Barbell Shrugged - Menopause, Weight Gain and Hormones with Fat Loss Expert Dr. Bill Campbell #828

Episode Date: December 17, 2025

In this episode, Dr. Bill Campbell returns to the show to discuss a major pivot in his research from building muscle and optimizing fat loss to understanding menopause and its effects on women's body composition. After watching his wife struggle through a severe perimenopause transition that resisted every traditional fat loss strategy, Campbell uncovered a massive blind spot in the scientific literature: almost no research exists on fit, resistance trained women going through menopause. His public comments sparked hundreds of messages from women describing the same struggles including unexplained weight gain, muscle loss, energy crashes, and sleep disruption highlighting how poorly understood this phase of life truly is. Dr. Campbell breaks down what the best research does show. Menopause accelerates fat gain, shifts fat distribution toward the midsection, and produces measurable declines in muscle and bone mineral density. Many women experience weight loss resistance where standard diet and training approaches no longer produce results. He also digs into the nuance of hormone replacement therapy how progesterone and estrogen can dramatically improve sleep, anxiety, and energy, why estrogen appears anabolic for middle aged women, and why HRT's effect on body fat varies widely. Campbell clarifies the long standing confusion created by the 2002 Women's Health Initiative study, how its flawed interpretation suppressed HRT use for two decades, and why today's evidence supports earlier intervention under an evidence based physician. The conversation closes with clear, practical guidance for women entering perimenopause. Maintain a consistent fitness lifestyle, lift weights to protect muscle and bone, prioritize sleep, get annual bloodwork and DEXA scans, and consider HRT early if medically appropriate. Campbell emphasizes that lifestyle habits do not replace hormone therapy and hormone therapy does not replace lifestyle. Together they help women navigate the most dramatic physiological transition since puberty. Whether you're a coach, practitioner, or someone approaching this stage of life, this episode provides a much needed framework for understanding, preparing for, and managing menopause with strength and agency. Links: Anders Varner on Instagram Doug Larson on Instagram Coach Travis Mash on Instagram

Shrug family this week on Barber L Shrug, Dr. Bill Campbell is back on the podcast, and he is most known for getting people super, super shredded. Like he is a fat lost researcher, fat loss researcher. His job, his whole science background is on six packs, eight packs, because he's so good at it. But today, he's got a very personal story in how his research has shifted to focusing on menopausal women and how he is, it started with his wife, and now he's doing tons of research in an area that, to be honest with you, I don't know anything about.

I'm not at that phase yet. I'm not there. It's getting close maybe. Maybe we're knocking on the door. Maybe menopause around the corner. But I'm not there yet. Not in my household. But guess what?

As soon as the door opens into that window of time, oh, am I going back to this show to listen and reading all of his research, probably just going to send someone in my house his way. Hey buddy, you got a new client, Dr. Campbell, come and help. This would be beneficial to everyone I know, mostly me. But today we're talking a little bit about fat loss and menopause. And as always, make sure you get over to rapid health report.com. That's where Dan Gardner, Dr. Andy Galpenter,

a new order free lab, lifestyle performance analysis. You can access that at rapidhealthreport.com. Friends, let's get into the show. Welcome to Barrel, Strang. I'm Andrew Larson, Dr. Bill Campbell. back on the show. This may catch the people by surprise. We're going to talk about menopause today. There's a bit of a transition from all the abs you've gotten everybody over the last many years of your career. I'd love to start off. You're like known as the leader in the space on just looking super shredded.

And now you're, how did the transition happen? Well, it's actually a good story, maybe a little sad. so I'm still a fat loss researcher, still obsessed with how to build muscle, maintain muscle when dieting. But let's talk about why this was interest or, yeah, why the change in interest from younger, mostly women to now middle-aged women. And I'll be honest, if this was five years ago, maybe even four years ago, if you said, hey, you're going to really, you're going to wake up every day and want to read menopause, and body composition research. I probably would have said, no, I won't. I don't think I'll ever

want to study. Yeah, that sounds awful. Trying to run away from that as fast as I can, yeah. Yeah, I think that would have been my perspective years ago. But probably not unlike a lot of other men. My wife

is, she's like two and a half years older than me, so she's in her early 50s. She started going through this. a couple years ago and had a very, I just called a train wreck experience for her. And then subsequently for me, as well on many fronts. And she hid a lot of the trouble she was having. But one of the issues was she gained a lot of weight for her. Now, most people would say, that's not much weight. I don't know what she gained eight pounds, nine pounds. But when you're 120 pounds and you know and you pretty and you work very hard and then you gain that much weight

