitoring specific things ~ like I was with my iron deficiency.  

That said, when I switched to a new doctor in 2023 I felt like I had another partner on my team who was paying more attention, and who understood the complexities of what is going on with my body and what I am looking for in my results.  My new doctor and I were able to have a conversation about what tests I wanted, what she might want to add, etc.  Meanwhile, my nutritionist and I would discuss the results and targets and next steps.

Do not discount the importance of the doctor in the conversation.  Before I switched doctors, my previous doctor was very open to sending in tests and letting me tell her what was going on, but I didn’t really feel like she was helping me to monitor what was going on (for example getting told by her nurse that first time that my ferritin results were ‘within range’).  I didn’t really feel like my doctor had my back or was paying attention.  With my new doctor I know she is part of the ‘team’ and keeping track with me and is likely to catch some red flags if I happen to miss them.  My new doctor has also put in additional testing for me she felt I needed with my bloodwork, and made suggestions we discuss, which makes me feel like she is there for me. I will be writing about my new doctor as part of my MPT Team in an upcoming story.

Conclusion

At first I found working with Rasa challenging because I am an ‘A’ student who always looks for the ‘answer’.  I like a recipe laid out in front of me to get to an end result (that is ideally perfect).  Rasa’s approach seemed open-ended and organic and I couldn’t see a clear path I was on and what ‘final result’ I was going to achieve; that was hard for me to wrap my brain around.  But I have come to understand that that is exactly the right approach.  

Subsequently my menopause course made everything Rasa said ‘click’ at a higher level.  I was lucky to be exposed to another great sports nutritionist, Dina Griffin, whose knowledge sharing reinforced what an amazing resource I have in Rasa, and had at exactly the right time.  Rasa helped open my mind, taught me to better feed my body, helped me understand sometimes the body needs a bit of help (supplements), and that nothing will ever be static.  As Rasa said, “inevitably our bodies will change’.  I know now that to expect a ‘fix’ is not the right mindset; to find aids to help you through the twist and turns and be open to adjustments is a better way to think.

Rasa gave me number of good nuggets:

• “Trust your body.”

• “What you are experiencing is a very normal experience, a very human experience.”

• “Keep it simple.”

• “You don’t have to be perfect.” “It is okay to be a C student.  C work means making mistakes.”

• “Everybody is an athlete regardless of what level you are doing.”

• “Restriction can increase midsection.”  Rasa talked a lot about body trust and acceptance, which didn’t always feel at the time like it was an issue for me.  But MPT body change has happened to me and it can be a huge challenge to ‘accept’. That’s a much bigger topic that I will be discussing in another story.

In June of 2023 everything Rasa had taught me started to sink in and this is what I emailed her:

My perspective is you have nailed it on every single thing over the last year.  

• My iron was/is low.  

• I do have LEA.  

• I do need to think about dialing back exercise and diversifying because it seems this year I have over trained.  

• I do need to eat more.  

All of it - you are right.  I think it just took me a year to absorb all that, and understand it.  

You are also right - this will be an ever changing landscape since the body is not static.  I have admitted that to myself now :p.

Thanks for being so smart and supportive!

Rasa’s reply:

So much goodness in this email.  I am happy to support you and provide space for you [to] find your journey.

I am very proud of you.

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Selectarianism

One of the things that made sense to me was that it was entirely believable I had an iron deficiency.  I am a selectarian ~ meaning I rarely eat meat, especially red meat.  I have been a selectarian (without knowing that was a term) since I was a young kid.  It never occurred to me that my lack of meat eating could be a problem, until the Wheels Fell Off.  At which point, it seemed like eating meat might be the solution to all of my problems.  Problem ‘fixed’.  Not so fast…

Let’s start with the iron deficiency journey.

Symptoms

To back track to When the Wheels Fall Off…

• I was having extreme bouts of fatigue during work days during times I would have normally felt alert.

• Bike rides I had done hundreds of times now seemed daunting.  I literally thought on more than one ride I may not make it home.

Generally I wasn’t feeling like ‘me’.  Grasping at straws, or a ‘fix’ as it were, I reached out to a nutritionist one of my workout coaches had recommended.

The ‘Team’: Nutritionist, Doctor and Me

On July 18, 2022 I called the Nutritionist and told her what was going on with me.  She recommended I ‘check labs’ by having blood drawn at my doctor’s office.  After that phone conversation I immediately checked in with my Doctor.  This was my message to my doctor on 7/19/2022:

Hi.  I left a vm yesterday on the nurse line, but am following up with an email.  I have my annual exam scheduled for Sept. 14, but the last few months I have been having increasing hip pain.  My conclusion is that the pain is related to late stages of peri-menopause and decreased estrogen.  I am also starting to wonder if I might be iron deficient.

I spoke with a Nutritionist referred to me by my trainer yesterday who urged me to first work with my Dr. (you) to determine if I am having some deficiencies.  My suspicion is potentially iron deficiency since I am an athlete in peri-menopause who eats very little meat.  I have a pretty well rounded diet (lots of greens, veggies, grains, other protein sources), but I think something is lacking.  My Nutritionist advised that I ask for some bloodwork to be done ahead of my appointment, to discuss with you, and potentially see if my annual appt. can be moved up.  Then come to her if needed.

