Why Early Hormone Headlines Mislead And How Pregnant Athletes Can Train Smarter

A wave of excitement hit social media over a perimenopause hormone therapy “study” that hadn’t even cleared peer review. We pull back the curtain on how posters at medical conferences actually work, why methods and nuance matter, and how hype from massive accounts can eclipse the careful voices of the researchers themselves. It’s a candid look at women’s health misinformation, how it spreads, and why long-form conversations offer a better path to clarity.

From there, we dive into real questions from active moms. What explains breathlessness and fatigue at just eight weeks when your body looks the same? How do you navigate the identity whiplash of being an athlete who suddenly feels slower, quieter, and less recovered? We share practical ways to stay consistent, lean on community, and reframe expectations without losing performance completely. You’ll learn how to assess lower abdominal soreness after toes-to-bar, when a hip flexor or lower abdominal strain is the likely culprit, and when anxiety or ectopic history means it’s time to see a clinician.

We map out first-trimester strength work in clear terms: three focused full-body days, two to four sets per lift, rep ranges that respect energy, and simple progressions—add a rep, add a little load, or add a set as recovery allows. Instead of defaulting to scaling everything, we push for a progression mindset and modify only when your body asks. On pelvic girdle pain and sciatica, we compare slimmer pelvic belts like the Serola with fuller supports, explain who benefits most, and pair any device with targeted hip and trunk strengthening. We also spotlight a missing piece in the literature: how pre-pregnancy injury history shapes pain during pregnancy, and what that means for prevention.

If you’re an active mom, coach, or clinician who values evidence with empathy, this conversation gives you tools you can use today—plus the context to spot hype before it takes root. Subscribe, share with a friend who trains, and leave a quick review to help more women find trustworthy guidance.