that's a lot of weight for that person relative to where they started from and again my wife had abs and all of that and didn't really change much so she had multiple issues that were more serious and than just the weight gain but i'm like okay well lucky for you you're married to a fat loss researcher. And I helped her diet in the past when she wanted to. So I was like, well, at least I can help with this. I can't help with some of the other things, but I can help with this. And it turns out I couldn't help with this. So we did the same things we had done years prior. Caloric deficit, kept her activity, well, activity was one of the things that she was crushed by. She had very low energy. So again, a lot of the stuff I wasn't really, I would say, well, she would say she tried to hide

from me and our daughters. So I wasn't aware of the extent to which she wasn't doing well. But the weight gain, you know, she would talk about that one. So then I realized, huh, I'm everything that we used to do isn't working. And I'm a big proponent of the energy balance equation, calories in, calories out. But that wasn't working for her. And I started talking about this publicly. Just, you know, just say, my wife is, you know, going through this once she gave me permission, so I didn't want to broadcast this as she weren't willing. And when I started talking about this publicly, I got, I'm not joking, thousands of responses, whether they were emails, direct messages of women with the exact same story. I would track every calorie. I've been tracking my food,

eat high protein, I lift weights, and I've gained this weight. So I realized, okay, my wife and I are very reactive to this. nothing about this phase of life. My wife didn't know anything. And I now I'm interested. A fat loss researcher who's having trouble, you know, helping somebody lose fat. I'm like, well, is there such a thing as weight loss resistance or fat loss resistance? A lot of women will claim that. But historically, I'm like, well, no, you're just not tracking accurately. Just eat less, right? Yeah. Or exercise more, which you tell that to somebody who's doing all the right things. It gets very frustrating. So, and again, I've had people throughout, you know, my,

my history like, hey, this isn't working and I would just kind of brush it off. But now it hit home. And I guess just fast forward to today, my lab team and I are designing a study that will hope, that I hope will bring more knowledge to the, to the area of weight loss resistance. So one, does it exist? And two, if it does exist to what extent, like how much, is fat loss resistance occurring. So that's, there's the story. Yeah. With this being, there's a giant owl outside my window.

It's so bad. With this being, that I call me by surprise, that's wild. With this being your wife that got you into this, do you guys talk about these things? Like, does this create a lot of frustration? or are you guys on the same page about nutrition? And I'm just curious on a personal level that can be like a touchy thing, I would imagine, in many households.

Yeah. So I would say the weight gain was not the most serious of her issues. And what was frustrating was she hit it from or tried to hide it from me, although she wasn't hiding it very well. So here's how I explain this. We've had a, we have and have a great marriage. always had a great marriage. But there was a year, or maybe a little bit longer, where it was, I just say, weird.

And again, she didn't know what was happening. I didn't know what was happening other than I didn't, it was very hard to recognize my wife of 20-some years. So everything now is in the rear view mirror. And yeah, I mean, during the time. And I'm, I fully understand why divorce rates go up during this, this, this, this phase of life. Like it's, again, fortunately, it never, never really crossed my mind other than to say, hey, if things weren't so good. And, you know, I promised her when we got married, you know, for better or for worse. And she was really suffering.

I mean, that's, that's the main. That's the main. And when I say she, she's representative of. a lot of women. Now, this is also a time for me to say since I've done some research, I haven't published any of it yet, but we're knee deep in this stuff. Not every single woman in her mid to late 40s or that goes through this menopause transition. Not every woman suffers. Not every woman has a bad time. Some have a horrible time. Some struggle a little in certain areas and not others. And some just breeze through it. So I don't want to just say, hey, it's a horrible time

for everyone because that's not true either. But no, back to your question, we're very open. Like I'm, I now do a ton of research to help her with her hormone or estrogen therapy. Projecticosterone, testosterone, all kinds of stuff. Yeah. That was actually the question I was leading into. Like, how does hormone replacement therapy fit into the mix here? So what I learned, and again, all reactive, wish I would have been proactive.

the day she took started with progesterone so the doctor that we were able to find that prescribed her progesterone immediately changed her quality of life like now she's back it didn't change everything but energy levels sleep hot flashes anxiety like it was it was an immediate turnaround and that's you know this is where I'm at now that set me on a path of, okay, I have to learn about HRT. What, like estrogen. So a ton of research on that one. So now my wife is on estrogen, estradiol, and progesterone.

And we talk about what that means for body composition. And she hasn't started testosterone, but she's thinking, hey, I think I want to, I wouldn't be surprised within a year or two if she's also on testosterone therapy. Let's go to the weight gain, though. her weight gain, taking HRT did not do anything for her body fat levels. Didn't make it worse, didn't make it better. The one thing that she noticed pretty quickly after she started estrogen therapy, so estrogen dial, she wears a patch.

