If you've ever left a doctor's appointment feeling dismissed, confused, or handed a prescription that didn't feel right, this episode on perimenopause and women's hormonal health is for you. I'm joined by Dr. Dana Culp, a physician with 25 years of experience who now exclusively specializes in perimenopause, menopause, and postmenopause care. Dr. Culp shares her own deeply personal experience of being dismissed by multiple providers while navigating perimenopause herself, despite being a doctor, and how that journey lit a fire under her to transform her entire practice. We talk about how to advocate for yourself in medical settings, the three questions every woman should bring to her next appointment, hormone testing, HRT myths, and how to find a qualified provider. If you've ever felt like you're not being heard, this conversation will change how you walk into your next appointment.

1. You Are Part of the Medical Team Dr. Culp introduces the concept of shared decision-making and why women need to walk into their appointments as equals, not passive recipients of care. Knowing what questions to ask—including what training your provider has in this specific area, how they individualize care, and how they monitor progress—can completely shift the dynamic and the outcome of your care.

2. Hormones Aren't the Cause of Everything, But They Deserve a Seat at the Table Hormone levels are rarely screened as a standard part of women's healthcare, and Dr. Culp makes the case for why they should be. She walks through how she approaches hormonal health alongside other foundational lab values, and why "normal labs" doesn't always mean the full picture has been examined.

3. Outdated Medical Thinking Is Still Affecting Women's Care Today From providers who are unfamiliar with current HRT research to blanket advice like "eat less, move more," Dr. Culp breaks down how old protocols are still being applied to women today and what you can do about it. She also explains how telehealth and menopause-specialized directories (like the Menopause Society registry) are expanding access to care no matter where you live.

Ready to start feeling good? Join me for my Monthly Becoming Her Workshop: my free monthly goal-setting session on Substack Live, designed for women who are done playing small.

👉 Sign up here: Becoming Her Workshop

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Website: thrivemidlifemed.com (includes a free perimenopause quiz) 📱

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If this hit home for you, I'd love it if you'd leave a quick 5-star rating or just drop a ❤️ in the comments. Or hit that follow button so we can keep spreading the word that midlife isn't a crisis — it's a comeback!

You've done the vision boarding. You've written about her. You've built her up in your mind—the version of you who shows up confidently, runs the business, lives the life. But there comes a point when planning for her isn't enough anymore. In this episode about embodying your future self and building self-trust in midlife, I share what happened when I decided to stop waiting and start being her today. Just me, showing up, trusting myself to figure it out. We talk about why we're not stuck so much as we are scared, how we use the "good" things in life to avoid the things that matter most, and the soccer field concept from the book Happy Pocket Full of Money that completely changed how I think about my future self. She's not far away. She's already here on the field. It's just a matter of claiming her. If you're a woman over 40 who's ready to stop futurescaping and start living as the woman you're becoming, this one's for you.

1. There Comes a Point When You Have to Stop Planning and Start Being

Vision boarding, journaling, crafting the future version of yourself, all of that work is valuable. But at some point you have to rip the bandaid off and just decide: I'm going to be her now. Not when conditions are perfect. Not when you feel ready. Now. It's what separates the women who transform from the ones who stay in the planning phase indefinitely.

2. We Use the "Good" Things to Avoid the Things That Matter

Workouts. Laundry. Grocery runs. Tied-up loose ends. We tell ourselves we'll get to the important work once everything else is done. But that list never ends, and using genuinely good things as avoidance is still avoidance. Don't cheat yourself. The hard thing you keep sidestepping? That's the thing she would do. So do it first.

3. You're Not Stuck, You're Just Scared of What Changing Will Cost You

Feeling stuck isn't really about being stuck. It's about not knowing what life looks like on the other side of becoming her. What changes? Who do you disappoint? What does your day look like when you start prioritizing yourself? That uncertainty is what's keeping you frozen, not a lack of ability or readiness. Your future self is already here, already on the field. You just have to claim her.

Join me for the Monthly Becoming Her Workshop. It's my free monthly live goal-setting session on Substack! Set your goals in real time, speak them into life, and come back at the end of the month to reflect on how far you've come.

👉 https://www.amcostanzo.com/free-goal-setting-workshop

Website: amcostanzo.com

YouTube: amcostanzowellness

Instagram: am_costanzo

What's one thing she would do that you've been putting off? Start there this week. Find me on Instagram or Substack and let me know — let's hold each other accountable.

If this hit home for you, I'd love it if you'd leave a quick 5-star rating or just drop a ❤️ in the comments. Or hit that follow button so we can keep spreading the word that midlife isn't a crisis, it's a comeback!