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Transcript

Welcome And Episode Setup

Reddit Q&A Round Two

Perimenopause Study Hype Explained

Posters, Peer Review, And Nuance

Early Pregnancy Fatigue And Identity

Why Long Form Beats Social Media

First Trimester Body Changes

Managing Anxiety Around Symptoms

Musculoskeletal Vs Pregnancy Pain

First Trimester Strength Programming

Progression Over Automatic Scaling

Pelvic Pain, Sciatica, And Belts

Choosing Support Belts That Help

SPEAKER_00 0:08

Hello everyone and welcome to the Farbell Mamas Podcast. My name is Christina Provitt. I'm a public floor physical therapist, a researcher in exercise and pregnancy, and a mom of two who has competed in CrossFit, powerlifting, or weightlifting, pregnant, post-partum, or both. In this podcast, we want to talk about the realities of being a mom who loves to exercise. Whether you're a recreational exerciser or an athlete, we want to talk about all of the things that we go through as females going into this motherhood journey. We're going to talk about fertility, pregnancy, and postpartum topics that are relevant to the active individual. While I am a pelvic floor physical therapist, I am not your pelvic floor physical therapist and know that this podcast does not substitute medical advice. All right, come along for this journey with us while we navigate motherhood together, and I can't wait to get to Hello everyone and welcome to the Barba Mamas podcast. Christina Previtt here, and today we are on our second episode. We were gonna do two because I didn't get through all of them last time on answering questions on Reddit. I loved this. I had a bunch of you reach out to me and say you really enjoyed kind of the variability in questions. Um, so we're gonna do that again. I got a couple more questions pulled up here. Before we do that, one thing that I thought was really interesting, and it's kind of in the menopause space, but I think it's an important thing for you all as consumers online. There was a lot of buzz about this study that was being presented at the Menopause Society about starting hormone replacement therapy in perimenopause. So if you are a person who is in their late 30s, early 40s, then you were kind of either in it or about to embark on your menopausal journey, as perimenopause can be the 10 years leading up to the menopausal transition. And menopause in Canada and the US, very similar in other areas of the world, is on average 50 to 51, plus or minus a couple of years. So if you go into menopause at 48, you can start having menopausal symptoms in your late 30s. And so what this study was showing was that initiating hormone replacement therapy in perimenopause seemed to reduce the risk of a variety of different cancers and different chronic diseases in later life. Now, it was a, there was a lot of influencers, obstetricians, paging Dr. Fran, Mary Claire Haver, the mama baby doc that were all really excited about this study. And it just really showed that there is such a huge need for more studies around perimenopause because we have a lot in postmenopause and lots in the general public, but nothing kind of to the experience of individuals transitioning into menopause, perimenopausal transition. And this study, like the findings of augmenting your hormones before menopause to help with long-term disease risk, is actually not as revolutionary as they were talking about, or at least it wasn't, in my opinion, because what we see is this stepwise increase in risk for certain conditions like dementia, for example, based on when you become estrogen low. What I mean by that is that if you go into menopause before 40, called premature ovarian insufficiency, you have a higher risk of dementia than somebody who goes into early menopause, which is before 45. And those individuals have a higher risk of dementia than those that go through menopause at that average age of 50 to 51. And so the opposite relationship has already been established that having low estrogen earlier in your life incurs higher risk for certain conditions later in life. And so this is essentially showing the opposite relationship is also true that having a boost in those sex hormones earlier in life can help for chronic disease risk later in life. Christina, why are you talking about this? So the interesting thing that happened was one, no person who was talking about this study was actually at the conference. And number two, the study hadn't even been talked about yet. It was a poster that was talking about these new findings. It's kind of like when we think about posters at a conference, a scientific conference, it is like a sneak peek, which means that we know as consumers in a research conference that these studies have not been published yet, and therefore they haven't gone through peer review. But when you have a poster being presented and you are physically there to talk about said poster, you are there with the author. The first author is there, and so you can ask some of the things that are gonna get sorted out on peer review. And then the second thing is that when you blow the the um the excitement on that study early, it actually can hurt the first author of the paper. The amount of excitement and downloads and clicks and citations and excitement about a paper that comes out can actually be really beneficial for the first author. And that attention is something that matters for people who want to stay in academics. And so this was a really interesting thing that I was watching online. I didn't really comment on it because it wasn't, I didn't really want to get into it. But number one is that posters are not peer reviewed. Some posters never go on to being accepted in a medical journal because they have fundamental flaws to them that are not making it acceptable to be published in the scientific literature. So you always have to have caution when you are