She's like, man, I feel like I'm getting stronger. And I feel like I've got some muscle back. So I started looking into that. And yeah, there's quite a bit of, well, there's some. very good quality research that supports replacing estrogen. Our estrogen is anabolic. So replacing it during this phase of life brings back muscle, helps you respond better to resistance training. Dr. Andy Galpin here. As a listener of the show, you've probably heard us talking about the RTA program, which we're all incredibly proud of. It's a culmination of everything Dan Garna and I have learned

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Now, back to the show. The interesting thing about body fat with what I've been able to find in the research, some research shows that when you start estrogen therapy, you lose body fat. So I'm like, yes, this is good. This will be easy. I can just tell women, hey, if you're a candidate for estrogen, take it. Other research said it doesn't have any effect. And then there's other research that says it actually causes you to gain weight, to gain body fat.

And what's funny about that, that's what the research says, which drives me nothing. because I'm a black and white. I'm a scientist. I want I want studies to be replicated and find the same outcomes. Kind of like lifting weights. If you lift weights, guess what? You're going to get stronger. Not so with estrogen therapy. So in all the women that I communicate with, again, a lot of data points just in digital conversations, I see the same thing. I had to stop taking estrogen. I was gaining all this weight. Or somebody else will say, man, I lost 10 pounds within two months when I started estrogen. So it's crazy how variable that is for, at least for body fat, the body fat aspect of body composition. Do you imagine there's some patterns in there, though, where people aren't starting,

they don't have the same starting point. And so when they start taking something, their endpoint is also different? Well, here's what else I learned when I kind of changed my scientific agenda to this. There is, and I'm going to say zero research because I haven't been able to find any. There is zero research in women going through menopause. Now, I'm going to contrast this. We have thousands of studies on women going through menopause. We are not lacking in menopause research. What we have zero research on, and I think you'll both appreciate this, zero research in women who embrace a fitness lifestyle.

So somebody like my wife who's lifting weights, you know, track and math. Macros, doing conditioning. We do not have data in that population. So one of the things that I'm really interested in, a lot of scientists, you know, the nerds, they'll fight like, oh, you lose a lot of muscle. That's what I hear. The research doesn't necessarily report that you lose a lot of muscle. Some research says you lose some. But all of this data, and everybody fails to recognize this, all of the data is on mostly or assumably sedentary women.

So if they haven't built up muscle over their life, well, one, they don't have as much to lose. And what I'm curious, and again, I think the majority of women who embrace a fitness lifestyle that have gone through this, they will say they lost a lot of muscle. My wife sure did. I mean, she lost. She's like, I spent, you know, 20 years, 30 years lifting weights to lose it all in 18 months. Like, that's how she felt. So the huge missing piece here is just we need data in people. that are kind of like in our in our population or in our neighborhood women who are fit

that are going through. Mm-hmm. Where should the where should people start specifically? Where should women start looking as like a first step when they know that this window of time is coming? Like if they have start to have like an irregular menstrual cycle knowing that they're 40, three years old or something like that and things start changing. What's kind of like step one in the process to get as far ahead of what's coming. Yeah. So you're actually, you're very wise,

like just the fact that I want you to know that if I were to run the magic eight ball, my current seven-year-old is going to hit, she's going to hit puberty the same day that my wife is going to hit menopause and I'm going to move into my log cabin and not talk to anybody. My son for seven years. So I just want to know how many blankets I should buy to stay warm out there. Well, one thing is you're already knowledgeable because you just declared one of the only signs we have of peri menopause, which is the start of this transition. And one of the, so there is no blood test to tell you, oh, I'm going through menopause.

I wish it existed. That's what I thought existed when I started this. No. The way that you, one of the best signs that you know if a, if you're not you or I, but if a woman's going through menopause is if her cycles become irregular. More bleeding or less bleeding than normal. Longer cycles. So typically 28 days. Now it's 36 days. So all those changes are a good sign that that they are in perimenopause. And this can happen. Early 40s can happen late 50s. The average age is about 51, 52. But again, some people go through it earlier. Some people go through it later. So what I've learned throughout this process and what I wish I had known, instead of, again, being very reactive. And also, being totally ignorant on this,

my wife suffered a lot longer than what she should have because I didn't know about progesterone or estrogen. I'm like, that causes breast cancer, or at least I heard people talking about that. So I read books and studies and many doctor's appointments because I didn't want to say, hey, yeah, just take these hormones and that'll solve everything. I didn't know and I wanted to be sure. So what I did learn was that had I known, if I would have known then what I know now, my wife would have started HRT the day that she started.

not feeling great. The day that her energy levels were starting to plummet. And she would, she would say her energy levels were in the garbage, like had a hard time getting off the couch, still drug herself to the gym, but maybe, maybe not four days per week, maybe two, and clearly not trying to kill it when, when she was feeling horrible. So that then brings in a whole other. And by the way, everything I say here, I'm going to, there's going to be half of people that are hate, they're like, you can't recommend this. Just as, as catty as people are in what, you know, just the general fitness space that exists here, maybe even up a notch because HRT, there's some legitimate health concerns for some

people. So the way that I always, the way that I feel good about discussing this is if you're a candidate for hormone replacement therapy, because some women, if they have a history of breast cancer, then they might not be a good candidate, although that pool is smaller than it used to be, because they have a diagnostic test to see if you're at an increased risk. So if you are a candidate for hormone replacement therapy and you are working with an evidence-based physician, so the reason I say evidence-based physician is there's a lot of physicians that are still scared to prescribe H.R.T. If they're aware of the evidence, I don't, I think that those fears get largely diminished.