The Nutritionist suggested the following bloodwork:

• -Omega 3 Index

• -hemoglobin ferritin (not sure if that is one thing or two)

• -Vitamin D (I know historically I have been low on this and planned to discuss at my upcoming visit)

• -Thyroid function

The pain is mostly in my right hip joint.  Initially I thought it was from cycling, but I do not believe that is the case.  If I am having some deficiencies, I would like to get myself back in balance sooner than later!

Thanks for your help!

DeAnn

The reply from my doctor:

These orders are in as well as a DEXA bone density test.

If the pain is persistent or worsening consider seeing a primary care doc prior to September!

[*Note: I did the DEXA scan and know more about that now. At the time I was like ‘sure, okay’. Today I would definitely be more in tune with those results (which I was told were good). DEXA is a whole other topic, as is my Dr. journey.]

What I knew instinctively, thanks to the PhD I was giving myself in the MPT, was that seeing a primary care doctor was not going to be the answer.  I needed someone who understood what I was going through as a 50+ athlete.

Blood Work

“Your body uses iron, an essential mineral, to build the red blood cells that carry fresh oxygen to your muscles via your bloodstream.  When your levels are low, you run the risk of iron-deficiency anemia, which can leave you chronically tired, hamper your workouts, and also cause more random symptoms…”  Next Level, Chapter 18 “Supplements:  What You Need and What You Don’t” by Stacy Sims with Selene Yeager

My first labs were done on July 26, 2022.  This is what they looked like:

• My Ferritin was at 17, the bottom of the range was 8.  This instantly was alarming to me.

• My Hemoglobin was at 11.7, that was the BOTTOM of the range!

• My Hematocrit was at 35.8, the bottom of the range was 35!

• My RBC Count was at 3.91.

These results, out of many, specifically alarmed me.  

After a few days I had to ask my Dr.’s office what these results meant (they hadn’t chimed in automatically), and I received this reply: “All your labs look great! They are normal and within range. ”  But… I know me, I know my body, and I knew this was far from ‘normal’, so I reached out to my coach Sophie and soon-to-be nutritionist Rasa Troup.  

This is what I was doing that day (going on a bike date), appearances (smiles) are deceiving:

Why I Worked with A Nutritionist to Start

August 4, 2022:

I don't expect either of you to do anything with this email, but since Sophie was curious to see my blood test results, I thought I would send to you both (attached are screen shots from the My Chart results).  The Dr. never wrote me back about them, and when I asked yesterday the nurse replied today "everything is within normal range".  I question this a bit, because some of these levels seem very close to the not normal range, particularly Ferritin, Hemoglobin, Hematocrit, and RBC Count.  But what do I know??

Rasa ~ If something alarms you here in the test results, and you think a paid consult could be worthwhile ~ I can think about that.  I am not a medical expert, but my gut (no pun intended) still makes me wonder if something nutrition related is going on.  I do think my iron levels could be low based on what I can tell, which makes sense since I am not much of a meat eater.  But really I have no idea.  

Rasa Replied:

There are some labs that need nutrition intervention.

And so began my journey of working with a nutritionist to ‘fix my iron deficiency’, or so I thought that was my only issue.

This was a few days before the stress of building a cabin was starting to kick into high gear.  Excavation had just begun on the Crash Pad.  A time I now realize was the perfect storm for my body.  Major life stress + major hormone fluctuations + iron deficiency.

My first meeting with Rasa was on August 8, 2022.  We met virtually and of course this iron situation was front and center. 

I took diligent notes, the first one being “Iron above 30, preferably 50.  Ferritin.  Difficult with nutrition itself.  Will take close to 3 months to get to normal ranges of iron.   Hemoglobin on low end.  Anemia indicators:  initial stages because hemoglobin dropping to low end.”  Hearing Rasa talk about Anemia, and then googling it, was a bit terrifying. I have a lot of other notes about a lot of other things I learned at the time from Rasa, and although I was listening and understanding my mind continued to grasp onto the ‘get iron fixed….me better’ chain of thought.  I desperately wanted to feel better.

The MPT (Menopause Transition) and Iron Deficiency

Rasa and I discussed menopause, but at the time (just two years ago!) so much less information and knowledge was available.

On August 8th I wrote my coach Sophie:

Just got off the phone with Rasa.  She is GREAT!  Thanks again for the recommendation.

What she has really pinpointed for me is an iron deficiency, so we are going to be working on that. 

What is fascinating to me now as a person with a poor memory is to see what I was working through in these emails and in my head.  The me of 2024 knows this was not the full picture, but the me of 2022 was sure the iron solve was key to me feeling better.

What I absolutely did not know also was that iron deficiency, particularly for non-meat eaters like me, is common during the MPT.  Over a year later Stacy Sims posted this:  Are You Iron Deficient? Are You Sure? (posted January 2023. my bold.) and I finally felt like I had part of the answer:  

Perimenopausal women are at higher risk because estrogen helps downregulate an iron-regulating hormone called hepcidin. When estrogen declines and hepcidin rises, iron is harder to absorb. It is also common for women to suffer from low energy availability (so many nutrients, like iron, may be insufficient) and to follow a meatless diet—the RDAs for vegetarians are 1.8 times higher than for people who eat meat—because heme iron from meat is more bioavailable than nonheme iron from plant-based foods.

