The Dr Louise Newson Podcast - 15 - Championing hormones, healing and strength with Christine D’Ercole

Episode Date: July 8, 2025

Content advisory: this episode includes themes of self-harmIn this episode, Dr Louise Newson is joined by Christine D’Ercole, a master world champion track cyclist and Peloton instructor, who shares her deeply personal and inspiring journey. Together, they dive into crucial conversations about pelvic floor health, urinary incontinence and eating disorders, shining a light on topics often left in the shadows. Christine opens up about the impact of body image and societal judgment on women and reflects on her own struggles with an eating disorder, self-harm, and the lifelong challenge of overcoming ingrained beliefs about her body, and how these experiences intersect with hormonal changes throughout life. The conversation also tackles the complex role hormones, especially testosterone, play in women’s health and athletic performance. Together, they candidly explore the difficult decisions around testosterone and athletics, weighing thebenefits of improved quality of life and muscle strength against concerns about performance enhancement in sport. We hope you love the new series! Share your thoughts with us on the feedback form here and if you enjoyed today's episode, don't forget to leave a 5-star rating on your podcast platform. Email [e-mail] with suggestions for new guests!  Disclaimer The information provided in this podcast is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment.Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. The views expressed by guests are their own and do not necessarily reflect the views of Dr Louise Newson or the Newson Health Group.    LET'S CONNECT  Website: Dr Louise Newson  Instagram: The Dr Louise Newson Podcast (@drlouisenewsonpodcast) • Instagram photos and videosLinkedIn: Louise Newson | LinkedIn YouTube: Dr Louise Newson - YouTube CONNECT WITH Christine D’Ercole  Website: Christine D'Ercole   Instagram: Christine D'Ercole LinkedIn: Christine D'Ercole  Wordshops: Upcoming Wordshops – IAMICANIWILLIDO.COMRelated resources: Click here to read more about Newson Research’s paper about testosterone and sport

On my podcast today, I've got Christine DeKohl, who is a master world champion in track cycling. She's also a peloton instructor. We cover so much in such a short time. We talk about eating disorders. We talk about pelvic floor, urinary incontinence. We talk about being put down as a woman and who you listen to and who you shouldn't listen to. We also talk about hormones and about testosterone, especially with sport. Loads to get into, and I just hope you really enjoy it as much.

as I did. So Christine, I am really super excited about doing this podcast. I've been waiting. It feels like months for you to come. And obviously you're not here in the studio, but you're here in real life. And my husband has a, he got his Peloton bike in lockdown and he uses it, I don't know, three, four, five times a week. He's really, and he's very competitive. So he knows that he's a lot better than all his friends. But I said to him, oh, do you know this lady? And he was like, what? Yes. So, like, that's really great.

And I actually do Peloton nearly every morning, actually, but I do yoga. And I get into a lot of trouble if I log on as him, as you can imagine. Of course, that's very, don't do that. But, you know, exercise is so important. We know that. That's just obvious. Like, that's nothing about hormones. But it's still a man's world out there.

and men are expected to do certain exercises and women maybe shouldn't or can't or whatever. So you've really changed the narrative in what you're doing, which is wonderful. But just taught me through a bit about how you came to be such an amazing cyclist, but also how you've come to work with Peloton and, you know, just get out there

and share everything with people. All right. Well, I could not have imagined this career growing up. I wanted to be a ballerina. and I was told as many young girls are told, your body's not right for the part. Specifically, I was told your thighs are too big. And how old were you? You know, we believe, oh gosh, I mean, this is going back,

as far back as like 9, 10, 11 being told that I didn't fit the part. You know, approaching puberty and the body's changing and my dance instructor coming up and poking her finger in my stomach and saying, suck in those marshmallows. And I look back at pictures of myself as a kid, and it doesn't matter whether I was big or tiny. But the fact that we believe what we're told creates such dysmorphic realities

in our mind and creates ingrained belief systems that some people never shake. Some people never shake. And it becomes what we tell ourselves, which is the most powerful thing anyone can say to us is what we're saying to ourselves because we internalize what other people say. So I took that and believed I am too big to be,

obviously be a dancer. I am too big to be lifted. I'm too big to be loved, to be successful. It translated into, I'm too big for this world in a negative way. And I tried acting. I moved to theater on recommendation from a therapist when I was 15, 16. The therapist came because I was doing everything I could to make myself smaller as a dancer. the eating disorder, the self-harm, everything I possibly could.