So my take on this is if you're a candidate, you're working with an evidence-based physician who's up to date, and it's available to you. Take H.R.T. If my testosterone plummeted to almost nothing, I'm sure I would take it. At some point, I'm sure I will. So I do talk to a lot of women, though, And I don't know what it is, but it's almost like it's not natural. I, this is just what we do. We suffer through stuff. And I get, you know, if my wife would have done that, again, it wasn't just her suffering. It was me too, along with her.

And again, I was the minor suffer and all of this. But it, it's the best thing you can do is be open-minded to the treatments that are available to you. And that is progester. and estrogen. Okay. So that's the hormone side of it. All the basics of nutrition weren't working. You started doing hormone things.

It got radically better. Is there any more steps along this continuum? So I think earlier one of you asked, like, what do you do to prepare for this? Well, the other thing is live a fitness lifestyle. So if you're lifting weights and, you know, you're doing conditioning or aerobic activity, or keeping your aerobic capacity up, you're at least setting yourself up for the best opportunity for this. But as in my wife's experience in many others, it doesn't guarantee that you're going to breeze through it. But what's the alternative? Let me just stop doing all forms of

activity. Let me now not eat any protein. Let me not prioritize sleep. And by the way, the data, you guys probably already know this, but the, just the data on sleep and body composition is very, it's overwhelming, because I looked into this a lot more intently. And one of the biggest problems of going through menopause is a lack of sleep, or sleep deprivation, waking up four or five times a night. So if you just solve the sleep problem with this, you're really going to have an impact on mitigating adverse body composition outcomes. So I always say, take your hormones or not, nothing should change your commitment to a fitness lifestyle. Now, I admit, though, it's not going to be as easy for some women because of energy levels.

Also, a lot of women start getting joint pain during this phase of life, which that helps, hurts with recovery, your motivation to train. So there's these other elements as well. So I don't back away from anything that I previously, you know, have researched my entire career doing. Of course, keep doing these things. things. The other thing we know, you lose, there's about a year or two during the menopause transition into early postmenopause where you lose a almost more lean bone mass, bone mineral content, that at any other point of life, like it's drastic. One thing we know is estrogen. If you're,

if you're on HRT, you kind of prevent that decrease. And then again, if you're remaining fit, you're still having the stimulus to maintain it. So many reasons to make just to focus on a, healthy fit lifestyle. So HRT is not a replacement for anything, except for the hormones themselves, I suppose, but it's not a replacement for actually doing the work and doing the training, eating high quality food, getting enough sleep, lifting weights, doing all your cardio, all that stuff's still got to be there. And then this is now, this new phase of life requires this additional component,

but you don't just switch over. Now, I think that's a good way to say. It's not replacing, um, it's a supplement to your lifestyle, which will enable you to have energy, to be able to recover, and in my wife, and according to the research, actually be able to build muscle can make no mistake. I believe estrogen is anabolic in middle-aged women. Estrogen is anabolic.

Randomized controlled trials giving a placebo patch or an estrogenial patch, significant increases in lean tissue from. from that. I just wish it was so, I wish it was the same outcomes for body fat, like just consistent. I'm always curious when when kind of like adding the medical piece, are there any in your research, does anything come up as far as like, what is the natural path that pre-current-day medicine people did to like moderate the symptoms of menopause. Is there any or was it just like you just deal with this for a decade and that's just like

part of being human. Do you just have to go through it? Yeah, I think that that attitude of hey, this is this is just what what women do. We just, we just through it. I think that's probably have been a lot of the, the typical responses. Yeah. Have either have either of you ever heard of the women's health initiative studies? That's something that you've ever heard of?

I have heard of it, but I don't know anything like in more than just I've heard of it. Same for the term, but I don't know. I don't know anything about it. So let's let's just spend like two minutes talking about the history of that study. So if we go back to the 1970s, 80s and 90s, women were being prescribed hormone replacement therapy at the highest levels. ever. Very high. I can't remember the date off the top of my head, but more than half of the women are being prescribed exactly what we're talking about. Estrogen, progesterone, probably more synthetic versions at the time. Now we use more bioidentical versions. And in 2002, there was a study

published. It's referred to as the Women's Health Initiative study. And what that study did was they reported with a lot of media fanfare. Now, I don't know where you guys stand about media. Media to me is more evil than good in most situations. Just will latch on to something. And that is what they did with this, with this particular study. In fact, the scientists were media horrors, so to speak. Like, they went to the media before their scientific colleagues to get this message out. Effectively what this study did. And by the way, just in the last like month the the new administration has removed some of the language on estrogen products medications that emanated from this study so this study basically said you

the risk of breast cancer is sick is increased from HRT from hormone replacement therapy and that study was published in 2002 and basically overnight the prescriptions plummeted. Doctors stopped prescribing it. A lot of people that are in this space say that changed women's health or did more harm to women's health than anything in our nation's history. We've had a quarter of a century of women being deprived of a treatment that helps them to, that helps benefit. Now, let me go over one of the things about this study. the breast cancer research data.