Ding ding ding!  I had been reading about iron deficiency in perimenopause, but it was always linked to heavy bleeding during the menstrual cycle; I never had issues with that, so it was not helpful for me in connecting the dots.

In October of 2023 the NYTimes published How to Know if You’re Iron-Deficient, and What to Do About It (my bold):

If you have heavy periods, eat a vegetarian diet or are planning to get pregnant, consider asking your doctor to test your ferritin levels, which measures how much iron is stored in your body.

increasingly, researchers suggest that the cutoffs should be higher: for ferritin, between 30 and 50 micrograms per liter; and for hemoglobin, 13 grams per deciliter.

I had already learned from Rasa that as an athlete the goal was to get my levels between 30-50, ideally up to 50.  It was nice to see the mainstream was catching up to the science.

On the same day the NYTimes also published More Than a Third of Women Under 50 Are Iron-Deficient.  Although I was 52, what I found again in this article was not eating meat can lead to iron deficiency:

Vegetarians and vegans, who might not consume enough iron-rich foods, should also get checked regularly, said Elaine McCarthy, a nutrition researcher at the University College Cork, in Ireland, whose work focuses on iron deficiency and anemia. It is harder for the body to absorb iron from plant-based sources, and those who don’t eat meat, poultry or fish may “struggle a little bit more with getting enough iron,” she said.

To some people who are full vegetarian the need for iron may seem obvious, but for me it had never been a concern. Being a selectarian is pretty close to being a vegetarian, with the benefit of sometimes I can ‘feel’ I just need a steak ~ and have one. So back to that ~ unfortunately it was not the solve. I do believe red meat gives me boosts, but I just am never going to eat it regularly.

So, on August 14, 2022 I began taking iron supplements per Rasa’s guidance.  2 tablets of Ferrasorb daily, indefinitely until my levels got up to that target of around 50.  I remember it well because we were at ROAM Basecamp camping and going over to our land where work had begun on the Crash Pad.  This was the day before:

I had one of the best bike rides of the Summer and finally tackled this technical stretch on one of our favorite groads.  Unfortunately this type of moment was a rare one that summer.  I was excited to get going on my ‘Ferrasorb Fix’.

Every three months after I started on Ferrasorb I would go to the lab at the U of M and have bloodwork done. This is my charted journey on getting my ferritin levels up to where Rasa wanted to see them (30, ideally 50). June was a strange anomaly because I almost passed out when my blood was drawn so we ruled that result out (I was dehydrated from a dentist appointment earlier in the day). In this chart you can see how loooong it takes to get levels up:

It has now been 1 3/4 years (19 months) since I began taking Ferrasorb. In September of 2023 I had a new doctor and had my next set of bloodwork done. My ferritin levels finally got up to (past) where Rasa wanted to see them! At this time, Rasa advised to switch to taking the Ferrasorb supplements every other day, which I have been doing since. In December my bloodwork showed that switch appeared to be stabilizing my levels.

The Hormone Factor

One of the most fascinating things about the chart above is that I realized perhaps the MPT was not the sole cause of my low iron, it is possible it could have been a trigger, but knowing what I know now I am thinking the iron deficiency was already there. The chart above shows blood test results with my new provider (Health Partners), who was actually my old provider when I first moved to Minnesota. For some reason in 2012 I had bloodwork drawn and was interested to see my ferritin level was at 18 way back then! In my mind that solidified that I have likely been in a low iron state for many many years.

What I did not understand at the time was that what Rasa said were ‘some deficiencies’ were being exacerbated by the crazy rollercoaster ride my hormones were taking me on.  I recently saw this chart and the middle diagram perfectly summarized what I realize today was going on in my body at the time, but did not realize then.  What this shows is pretty much how I felt:

Credit:  Navigate Menopause (my red circle).

So, I knew something was off for sure, but at the time I just couldn’t figure out why ‘all of the sudden’ I would be having iron deficiency issues.  It seemed like it came out of the blue. 

Fatigue is a symptom during the MPT, another one of those quiet symptoms you never hear about. Had I known that, and that these crazy hormone fluctuations were going on like this picture shows, it would have made SO much more sense.  But again, as a long time selectarian, iron deficiency made more sense then.  And so it became my mission to solve the iron deficiency.

I am lucky to know now that 1. I have an iron deficiency, which I know now thanks to the MPT and have been in treatment for. and 2. I was in the throws of late perimenopause and my body was trying hard to adjust to the ups and downs. I am also being treated for that, which is an upcoming story for sure!

So what’s next?

I am trying to switch to doing bloodwork every 6 months instead of every 3. In June I will have my levels checked and go from there.

So what have I learned?

• Being nearly anemic is not good.

• I should have been paying attention to this years ago; I wish I had known to do so.

