If you’re strength training, eating “clean,” and still gaining fat or losing muscle after 40, it’s not just willpower—it’s physiology. In this episode we break down what actually changes during perimenopause and menopause (lean mass, central fat gain, estrogen shifts), plus the research-backed levers that still move the needle: resistance training intensity, protein targets, smart cardio, recovery, and when HRT may help. If you feel like the old playbook stopped working, this is your reset with a real framework.

KEY TOPICS

1. Why weight loss resistance shows up in midlife even for active women
2. How menopause shifts body composition toward central fat gain and lean mass loss
3. HRT and estradiol research for muscle gain and inconsistent fat loss outcomes
4. Protein targets for midlife women and how to hit them consistently
5. Training strategy that works: heavy lifting, cardio for VO2 max, power, agility, and recovery

TIMESTAMPS

[00:00] Why Bill Campbell shifted his research to menopause after his wife’s experience

[00:24] Female physiology matters: women are not “small men” and body composition changes hit hard

[00:57] First generation of strength-trained women entering menopause and why the research gap matters

[01:40] What’s really happening: gaining fat and losing muscle isn’t just about effort after 40

[09:13] Menopause vs aging debate: what the SWAN data suggests about the transition

[12:40] DEXA findings: lean mass loss begins and fat gain accelerates during the transition

[14:10] Why fat shifts to the middle: central adiposity, FSH rise, and estradiol decline

[15:00] HRT question: what changes when women use hormone therapy during training

[16:46] Estradiol and muscle: why estrogen therapy may be anabolic in trained women

[18:30] Estradiol and fat loss: why results are variable and not a guaranteed solution

[20:28] Hormone balance and nuance: estradiol, progesterone, testosterone, and body fat context

[22:55] Estradiol target ranges discussed for bone and muscle support

[27:53] Progesterone vs progestins: why older research can be misleading

[29:21] Protein targets: 0.75–1.0 g/lb ideal body weight and why most women under-eat protein

[33:47] Practical protein strategy: distribute evenly across meals to hit your daily target

[38:17] Protein timing around workouts: why pre vs post doesn’t matter much

[40:39] Supplements that matter: creatine, whey/complete protein, omega-3s

[43:22] Magnesium and vitamin D: common deficiencies and bone-health relevance

[45:00] Strength training minimum effective dose: 1 day for maintenance, 2+ days for best results

[47:16] Training doesn’t change by decade: intensity and proximity to failure are the difference

[49:46] Benchmarks: squat bodyweight and deadlift ~1.25x bodyweight as aspirational goals

[54:47] Cardio after menopause: VO2 max, HIIT, and why walking isn’t the same stimulus

[58:41] Stress resiliency: when pulling back is smarter than pushing harder

[01:00:16] Ideal weekly structure: resistance, aerobic fitness, power, agility, plus daily movement

[01:03:16] BFR/Kaatsu for joint pain and training around injuries

[01:05:02] What turned it around for Bill’s wife: progesterone first, then estradiol, plus patience

[01:07:46] HRT isn’t one-and-done: adjust, track, and combine with training, sleep, and recovery

[01:11:26] Where to follow Bill Campbell and his menopause fitness content

[01:12:00] Support the...

This episode explores how women’s hormones, aging, regenerative therapies, and technology are shaping the next era of longevity medicine. Dr. Amy Killen shares her evolution from ER doctor to multi-company entrepreneur, her work in stem cells and full-body regenerative procedures, and the role of diagnostics, AI, and hormone optimization in midlife women’s health. You’ll get an inside look at the queen phase of perimenopause, the future of longevity clinics, and how women can stay proactive as they age.

KEY TOPICS

• Estrogen, perimenopause and the queen phase of women’s midlife
• Dr. Killen’s shift from ER medicine to entrepreneurship in longevity
• Stem cells, exosomes and whole-body regenerative therapies
• Reputable Health, Hop Box and Humanát Health’s tech-enabled clinical model
• AI-driven care plans, advanced diagnostics and the future of preventive longevity care
• TIMESTAMPS

[00:00] Estrogen as a forgotten longevity drug and the mental health impact of perimenopause

[00:56] Show intro and framing women’s health, resilience and personal transformation

[01:27] ER burnout, single motherhood and the moment everything shifted

[03:23] Leaving the ER and confronting criticism around hormones and regenerative medicine

[04:08] Partnering with Docere Clinics and developing the Full Body Stem Cell Makeover