Again, just look up, you know, just Google Women's Health Initiative controversy. You'll read everything I've read. It was very shady. So, first of all, there was no statistical significance in breast cancer increase. It was 0.085 or whatever. But, you know, scientists, if it's not less than or equal to 0.05, it doesn't count. So they latched onto something that wasn't statistically.

significant and assume that it was, and their whole discussion and interpretation of that data was this. But effectively, I'm going to just give a more understandable version. If there were a thousand person years or a thousand women, the women on placebo during this time were getting breast cancer four times out of a thousand. And then the women that were prescribed HRT, they were getting breast cancer at a rate of five times out of a thousand. So when you go from four to five, that's a 25% increase. Sure. That's scary.

When you go from four out of a thousand to five out of a thousand, that's an increase of like 0.00,029, whatever, whatever it is. Which one of those values are you going to report on? Because if you say 25% increase in breast cancer risk, rightfully so, that should, that, that, that would put a lot of fear into people. But if you say it went from four out of a thousand to five out of a thousand, well, that's not, that's not scary at all, especially if there's other benefits of this. Like, well, I'll take that risk any day. Well, the media, of course, really latched on to this 25% increase, which, which, really compounded the fact that prescriptions just plummeted. And now we fast forward today. And you can look at all of the studies. And by the way, almost every, if not every, but almost

every author of that study has since walked back their own study as other people analyzed the data and called out these very severe limitations. So basically we lost a quarter of a century of these medications or these treatments, estrogen progesterone, being widely available to having to beg your doctor, if you even were empowered to do so, to getting them. And now we're back at, now we're at a time compounding pharmacies. So my wife started on a compounded progesterone. The recent FDA pulled the, what they call the black box warning off of one, you know, that it causes increased risk of cancer. I don't remember exactly, but major news recently

on kind of correcting some of the over-responsiveness of one study. Now, I also want to suggest, I want to say, there are some increased risk with hormone replacement therapy. There are also some documented benefits. Again, protecting bone mineral density. There's a debate in whether it lowers cardiovascular disease. There's a debate on if it lowers dementia risk.

So those are debates. Nobody debates that it significantly helps outcomes for bone health. It's debated cardiovascular disease. It's debated about cognitive health. But we are now getting to a point where it's becoming much more mainstream in common. Just in my own life and some of our own personal friends, two years ago, you know, just like we're talking. This is what my wife's story was. women with the women that my wife and I were talking to. Nope, I'm not doing that. And then my wife

tells me every week. Oh, yep, Sally. Sally's on it now. Yeah. Do the studies ever tease out the difference between, say you get a home replacement therapy and maybe it doesn't directly influence fat loss or muscle building or any other things we could measure here. But what it does do if you have more energy and or more motivation is now you're a different person psychologically. So you're more willing to go train and you're more willing to get up early in the morning if that's the only time you have to train. So now you train when maybe you wouldn't otherwise. Like those types of things where you're just more motivated in general.

And so because of that, you're going to live a different lifestyle. You're going to do the things you know you're supposed to do because you just, you've crossed whatever threshold there is to have the energy to do so. Yeah. So now I'm going to go back to we have zero day in women who were fit and lifting weights. It does not exist. Now, we do have some research on previously sedentary women who have started a training program. So that data exists.

I'm not aware, it doesn't mean it doesn't exist, but I'm not aware of many studies about the energy levels. But I think that's where we can rely on our common sense or just the way we observe the world. And I'll use anecdotal evidence. My wife, for sure, when she got more energy, just from progester, not even. even estrogen. Her work out, she now had motivation to go to the gym. So again, it was a huge change for her. And this is where I want to be careful. I'm not saying that every single person should be on HRT, but, because I remember, I get beat up on this stuff a lot when I talk about it. Sure. If you're a candidate and if you're working with the physician, don't take it off the table.

if it's an option for you, know why you would decline it. Like, educate yourself on why you would say, no, I don't want this. Yeah. On the other side of the paramedopause window, are there any real lasting effects to the ability to build muscle? I don't know if you've gone to the postmenopause side of things. and seen any research on that side. But is there, like, you go through this massive transition

and then you come out the other side and what's the game plan? Yeah, so here's what I've learned. And this is, I'm doing some of my own research, which I can talk about. It's mostly fat loss research. But the research that I've been reading, and this is the best designed research,

the research I'm going to share here is research that was designed. to answer the question about body composition changes. And here's what several of the best studies, longitudinal studies have found. And by the way, the best studies in this would be start following a woman in her early 40s when she's pre-menopausal and then follow her for 10 or 15 years when she's post-menopausal. And what's happened to her body composition during that time? So we have a few studies that have done that. Now, the hard part is, and this is where, again, the nerds will fight, whatever changes occur, some people will say, well, that's not menopause, that's just aging.