• MPT changes everything. Hormone fluctuations work in quiet ways and for me one of those was getting close(r) to an anemic state.

• Getting help is important. Find a nutritionist who works with athletes and a doctor who understands your test results and keeps an eye on them with you (and for me both of these people are women, which I feel is very important).

• Problems aren’t often ‘fixed’ but can be altered. And there often isn’t a single ‘fix’ (like a steak).

Why am I sharing this long story with you? My hope is that if you see some of yourself in this story a red flag goes up and you do some research and get some assistance in checking into it.

Taking an iron supplement is definitely not a be-all-to-end-all fix for me, but I do know now how important it is. I know enough now to know that I need to work with my team and keep monitoring my iron levels.

And I also know now being in the MPT means there is no ONE thing going on with your body, there are A LOT of things going on. It is important to work on some individual fixes, but you may need more than that one ‘fix’. I also was finding out in the midst of my iron deficiency that more was going on. It was time to find the right doctor to discuss my long list with, and so I did. More on that in an upcoming story. And more on my journey with Rasa coming up as well.

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By the Summer of 2019 (48 years old) I had a new love in my life ~ my gravel bike, and we were going places I never imagined I would on a bicycle; The gravel roads of the Black Hills National Forest in Wyoming, The Driftless in Minnesota, and up to the Chequamegon National Forest in Wisconsin.

In 2020 and 2021 (49 & 50 years old), the travels continued to many of the same places, plus we added the gravel roads around ROAM Adventure Basecamp in Wisconsin, The Flat Tops Wilderness of Colorado, and The Gunflint in Minnesota.  Those two years were pinnacle years for me as a gravel cyclist. I felt that I was at a cycling, and physical, peak.  I felt great, and I was having a hell of a good time riding my gravel bike.

By November of 2021 I had fallen so deeply in love with riding gravel that I turned to Kurt on our last ride of the Season on November 7th near ROAM and said “I want to ride as much gravel as I can for as long as I can”.  [I’ve mentioned that in our Cabin Stories, it is in part why we now have The Crash Pad.]  I knew in that statement that time was moving fast, I was feeling good, and it likely would not last at that level forever.  I just didn’t know that ‘not forever’ was actually happening at that time.

At the age of 51, in early 2022 I decided to call myself an athlete.  This felt like a big step.  For a woman who never participated in sports in school, who never was on a bicycle team, who never went on group bicycle rides, and who considers herself more of a soigneur than a cyclist ~ this was a big mental shift for me.  I was starting to understand that what defines a female athlete isn’t being an elite athlete, it is being a woman who exercises.  In fact, exercise had been my lifestyle for a long time.

Concurrently with my increase in gravel cycling, I had started virtual cycling classes with The Fix Studio in October 2020, and shortly thereafter I also started doing Core + Strength Classes with The Fix (more on that in a separate story).  Additionally, in May of 2020 Kurt and I began doing Yoga with Adrienne.  I was exercising almost every day of the week, and I was beginning to understand I was what my friend Sophie would call “an everyday athlete”.

What I didn’t foresee in any of this, especially not in November of 2021 when I said that quote and we decided to build a cabin so we could spend more of our time gravel cycling, was that by Spring of 2022 the wheels would fall off.

We were already well underway with our cabin by the Spring of 2022, with many trips up to the property over the Summer, and sneaking in gravel rides when we could while we were there.  But by July both Kurt and I were realizing that something was not quite right with me.  

Things started to happen to me that weren’t ‘me’.  I was having extreme fatigue at odd times (for me) during the day.  Only a napper on weekends, it was starting to feel like I could barely function and like I could/should crawl into bed during weekdays.  I fought the urge, but was thankful I was mostly working from home so I could fight through it.  On many a bicycle ride with Kurt in the city, I was dogging it.  It felt like I could barely do the rides I had done hundreds of times and on many occasions, it was starting to feel like I wasn’t sure if I would make it home.  It was a bit like biking in slow motion and I had zero energy.  I also remember trying to do my virtual classes at least once a week that Summer and struggling significantly; I stopped going.

Kurt knows me well, and as my main (only) riding partner, he also knew I wasn’t riding like myself.  Neither of us understood why I wasn’t riding like me.  It was becoming a real bummer of a Summer because one of the most important parts of my life, riding bicycle, was becoming one of the hardest things I had ever done.  All my dreams of Summer cycling seemed like they were imploding.  

On July 5th 2022 I got together in person for a kombucha with my coaches, and friends, Sophie and Otte.  When I mentioned my cycling struggles, it was Sophie who said I might want to talk to her friend Rasa who is a nutritionist.

At some point in there, Kurt and I decided to grill a steak for dinner.  Being ‘flexitarians’, eating meat was more like a biannual event for us.  The next day I had a FANTASTIC bicycle ride, it was like I was an entirely new person.  Kurt noticed and said, “I think you have an iron deficiency” ~ and I started thinking he was right.

So I called the nutritionist Sophie had recommended.  Before even having me meet her, the nutritionist gave me advice on getting bloodwork and what tests to ask for from my doctor.  She also thought I might have an iron deficiency.  Spoiler alert ~ I did have an iron deficiency.  But that wasn’t all.