reporting on a poster. Number two, if you are gonna report on a poster, make sure you were there and that you can actually speak to the pros and cons of the study and you've actually read the methods. A poster does not do a deep dive into the methods of the paper. And then damage control had to happen where the primary investigator, uh, Dr. Rachel Pope, went online and said, Hey, hey, hey, I'm so excited that people are excited about our poster that has not even been presented yet. But let me talk about the ins and outs of this study and why we cannot extrapolate so largely in the way that these influencers have been. And so this was just an example that was kind of in our area that just totally made me think about how we have to be very careful of how misinformation can be spread. Because Rachel Pope, the author or the primary investigator, the person who was supervising the first author, had like 2,000 followers online, and Mary Claire Haver's over a million. So she reported on it without the nuance, and the nuance is never gonna reach those people. So they're gonna hear start taking hormones in perimenopause, which could be beneficial, but is missing a lot of the nitty-gritty. And that is why I've been talking so much lately, and why I love this podcast, if I'm being really honest, because there is so much lost in social media that gets misconstrued. And what Emily Fender, who's a postdoc Dr. Emily Fender, is showing in some of her misinformation around women's health, is that healthcare providers are a big part of this problem. And it's because we're trying to play the social media game, and a lot of times just because you're a doctor doesn't mean that you understand research. We get exposed to understanding research, but we are not experts. I am a postdoc and I still don't consider myself to be a huge expert in understanding all the literature, especially as you drift even a little bit outside of my circles of expertise. And it's just really interesting to see how easy it is for these things to pop off. And when they pop off, how down the line it can feel like we've kind of missed the main point of the study or we've gone too far in our conclusions, and it can be really frustrating. And so, like, long form like this for me has always been so much better because you can kind of get into the ins and outs and the nuances because like that was kind of painful to watch. Um, but it's also really interesting to reflect on and where my role is in this, and if I can kind of get into that as well of like over over-emphasizing certain points and not emphasizing enough some of the nuance. Um, especially when you're playing the social media game, unfortunately, where it hates nuance, and I hate that about it. Um, so just really interesting to see that. And, you know, something that I've been thinking about a lot over the last little while and why this shift to long form or like just putting a big emphasis on long form for me has been um something that I wanted to kind of shift into. All right. I have one, two, three, four more questions. One's actually a comment, but I think it's really important to talk about that we are going to go through in today's episode. So, number one, which is kind of a comment, I am a first-time mom, eight weeks at almost 40 years old, and an athlete. Can we talk about how humbling it is to not be able to stick to your previous exercise routines, even though you look mostly the same? How about getting out of breath using much lighter weight? I know how lucky I am to be able to exercise at all right now. I'm just really shocked with what a mind game it is. The first thing that I kind of want to talk about with this is one to validate your experience. Yes, you may not have that big pregnant belly out in front of you that kind of shows why you are feeling so different within your body with exercise. But as soon as you pee on that stick and it is positive, every system in your body is starting to change. And the out-of-breath piece is definitely the ramp up in our cardiovascular system to try and increase blood volume really quickly in order to supply blood to the growing fetus, placenta, and the growing uterus. And so it is hard because a lot of people, too, she's eight weeks, she may not be telling anybody at the gym. And so you're at the gym, you're feeling like trash, you're super out of breath, you're not maybe performing as well as you usually do. People are beating you in workouts that you used to crush them in, and you're not saying why. And so it's like the first part of this mind game around identifying as an athlete and then having to feel these changes in your body that are very new and probably not fully understood until you're probably on the postpartum side of it. And so I think the the thing that is really important from an education perspective that we need for people who are active and those that aren't is that that first trimester, there are so many things happening that are not in the growth phase, like baby getting bigger, but in the development of one, your body's readiness from a heart health perspective, and and every other body is starting to adjust in order to get your body ready for pregnancy. And then number two is the idea around the energy it takes to start to develop those systems leads to so much of that fatigue and nausea and feeling kind of breathless right away. And so I think that it is so great that we are actually starting to talk about this. Uh, we are seeing way more people who are announcing their pregnancy earlier, and it's a double-edged sword as I have been in the last year. I've had two losses, one that I had announced the pregnancy of, one that I didn't, but announced the miscarriage of. Um, and so there is that worry, but I think a lot more people are starting to lean on their community that's around them to know and share their joy when they are early in their pregnancy, but also