Other people will say, well, no, that's not aging. That's clearly menopause. And the reason it's hard, if not impossible, to answer that debate or address who's right, who's wrong, you can't pause menopause when you're aging, and you can't pause aging when you're going through menopause. So it's, it's, it's difficult. So the research studies that are the best designed to answer this question basically did this. They're starting premenopause and then they follow them through perimenopause and into early postmenopause. And they basically look for are there is the, are there any accelerated rates of fat gain or what happens to muscle during this transition phase? And the answer in my, based on the.

based on the highest quality studies, we find two things. For the first time, and by the way, this is split, about 50-50. Some of the studies will report for the first time in a woman's life, she starts to lose lean mass. So women are gaining lean mass. And again, what is this based on? Sedentary, non-fit women, but that's all we have. And they start to not, the weight, the loss of lean mass isn't drastic, but it's now

evident. It's visible. Slight declines from mid-40s onward. Now again, that's not shocking, right? We know that people lose leanness as they get older. Does menopause have anything to do with it? That's the question. And we can get into that later of why I think it does. The other thing, which is much more robust, which is repeated in almost all of these longitudinal studies, is a significant accelerated rate of body fat gain during this time. So, Gaining fat 30s and 40s at a slight rate of increase, and then you hit this transition, and it's a significant tick up. Then you ask, Anders, when you get into postmenopause, things start to kind of chill out.

So you're not gaining nearly as much body fat. You're not losing lean mass as much in that phase, which, again, that's evidence to me that this is menopause specific. One other thing that's very clear, I don't think anybody argues with this, it's not just that the women are gaining body fat, but it is unevenly distributed on their bodies. So if you gain 10 pounds of fat, oh, some in your arms, some in your midsection, some in your legs, no. What's happening is there is a kind of like a masculinization body fat accrual, or what they call more of an android body fat. gain. And this is where one are gaining more of this. They are gaining fat. No, no, no, question that. But this fat is being gained principally in the midsection, in the abdominal region. So visceral fat goes up and fat in the abdominal region and less fat is being deposited in the

lower body. So you have more of, and again, that's a typical, that's more of a male profile. So we say that women going through menopause resemble male fat patterning more so, them what they did when they were younger and female. That's interesting. And by the way, everybody, I mean, not everybody, women that go through this,

they all say the same thing. Like, why did I gain weight in my, just in this area? So it's anecdotally. You see it everywhere as well. Yeah. Yeah. One of the concerns that I've heard, both from men and women with any type of hormone

replacement therapy is that they have concerns of like, I really sign of my, myself up to like do this for the rest of my life and and what if I do it for 10 years and then I can I get off it like can I get off of it or if I do get off of it am I just going to like just completely plummet and just and just tank and then it's worse than before et cetera like what are your thoughts on the longevity of taking hormones yeah so I'd love to get your guys this take too just from the from a male perspective because that's exactly like I'm 50 years old that's the

reason I don't want to go on testosterone therapy yet because I'm exactly that. Like once I start, I have to be on it forever. Plus, I have these weird thoughts that society's going to crumble and then I can't get. Supply chain's going to. I've heard other people say the exact same thing. Like, that's a real concern. Like a lot of people, a lot of people think that and rightfully so. We just, COVID was the easiest, you know, not a normal situation, of course, but that's, it's a real thing. Yeah, and they don't let you. Again, I'm not educated on this, but like, let me buy 10 of them. way I can at least plan out for a year or two if I need to, again, assuming that it doesn't,

that it doesn't go bad. Yeah. But no, from what I understand, it's pretty much month by month or prescription by prescription. So again, let me stockpile it. I'd feel a lot better about it. Yeah. I was to answer your question, I was saying there, I feel like there's like a, there's going to be a day where I go, oh, that's different.

And I haven't hit that day yet. I guess I still feel like I get stronger. I don't know if I actually do, but I get to like improve. And as long as the like momentum is still moving in the right direction, I don't want to, I don't want to have to rely on anything if possible. How old? Can I ask how old you guys are?

I'm 42. Same. Okay. So I'm 50. And what I've noticed and what really tempts me, because my levels aren't that bad. I just had them tested. 600 something, I think.