You think you're doing all the right things. You started the podcast, launched the business, wrote the emails nobody asked for. But what if you're still only going halfway? In this episode, I share how The Mel Robbins Podcast with Seth Godin made me call myself out. I'm doing the things, but I create something, throw it out there, and run back to safety. It's a deep fear of being truly seen, and it's been running the show. I talk about what it really means to put yourself on the hook, why your body is one of your best signals for where you're playing it safe, and the practice one woman in my accountability group does every week that made me realize I had work to do. Honest, a little uncomfortable, and exactly the conversation women over 40 need to have.

Key Takeaways

1. Doing the Thing Halfway Still Feels Like Doing the Thing, Until You Look Closer Starting a podcast, launching a business, writing emails nobody asked for, these feel brave. And they are. But there's a difference between doing something uncomfortable and truly putting yourself on the hook. If you're creating and then detaching entirely, "it's out there, people can find it," that's not non-attachment. That might just be a sophisticated form of hiding. Ask yourself: where am I stopping right before it gets really real?

2. Your Body Knows Before Your Brain Does That tightness in your chest, the fidgety energy, the sudden constriction when you think about stretching past your comfort zone, that's not a stop sign. That's a signal. Get curious instead of backing away. Ask: what just shifted? What am I afraid of here? The growth lives right past that edge.

3. Putting Yourself on the Hook Builds Self-Trust One woman in my accountability group goes somewhere new every week and starts a conversation with a stranger. She walked into an art gallery and ended up connecting with the head of the Chamber of Commerce, because she did something that scared her, on purpose. Treat discomfort as a growth experiment. Just do it once. See what happens.

Join me for the Monthly Becoming Her Workshop. It's my free monthly live goal-setting session on Substack! 👉 https://www.amcostanzo.com/free-goal-setting-workshop

Links Mentioned

Mel Robbins + Seth Godin Podcast Episode

Connect With Me

Website: amcostanzo.com

Substack: amcostanzo.substack.com

YouTube: amcostanzowellness

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Are you putting yourself on the hook, or just going halfway? I'd love to hear where you're playing it safe and what one scary thing you're committing to this week.

If this hit home for you, I'd love it if you'd leave a quick 5-star rating or just drop a ❤️ in the comments. Or hit that follow button so we can keep spreading the word that midlife isn't a crisis — it's a comeback!

What if your 3 a.m. wake-up wasn't something to dread — but one of the most powerful moments of your day? In this episode on living intentionally and breaking free from autopilot in midlife, I share how I turned my own middle-of-the-night restlessness into a personal prayer practice—and the insight it gave me: I'm playing a role I no longer resemble. I discuss how most of us live 90% of our lives on autopilot, quietly losing ourselves in the roles we play — wife, mother, daughter, colleague — while our actual gifts go unused. I break down why that low-level hum of overwhelm you feel isn't a flaw, it's a signal. We also dig into Gay Hendricks' upper limit problem and why self-sabotage shows up the moment you start to grow. If you've been feeling unfulfilled, like something is missing, or like you're waiting for permission to finally use your gifts — this episode is your invitation to stop waiting.

1. Autopilot Is the Enemy of Expansion — And Intention Is the Antidote Most of us aren't asking ourselves how we want to show up — we're just moving through the schedule. Being intentional isn't about goals or routines; it's about pulling yourself off autopilot long enough to feel what you want, how you want to respond, and who you want to be today. That kind of awareness is what builds real momentum — and it can start at 3 a.m. with one hand on your heart and one on your belly.

2. You're Not Lost — You're Buried in Roles Wife. Mom. Daughter. Colleague. We play all of these simultaneously, and over time we disappear into them. That quiet feeling of emptiness at the end of the day isn't a mystery — it's what happens when you've spent all your energy responding to everyone else's fires without ever checking in with yourself. Your gifts are still there. The work is becoming aware of the roles you're playing so you can consciously choose which ones still fit.

3. The Upper Limit Problem Is Real — and It Explains Everything When you start to grow and suddenly everything falls apart — the inconsistency, the pullback, the kids getting sick, the stress piling up — that's not bad luck. Gay Hendricks calls it the upper limit problem: we hit the ceiling of what we believe we're allowed to have, and we self-sabotage without realizing it. The move isn't to blow through that ceiling — it's to expand it incrementally, ask questions, journal on it, and let your head and heart work together. That's coherence. That's where the magic lives.

Every month, I host a free workshop on Substack. It’s part teaching, part workshop, and it’s where we speak life into our goals by becoming intentional. If you want to change your life, you have to show up differently, and this is how. Click here to become a free subscriber and join me!