What I learned many months later in retrospect was that both the fatigue and the iron changes I was noticing in my body were both what I would call ‘quiet’ symptoms of the menopause transition.  So quiet it is easy to not notice them.  So quiet as an athlete it is easy to think they are happening for reasons other than what now seems so obvious to me ~ the MPT (the menopause transition).

I had always thought menopause was something that happened one day; you essentially no longer had your period, and you maybe had hot flashes.  So little I knew. 

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What I wish I had known, and that I do know now, is that during late perimenopause (which I was in) and the MPT (which I was in) is that your hormones are far from an even line, instead they are constantly fluctuating and changing.  Those extreme hormonal fluctuations have all kinds of side effects.  One of which for many women is fatigue.  Another of which can be an iron deficiency.

In the meantime, what I want you to know if you are an athlete of any type, and you are a woman - you too will go through the MPT and you should be aware that there are many, many, many symptoms during this time of transition.  And many of them are what I call ‘quiet’ symptoms.

As an athlete it is so easy to attribute symptoms to something other than the reality of what it is (MPT). And because so few people have been educated ~ it’s quite easy for well meaning people, even professionals, to corroborate with you, or to not have the best information for you.

And it is SO easy to think you have one problem (for me an iron deficiency), when in reality a whole subset of changes are at work on your body and solving the one problem, may not actually solve the bigger problem. 

Once again I urge you to find the right doctor.  Once again I can not overstate the importance of ‘your team’ to help guide you through the transition, because one professional may not have all the answers. Once again I can not stress enough how important it is for you to educate yourself so that you can advocate for yourself.

In upcoming stories I will share my experience with my iron deficiency, my journey working with a nutritionist, and what has happened to my workouts in the last two years.

Bonus content: After I wrote this story, and right before I published it, I heard a podcast the mirrored a lot of my experience above. I wondered, ‘would it have clicked if I had heard this then?!’. Perhaps it will for you.

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For awhile I had Girls Gone Gravel on my podcast feed and instagram feed. I am pretty sure that is what lead me over to Hit Play Not Pause. And a whole new world opened up to me at exactly the right time. Girls Gone Gravel Podcast was good, but Hit Play Not Pause was really much more interesting to me, because it was about me. I was hooked.

Hit Play Not Pause launched in October 2020. I was pretty unaware at that point what was going on with me, but in 2021 I definitely started to clue in that I was getting closer to menopause (although not computing at all that I was in the menopausal transition and that was actually the time of turbulence). I was more in the learning to educate myself when ‘it happened’ phase, than realizing I was in the it is happening phase.

I believe I really started to listen to Hit Play Not Pause in late 2022; I remember I still had my small business going and would listen to it when I was cutting out fabric, sewing bags, doing product photography, and a myriad of other small business things. I also have cooked and baked quite a bit since 2018 and podcasts are great company for cooks like me who do not enjoy cooking ~ I listen(ed) to Hit Play Not Pause a lot then too.

In late 2022 we had been working on our cabin heavily, and it was making me heavy. I was attributing the weight gain more to all the stress and lack of exercise ~ and not connecting the dots that my body was actually changing in other ways (forever). I also would have tremendously sore hip joints on all the car rides back and forth to the cabin, so sore it was hard to walk when I got out of the car ~ until recently I attributed this to sitting too much, again not connecting the dots. I was also having major fatigue issues around exercise throughout 2022 and into 2023 (still seeing if I am through it yet) ~ yet again, no dots connecting. I started meeting with a nutritionist, so was digging into the topics related to female athlete diets and fueling. [I will talk about ALL of these subjects separately coming up]. I found myself interested in episodes like:

• 115: WHAT YOU NEED TO KNOW ABOUT WEIGHT IN MENOPAUSE AND BEYOND WITH FATIMA CODY STANFORD, MD, MPH, MPA

• 105: HEALTHY, PAIN-FREE JOINTS THROUGH MENOPAUSE. HOW REGENERATIVE MEDICINE CAN HELP

• 103: LESS FUEL, MORE PROBLEMS. WHY MENOPAUSAL ATHLETES NEED TO EAT MORE WITH HEIDI SKOLNIK

One of the more recent articles I flagged to share was:

• 142: WHAT MENOPAUSAL WOMEN NEED TO KNOW ABOUT CORTISOL WITH CARLA DIGIROLAMO, MD, PHD

Specifically I wrote down what is said at around Minutes 31-35ish:

In Midlife it’s a very catabolic time of our lives, we are losing muscle mass, we are losing bone mass, we are losing power, because that’s what happens when your estrogen receptors go down, your estrogen levels go down…  To prevent that, you NEED to exercise, because if you don’t exercise, those declines are going to keep happening at a very rapid pace…  You have to mitigate that, and the only way to mitigate that is by exercise.  And not just walking… You need to do the exercise to maintain and become fitter…  To do that exercise you need your stress response to be activated.  But what the focus needs to be on is the RECOVERY and bringing the response back to equilibrium, that’s where the focus is…  I need to recover better, I need to fuel appropriately, I need not to overtrain, I need to do enough tissue care, get the sleep, so that’s where the focus needs to be…  

Your body changes, I’m menopausal now, my body has changed, so I’ve had to figure out through a lot of trial and error, what do I need to do and one of the things I personally need to do is warm up more and cool down more.  The other thing I need to do is a lot more yoga, mobility work and mindfulness stuff… so I’ve had to totally turn upside down and start from scratch saying ‘okay, here’s where I am and what do I need now?  What’s working and what’s not working?  Which starts with ‘what are my stressors?’  Is really the most valuable thing you can do.