Oh, you're good. Yeah, very good, right? Like, not bad at all. My energy levels in the afternoons are been a little better lately, but I'm just, I'm almost not, there are days when I'm not functional and I'm like, would testosterone therapy help with this? Because I don't remember when I was in 42. Yeah.

that being so and again i'm i'm pretty fit i lift weight to do some conditioning i could eat better i'm a fat loss researcher i eat too many processed food so that's something i know i could tighten up but that is something that i'm curious about um but yeah i yeah what am i what am i going to get my levels to 1100 i don't know so i don't have an objective reason your wife would really be bad at you They get away from me. That's right. Those days are over. Knock it off.

Wait, so for men, though, like, you know, your soft drone starts to decline. And presumably it's just going to go down and down and down until the end. And we're not going through a 10 or 15 year phase. So with women, it's kind of subtly different where they're going through this like, you know, I've heard it even compared to puberty, like in its intensity and its significance. Like, you're going through this phase that presumably will have an end at some point. Are you just managing your, through this phase and then and then after the phase is over it's a little different like how

I actually don't know the answer these questions my understanding and by the way I'm I'm obviously my training and my expertise is more on the fitness and nutrition side of this I am new to the hormone therapy aspect so I will fully admit I'm not an expert on this but my understanding is my wife I'll just use her as a real life example she will be on her progester on her estrogen for the rest of her life. There won't come a time when she will stop taking them. And then I just, you know, I always try to just check everything with with some logic. Okay, let's say she did stop.

Well, where would she, and we've thought about this with testosterone, too. Let's say she starts testosterone and then she doesn't want to continue doing it. Well, what's her levels anyway? They're low. her estrogen is going to be almost zero during her yeah estrogen will be almost zero for the rest of her life so even if she were to stop okay well now she's right back to where she would be if she never went on it so i'm not aware of any harm with stopping but yet and that's not that's not how it's practiced that's not how it's prescribed the intent i believe for everyone is you're on this for the rest of your the rest of your life Mm-hmm. It's interesting. I never really thought about this until now, but almost all the conversations I've ever heard about hormone replacement therapy for women centers around menopause. But I never hear about like, oh, my mom's 75 and, you know, she's thinking about taking hormones. She wants some energy. Like, I never hear older people in the conversation. Is that in your limited time in this world, is that a part of the conversation? Well, that's where there does seem, there is evidence that starting it too late is, does have risks that you might not want to, that you might not want to take. So there's something called the timing hypothesis of HRT, whereas if you don't start it early, if you don't start it early enough, you get none of the benefits of, let's say the bone mineral density decline or the potential cardiovascular benefits or the potential.

cognitive benefits. There's even some evidence that if you do start later, that it is, it is better to not started at all. So that's all centered around this timing hypothesis. So normally what you're going to see is the message of starting it earlier rather than later. And earlier, to me, would be the ideal, starting it right when you're going into perimenopause. so that you don't have any dips so that you're, again, training as normally with as much energy and tenacity as always. So that is my understanding of just the mindset of once you start it, yeah, we're going to be on it forever. And there is evidence to say, don't wait till you're 70 to start it.

Start it now while you still have a higher bone mineral content. You mentioned it's hard to tease out menopause from aging. They're obviously happening in parallel. What about menopause and like being a parent? Like you become a parent and all of a sudden like your energy is low and your body composition is changing. But also to your point from earlier like lifestyle matters a lot here and your lifestyle is just going to through no fault of your own, so to speak. Like it's a consequence of the situation.

Once you're a parent, your lifestyle is going to be different and more than likely you're not sleeping as much and you have more junk food in your house and on and on and on. And so for someone who's not sure, because perimenopause can be a decade long from what I know, how do you know if you're in perimenopause? Is this like you need to be getting quarterly labs and then you can see very, very clearly your hormones are changing? Or are we just relying on body composition and energy and the like? So I'm a proponent of getting blood work done. So that's one of the mistakes I made. Like we didn't get annual blood work.

The problem, though, that a lot of. lot of people will say is you're it's so variable that depending on the day that you get your blood work you might be very high estrogen that day and you'd be like oh everything's fine i'm not in menopause but if you had waited for two more days it would have been very low in the morning same time so getting blood work during this phase is it's not as consistent um or it's not it's it's it's it's it's offers a little bit from validity in terms of repeatability of the assessments. However, if you're getting annual, if you're getting enough data points, well, then you start to tease out the highs and the lows. Now, I'm not saying you get blood work every week, but consistent blood work. Also,

just getting Dexas scans, let's say yearly. You'll be on top of this pivot point when bone mineral density starts to decline. Yeah, the other things would be, like you said, just the more subjective, like mood, menstrual cycle, the variability of the menstrual cycle, things like that. But yeah, so I always just say, hey, try to get a Dexa once a year so you're on top of where your bone mineral density is. Get blood work. Because I know, because I'm, as a scientist, I'm very, I learned through looking at data. If I would have saw that my wife's hormones started to plummet, like her progester on an estradiol, I would have been much more proactive. rather than her telling me, I'm miserable after like, you know, a year of whatever she was going through.

