118. Your Midlife Health Questions—Answered with Heart & Science

Are These Midlife Health Questions Keeping You Up at Night?

Have you ever found yourself deep in a 2 a.m. Google rabbit hole, trying to figure out if collagen powder is worth it, or whether that weighted vest in your closet could actually help your bones? You’re not alone. Midlife brings a flood of changes—and questions—and it can be hard to know what advice to trust.

In this episode, I’m answering the most common (and most Googled!) health questions I hear from women in midlife. From supplements and strength training to anxiety and brain fog, I’ll guide you through it all with honest insights from both a functional medicine and Chinese medicine perspective—plus a whole lot of compassion.

In this episode:

• Whether a weighted vest can really help support bone health (hint: it can!)
• What to look for in a quality collagen powder—and why cycling your supplements might be a good idea
• The truth about NAD for energy and healthy aging (and whether oral supplements are worth it)
• Why walking is great—but heavy lifting may be even better for midlife wellness
• What might actually be causing your brain fog (spoiler: it’s not just low estrogen!)
• How to nourish your skin from the inside out as it becomes thinner and drier
• Why anxiety may spike in your 40s and 50s—and what your nervous system really needs

Connect with me, Dr. Sara Poldmae:

Website: https://risingwomanproject.com

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

Email: hello@risingwomanproject.com 

Transcript

Sara Poldmae: 0:01

Sarah, welcome to menopause. Rise and thrive. I am Dr. Sarah pulled me and this podcast is your go to guide for navigating perimenopause and menopause. If you are feeling a little overwhelmed, trust me, you are in great company. Each week, I'll bring you expert advice, raw, honest conversations and simple tips to help you stay grounded and maybe even find some humor in the process. Let's rise thrive and tackle this wild ride together. Hey, ladies, I have a super fun episode for you today on menopause. Rise and thrive. I am Dr Sarah pulled me, doctor of acupuncture and Chinese medicine, functional medicine, practitioner and a midlife woman right along side of you, I have been going through it too. Today I am going to tackle some of the common questions I get from both my patients and also the things that women may be Googling at 2am when they can't sleep, or just, you know, questions I've had in my life in general. So if you are a woman in Maryland and want to deep dive into your midlife health with the time testing and care that you deserve, you can still join us in renew her, which is our brand new concierge membership program for women that really want to take the time to figure out what's going on with their lives, to not only focus on what's wrong, but how they can make midlife and beyond the best years of our life. We are not looking to just get you well, so to speak, we are looking to get you to optimal health, to have amazing energy, to really, you know, make this your prime of your life. And for those of you outside of Maryland, I don't want you to feel abandoned. I can't work with you with medical advice, but I can definitely work with you on coaching. And a lot of what we have going on in midlife really is about lifestyle and making good choices and honoring boundaries. So I welcome you to email me if you're interested in a coaching session. Hello at rising woman project.com and we can get you scheduled. All right, let's jump in. First question, Should I be wearing a weighted vest for bone health? So the the the answer, right there, is yes, absolutely. If you tend to go for walks or think that you would use it around the house, even weighted vest can be a great tool, especially in midlife, when bone density becomes a real concern. Well, frankly, this should be a concern earlier, but most of us start thinking of bone health in midlife from a functional medicine perspective, Bones love stress, the good kind of stress, the load bearing exercise that signals your bones to hold on to minerals like calcium. A weighted vest adds gentle resistance during walking and strength training. The key is to start light. You want to start at four to six pounds at most, and make sure that it's comfortable and fits well so that does not strain your joints. I have a lot of neck and shoulder issues from car accidents, so I have to be super careful. It's going to depend on each woman, as far as, like, what weight they can get. So make sure to get a weighted vest that actually you can add and subtract weight from. And there's a lot of options out there. I don't have a particular brand that I love, but just remember to honor your body, and it should not cause pain. It can definitely cause some soreness at first, but pain is a whole nother perspective, so you want to make sure that you just honor your body when you're using a weighted vest and with any kind of exercise that you take on, all right? I hope that helped. Question number two, should I be taking collagen and what should I look for in a collagen powder? I feel like I get this question from at least half of my patients, and collagen is like the scaffolding for our bodies. It keeps our skin plump, our joints cushioned, our connective tissue strong, and as we hit our 40s and 50s, our collagen is definitely declining. For some women, it declines faster than others, but it's an absolute. This is what happens when we age, we'll start to see more wrinkles, more joint aches and slower recoveries from workouts. So in CO for collagen, I suggest looking for a hydrolyzed collagen powder, sometimes labeled collagen peptides, and make sure that it is third party tested for heavy metal. Metals and any contaminants. I actually like to cycle my supplements in general, but especially collagen. So maybe you know, one time, one one container, or two containers a couple months in a row, you use grass fed beef collagen, or then you cycle into maybe a fish based collagen. Some people also benefit from collagen blends that include things like vitamin C, hyaluronic acid, or for better absorption. I i Love meta Glo collagen. It has a lot of different qualities that I like. It is a marine based collagen. It has ingredients in there to help with stress and for boosting your natural GLP ones. But I'm not tied to any particular collagen. I'm more concerned with quality. I think the first and foremost is just to make sure that there are no heavy metals or contaminants in