Ding Ding Ding Ding Ding! YES! Yes, this is me! When I heard this it was like ‘WHY??!!! Didn’t I know this a year ago?!’ Why didn’t I absorb what my nutritionist was telling me a year ago?! Well, it’s because what you don’t know you don’t know, and what you don’t get you don’t get.

I have emailed myself so many episode links to share with you (not a good organizational tool), but at this point it is SO MANY episodes I am not sure how to even tell you where to start, so hopefully the above helps. My advice: peruse the most recent episodes of Hit Play Not Pause by subjects that capture your interest and go from there. More recent episodes will have more recent science, as there is so much going on right now in research and understanding of perimenopause and menopause, and the landscape is quickly changing. I would also suggest signing up for the Hit Play Not Pause newsletter; very very helpful information in both the podcasts and the newsletters.

I am tremendously thankful to Feisty, and in particular Selene Yeager for her good journalism. Hit Play Not Pause has opened my world and been a game changer for me, I hope it will be for you too.

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There is so much I wish this woman in the picture had known. But the world wasn’t quite ready to share it with her at the time. She knew ‘IT’ was coming, she had heard faint whispers. But that’s really all she knew.

I envy this woman; what she didn’t know, she didn’t know. BUT, she also knew that that was the whole problem!

She knew because she had just switched doctors. She knew she needed to ‘prepare’. But that’s pretty much all she knew.

I wish she had known so much more, but she didn’t. She couldn’t. Because the world wasn’t there yet, and really ~ neither was she.

Fast forward to 4 years later and BAM! This woman is a very different woman, and lucky for her ~ so is the world of information she lives in. She’s definitely living IN ‘IT’ ~ the moment she had hoped to know more about back in 2019. But she has realized, maybe you can never really know more until you are IN IT.

That said, she knows that there is MUCH MORE you can know before you get to the point where you realize you KNOW NOTHING. Let me explain…

As a GenXer, the words 'perimenopause’ and ‘menopause’ were never part of my vocabulary. No one talked about these things, and no one said these words.  I had absolutely NEVER ever even given them a thought.  That is until I was around 43, and my dermatologist said the word ‘perimenopause’ to me.  I pretty much froze in the moment; it was a bit shocking, and terrifying. And I had no idea what it was, I had never heard the word before.  What the heck IS perimenopause?!

I started noticing that I wasn’t alone, my friends and acquaintances were having similar experiences.  Most women I talked to would also ask their mother’s what their experiences were like and would get responses similar to ‘oh, I don’t remember’.

I didn’t understand why the terminology was like a foreign language to us, why we all had to feel so alone, or why NO ONE was talking about this.  I knew I wanted to use my small platform of äventyr to TALK about these things.  And what got me excited was that from the time I decided I was going to say something, other GenX women decided to say something too.  In the four years I have been thinking about writing about this topic, multiple celebrities have started not only talking about perimenopause, turning 50, menopause, and aging ~ they have launched companies and written books. But more importantly, there are better educated doctors, well researched books, well researched articles, smart podcasts, and I have athletic peers who are willing to talk openly about their experiences and support me through my challenges. I no longer feel alone, and ‘THE TRANSITION’ is so much less scary to me now (still a little though…).

When I started this journey into late perimenopause and the menopause transition (which likely was kicking into high gear around 2019), I was very unaware I was on it. I was still in preparation mode. And unfortunately MUCH of the information at my fingertips today did not even exist. There are definitely things I would have done differently knowing what I know now. I can’t go back and change time, but I can tell you from my personal experience my top tips ~ whether you are having symptoms or not.

These are my top tips for you:

1. Be honest with yourself. The menopause transition (moving from late perimenopause to menopause) is not going to skip over you. Don’t have thoughts about ‘maybe I won’t get it’, because it is not a virus! This is a major physical change going on in your body and whether you have symptoms big or small, you will go through it. The sooner you admit that to yourself you can get on with the important bits…

2. There is a TRANSITION and this can, and most likely will, start in your 40’s. Just because you don’t think you are in menopause yet doesn’t mean you won’t have symptoms, in fact it is the opposite. Many symptoms start in perimenopause. Pro Tip: It’s not just about hot flashes. It’s not like all of the sudden you are ‘in menopause’, in fact the transition is the rockiest part for many women.

3. Pay attention to your body. If you are an athlete, you may have a tendency to think symptoms you are having are because of anything but the menopause transition. And it is possible you may actually find you do have a health issue you did not realize you had. But, you may also be suffering from symptoms of late perimenopause that you can talk to your doctor about, and work with them to alleviate the issues. I WISH I had figured this out a year ago! I blamed so many of my physical challenges the last year on other things, but if I had known that my best friend estrogen was having a wild ride out of my body saying goodbye, I would have definitely sought better help sooner. More on this in a separate story later.