Website: amcostanzo.com

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What was your biggest takeaway from this episode? I'd love to hear from you!

If this hit home for you, I'd love it if you'd leave a quick 5-star rating or just drop a ❤️ in the comments. Or hit that follow button so we can keep spreading the word that midlife isn't a crisis — it's a comeback!

If your goals keep falling apart a few weeks in, it's not a discipline problem — it's a pattern problem. In this episode about goal setting for women over 40, I break down the three most common reasons your goals flatline and what to do instead.

After 15+ years as a personal trainer and accountability coach, I've watched these same blocks show up again and again — and they're so common. We're talking about why you lose connection to your feelings and get buried in effort, how old identity stories hijack your momentum on autopilot, and why winging it without a plan almost guarantees you'll quit. This isn't about grinding harder. It's about nervous system regulation, embodiment, and self-trust — tuning into your body, questioning the stories running in the background, and building a backup plan that keeps you in the game. If you're ready to stop repeating the same cycle and start building real momentum, this is for you.

1. You're Losing Touch with the Feeling and Getting Stuck in the Effort That fire you felt when you first set your goal? It wasn't just motivation — it was emotional connection. When your focus shifts to the grind (the early mornings, the meal prep, the heavy weights), everything starts to feel like deprivation.

The fix: reconnect to the feelings your goal will create — confidence, energy, aliveness — and start embodying them now. Your body needs to get comfortable living in those emotions before the external results show up. This is embodiment and nervous system work.

2. Your Old Stories Are Running the Show on Autopilot The moment you hit a wall, your brain pulls up every past attempt that didn't work and serves you a story: "I never follow through," "Something always gets in the way." That triggers a familiar sense of relief in your nervous system and you're back to old programming. This isn't a willpower failure. It's an identity issue.

The fix: question those stories. Journal on them. Ask yourself, "Is this really true, or is this a repeated pattern I'm playing out again?" Start separating old narratives from who you are becoming.

3. You Have a Wish But You Don't Have a Plan Wanting to eat healthier or get stronger isn't enough if you haven't set up support systems, boundaries, and backup plans.

The fix: an if-then plan: if something disrupts your routine, then you do this instead. It doesn't have to be intense — it just has to happen. Every time you follow through on a backup plan, you're building self-trust.

Join my Dream It Do It Club on Substack — completely free!

At the start of each month, we come together and set goals for the next four weeks. This is how you live intentionally!

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If this hit home for you, I'd love it if you'd leave a quick 5-star rating or just drop a ❤️ in the comments. Or hit that follow button so we can keep spreading the word that midlife isn't a crisis — it's a comeback!

Some of the most important things you'll ever do for yourself will happen when nobody's watching. No applause, no recognition, no validation — just you, choosing yourself. In this episode, we're talking about showing up for yourself in the quiet, unglamorous moments that don't make the highlight reel but absolutely build the foundation of who you're becoming. I share what happened when I went live on Substack and nobody showed up — and why it was one of the most meaningful things I've done for my growth. We dig into nervous system regulation and identity work, and why your body's resistance to doing the scary thing isn't a stop sign — it's the exact place where self-trust gets built. If you've been waiting for someone to notice your effort, validate your path, or give you permission to keep going, this episode is your reminder that the most powerful thing you can do is show up for yourself — consistently, bravely, and without needing an audience to make it count. This is how we age fiercely.

1. Your Body Resists Change Before Your Mind Does — and That's Normal That physical feeling of wanting to run, hide, or make cookies instead of showing up? It's not weakness — it's your nervous system doing its job. Recognizing it as resistance rather than a sign to stop is the first step in breaking through fear and building self-trust.

2. You Need a Body-Based Tool, Not Just Mindset Pep Talks Reasoning your way through resistance only gets you so far. I share my personal secret weapon — a specific song that helps me shift from anxious overthinking into my body — and why getting somatic before doing something scary is a game-changer for nervous system regulation and personal growth.

3. Nobody Showing Up Is Not a Sign to Stop — It's a Sign You're Building When you do the brave thing and the world doesn't immediately applaud you, that is not failure. That is momentum. Showing up for yourself, even when no one is watching, is how you create the energetic shift that changes everything over time.

Every month I host two free live sessions on Substack — one at the beginning of the month to set your intentions, and one at the end to reflect on how far you've come. It's interactive, it's real-time, and it's free to join.

All you need is a free Substack subscription to get access.

👉 Join me here: amcostanzo.substack.com

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What was your biggest takeaway from this episode? I'd love to hear from you!