your collagen. And from a Chinese medical point of view, the collagen supports Yin, which is our moist, cooling, nourishing aspects of the body. Think of it as self care and really as a nourishing supplement. All right. Question number three, should I take NAD for energy and anti aging. I actually threw this one in because someone just asked me, I believe yesterday or today, whether they should take NAD and I threw this one in. It's not a super common question, but it comes up in here and there. NAD is a coenzyme that it is involved with energy production and cellular repair, and levels naturally decline as we age. So supplementing can improve mitochondrial function, which means more energy, better brain clarity and possibly healthier aging. Oral NAD supplements, I'm kind of on the fence about. A lot of women have compromised gut health, and there are certain things you need to break this down orally. So IV therapy may be the best and most effective route. It bypasses the gut and delivers it straight to your cells. And so if you are considering NAD, you might get more bang for your buck by going for some IV therapy, we think of it as like a cellular recharge button. So it's definitely worth it, but it is one of those supplements that you may end up just excreting rather than using if you take it orally. So definitely thinking about that. It may not be my first choice. Sometimes you'll find NAD in some mitochondrial repair or energy supplements, and in that case, no harm, no foul. But it may, if you're looking specifically for that supplement, may make sense to do it through IV. All right, do I really need to lift weights? Question number four, is walking good enough? Or do I really need to lift those heavy weights? Walking is amazing. It lowers your stress, it supports heart health and boosts mood. There's so many things that walking does do for you, and I think it's a really underrated form of exercise, however, for preserving muscle mass and for looking at bone density. You do need to challenge your muscles a little bit more. This means lifting heavy weights. And I mean really heavy, I don't you know, I love bar I use bar classes as a way to stay strong, but we also want to lift heavy weights. Functional Medicine loves resistance training for a lot of reasons. It's not just bone health, but also by keeping yourself strong, by keeping more muscle mass, you can improve insulin sensitivity, which is super important, lower inflammation and maintain a healthy metabolism. In Chinese medicine, staying strong helps to boost your yang energy. So while collagen helps with Yin, think of strength training as helping with Yang so that fire that keeps you active and warm. Kind of parallels with the metabolism concept in functional medicine. And, you know, I sometimes like to think of lifting something heavy, like there's a little spiritual metaphor that I think of there for proving to yourself that you're stronger than you think, so, that mind over matter piece is also really important, because we need to believe in ourselves, especially in tough times. Okay, so question number seven, what is the best supplement for brain fog? I don't think that there is one magic pill for this. For. Brain fog. I actually consider this. I specialize in midlife women, but I would say that brain fog is one of my biggest like sub specialties. I love treating women for brain fog. I have shared on previous episodes that I struggle with ADHD, and I definitely struggle with brain fog. And I know that one thing for me is not necessarily supplementation. I can tell you that diet really plays a huge part in brain fog for me, and it can be individual for each person, which is why I think it's so important to work with a practitioner. This is a big one. So for me, when I start to experience brain fog, the first thing that I usually do, and sometimes it takes me a few weeks or even a few months to catch up with Wow, and not thinking as clearly as I'd like to, and really struggling. But then something goes off, like in a little alarm bell or a little reminder, ding, ding, ding, ding, ding that I've been eating too much gluten. So I have never tested as absolutely gluten intolerant, like some of my patients, but gluten intolerance is definitely dose dependent. So do I need to be gluten free? No, probably not. Would I benefit from it, probably. But one thing that I notice is, if I am eating a lot of gluten, all of a sudden, I'll look back and be like, Duh. That's why I can't think very clearly. That's why I'm getting really fatigued in my work day. That's why everything in front of me seems overwhelming. I don't know if you can relate, but it's hard sometimes to focus. So the first thing that I do, personally is not supplementation. It is checking what I've been eating first, pulling back on the gluten. Dairy doesn't seem to affect me that much, but it could affect you. So pulling back on the gluten, and then the dairy, and then just any kind of junk foods in general. And when I say junk, it's basically almost anything that comes in a box. So crackers, certainly cookies. Looking at our sugar levels, how much are we eating? That's just, you know, a straight shot of sugar to get us through the day. But if we, you know, again, we should use some guidance, if you if you need guidance, if you don't know what's causing your brain fog, come see me if you're able to or we can even step on a coaching call. And we can check for things like diet, exercise. Just look at your lifestyle in general. But as a patient, we could potentially check your hormones, check your blood sugar levels, your inflammation levels, micronutrient levels, new neurotransmitter levels, and we can check your gut health, because sometimes it could be low estrogen, and it's not always low estrogen. I think there's a lot of talk out there that ioidentical hormones are the rage, and we can definitely do those in clinic, but oftentimes that's not the full picture. Estrogen can play a part in brain fog, but usually, there's some lifestyle things that we can definitely work through to help you. Sometimes it's poor sleep. Most women in midlife, I think it's like 60 or 70% of women in midlife had sleep struggles. So we want to look at that as well. That said, Now I'm going to actually answer the question, because the question was about supplements, but that said Omega fatty acids, omega threes in particular, are really good for brain health and cognition. Magnesium, three and 8b vitamins often support the brain in Chinese medicine, brain fog