4. Estrogen. Estrogen. Estrogen. Know for a fact that estrogen is a crucial part of your body, and has been for your entire adult life. It is leaving. It can not be ‘replaced’. And it’s not the kind of leaving where it will exit through the front door and that’s it. Nope, your friend Estrogen is leaving through the front door and taking you with it on a crazy rollercoaster ride you can’t get off. It is probably a longer goodbye than you would like. BUT, you can do something about it. Much more on this later.

5. Don’t Go IT Alone. Build ‘your’ team. You need a doctor, first and foremost above all else. A GOOD one (see #7). But you also may benefit from a dermatologist, fitness coach, a nutritionist, and friends going through the same thing. That said having a team isn’t perfect and can potentially lead you down the wrong path at moments, so proceed with educated caution. Before all this do #7. More on all of this coming up.

6. Trust yourself. No one knows you better than you. Your ‘team’ of course can be helpful, but they can only meet with you rarely and for brief periods of time (unless you have a lot of money to spend). If something isn’t working, evaluate and address. You know you, even though you might not be feeling like you at the moment. Don’t just take the advice and run with it in desperation. Trust me.

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7. Find a NAMS Certified and up-to-date Board Certified Doctor! NOW! This really should be my #1 tip. I partially did the right thing in 2019, I switched to a women’s specialist doctor, and I really think she tried her best to get me down the right path. BUT, I wish instead I would have immediately found a NAMS Certified doctor (which I now have). This truly is THE most important thing you should do. NUMBER ONE. Much MUCH more on this later.

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8. Yes, you still need to have a annual exam. In fact, these exams are more important now than ever. Keep doing them! I didn’t so much need the advice to schedule an exam in my 40s (I needed my birth control refilled), but I wish I would have had advice about how important this appointment is during perimenopause and the menopause transition. Your healthcare as a woman isn’t ending, it is beginning a new important and life changing chapter. Keep going! I am lucky to have found a NAMS Dr. who will also be giving me my annual exam, bonus!

9. Your annual exam is NOT the time to have an in-depth conversation with your doctor about perimenopause and the menopause transition, that’s a different appointment. If you are having ANY symptoms, or want to be prepared, find the right doctor who can help guide you. See #7. This will be a separate piece I will be writing (lots to say there!).

10. Knowledge is power, educate yourself (with factual researched scientific information)! Unfortunately in 2019 I was given a maroon folder of information called “Mid—Life Transitions” from my new doctor at my annual exam. I wish instead of the folder she had said ‘I unfortunately do not have time to explain this all to you at your annual exam, but please use this as a starting resource and do #7. Even if it doesn’t seem relevant now, it will’.

    SO.MUCH.MORE. to say about all this, and I will in an upcoming story.

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11. There is no FIX to get back to ‘NORMAL’. I have finally realized I’m not getting the ‘old me’ back, but I can get the new evolving me to a pretty good place for where it is at today. That doesn’t mean it will be the same tomorrow or next year. And that means ACCEPTANCE and MANAGEMENT ~ that doesn’t mean ‘live with it’, it means there are better ways to live.

12. Give yourself some grace. “Your Body WILL Change and here is why….” Totally wish someone had said that to me and explained the scientific reasons of what was going on. Luckily today I have good books and podcasts. This is one of the biggest mental adjustments to wrap your head around, and I am still doing it. I just realized recently that it didn’t help this was all happening to me in the hardest parts of the pandemic, the parts where we were told not to go to a doctor. I’m pretty convinced that wasn’t helpful to me. But realizing it helps me give myself some grace.

13. Symptoms may seriously affect your health, be careful. Luckily they can be MANAGED. This is why #7 is so important.

My hope is that by writing Gen X Notes someone finds what I have to say useful, even if it is one person. The worst thing we can all do to ourselves as women is none of the above. I see it with my own eyes - women who haven’t found the resources I have and are suffering. I myself was suffering until just two months ago. As I say in #11, there is no going back to ‘normal’, but you can get to a much better place once you start facing this transition head on.

And if you are not anywhere close to this part of your life, do yourself a favor and understand it and support the women in your life who are.

I can’t wait to share with you all the stories I want to write in the coming months. As an everyday athlete, I have a lot to say. Thanks for being here. ~DeAnn

I have found that because I am open and honest about what I will be discussing here, people tend to ask me questions, or I find myself regularly sharing information. GenX Notes will be a place for me to refer people to, and allow me to do something I enjoy ~ writing. I am sharing my experiences in hopes you will do your own research, to help you understand how important it is to take your journey seriously and get help when you need it, and most importantly to do my part in reducing taboos and ageism due to lack of discussion, understanding, and empathy. Please read on.

For at least four years, I have been writing these stories in my mind, and I have also attempted to begin writing them a number of times.  But a lot of what I want to write about feels a bit daunting, personal, and yes I hate to say it ~ at times embarrassing.  Which is evidence of why I need to do this.