then share their sorrow if that pregnancy doesn't end in a baby being born at the end of that pregnancy. But when you do share those, sometimes having that shared experience with others of like, oh yeah, I'm totally there with you. I remember when I was in my first trimester and I was, you know, crushing people on my 5K and now I was feeling really slow. Those types of experience, that shared experience, can be really helpful. And so gonna finish off this comment by saying, Girl, I'm with you. I was there too. Totally get it. Totally get it. All right, number two is getting sore after toast bar. I'm um not even six weeks today, so very early and still feeling up to my usual gym routine for the most part. Today I was doing a toast bar drill and I noticed a little discomfort in my lower abdomen during the exercise, so I stopped. Now, just a few hours later, my lower left abdomen is so sore when I tried to sit up or turn over. It's almost exactly where I've experienced right lower pain before. RLP, I think that's what maybe that's an acronym. I just don't know. It's almost exactly um um, I don't know what that RLP is. I've experienced lower quadrant pain, maybe. Oh gosh. Uh, except this is more a soreness than a sharp pain. Um, I have a history of ectopic pregnancy and I haven't confirmed placement of this pregnancy yet. So before I go down that rabbit hole, I'm curious if anyone else has experienced this. This is a really wonderful question. Um, and as somebody, you know, who has experienced pregnancy loss, like this person, um, not me, this person, it is very easy to be very aware of every sensation in your body and jump to that anxiety and worry right away. If you are worried at all, seeing a doctor is probably your first course, right? If you are really at that level of worry. Um, just to kind of talk very broadly, um, what because there was a immediate like I did this exercise and then I experienced this sensation. Um, where I would want to rule out first is a muscle skeletal issue. And so when you're pregnant, a lot of times we we want to have these sensations related to the the pregnancy itself, but it could be that you kind of experienced a strain of a muscle because you were very hyper-vigilant about that area of the body, and so maybe you were recruiting more than you would before in an attempt to, I don't want to use the word protect, but have heightened awareness of that area of your body. And so if you were doing a toast uh bar drill and you were experiencing, let me think, for example, of you doing like swings and then you're trying to learn toast bar, so you're bringing one toe up to the bar and one down, um, it would make sense potentially that you could have had a hip flexor strain. Um, and that could be what you are feeling because it can have that sharpness. The insertion is very close to that right lower quadrant. And so you may be experiencing musculoskeletal pain. Um, and so it is always where you want to have this differential diagnosis and try to see if there's anything that is engaging or kind of causing your symptoms. When they're saying to do a sit-up, that is also a lower where the lower abdominal wall attaches into the pelvis. And so if you're engaging rectus, that six-pack muscle, right, it attaches into that pubic bone. And so you may be having lower abdominal muscle strain as well. And so um having some of that soreness being mimicked by how movement or certain types of movement, if I was doing an evaluation, I would think that there was some sort of muscle scatter cause. Um, but if I was seeing you, I would want to see if there was any reason for us to have to rule out anything related to the pregnancy. I would assume, and again, I'm not a medical doctor, so I wouldn't want to go too far down that rabbit hole. Um, that when we're thinking about things like ectopic pregnancies, et cetera, that usually those are um not movement specific pains in the most part. I don't want to go too far out of scope, so I want to make sure that I'm being aware uh of that um and and telling you to go see a doctor. Um but on an MSK side, we would be thinking about is there a reproducibility factor or are there certain ways that I can reproduce your pain that are consistent? And that would make me think that maybe there was an MSK or a muscle component to that. But I also totally understand the emotional side of it, and if in doubt, always go get it checked out. All right, next one is weightlifting modifications for the first trimester. I'm in the first trimester with my third baby. I have been doing three full body um days for strength training, lasting about 30 to 30, uh 30 to 45 minutes. I'm currently in the fatigue, easily breathless, and poor recovery stage. I would like to hit all the muscle groups, major muscle groups in a a week, prioritizing lower and core as my hips get pretty achy in pregnancy without hitting lower body once a week. What are some helpful sets and rep ranges? What is a split you have found helpful during this stage? This is a fantastic question. And a couple things. Number one is that I love that this poster is saying strength training helps my body feel better. And in the first trimester, building up as much muscular reserve as possible so that your body is able to handle the stress of later pregnancy, I think is also a really healthy mindset. And I think that's really great. Um, I also think that it's a wonderful routine to be doing three full-body upper lower days, um, kind of in this traditional bodybuilding, isolated strength training type of paradigm for 30 to 45 minutes. When she's asking about helpful set and rep ranges, um, this is where there's so much it depends that is probably so frustrating for a person who just wants a very definitive answer. Um, and so in the set and rep ranges, it really um is it could be any set and rep range. Um, we probably want to get into the two to four sets, but