can be sometimes due to dampness, which goes back to diet, like what's causing your system to be sluggish? So we can definitely use Chinese herbs or Chinese medical nutrition to clear excess and strengthen your digestion, so that your mind feels light and clear. Brain fog can often be a nudge, also to slow down and focus on one thing at a time, instead of juggling it all. Think of our brain as like a filing cabinet. If we are stressed, that could be a huge source of brain fog, because we're trying to manage 75 things, and we can't put 75 pieces of paper into a file cabinet all at one time. So thinking of our brain as a filing cabinet, maybe we need to, like, put some of the things in the non urgent pile for a little while, until we deal with the few things in front of us that are a little bit more urgent, and just slow down and realize we cannot do it all. So, you know, in my clinic, women will come in with specific symptoms and want a quick fix. We all do, myself included, but sometimes it takes like, some reflection. And midlife is an amazing time to reflect on things. And really ask yourself, is there anything my body's trying to tell me that I need to change? Okay, question number six, what can I do for my skin now, because I'm noticing it's thinner, it's drier, it's just more sensitive. So as a functional medicine practitioner, yes, skincare is important from the outside, but more we want to hydrate our skin and nourish our skin from the inside out. Collagen can help with that, but also making sure that we're getting enough healthy fats and adequate protein that can help as well. The lack of estrogen is definitely a thing. So if replacement therapy makes sense for you, that could help your skin. There's even topical estrogens out there now, specifically for your face. You know there, there's a lot of things. Vitamin C can help with your skin as well. In Chinese medicine, dry skin is going back to that concept of Yin deficiency, or blood deficiency. So we can actually nourish our skin with foods like black sesame seeds, bone broth, pears. I i also like to think of midlife skin changes as a vis visible map of our journey, just like our stretch marks, like we don't need to erase every wrinkle. We can look at it as, you know, we're we're getting older and wiser, and that's okay. There's a funny meme that was going around on Tiktok that I really resonate with that says, you know, you get to look young once, and you can preserve it a little bit and grow old gracefully, but at some point, if we continue to try and look 20, we're no longer going to look young. We're just going to look weird. And I'm not throwing that out as shade. I'm not throwing that out as judgment. I just think that we need to be careful with getting too caught up in that, in that culture of like we should look 20 forever. I've said that before on the podcast. I get it. I'm with you on this. I am a member of the do not care club, but I also care about my looks. You know, there's it, you know, it's balancing what's right for you and making sure that it feels good on the inside how you want to look on the outside. All right. Question number seven, why do I feel more anxious now than I did in my 30s? That's an amazing question. Hormonal changes definitely can play a huge part in that, especially the drops in progesterone and then estrogen, which can make the nervous system just more sensitive. In general, we also consider things like adrenal health and functional medicine. So if you've been running on stress hormones for decades, that's going to make the ride through the reproductive hormone changes a lot more bumpy, and so your body can't really pump out those stress hormones and deal with all these reproductive hormones at the same time, all of these changes can become overwhelming, and that can manifest as anxiety. So we definitely want for you to work on hormonal balance, to help with your anxiety, your adrenal health. There are definitely a lot of herbs out there, both Western and Chinese herbs, that can help to kind of soothe your nervous system and just find the practitioner that can help you to restore that balance so that you don't feel anxious. Because too many women come into my practice and they've been put on anti anxiety meds, and that is just not good enough. I think we deserve to know where this anxiety is coming from, rather than to just put a patch on it. I want you to be less anxious, and if that is where you are at and the meds help, I am not stepping in and saying, Get off those meds. I'm just saying that we want to see the root cause our medicine and myself as a practitioner, I want to figure out why you're anxious and treat that rather than just putting a band aid on. However, that being said, if you're in a really bad place, medicines can definitely anti anxiety. Medicines can be the right choice for many women to get you to a place that you feel good. Life is way too long to feel like crap, but it would be nice to unravel where this is coming from so that we can fix it. All right, that was a lot of questions. I get really passionate about answering questions. I think you probably can tell, can tell, but if you found yourself nodding along to any of this questions, you're just you're not alone. This is why I love working with women in midlife. It's not just about managing symptoms. It's about understanding your body, your energy, your spirit, your soul, so you can thrive in the years ahead. And when symptoms come up, we don't want to just fix it by slack, slapping on a lotion. Or or taking a pill, we want to figure out where things are coming from and like, really develop an amazing relationship with ourselves. It's it's really more than just taking care of those symptoms. So if you're in Maryland and you want this kind of deep, integrative care, I'd love to see you become a renew her member at Meadow wellness, but if you're outside of Maryland, just hop on a call with me. We can definitely spend an hour going through some of your situations, and I can point you in the right direction and maybe advise you on what type of healthcare practitioner you may need for some of these issues. There's a lot of choices out there, so I could potentially just be your advocate in finding the right kind of doctor to see you are not broken. You're just in transition. Along with myself, it can be a tough road to navigate alone, but you get to write this next chapter. If you need anything, reach out. You have my email Hello at rising woman project.com and until next time be well. You.