[06:33] Stacking stem cells, exosomes, peptides, light therapy and sound therapy

[08:10] Transformations in pain, sexual health and functional recovery using stem cells

[10:09] Musculoskeletal outcomes and delaying joint replacement surgeries

[10:57] Skin quality improvements, subtle rejuvenation and hair restoration in women

[13:33] Stem cells vs PRP and when each modality is most effective

[13:51] Founding Reputable Health to modernize clinical trials using wearables

[15:11] How biohackers join studies and test real supplements and devices

[16:28] Using AI to extract insights from sleep, HRV and wearable data

[16:57] Creating Hop Box as a simple, evidence-based female longevity stack

[18:17] Supplements tailored to female physiology, insulin resistance and skin health

[19:29] Why Hop Box is not a multivitamin and how ingredients like spermidine fit in

[21:06] Defining the queen phase and why women lose hormonal protection

[23:11] Men’s gradual testosterone decline vs women’s hormonal cliff in midlife

[24:52] Stress load in midlife and why so many women struggle in their 40s and 50s

[25:43] Hormone therapy as a foundational pillar for women’s longevity

[26:18] Building Humanát Health as a next-gen longevity clinic franchise

[28:21] Core pillars of longevity care: lifestyle, diagnostics and prevention

[30:39] Comparing Humanát to other longevity and biohacking clinics

[32:36] Evidence-based hormone protocols and training providers at scale

[35:31] How Humanát uses advanced diagnostics and AI-generated care plans

[39:45] Why the franchise model expands access to longevity medicine

[42:54] Membership tiers, affordability and the future of nationwide rollout

[43:41] Inside the Humanát gym: VO2 max, strength, balance and kinetic testing

[44:34] Advice to clinicians entering longevity entrepreneurship

[45:42] The next decade of regenerative medicine and the role of women

[46:41] Balancing motherhood, procedures, multiple companies and travel

[47:45] Where to find her clinics, supplements and platforms

[49:14] Closing reflections on the women’s longevity revolution

Guest: Dr. Amy Killen

Website: https://dramykillen.com/

Instagram: https://www.instagram.com/dr.amybkillen/

LET’S...

Discover how to build lean muscle, balance hormones, and reignite metabolism after 50. In this episode, you’ll learn the science behind muscle as a metabolic organ, how to train smarter (not harder) through menopause, and why recovery and hormone balance are key for strength and longevity. Perfect for women who want to stay strong, lean, and vibrant at any age.

• Muscle as metabolic medicine for women in midlife
• Smart strength training splits and recovery for hormone health
• Balancing HIIT, Zone 2, and daily movement for longevity
• Hormone replacement therapy and testosterone in women
• Protein, creatine, and supplement strategies for women over 50

TIMESTAMPS

[00:00] Why muscle is key to metabolic health and glucose control in midlife

[00:44] Starting bodybuilding at 50 and transforming your body at any age

[01:33] Perimenopause, insulin resistance, and how strength training helps

[03:19] Common training mistakes: too much cardio and skipping a coach

[05:44] How to find the right trainer for women 40–60+

[09:46] Bodybuilding lessons: muscle splits, compound lifts, and progression

[12:37] The best full-body plan for busy women (2–3 days a week)

[14:21] How to train with balance and recovery between workouts

[15:14] Heavy lifting, volume, and tempo — finding your intensity sweet spot

[17:55] Conditioning vs cardio: HIIT, Zone 2, and power training explained

[19:07] The ideal weekly mix for fat loss, recovery, and stress control

[22:30] Daily walking, HRV tracking, and training around your stress load

[27:26] Injury prevention: knees, shoulders, hips, and posture correction

[33:17] Midlife recovery tools: mobility, foam rolling, flexibility, and rest

[34:12] Men vs women in training — why women won’t “bulk up”

[35:04] Estrogen decline, sarcopenia, and how to preserve muscle in menopause

[36:23] HRT and testosterone therapy — benefits, myths, and what to watch for

[41:13] Protein goals and timing for women 40+

[42:54] Carbs, fats, and how to eat for energy and body composition

[44:22] Creatine, protein shakes, and supplement stack for strength

[46:47] Carol’s book, podcast, and where to connect with her online

Guest: Carol Covino

Website: https://carolcovino.com/

Instagram: https://www.instagram.com/carolcovinofitness/

LET’S CONNECT

Host: Orshi McNaughton

Website: https://www.optimizedwomen.com/

YouTube: https://www.youtube.com/@optimizedwomen

Instagram: https://www.instagram.com/orshimcnaughton