If you've ever leaked when you laughed, jumped, or sneezed–or felt like your core disappeared after pregnancy, injury, or into perimenopause–you're not alone. This week, fitness specialist Leah Keller joins us to unpack deep core dysfunction: what causes it, and why healing it changes far more than just your abs. Leah's breakthrough came when she realized she could help women actually heal the separation between their abdominal muscles–known as diastasis recti–even years after giving birth. Clients who came for core work started reporting that they'd stopped leaking, that sex felt better, that back pain eased, and that their bodies finally felt like their own again– issues they never mentioned at the start. She explains exactly how fixing the deep core resolves problems women didn't even know were connected. We’ll give detailed descriptions of the exercises. You can also watch this one on YouTube to see the exercise demonstrations as well as the anatomical illustrations referenced in this episode, showing the difference between a healthy midline and one with significant diastasis recti separation.

Leah Keller is a certified personal trainer specializing in core and pelvic floor health, and co-founder of Every Mother (formerly The Dia Method). Her approach earned medical validation in a 2013 Weill Cornell pilot study — published in the American Journal of Obstetrics and Gynecology — and was further supported by a 2021 Hospital for Special Surgery trial in the Journal of Women's & Pelvic Health Physical Therapy. She has been featured as a women's health expert by NPR, Goop, and Good Morning America. You can find Leah’s published studies, resources, and learn more about her work at leahkeller.com

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Women in their 50s, 60s, and beyond are crushing courses around the world. At a time when we’ve been preconditioned to believe we’ll slow down, many women are holding strong—or even improving. This week’s guest Anna Troup, 56, who has clocked many of her greatest ultrarunning feats since turning 50, is a perfect example. Last year she took first overall (including the men) at the 268-mile (430K) Montane Summer Spine race—Britain’s toughest ultra marathon—in 84 hours, 56 minutes, and 37 seconds. This after a 2022 injury that left doctors questioning if she’d ever run again. This week, we talk about her most recent feat: completing the Montane Winter Spine Race this past January in 106 hours, 19 minutes, and 12 seconds—through brutal conditions including gale-force winds literally blowing runners off their feet. We dig into her journey to ultras, how she trains, races, and recovers, her menopause experience, and why more midlife women should line up and give it a go.

Anna Troup took up ultra running in 2013 with the sole aim of completing the UTMB, which she did for the first time in 2014. Unexpected success followed, much of it after she turned 50, and she has since won and held course records for many of the UK’s toughest single stage ultras including the Arc of Attrition 100, the Lakeland 100, Exodus 100, Wendover Woods 100, the Oner and the Summer Spine and Winter Spine. She has run the women’s Fastest Known Time for the Pennine Way and was the first female British finisher in UTMB in 2022. Ultra running has been a family sport since the beginning and she normally competes with Richard Staite, her partner, whilst her two children can be found either running themselves or as volunteers in aid stations. She works as non executive director and has recently moved to the Lake District to be closer to the mountains she loves.

Resources:

Ultramarathon winner's 'tough and terrifying' race at BBC

How a 55-year-old woman won Britain's toughest ultra marathon outright at Running Matters

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Now that menopause is finally getting the research and medical attention it deserves, we are finally putting perimenopause in the spotlight as a pivotal period in a woman’s life that demands its own care and attention. This week, midlife gynecologist Dr. Alyssa Dweck returns to break down perimenopause care, the state of hormone therapy, and much more. We dig into how perimenopause is so variable, how to think about the pill, IUDs, hormone therapy, and the new non-hormonal drugs, plus what hot flashes may be revealing about your heart health. We wrap with a look at wearables, telehealth, and the coming era of precision menopause medicine that treats ovaries as the powerful “conductor” organ they are. (Note: Dr. Dweck accidentally misspoke regarding fezolinetant. She would like to clarify that it is an NK3 receptor antagonist not an NK1.)

Alyssa Dweck MS MD FACOG MSCP is a practicing gynecologist at Well by Messer in New York City and the Chief Medical Officer at Bonafide Health. Dr. Dweck is a menopause society certified provider with a special interest and expertise in female sexual health and medical sex therapy. Dr. Dweck was recently appointed to the Board of Directors of HERmedicine, a nonprofit education organization dedicated to advancing women’s healthcare across the lifespan. This role at HERmedicine recognizes her as a distinguished leader dedicated to educating clinicians and integrating evidence-backed care into everyday medical practice. Dr. Dweck has authored three books, the most recent The Complete A to Z For Your V also co-hosts Business of the V, a podcast which focuses on unmet needs in gynecology and women’s health and the businesses created to fulfill these needsYou can learn more about her and her work at drdweck.com

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