Why Midlife Women Get Stronger, Smarter, and Healthier After 40

Hi, I’m Dr. Tracy Page. I’m super excited to be starting this podcast, and I’m doing it for all women. I believe women take care of everyone, so if I can take care of women and help you in some small way, I know you’ll go out into the world and help everyone around you, because that’s really what women do. I see it every day in my practice, and it’s good and bad. It’s good because women are nurturers and caretakers—smart and vibrant —and they can multitask and do it well; there are so many great qualities in women. But women also tend to put themselves last. And I see this in my practice too: some women thrive during this time of midlife, and some women really struggle. And just like death and taxes, you can’t get around it, or through it, or avoid it — you just have to learn how to manage it, and also how to thrive during it. And I truly believe you can do that. I’m in it, I’ve lived it, I see it every day in my practice. I have the privilege of caring for thousands of women, and I want to share with you—I can’t take care of everyone, but I thought starting this podcast would let me share the wisdom and knowledge. My patients teach me things every day that I can share with you, along with what I know to help them thrive and be their best selves.

Because here’s the truth: you weren’t designed to fade after 40; you were designed to evolve. Women spend more than one-third of their lives after menopause, yet most of us were never taught how to thrive during this time. Think about that — one-third of your life is spent after menopause. So I don’t think midlife is when women decline — it’s when biology finally forces you to stop ignoring your body and pay attention. You have to find out what your body needs. And that’s what I see in my clinic: most women who walk through the door don’t know what their body needs. They don’t know what’s going on in their body; they don’t know the answers, and they don’t know where to find them. So I hope this podcast becomes a resource for you, to help you grow, to nurture yourself, and to share with others. Community is so important — we’re going to talk about that in the future.

So, welcome to Midlife Clarity, where hormones, metabolism, strength, confidence, and science all meet real-world strategy for women who refuse to quietly settle for feeling less than their best. I’m Dr. Tracy Page. I’m a functional medicine physician, and every day I sit across from women who are intelligent, capable, high-achieving, and completely confused about what is happening in their bodies after 40. This podcast exists because you deserve clarity, not dismissal — which I hear every day. It happens to my patients: they get dismissed for their symptoms, they’re told that they’re anxious, they’re depressed, they’re crazy. It doesn’t make sense. So it’s not guesswork, and certainly not the message “just accept it” — they hear that every day as well.

So our core value at WIFM is integrity, and with integrity, I think it’s important for us to talk honestly about what’s going on and what the science tells us. So I really think this is the time in your life when you can be vibrant, live healthy, and live fully. So let’s get on with it. Midlife is not loss — kind of think of it as a recalibration; I think of it as a power phase. If you understand how to work with your biology instead of against it, you’ll really be able to thrive during this time.

So I wanted to share with you some of the things I hear every day in my practice that made me decide to start this podcast. Women walk into my office, and they say things like this — you might recognize them. “I don’t recognize my body anymore.” “I’m doing everything I used to do, but nothing’s working.” “My doctor says my labs are normal.” “I feel like I’m losing myself; I don’t feel like myself.” “I can’t sleep.” “I’m gaining weight, and nothing I do helps.” “I feel like I’m losing my mind; I can’t remember anything, I have so much brain fog.” “I can’t sleep.” “I have these weird sensations in my body.” “Sex hurts.” “I’m not interested in sex.” It’s just one thing after another.

And these aren’t weak women — these are leaders, professionals, mothers, caregivers. These are women who have thrived in their lives up until this point. They have spent decades taking care of everyone else, and typically haven’t been really focused on themselves. But, like I said, this time in your life forces you to really take a look at your body, and what it’s saying to you, and how it’s speaking to you. Suddenly, their bodies stop responding the way they have, and they don’t know what to do—not because they failed, not because the rules changed. Yet most women are given three responses when they talk to their primary care physician: “this is just aging,” “it’s stress,” or “everything looks normal, and you just have to live with it.” And I don’t know about you, but I’d be pretty frustrated if someone told me that.