It's like, ooh, all right, well, now let me start learning. Mm-hmm. Yeah, as far as the normal kind of like nutrition, any supplementation pieces that play into this that are beneficial? going back to this weight loss resistance area, which again is kind of the area that I'm interested. By the way, were you guys, did you guys just as average males in the fitness space, were you aware that women do gain weight during this phase? I mean, very, very consistently or not really. It's never really registered. I mean, that piece, yes.

All the other changes. I didn't know much about it at all until my wife started. talking about it, but that piece I did know. I feel like that was kind of an obvious piece, the fact that you gain weight during menopause. Yeah. Yeah, I feel like this is like a very broad observation, but if you look at like most grandmas, they kind of all have the same shape. And there's a reason for that, in my opinion.

It's not because they don't work out or they don't walk and they can be bigger or skinny here, but they're all like, um, there's not like tons of muscle tone and like a six or like a male can still have like there's there's lots actually like when I when I was younger there I remember there was a guy that used to go to the track that was like 65 run wind sprints yeah like dude's fucking gangster man like the dude is just out here getting it still and like you could just tell that he had just eaten well and trained hard his whole life and you can keep it when you're a dude.

You can keep like a 4 to 600 testosterone level, I would imagine, for a relatively long time and keep your muscle mass if you just stay after it. But there's something that happens where like, this is, I hope I don't offend all the grandmas that listen to us. Hi, Mom. But they do kind of like, kind of like have the same shape and it's very hard for them to keep muscle mass. So two observations to that. one, how many of those women were lifting weights in their 30s and 40s? Probably not many because

we've had a cultural fitness revolution in the last 20 years where women, I go back to, I'm only eight years older than you. When I go back to my undergrad college days, I can literally to this day name the two girls who were in the weight room. Oh, yeah. Now, go to a college room. I remember, I remember the two. I remember. I totally remember them. Yeah. They stuck out at that time. And that's interesting.

One was a power lifter. You never saw that. Yes. So again, a fitness cultural revolution where now, let's go forward 20 years when we're going to have new grandmalls, that may be different. I don't know because we're not there yet. But that population didn't exist before my current day. So that's one thing.

Two, this is where we get into, women are going to be taking estrogen to help maintain muscle mass. And maybe they hadn't been for, you know, again, it would be interesting. What we had in the 90s was a lot of women taking HRT, but not lifting weights. Now we're going to have women taking HRT and lifting weights and potentially taking GLP1s, whatever impact that will have on muscle. And the other thing is, which is pretty popular in the, you know, the more serious fitness cultures, is testosterone therapy for women. So that alone will have a pretty big impact

in going into what we, what a normal fitness physique may look like when a woman's in her 60s and 70s. Yeah. This has been fantastic, man. I always enjoy, this is not a current podcast to me, but it's coming.

It is coming. I just want to say if you are, I'm going to sound arrogant, you guys are so lucky to have, to have somebody. If I were 42 and somebody that I respected would tell me, hey, this is what I know. Oh, I could have saved myself and my wife so much grief. Yeah. And suffering. My wife, I just, I felt like, oh, I felt so. Is there any research on, like, like,

if you are a fit person, does it change the timeline? I'm going to say no, because we don't have that research, but go on. Does it change the timeline of, does it like push it back where you're like a more breedable person longer? Or is that date kind of like firm? And then does it shorten the amount of time and that you like get through the process more efficiently, the fitter you are? So I'm not aware of that data existed. And effectively, you begin your life as a baby girl, like an infant female. You have, let me just say, a million eggs in your body.

And then over time, they get less and less and less. And then when you are literally postmenopause, no more eggs. So it's just, and I think that's more genetically determined. I'm not aware of, I'd never read anything to suggest. that your lifestyle impacts probably the quality of the eggs, but not the number, which defines a menopausal state. Crazy serpents, man.

They are wild creatures. Where can people learn more, sir? Instagram, probably the best place, since it's the only place I'm really at. That's Bill Campbell, PhD. There you go. Douglasie Larson. You bet.

On Instagram as well. Douglasie Larson. Mr. Bill Campbell, appreciate you coming on the show, my man. This was a sharp direction term from where I thought we were obviously going to go with muscle building and fat loss, but a highly relevant topic in my world. And my wife's going to listen to this show 100%, probably more than once. Don't tell her not to, man. She's going to hear me and say, oh, there's something.

That's right. You're going to get some text messages for my wife. He's been listening long enough, you know. I'm Andrews Varner at Anders Varner, and we are Barbbell Strug to Barbell underscore shrug. And make sure you get over to Rapid Health Report.com. Dan Garner, Dr. Indie Gallup, doing a free lab, lifestyle, and performance analysis. And you can access that at rapid health report.com.

Friends, we'll see you guys next week.