the reps, it doesn't really matter as long as it's effortful. So if you're a person who you're like, oh my gosh, if I have to do four sets of 15, I'm just not gonna go in because that's so overwhelming to think about doing that type of volume. Um, then doing two to three sets of eight with a higher load so that you complete the exercise without being overwhelmed and seeing it as a barrier to your motivation to get into the gym can be super helpful. When you are thinking about a split, I love doing supersets or I don't want to say circuits because circuits uh implies that you're doing it to heart fatigue, but kind of working through a pair or triplet of exercises that work on opposing muscle groups for efficiency is something that I love to do in the gym. If I'm kind of doing a traditional bodybuilding type of program, what that would mean is like an A B of an upper body exercise and a lower body exercise. If you are doing three full body days with a day in between, I would focus on getting different exercises, but I wouldn't be focusing on hitting certain muscle groups necessarily because you probably are going to be able to do some sort of upper body pulling, pushing, pressing, um, and lower body squatting, hinging, um, and then single leg work in almost all of your sessions. And so having upper body and lower body and core in each of those days, picking two or three exercises from those buckets and then rotating them on day two and three, and then going back to day one and trying to have that progressive overload where you're trying to increase the number of repetitions with the same weight, bring the weight up a little bit more, or add a bit more volume, is how I would be approaching it. In the first trimester of pregnancy, I am not really modifying anything unless your body is telling me to modify. What I mean by that is I'm probably modifying by how you're feeling from the fatigue and breathlessness perspective. And if that's the case, we may hold steady at the sets, reps, and weight. Um, but if you are able to continue to progress, I will. Um, and so trying to get you doing a couple more repetitions, a couple uh exercises get you to increase the weight so that again, we're we're still in a building phase in the first trimester, especially in this uh kind of typical strength training area. Um the reason why I say that and put an emphasis on that is that so many people think that as soon as they're pregnant, they're now in modification or regression or scaling mode. And I just fundamentally disagree with that because nine months is a really long time and your body can still adapt. Um, if you're at like your peak athletic performance, like you know, your national level lifter or or whatever, um, you may not be hitting PRs in your pregnancy. I've seen a lot of people who have. But um for most people, they can still see improvements in their pregnancy, especially depending on the the type of exercise you're doing. Like there is no reason why you can't increase your overhead press or your max bicep curl like because you're pregnant. Um so it's just really interesting, this like mindset that we've taken that everything about pregnant exercise is around modification um rather than you know thinking about progression and modification when necessary. All right. My last one is pelvic pain and sciatica during pregnancy. Do belly bands actually help? So, hey mamas, I'm in my second trimester and my pelvis has been killing me. Sitting for too long makes my sciatica flare up, and it's honestly draining when I'm stuck at a desk all day. I keep hearing of a pregnancy belly band. Hello, Rosie, and can take some of the pressure off, but I'm not sure which ones really work. I came across the Mom Cozy and the Ergo Ness reviews look solid, but I'm worried it'll feel hot, bulky, or just end up being useless. Has anyone here actually tried a belly band for pelvic pain or sciatica worth it or just the hype? I love this. So um I see women coming in for uh pelvic pain, pelvic girdle pain, sciatica during pregnancy all the time. Um, and it can feel a little bit hopeless because uh sometimes the messaging from obstetrical providers is well, it'll go away when the baby comes out. Um which that's true, right? It is true. But um, when you're 18 weeks pregnant and you're like, well, am I gonna have to deal with this really excruciating pain for 22 weeks? That messaging isn't necessarily always helpful. When we're thinking about pelvic pain, um, what the belly band is trying to do is give you static support. I've talked about in previous podcasts how our body supports all of the joints with a combination of dynamic supports, which is muscular support, and static support, which is our ligaments. In pregnancy, our static support is loosened in order to prepare the pelvis for labor and delivery. And so we rely more on our muscular supports and our muscles are under more strain with the stretch and weight of the growing baby. So it can create this kind of unfortunately perfect storm for lower extremity pain. And it's probably why we're seeing that rates of um pain, especially pelvic girdle pain, lumbopelvic pain are really high in pregnancy. And so what the band is trying to do is kind of augment or give more static support because your hormones are making that static support decrease for a very good reason. So if I am thinking about working with somebody, I like using pelvic bands or supports, especially early on, to help you manage your day right now. And we're working on strengthening around the pelvis in order to bring up your dynamic supports that need to be helping more. This becomes this and not or conversation around how we are helping to treat women who have these types of issues. When it comes to the best type of band, the hard part is that there really isn't a right answer. I use a very standard just compression support band in the US. If this is where the poster