And I actually was frustrated, because I got those answers too, when I saw my primary care doctor and was struggling with not getting out of bed because I was tired, not being able to focus and concentrate as I’d always done in the past, being cold all the time, not being able to lose weight, dry skin, dry vagina, no interest in sex, hair loss. These things were happening to me. It wasn’t until I saw a functional medicine doctor that I realized I didn’t have to live this way. And that’s part of the reason I started Wisconsin Institute of Functional Medicine — so I could really help women know that they could thrive in midlife.

And we all are hearing these sayings from our doctors, from others: “hormones are scary,” “hormones will kill you,” “they’ll cause cancer,” “you just have to live with how you feel.” It’s really interesting. So I want to create clarity around all of this for you — and you may have recognized some of what I’ve already said, because you’ve been told these things as well. “There’s no roadmap, no strategy, no real explanation” is something my patients have heard too. So there is a gap between what women are experiencing and what they’re being told, and that’s why Midlife Clarity exists — because I want to close that gap. I want to use real, science-based evidence to show you that you can take control and live and feel amazing.

So let’s talk about hormones, and how they affect metabolism, and your sleep, and your brain, and your body — because in midlife, that’s really what’s happening. Your hormones are starting to fluctuate and shift, and when your system shifts, it’s never one isolated problem, because hormones affect every system in the body. In medicine, we’re very segregated — we have a pulmonologist for our lungs, a cardiologist for our heart, a gastroenterologist for our GI system. And I see this: patients come in to me, and they’re like, “Well, I’ve seen this specialist, and this specialist, and this specialist — I’ve gone to all these specialty doctors, and each one of them tells me nothing’s wrong.” Yet all of those systems work together to produce a symptom that you face or feel.

I’ll give you a perfect example. I have a patient who ate something and developed gastritis, which turned into colitis, where she was having diarrhea all the time, and went to the GI doctor — scoped her, nothing was in her colon, said, “you know, this is something you’re just going to have to wait out and see,” tested her for bacteria and viruses, didn’t find anything. But when I saw the patient, and we did a GI workup, we found that when she had this bug, she had an overgrowth of what we call opportunistic bacteria in her gut. More importantly, she’d had a hit to her immune system, so her immune system was activated and had a hyperreactive response. So really, the symptom of diarrhea and the GI symptoms weren’t the problem — they weren’t the root cause. The root cause was the activation of her immune system, and if you can calm that activation down and get the immune system to work properly, the colitis went away. So that’s how I show you that the immune system and the gut were both affected — it’s never just one thing. And with hormones, metabolism, sleep, brain, and body health, it’s never just one thing.

Perimenopause can begin as early as your late 30s or early 40s. And estrogen and progesterone don’t simply decline; they actually fluctuate pretty dramatically. We all know progesterone is the first hormone to start to decline, but that doesn’t mean it’s the only hormone affected. When estrogen and progesterone start fluctuating, it can affect your temperature regulation; it can affect your mood; it certainly affects your sleep, your brain function—you get a foggy brain. You start storing fat on your body, especially in the tummy and lower body, like the hips and thighs. You get insulin resistance because your hormones fluctuate. So your metabolism becomes more efficient at storing energy, and less forgiving of metabolic stress.

So when we were younger, even 30 and less, we could have a few nights out, have dinner, have drinks — we could have that Easter candy, or that Valentine’s candy. We didn’t really think about those times when we had a little excess, because we could typically work it off, eat a little less, and our weight would usually fall back in check. But now, when you get older and you have this fluctuation in hormones, those little episodes that really never meant anything before now really derail you, because you don’t have that forgiving metabolic flexibility. Your body doesn’t adapt well to change—especially changes that aren’t favorable to the body, like alcohol, processed foods, sugar, and all the things we eat and do. I mean, it’s just normal; that’s what we do. And, you know, I will tell you, first and foremost, I’m not a perfect person, never claimed to be — I have some of these things too, and I notice that I can’t have them like I used to.