Stealing liquor from my parents' basement. I mean, it was self-medicating, self-harming as a very, very young girl. And the therapist suggested theater that that might be a good outlet for me since dance was not working out. And I got myself into Carnegie Mellon University for the theater program, which I thought, you know, I am definitely on the right track now. This is a sign I can can act at any age, any size, any type. This is perfect.

But one summer I caught a glimpse of a feedback form from an audition I did. And it said, loved her Shakespeare, loved her comedy, that she's a little heavy in the thigh. Oh, no. And I remember seeing that. and just felt like I got slammed to the floor. How could it be that I have all of these aspirations and dreams of, I want to be on stage because I want to tell stories that inspire people. What the hell does that have to do with the size of my thighs?

And like, it's a cruel joke to have all of this aspiration and desire to do something important and to be told them. that your body is the problem. So when I, can I just ask, when you had your eating disorder, what was happening with your periods around that time? Can you remember? I always had, pretty much always had.

I think there was a brief period of time where it disappeared because I was, I was never good at starving myself and I still ate. I mean, even at 5 foot 6, I got down to 112 pounds, which is thin. But it was still on your mind.

I mean, the reason I'm asking is I see a lot of women and whose periods have stopped when they were younger. But we see it a lot when people then become perimenopausal or menopausal because the same hormonal changes occurring in the brain. And so, and body shape can change. Of course when we are hormones alter. And you're really right. I think what you said really resonated.

If somebody says something, it's really hard to erase, especially when it's something negative. Positive things can come and go, but it's negative. But these things that come back, and a lot of things come back when our hormones change. But there are lots of people who have eating disorders, their periods stop,

or there might be extreme athletes, but then no one's thinking about their hormones or they're giving them contraception, which is not the same as the natural hormones. And it's blocking testosterone as well, which can be a real problem. So it's like a double whammy really, isn't it? You've got things going on and then it can affect your hormones,

but then it can come back and haunt us when we're perimenopausal or menopausal. Yeah, we're not taught enough about it as young women. And we're, I suppose with birth control, as you said, sort of messes up the process. A process that has an unfortunate, state as we get older. Days, yeah. So then tell me about your cycling.

Okay, so I had been very attached to my bicycle growing up all through dancing and all through acting and I took my bike to college. I was very impatient. I did not want to wait for the bus. I could not stand that. And I would smoke a cigarette

while it was riding my bicycle to go. class. And then I took a year off from college and I went to New York City and trying to learn the city, I got very, very terrified of the subway. I was sure someone was going to mug me. I mean, New York City in the 1990s was very different. So I used my bicycle to get around. I learned the city on the top instead of underneath. And I got fired from a bartending job. And I was looking through the... I was giving away way too much liquor. I was looking through the wanted ads in the newspaper, and I saw careers needed. All you need is a bicycle and a chain and a bag. No experience necessary.

I'm like, this is perfect. I had no idea the world I was about to enter. It was... It's like an underground sort of Mad Max bicycles in New York City. situation. And I was welcomed in and shown the ropes. And I changed my chemistry to be riding a bike for eight hours a day to be constantly active, pulled me out of a depression. There was one funny detail, though. We had these walkie-talkies and they gave us all handles. There was like somebody called Zippo, somebody called

Bessoro and they called me legs. And I remember telling them, can you please just not call? I am really like that, just please give me another name. They're like, but why?

Your legs are so fast. You're so strong. In fact, you should race. Wow. And I connected with some of the guys who raced and they showed me the track and that was it. I started winning races and suddenly

this body that I have always been told was wrong. Wow, it was your secret power. capable of being successful. I could be successful because of my body not because of somebody else's opinion of my body. I could own that.

You can't own someone else's wavering opinion. You can't own that. kind of success. So that was a major revelation for me to, in self-acceptance and in changing the narrative of who I am and who I am capable of being. And I kept racing. I did go back to school. And then when I came back to New York City again after graduating, I was auditioning. I was trying to get cast in a show, I would also, I was messengering again, so I would be ready to go to an audition in between delivering packages. I would sometimes fold up a skirt under my jacket,

and then I'd have packages in my bag, I'd lock up my bike, go up, do a Shakespeare audition, and come back down and tell dispatch that I had a flat and sorry I'm late. I was trying to make it all happen. And then finally, it became very clear that if I don't dig into racing now, and we're going back to 96, 97, 98, I was like, I've got a limited time to do this. That's what I thought at the time. I only have my 20s and 30s to race my bike. And so I told my acting agent, I'm going to pursue this now.