is, the Cerola belt is the one that is most commonly used. Why? Because it's really inexpensive, it isn't bulky, and it's purely just a compression band that goes around the hips. And so it's not usually as hot. There are other options. We really like the fit splint as well. If you want a band that is also on top of the belly, so it's a little bit more cumbersome, not by much, but it is a little bit more, and it might give a little a tad more support. Can it help? Is it worth it? It really does depend on the human. For example, I've seen it help a lot for my mamas, who their job requires them to stand a lot. Like daycare workers, teachers, nurses, where they are dying from the weight on their pelvis. And usually I get them to try it out in clinic and see, like, do you notice this as a help? The hard part is that you can't really know until you try it. And you know, some people are gonna be like, yep, this helped me, or at least helped me manage a little bit. It brought the edge off that pain. And other people are gonna say, no, it did nothing. And it's because what is contributing and what is causing pain is gonna be so individualized. I do usually say, hey, try it out. And if it helps, that's fantastic. But understand too that if financial constraints are an issue, um, you kind of are gonna want more of a guarantee. So maybe reaching out to your networks of women who have been pregnant around you and see if any of them have a belt that they've used to at least try before making the financial investment. One of the things, too, that I think is really interesting about this, that isn't what she directly asked, but I think is important for us to consider and what I am looking into a little bit with some of my research right now is that your body, how you felt within your body and your injury history and pelvic floor-related history going into pregnancy is really gonna matter for how you feel within pregnancy and the amount at which you've recovered from those previous injuries. The way that this poster had kind of talked is my sciatica is flaring up on me, makes me feel like she had that sciatica before. And so understanding what previous injuries we had is something that we really haven't looked at in the literature before. And this is something that I'm kind of looking at right now because if we think about our active women and some of our statistics that 30 to 50% of women who have never had a kiddo before experience pelvic flora dysfunction with sport, we need to take into account that they had pelvic floor issues before pregnancy when we start talking about risk factors to pelvic floor injury or exacerbation of pelvic flora dysfunction in pregnancy. And I think this is true in injury as well. Like we have that 70 to 80 percent statistic. In some of our studies of reported pain, but how many of those people had low back pain before pregnancy? Right. We know that there's an epidemic of low back pain in some uh uh professions, such as in nursing. And so, you know, there's a good chance that somebody who is pregnant who's also a nurse had low back pain prior to getting pregnant. And then you add in the stress of pregnancy, your body was already not handling the demand that you were asking on it in a non-pregnant body. And then you add in the extra demand on the low back and pelvis while also being pregnant. And so one of the things that I try and think about when I'm working with somebody and what I'm trying to answer questions about in my research is what was your injury history prior to being pregnant? And then if you're especially if you get to work with people on a prevention space or if you're an obstetrical provider listening to this, and you are seeing people earlier on in pregnancy asking about those previous injuries, especially to the low back and lower body, and using that as a way to counsel on the importance of strength training and trying to maintain activity level in order to try and reduce the burden of low back pain and pelvic girdle pain later in pregnancy. I think is something that is going to be a net benefit and something that, you know, I've been thinking about a lot with my research area. All right. Again, this is so fun. I love having these like little prompts and then it allows us to go on like these little tangents. But um, yeah, let me know if you have any questions. Um, sorry for the rant on the very beginning about the peri-menopause space, but I think it's really important for us to consider as consumers. And again, um, as I said, why I've been really enjoying this long form space. Um, I really want to lean into it a little bit more. Writing, talking, YouTube, I don't even know, but um more on that when my life is a little bit less chaotic. I'm teaching an undergrad course in the kinesiology department at Queens. Um, and it was a wonderful school and it is has been a wonderful experience, but there has been a lot of learning and there's been a big learning curve, and um this has probably been like the the busiest semester from the beginning of September until currently. And uh, you know, I got another month left of this course, um, probably of my professional career. And then you add in first trimester of pregnancy feeling like trash, and then the emotional devastation and physical ramifications of miscarrying. I am still struggling with the fatigue and drain of the blood loss from my medical management. And I, you know, I'm three weeks post-miscarriage. So this will probably be a 2026 conversation about how to expand, um, how to expand here, but I'm really enjoying it. And so thank you to all of you who are listening uh to the podcast. I really appreciate you all for taking the time and trusting me um with your time because I know your time is limited. Um, and let me know if there's anything that I can do to better serve you all. All right, have a wonderful week, everyone, and we will see you all next time.