If this hit home for you, I'd love it if you'd leave a quick 5-star rating or just drop a ❤️ in the comments. Or hit that follow button so we can keep spreading the word that midlife isn't a crisis — it's a comeback! 👊

Ever notice how the more stuck in routine you get, the harder it becomes to do anything different? I went live on Substack for the first time and completely lost my mind—sweating, heart racing, wanting to hit "end" the entire time. And I realized something: my day-to-day had become so programmed that any deviation sent my brain into a tailspin. In this episode, I walk you through what happened when I forced myself to step outside my comfort zone and why that terrifying feeling isn't a red flag—it's actually proof you're expanding. I break down the difference between real danger fear and the fear of doing something unknown, why your nervous system fights change so hard even when you desperately want something more, and share my favorite goal-setting approach that focuses on emotions instead of outcomes. If you're a woman over 40 who feels stuck in routine but craves expansion, this one's for you. Plus, I'm starting a free accountability chat on Substack where we can navigate these uncomfortable changes together.

Key Takeaways

1. Not all fear is created equal—learn to distinguish growth fear from danger fear Your body's fear response doesn't differentiate between a dangerous situation and simply doing something new and vulnerable. When you feel fear around exposing yourself or trying something different, that's your nervous system reacting to the unknown—not actual danger. Learning to recognize this difference helps you push through instead of retreat.

2. Comfort zone routines keep you stuck, even when you desperately want to expand The more programmed and routine your daily life becomes, the harder it is for your brain to handle any deviation. Even when you consciously want to feel elevated and expansive, your nervous system will fight you on anything that feels unfamiliar. This resistance is preventing the growth you're craving.

3. The Sun Ray Method: Goal-setting that focuses on emotions, not outcomes Pick one goal for the next month, write it in the center of your paper, draw six lines out like sun rays, and write the emotions you'll feel when you accomplish it. Instead of focusing on unpredictable outcomes (like how many people show up), you focus on what you can control—showing up and connecting to those feelings of confidence, pride, accomplishment, and self-trust.

Free Resource

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💬 Let's Continue the Conversation

What was your biggest takeaway from this episode? I'd love to hear from you! Share your thoughts on Instagram and tag me @am_costanzo.

Don't forget to subscribe, rate ⭐️, and review the podcast if you found this episode valuable. It helps other people discover the show! ❤️

There's a big difference between going all in and doing just enough in order to stay comfortable. Recently, I've realized I've been circling my goals, meaning I'm keeping them at arm's length instead of actually committing the time and effort to make them a reality. And I figured out why: I'm playing it safe because I don't want to embarrass myself or disappoint anyone. So what ends up happening? I abandon myself instead.

In this episode, I break down the barriers we create that keep us stuck: the people-pleasing that makes us unmemorable, the busy work that looks productive but keeps us dancing around what we really want, and why we're so terrified of being vulnerable. I also share something that scares me—I'm starting monthly live vision boarding and goal-setting sessions on Substack where we work on one goal together each month. First one is February 3rd at 10am EST, and yeah, I'm nervous nobody will show up. But I'm doing it anyway because one of my words this year is self-trust, and that means showing up for myself even when it's uncomfortable. If you're a woman over 40 who's tired of the hokey pokey approach to your goals (one foot in, one foot out), come join me.

1. People-pleasing keeps you safe but makes you unmemorable When you don't rock the boat and try to make everyone like you by staying in the background, you end up being kind of forgettable. You might look back and realize you've had friendships but no deep, real connections—because you've been trying to be everything to everyone, which means you're really not much to anyone. The reason we don't go all in? We're managing our vulnerability.

2. "Working on It" isn't the same as going all in - overcoming goal avoidance You can spend years creating podcasts, shooting videos, writing programs, and staying busy—but if you're still keeping your goals at arm's length, you're playing it safe. The hokey pokey approach (putting one leg in, taking it out, circling around) keeps you from the vulnerability of truly committing. Going all in means being willing to say "I did this embarrassing thing and nobody showed up, but I showed up for myself."

3. There's power in doing uncomfortable things together as a community Starting February 3rd, I'm hosting monthly live vision boarding and goal-setting sessions on Substack (10am EST). We'll work on one goal each month, support each other through an accountability chat, and come back together at month's end to reflect on what we learned.

Join the Live Vision Boarding Sessions:

amcostanzo.substack.com/subscribe

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What's the one goal you've been circling around instead of diving into? I'd love to hear from you! Share your thoughts on Instagram or Pinterest and tag me.

If this hit home for you, I'd love it if you'd leave a quick 5-star rating or just drop a ❤️ in the comments. Or hit that follow button so we can keep spreading the word that midlife isn't a crisis—it's a comeback!