So what we notice, when you become more efficient at storing energy — which basically means storing fat — is weight gain, despite the same habits. Abdominal fat accumulation. Blood sugar instability — so you feel like a roller coaster up and down; you feel really good one minute, you’re tired the next. Increased inflammation — so the body hurts, aches, and pains start to develop. It’s amazing how hormone fluctuations can even affect inflammation. Then you start seeing critical changes—we start losing muscle, and we can lose a significant amount of muscle mass after 40 if we’re not strength training. We’re going to talk about that in a later podcast, but it’s so important to maintain our muscle, because it gives us that metabolic flexibility that I was speaking of. Muscle isn’t just about appearance — it regulates our metabolism, our blood sugar, our bone density; it helps with longevity, and it really allows us functional independence. So it’s important to maintain muscle, and there are lots of ways to do it.

I just saw a patient the other day, and she loves Pilates, and she’s like, “Well, you know, I think I should be lifting weights — everyone’s telling me I should lift weights.” And I said, “You know, the most important exercise is the one that you enjoy — so do Pilates, find ways to create more resistance while you’re doing it.” But stick with something that you love, because it’s what you’ll do. So I really encourage all of you, as you work with me and listen with me and try to optimize this time in your life, to find things that you love, because there’s no one perfect exercise — I always say it’s the one that you love, because it’s the one that you’ll do, okay?

When our hormones start to fluctuate, our sleep changes, and we get sleep disruption. Progesterone declines, sleep quality changes, we don’t get into that deep sleep, recovery then declines, and everything starts to worsen. Another thing we notice during this time is that stress tolerance changes—our nervous system becomes less resilient to chronic stress. What you tolerated at 25, 30, and 35 can now deplete you. It can make you feel anxious; it can make you angry, and your fuse becomes short, and you just don’t tolerate stress the way that you used to. And a lot of people don’t know, but stress affects our gut—so we can get a permeable gut, and we start reacting to foods. Stress affects our hormones — thyroid, testosterone, estrogen, progesterone. So we really don’t tolerate stress the way we used to. And in our 40s, all of us — everyone — have some type of stress, more or less.

Okay, so why can midlife be better? So why should you listen to this podcast? What are you going to learn, and what value does it bring? Because I’m all about value. So here’s where you get to flip the narrative: how I think about it. Midlife brings, you know, extraordinary adventures and changes in our lives, and we can never predict what life is going to be about — but I feel like you can flip the narrative and gain an advantage others might not have if I can create clarity for you.

So, self-awareness is the first thing — knowing what matters and knowing what doesn’t. And we’re going to talk about that a lot during this podcast, because I think our truth really comes to us during this time. Things we’ve kind of pushed down or haven’t addressed all come to the surface. So definitely, self-awareness is crucial during this time. And agency — you stop outsourcing decisions about your body and your life. So I’m going to teach you and share with you what I would say to that physician who says, “You just have to live with it,” and hopefully give you the resources that you need so that you can make the best decisions, with confidence and clarity and science-backed evidence, for your body and for your life.

One way to help you flip that switch during this time is to reduce people-pleasing. I will tell you, I’m a notorious people-pleaser — I always knew this, but I really had to come to grips with it when I owned a business. I used to chase everyone’s happiness, trying to make everyone happy, which drove me pretty crazy. And I realized happiness is a moving target for all of us—what makes us happy right now might be different a month, a week, or a day from now. So you really have to give up the people-pleasing mentality, because your energy becomes too valuable to waste it on people-pleasing for others. So I’m going to put that out there, because I think it’s really important, and we’re going to talk about it more, because it does play a role in how we take care of ourselves. It could be meal prepping, it could be choosing certain things for your body, it could be going to bed earlier, it could be wanting to schedule time for exercise, wanting to schedule time for book club or reading — or, you know, you just really have to allow yourself, maybe, some downtime, and to be able to say no, which I always say is a full sentence. So we’re going to talk more about that too.

And then, strategic focus — you can finally prioritize your own health without apology. And that’s something I want to really instill in you during this podcast: it doesn’t mean you have to be cocky, it doesn’t mean you have to be unkind, but it’s okay to prioritize yourself. It’s okay to prioritize your health and, as I say, put yourself on the list. I see this every day — many women discover that when they stop trying to maintain their younger self, they become a stronger, wiser, more resilient version instead. It’s so empowering; it’s just so needed. It’s so important, for this time of your life, to really put yourself on the list, and to prioritize yourself, and to maintain your health — because, at the end of the day, you end up showing up better for everyone else around you. So they all benefit too, and they may not realize it, because they’re all pulling at you and needing things from you. But what you’ll realize, in the end, is that you really show up as a better self and as an example, because you have been taking care of yourself.