And I did for a couple of years. And then I got pregnant with my daughter. And I gained a lot of weight. And I was finally, actually was the big girl. Everybody was telling me that I was. And I thought, well, it's really awesome that I've just, I discovered the unknown athlete in me. I know that I've done this thing.

But in order to raise my daughter, a strong, confident female, I have really got to accept that I am the big girl. I really am the big girl now. And I need to celebrate that. I need to celebrate what my body can do. So I decided I'll become a plus. size model. That's what I'll do for work. So I go to QVC and I audition and very much like that audition form from acting where they said she's great, but her thighs are big. At plus size

modeling, they said, we love your walk. We love your energy. We love your look, but you're not big enough. And what's happening? They told me, though, that if I wore this set of pads, I could do the spring, I could do the fall and winter line, but not the spring and summer line. Because for spring and summer, I'd have short sleeves on and my arms would look too small next to my body. So I did it. I did it for a while. And every time you had to go on set, you had to stop and check in the mirror, make sure everything, you know, your lapels were flat, your hat was at the right angle. And as you're walking into this mirror about to go on live TV, you're posturing proud.

And like a psychological gesture where if you stand up proud, eventually you're going to create that sort of chemical sensation in your body. if you walk around hunched over, you can also exacerbate sadness. Your posture not only reflects how you feel, but you can change how you feel by changing your posture. And I feel like I

strengthened my proud muscles, if that is possible. And one day, I was going up to that mirror to go on set, and I caught my eye. I did a double take because something in me, I was talking to myself,

and suddenly I listened to myself. And I told myself, you've been missing the mark. There is no too big or too small. There's no too much of anything at all. It's all about you and being your strongest. What makes you feel strong? I was like, I need to get back on my bicycle.

I need to get back on my bike. It was a revelation. I finished the day. I did not go back. And that's when I started teaching cycling. And I years later got back into racing. And that being racing as a master's athlete, realizing that they're, is a whole world for people.

Master starts at 35 and up. And to recognize, to see how many fields of women in their 40s and 50s and 60s, we even have a few 70s and 80s. The fields get smaller as we get older. But there's a place for us. Absolutely. And it changes what... Like when I think of my mother's 53 and my 53, these are completely different universes. And so I want to keep racing, right?

This is the most empowering thing I do. I use bicycles at Peloton as a vehicle to help inspire people to think more deeply about what they're capable. of and by continuing to race, I hope I'm setting an example that we might be able to be more active than we thought and make ourselves proud in more ways that we knew were possible. I've gotten quite a few women, grown adult women, to try track cycling. And even if they don't get into racing, it's like, at least they tried it, you know? tried something wildly different. It's great, isn't it?

I used to cycle a lot when I was a student just because it was cheaper than obviously going on the bus. And I used to cycle for miles, love it, you know? Yes. But I've got a lot of patients who are in their 40s, 50s and started up racing. And I've got cover to patients who are doing so well, but then their personal best times have dropped.

They've been getting muscle and joint pains. They've reduced stamina. they've realized themselves that they're having hormonal changes. They go on HRT, they feel a bit better, but their testosterone is in their boots really low. And if they're a few of them are professional athletes, they're not allowed testosterone because it's not allowed. This is exactly where I'm at.

And I have a real issue with this. And we've just done a paper that's just come out in a peer-review journal, actually, showing that women are really struggling. And people are now trying to decide between their career. or having testosterone. And it feels so wrong and we've been sort of contacting various authorities about it and they're like, oh, it's on our committee meeting,

it's not really our problem and da-da-da-da. But men can have a medical exemption certificate if they need testosterone. Women are allowed estradiol. They're allowed progesterone. But they're not allowed testosterone because they're worried that it's an antibiotic steroid and it might really affect people.

But the synthetic testosterone that's injected is an anabolic steroid, but the natural testosterone we're just replacing. And I feel really sad because even if you just look at the data in women about testosterone, we know it improves libido, you know? No one's really arguing that. We also know it improves muscle and joint pain. It improves sleep. It improves mood.

It improves stamina and so far. forth. But does that mean that women aren't allowed a libido if they're a professional cyclist with low testosterone? I am so very much with you on this. And I have been deep in the question of my knees, my back hurt. And now I'm on HRT. And it's better sometimes, but I'm training. and if I make one false move, I'm going to tweak that knee, I'm going to tweak my lower back. It's a whole, you know how the body works.