I am 52. Much to my surprise when I started thinking about this phase of my life, probably starting in my mid 40s, I never ever expected the topics of perimenopause and menopause to explode in the way they have.  At the beginning of my journey, just a few short years ago, I felt like I was walking down a dark tunnel with absolutely no idea where I was going and no one to help me find the way.  But NOW! Now… the landscape has completely changed.  I can’t keep up with all the articles, all the books, all the podcasts, all the YouTube channels, all the everything that is going on around me. WHAT.A.CHANGE! I feel lucky to be living through a moment that is ~ having a moment.

The truth is, I am slightly obsessed with researching and learning about the late perimenopause/menopause transition (and aging).  Because I am in it.  And before I was in it, I wanted to understand where I was going (I’m a planner by nature and like to do research and have all the details laid out).  

I think I can speak for most GenX women who are leading the forefront in researching and discussing this topic, WE KNEW NOTHING.  Therefore, GenX women are saying WHY ISN’T ANYONE TALKING ABOUT THIS?!  WHY do I know NOTHING?!  What the heck IS Perimenopause?! WHY IS MENOPAUSE A ‘TABOO’ SUBJECT? F&*# ALL that!  It’s time for us to change it!  And thus, I add myself to this group of GenX women sharing our journey, so that the next generation of women (because we ALL will get there if we are lucky) has the information they need for a successful journey to their next physical phase of living.

To ‘complicate’ my journey, I am an athlete.  Let me say that again, because it is important in how I approach talking about this subject.  I AM AN ATHLETE.  I didn’t call myself an athlete until early last year, at 51 years old.  And right after I did ~ pretty much the wheels fell off and for the last year so many things have happened, making me wonder at times if I was ‘worthy’ of the ‘declaration’ I had made.  But I am.  I AM AN ATHLETE.  And it is an important lens through which I am experiencing this journey I will be sharing with you.

If you want to be successful on this journey, and you have men in your life ~ tell them to read this and talk about it with you too! During this transition it is easy to want to keep the challenges of change to yourself, but it is important for MEN to understand and support women, specifically you, on this journey.  Women make up half of the world population - HALF!  Men aren’t existing solo in this world, we are their partners, their mothers, their sisters, their work colleagues, and what we are experiencing is real. We need to be truthful and honest with the men in our lives, otherwise the status quo around perimenopause and menopause will remain. No more pushing this discussion under the rug, and no more ignoring WOMEN, who are in this transition. It is important to understand that every single woman who is lucky enough to go through this transition, WILL go through it, and that includes MEN understanding it.  None of us are exempt.

It is hard to even know where to begin, because there is so much to talk about.  But the general outline for the topics I want to discuss in GenX Notes will be:

• My journey with the words 'perimenopause’ and ‘menopause’.

• Why calling myself an athlete is important, and what it means in regard to ~ everything.

• My exercise history.  I will discuss my history with exercise, my current routine, what I may be missing, how I have had to alter my routine, why I do what I do and how I got there.

• Books, articles, resources. Believe me, I have A LIST! I’ve been curious, and I’ve been getting educated. I want to share with you some good and helpful resources I wish I had had a few years ago that are thankfully available now.

• The importance of finding a good doctor, what my experience has been, and how you need a ‘team’ around you.

• Being proactive, asking questions, being your own best advocate.

• Acceptance without complacency. You can ignore the transition all you want, but it will be there every single day to smack you in the face. And you can do something about it!

• Fatigue. My experience with fatigue over the last year.

• Nutrition.  Why I worked with a nutritionist over the last year, how my diet has changed since 2018, how my diet is evolving, what I have learned over the last year, and what I am doing differently.

• Iron Deficiency.  On the heels of nutrition comes something I want to discuss separately, having an iron deficiency as an athlete, why it took me a year to figure out why I was iron deficient, and where I am at on my journey.

• Body composition changes.  Yup, the stomach bulge and added tire are real ~ even more so if you are used to being athletic (yup, mind blower there).  I will share my experience and what I have learned.  I will talk about how this is more than about your body, it is a lot of work in regard to your mental health too.

• Vaginal Dryness and why to take it VERY seriously. Hint: It’s not just about your vagina, this is SERIOUS stuff not to be ignored.

• Birth Control, MHT and why they are so important before you hit the transition and through it.

• Also, you should understand that for your partner’s mental health, you should also have a good support group of women, and professional women, who ‘get it’ or want to ‘get it’.

• More and more.

I am not sure if these will be all separate topics, combined, or likely interweaving many times, but it is a beginning framework for things I will be discussing in regard to my own journey.

Additionally, there are more general topics all GenX-ers, specifically Kurt and I, can relate to:

• Glasses.  Just admit you need to wear them, and the best brands we have found for our athletic lifestyle.

• Adjusting portion sizes, and what we put in our bodies, together as aging athletes.

• Yes you can still wear, and should wear, lycra ~ and why it can be the most comfortable and sexiest thing you wear all week.  Positive body image!!

If this is something that is of interest to you, or someone you know, please follow along!  There are so many great things we can do here together on Substack to build a supportive community.  Thanks for being part of the journey, and community!