So we’re going to create some new rules of midlife health, and I’m going to go through them — I have four of them that I want you to think about.

The first is strength versus endless cardio. As we work together, I want you to think about how cardio alone would not preserve muscle or metabolic health. Now, I just told you I want you to do the exercise you love, and I have patients who love running—so that’s kind of the opposite of what I just said, but they can still run. I like to run intervals — my body is not the same body I was at 25, or 30, or 35 — so I still run, but I do intervals, and I also do incline walking, so that way I can still, and I put on a weighted vest so that I’m stimulating muscle but getting that cardio effect that I really like. And also, too, I put in strength-training days, and you can make those strength-training days cardiovascular days, and you can challenge yourself to get your heart rate up while you’re strength training. But I really want you to just think of strength over endless cardio for long-term longevity and health, because strength training is really, truly foundational.

So the second rule is: protein matters more than ever before at this stage of life. And I will admit, I have a hard time getting my protein in, but I talk to women about it every day. Muscle synthesis declines as we age, so we really have to work to maintain that muscle—it’s metabolic health. Women need adequate protein intake to maintain lean mass. And, you know, a perfect example: I got on the InBody, which measures muscle, percent body fat, visceral fat, and I had lost some weight, but I had lost muscle. So for one month, the only thing I changed — I didn’t change my workouts, I didn’t change my sleep, which isn’t always great because I’m working a lot, I didn’t change what I drank water-wise, or otherwise — I mean, I might have a Monster every now and then, to be honest — but what I did change was trying to meet my grams of protein. So I was trying to get 100 to 120 grams of protein for my body. And when I increased my protein while changing nothing else, my muscle mass came back higher, and I didn’t change my workouts. So muscle and protein go hand in hand, and you can’t have one without the other.

The third rule I want you to think about is that recovery is not optional. So we have to make time to recover. As we get older, sleep, downtime, nervous system regulation, our biology—it’s necessary for us to feel our best. I will tell you, I have nights where I sleep 10 hours on the weekends, because I don’t have to be anywhere on Saturday morning or Sunday morning, depending on my schedule. And the days I wake up after sleeping 8 to 10 hours, I feel amazing — there’s no cravings, there’s no yawning, there’s no endless caffeine, there’s no aches and pains. It’s just so important for us to give ourselves downtime. And I’m a realist — I mean, Sunday through Wednesday, there are nights I get five hours of sleep, and so I know it’s not always easily possible. So as I make suggestions about strength, and protein, and recovery — and the last one’s going to be stress — I do realize that you’re not going to be perfect; none of us are. But what I want you to think about is: what could you work on or change to help move you closer to that ideal state, okay?

The last thing is stress. Stress management is physiological. Cortisol is not our friend — it causes fat storage, increases blood sugar, and affects our sleep, mood, and hormones, including thyroid, testosterone, progesterone, estrogen, and DHEA. So it’s just so important to learn how to manage stress. And I haven’t perfected it — but as a physician who deals with women every day who have all types of stress- physical, mental, emotional- we talk about it a lot, so we have a lot of great tools to share with you. But I will tell you, you cannot out-discipline chronic stress, and it will catch up to you. I’ve experienced it; I have taken care of women who have experienced it, and you either have to get a hold of it, or it will get a hold of you, and it’s not pretty. So we’re going to really focus on how we can help manage stress as well.

The last thing I want to talk to you about is what “getting smarter” means. So midlife health is not about trying harder; it’s about becoming more strategic — and that’s why I decided to name this podcast Midlife Clarity, because once we have clarity, everything makes sense, and we work smarter. We have more tools in our toolbox, we’re more strategic, and that’s really what I want to do. It’s kind of like this whole AI thing — I truly believe AI isn’t going to replace everybody, but it will help us become more efficient; it’s going to expand our knowledge. I think there are a lot of great things about it — we can have a whole podcast on AI in the future if we need to. But what I’d say is, it can help us work smarter, and so I think it’s important that we strive for that in this podcast.