Absolutely. But are you... It goes up the chain. Yeah, and are you taking testosterone? No, because of racing. And I'm at the crux of a decision. Like, do I... If taking testosterone,

the tiny amount to replace what my body naturally had when I did not have all these aches and pains, if that's going to improve my quality of life and help facilitate keeping my bones strong and avoiding osteopoeia osteoporosis and help me maintain some muscle, then yes, that's going to improve my quality of life.

And if I don't have those aches and pains, that will potentially improve my performance. But is that considered performance enhancing? Well, it shouldn't be. It should be just performance resuming, really, to what you are. And it's a difference. You know, when we give testosterone, we're just giving it in a physiological way. So when I had low testosterone, I found my yoga practice very difficult. I had a lot of stiffness, a lot of muscle and joint pain. I had low stamina. I just, I couldn't be bothered, really. You know, I felt quite flat and joyless. But musculoskeletal really common. I had frozen shoulder. a couple of times had steroid injection. I just didn't feel, and it's not just me, I see it with thousands of women that I see through the clinic. And it improves. And it's no surprise because testosterone works in our muscles, it works in our joints, it works in our brains.

Really important. And I can't really understand, you know, even if you were 20 and you had your ovaries removed and your testosterone would then decline very quickly with that operation, you're still not allowed testosterone. if you were a professional athlete, which is just madness. I don't really get it. There's so many hormones in our body, and they all work together. Like how do you pick and choose? You can have these ones and have those ones because we said.

Precisely. I mean, if you're low in iron, you can have a lot of iron. If you're low in thyroxin, you can have thyroid hormone. They're not going to stop you having insulin as an athlete, but there's something about testosterone. because there's misunderstanding of what it is and what it does. But it feels really, really wrong. But so we've got to do work on that. And I'm committed to trying to help because I feel very sad

when I speak to women who are really struggling. Because if I gave up cycling, then I'm compromising my quality of life because I'm not doing the thing that brings me joy anymore. Absolutely. But why should you? You're young. You're in your 50s. You're not in your 90s. Like even then, like it shouldn't be determined by your home age.

by your hormones, you know, you shouldn't be, it's wrong. But the other thing that you've been very vocal on, and I'm very grateful, and I'm sure a lot of women is, is just talking about your urinary tracts, talking about incontinence. Because, you know, lots of people don't want to talk about their symptoms that they don't want to talk about, you know, their libido or their vaginal dryness or soreness or soreness,

but urinary symptoms are really common, but they're so common, they're normalized. You know, so many of my friends will say, well, I won't jump or sneeze, because I'm going to have a leak. But I'm like, why? Why aren't you using vaginal hormones? Why aren't you thinking about it?

Oh, when I do my pelvic floors, but that's not enough if you haven't got those hormones in your pelvic floor, your urinary tracks and so forth. But you've been very out there, haven't you, about your kidney symptoms? You know, I did those box jumps at the gym a couple weeks ago, and I, you know, I think that I have gotten so accustomed to not doing things that put me at risk for leaking that I, that day, I just thought, I'm going to, I'm going to see if I can do these, see if I can do the box jumps and wasn't really thinking

about it. And then I hop up there and I'm like, whoa, yeah, that's why I don't do these. and I remember, I did all three sets. I was like, well, I'm in it now. Like, what am I going to do? And I kept turning to the mirror to the back to see if you could see. And I finished the set because I was angry. It was angry. It was really angry.

and but I had other exercises that I had to do, which would have required me to sit on a machine to do my cable rows. And I said, I can't. I won't do that. I'm not going to sit on the machine. I'm damp. That's not okay.

And my husband was still working out. And I felt like I was on fire in most. I was so upset and he felt humiliated. I felt ashamed. I felt embarrassed. And so I went out and sat in the car. And I wanted to journal. I wanted to write about it. And I opened my phone to write about it. And it occurred to me, Christine, you should share this story. You know you're not the only one going through this. And I said to myself, I, oh, this is too much. This is too much. And then my other inside voice said, no, this is exactly why you should share this. Oh, but you're going to come off like you're performing.

You're like, no, this is really happening. And so I said, forget, I'm doing it. And I shared my authentic thoughts and feelings in that video. And I'm so glad that I did because the responses were profound. I knew I wasn't alone. But sharing that vulnerability made me realize in, like, you know by the stats you're not alone, by the metrics out there. But this was, I knew I was not alone because of their stories, because they shared their stories with me. And I said, my God, I had no idea that this was the response I was going to get.