So I’m going to bring all the evidence — I’ll have already done the research — and then I’m going to help you understand how to be more strategic and healthier without working harder. I’m going to teach you how to work with your physiology — understanding your body’s signals, which you might not even know are signals — and so that’s my job: to make you aware and help you adjust your inputs accordingly so that you get the best output. We’re going to work on precision versus willpower — we’re not going to white-knuckle it. I don’t believe you should white-knuckle through fatigue, hunger, poor sleep, because it’s just not sustainable. I also talk about this a lot when I’m helping women lose weight: we can’t create a program where you have to constantly white-knuckle through it, because you won’t continue to do it — and as soon as you get to your goal, you’ll stop, and then all that effort will be wasted. So, not a big fan of white-knuckling.

And then, finally, strategy versus hustle. Because I don’t know about you, but being in midlife, you’re kind of tired, and you’re like, “I don’t want to hustle for everything anymore; I want to be smart, I want to slow down a little bit — I still want all the things I want.” So midlife rewards intelligent effort, not maximal effort. This is what I believe, and this is what I teach. The women who thrive aren’t necessarily working harder; they’re just working smarter. And that’s my goal — to create clarity on how to work smarter during this part of your life, and to feel amazing.

So to wrap up here — and I promise I’m always going to keep these podcasts 30 minutes or less, because, as I said, we’re all busy. There’s a zillion things you can listen to; there’s a zillion things you can be doing and reading. So I really wanted to make this podcast valuable, efficient, working smarter, not harder, and under 30 minutes.

So one thing I want you to think about — I want you to just take a moment, and I want you to ask yourself something to really consider: what’s the one thing your body has been asking for that you’ve been ignoring? Has it been more sleep? Is it strength training, because your muscles feel flabby? Is it less stress? Is it just simplicity? Is it better nourishment? Maybe some boundaries — those never hurt. Because your body’s not your enemy; it’s just your messenger, and it’s trying to tell you something, if you’re listening. So I really want you to ask yourself: what is your body trying to tell you that you’ve been ignoring?

And finally, you know, midlife isn’t the end of something — I really believe it can be the beginning of a more intentional phase. It has been for me, and that’s why I love sharing this information with you. I always tell my patients, I feel like I’m 35 most days, and I want all my patients to feel that way inside. I want them to be in a place where they’re building strength, resilience, clarity, and confidence. That younger version that you may have had, or didn’t have — I want you to have that. And I want you to know, you don’t need to settle; you don’t need to guess. I want to be a resource for you. You don’t need to go through this alone, because I’ll tell you, millions of women just like you are trying to figure this out. And that’s exactly why this podcast exists, so we can do it together.

So if this episode resonates with you, share it with someone else who might need to hear it, because, you know, it helps another woman know she’s not broken. We just went to dinner last night with some couples, and I was talking about having a big birthday coming up — I’m going to talk about that in one of my upcoming episodes. And, you know, aging is a privilege — one of my friends told me that, and that really resonated with me, because I was having trouble with this birthday. And she said, “You know, I just really kind of think of it as, aging is a privilege.” Another patient said to me, “I don’t let that old lady in,” which I really liked—so the door’s locked; I’m not letting the old lady in. But I want you to know that this can be a great time in your life. And if you’re feeling hopeless, or you’re struggling with things and you don’t understand what’s going on, or you feel like there are no answers — you’re not the only person.

So I was surprised when I talked about my feelings about aging and shared them with some of the ladies I was having dinner with — we were at a couples’ dinner — and they opened up and said, “You know, I’m struggling with some of those same things too.” So that’s why I said: if you know someone who needs reassurance that she’s not broken and wants some answers, this might be a great podcast to share with her.

So if you like what you’re hearing, subscribe to Midlife Clarity so you don’t miss future episodes — I’m going to unpack the science. So today was just really kind of an introduction about what we’re going to talk about, who I am, and how I want to help you, and just how this whole podcast got started. And I just want to help you feel like yourself again, or maybe even better than before. So until I talk to you next time, take care, and listen to what your body’s telling you.