But it seems like it's contagious. Well, it's so common, and we've just written a paper actually with some American doctors and nurses and clinicians, trying to change the terminology because we call it GSM, you probably heard, genitourinary syndrome of menopause, but it's not of menopause because perimenopals or women have urinary symptoms, but also women who've had a baby, women who are on the contraceptive pill, women in general. You know, you don't have to have a certain, but a lot of it is due to, hormonal changes, but it's not being picked up. So if you're on the contraceptive pill, that will block your natural hormones, it will block your testosterone. If you've had a baby, your hormone levels fall off a cliff, if your perimenopoles or your hormone levels are changing, if you're menopauseal, you have no hormones. And these hormones, all three, eustradal progesterone, testosterone, have really important roles and functions in the pelvic floor, the bladder, the ureter, the urethra that we we've we out of. All of this is really crucial.

crucially important. So you can be as fit as you like and obviously you're super fit, but that's not, if you haven't got those hormones, the tissues will change and they won't support the bladder in the same way. The muscles won't be as strong. The collagen won't be there. The blood supply won't be there. And that's a real problem. And we know that although the majority of women with age will have urinary symptoms, around, you know, 5% or less will receive vaginal hormone. So this isn't HRT, this is different, this is just, they go in the vagina, but then they leak out, obviously, through to the surrounding tissues with the bladder. And they're very safe. And we actually, I first line, use something called prasterone, which converts to

estrogen and testosterone just locally in the bladder and it reduces urinary tracts infections, but it can help with incontinence. So it's like I always, well, I spend a lot of my life really frustrated because it's so sad the suffering, but even sadder for me as a clinician, knowing that there's a treatment that's really readily available, that, you know, your followers, my followers, people out there will not be even offered, let alone be prescribed. Exactly. I was just speaking with a woman yesterday who, all of these symptoms, she's in the perimenopause state, and she says she went to her doctor and, explained all the symptoms

and she was like, it's normal. Yeah, it's just aging. But we don't have to no. We don't have to age that way. No. We don't have to. We don't have to just accept it

and like lie down and take it. And you're so right. You know, I'm so grateful for you being so open. But there's so much more we need to do by just empowering women. And a lot of my work is really about empowering women with knowledge and then they can make choices

that is right for them. So just before we end really, because sadly we've got to wrap it up but there's lots more I really want to ask you. You know, your work is just so empowering and I think also, I don't know if I'm allowed to say this or not, but being American, you do go for things stronger than we do. And once you've made your mind that,

it's brilliant, but you're so forthright, you know, you've got to be really strong to keep going in what you're doing and what you believe in. But I always ask for three take-home tips at the end of my podcast. What three things do you think women should be really doing

to change the narrative going forward so that they are not dismissed as just being older? We've got to speak up and keep speaking up until we get to a productive conversation. Yeah.

Absolutely must. And in order to do that, we need to have a sense of agency. I think that our culture has taught us that we need permission to have agency. Yeah. Which is, does not make sense. And I believe that we create a sense of agency,

which is the sense that you can take action about something. We create that sense of agency by managing how we're talking to ourselves because that's the voice we listen to in our head and that's the voice that drives our action. So, in managing our self-talk,

which is another whole world of the work that I do in my word shops and my wordswork retreats, is learning how to manage what we're saying to ourselves. Recognize when we are defeating ourselves, when we are being our own oppressor, changing the words. Now, changing your words is not going to change a diagnosis. It's not going to change what happened.

Changing your words is not going to change your life, but we'll change how we handle the challenges in life. And understanding that, We can change the narrative and then change what we do, which means to keep speaking up. Make the appointment. If your doctor, if your caretaker is not addressing your needs, is dismissing your concerns, then find somebody else.

And I have encouraged thousands and thousands of people to start a conversation. Make an appointment, start a conversation. And there's so many women who are like, oh, I can't do HRT because of breast cancer and the estrogen. And just have a conversation because we all know what happened with the study. There's always options. Speak up, speak up, speak up, speak up, speak up, have a conversation. Keep asking questions because no one should suffer like this. Absolutely.

really, really important and great advice. So thank you so much for your time and I will remotely wave to you next time I'm doing a peloton when I'm allowed to sneak onto my husband's bike. Awesome. Thank you so much. I really appreciate the conversation. Subscribe to my newsletter for exclusive insights and updates on new episodes.