Health, Fitness & Personal Growth Tips for Women in Midlife: Asking for a Friend

Ep.183 Stronger, Not Smaller: Dr. Vonda Wright’s Blueprint for Muscle, Bone Density & Midlife Vitality

• Michele Henning Folan

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Absolutely no one warned us that midlife would be this loud—hot flashes, achy joints, bone density, belly fat, all competing for attention at once. And yet the message women still get is, “This is just how it is.”

In this episode, I’m joined by orthopedic sports surgeon and longevity visionary Dr. Vonda Wright, author of Unbreakable: A Woman’s Guide to Aging with Power. We dig into what it really takes to stay strong, mobile, and independent for decades—so you can carry your own groceries at 80 and stay out of the nursing home.

We cover:

  • Why bones are an endocrine organ (yes, your skeleton is talking to the rest of your body)
  • The truth about osteoporosis, fracture risk, and why waiting until 65 for a DEXA is a terrible strategy
  • How to safely use impact, heavy lifting, and sprint intervals even if you’ve been told to “be careful”
  • The role of estrogen, testosterone, and vitamin D in bone and muscle health
  • Protein, leucine, vegan vs animal sources—and why under-proteining is keeping you weak and inflamed
  • Weighted vests, jumping, Pilates and yoga: what actually moves the needle for strength and longevity

If you’re a woman in perimenopause, menopause, or beyond—and you want denser bones, stronger muscles, better balance, and a body that can keep up with the life you want—this conversation is your blueprint.

👉 Grab Dr. Wright’s book Unbreakable, A Woman's Guide to Aging With Power, and connect with her online.

Dr. Wright's website https://www.drvondawright.com/

Check out her new bone supplement, Unbreakable Bone, on her website.

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

Dr. Wright's weighted jump rope https://amzn.to/3Mi91VU

Don’t forget to follow Asking for a Friend for more real talk on midlife health, fitness, hormones, and longevity.

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1:1 health and nutrition coaching or Faster Way - Reach me anytime at mailto:mfolanfasterway@gmail.com

If you’re doing “all the right things” and still feel stuck, it may be time to look deeper. I’ve partnered with EllieMD, a trusted telehealth platform offering modern solutions for women in midlife—including micro-dosed GLP-1 peptide therapy—to support metabolic health and longevity.

https://elliemd.com/michelefolan - Create a free account to view all products.

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🎤 In addition to coaching, I speak to women’s groups, moderate health panel discussions, and bring experts together for real, evidence-based conversations about midlife health.

Transcripts are created with AI and may not be perfectly accurate.

Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your qualified healthcare provider with any questions regarding a medical condition.

Michele Folan:

The new year is coming, and with it, that familiar crossroad. Another year of saying, This is it. I'm really doing it this time. Or a real commitment that finally sticks because it's built for the body that you're living in right now. Here's the thing motivation isn't the problem. You've had plenty of that. What you've been missing is a plan grounded in science, structure, and accountability, not wishful thinking. That's where the 21-day metabolism reset with faster way changes everything. It gives you the blueprint your midlife metabolism has been begging for. Smart workouts, dialed in macros, real food, real support, and a roadmap that actually makes sense for women in midlife. No more guessing, no more starting over every January 1st, no more promises you can't keep because the plan wasn't built for you in the first place. If you want to start 2025 feeling strong, energized, and in control, this is the place to begin. Join me inside the 21-day reset and make this the year you follow through because the framework actually works. Click the link in the show notes to learn more and to register. Health, wellness, fitness, and everything in between. We're removing the taboo from what really matters in midlife. I'm your host, Michele Folan, and this is Asking for a Friend. Welcome to the show, everyone. Today's guest is the definition of women's health powerhouse. Dr. Vonda Wright isn't just an orthopedic surgeon. She's a longevity visionary who has dedicated her career to rewriting the narrative of aging for women. She's operated on professional athletes and weekend warriors alike. But what drives her passion today is preventing the injuries and decline she repairs in the operating room. Her latest book, Unbreakable: A Woman's Guide to Aging with Power, is the ultimate blueprint for living strong, not shrinking. It's about stronger muscles, denser bones, better mobility, and a mindset that says, I'm just getting started. In a world that still tells women to take it easy, Dr. Wright is flipping the script. She's teaching us to load the bar, to jump, to fuel our bodies with purpose, and to treat muscle like the currency of aging. Whether you're navigating perimenopause, recovering from injury, or simply ready to invest in the decades ahead, this conversation will show you how to train your body and your brain for lifelong independence. If you want to stay out of the nursing home, keep your confidence and carry your own darn groceries at 80, you need this conversation. Dr. Vonda Wright, welcome to Asking for a Friend. Thank you so much for having me. Well, I told Dr. Wright before we started recording that I am quite the fan, and I have been sharing her wisdom with my clients for quite some time now. And I know you have quite a following, and I wouldn't be surprised if many of our listeners already are fans of yours as well. You know, you have spent decades in orthopedics, and I'm really curious what led you to that specialty when you were first starting out.

Vonda Wright, MD:

Well, you know, Michele, my first career in medicine was as a cancer nurse. And in 1989, when I graduated from college, uh, there was such a uh shortage of nurses. When I graduated with a biology degree, they were offering people another bachelor's and a master's in three years if you would come and be a nurse. So I did that. And my master's degree is in cancer, as cancer nursing, as I said. And it was there that I think I learned the life lessons about what's important, life and death, the value of a woman's health, the suffering that people go through. And it really informed my whole career. So that when it was time to choose a different career, because frankly, I progressed really quickly in nursing and and it was within a few years I needed to decide what direction I was going. When I went back to medical school, I really did expect to go back into oncology. And for a variety of reasons, I went into orthopedics, but it fits so well. Or it either retrofits so well or it fits so well, it guided this whole pathway, in that I do not believe that aging is an inevitable decline from vitality to frailty. And orthopedics, especially the kind I do. I'm an orthopedic sports surgeon. So if I shift my camera, you'll see all these lanyards that I've, and these are only a few of them I've accumulated over the years, because I'm the doctor that stands on the football field or whatever field and runs out there when people are hurt, right? So my job is really aspirational, meaning I am here to make you walk again, make your shoulder work again, make you able to feed your family. And that is the same philosophy that I bring to the health of midlife women. Because frankly, I think when women are told that, oh, you're just getting old, or uh, you know, why don't you act your age? That is the world's biggest cop-out, whether that comes from your doctor, whether that comes from your friends, or whether that comes from your own mind. That is a cop-out to dying slowly over 40 years. And I just won't have it.

Michele Folan:

You know, and you've done surgery on thousands of joints and bones. And I've heard you talk about those, those frail bones that you come in contact with. Can you talk about that a little bit and how challenging that can be as a surgeon to have to deal with that? Well, you know what?

Vonda Wright, MD:

It's uh I think nobody thinks about their bones until the last year. Thank goodness I introduced it on uh another podcast, Diary of a CEO, and thank God it's caught on. The world is talking about bones, because bones play so many roles in our body from storehouse of minerals, incubator of our blood cells, master communicator. And yes, I can yet I can tend to you, nobody thinks about their bones unless we're looking at them uh during fashion week, going walking down the runway, right? Right. And because we don't think, yeah, right? Oh, cheekbones, collarbones, look at those. But the reality is that many of us don't build good bone density when we're young. You know, maybe we don't eat enough. Maybe we we eat poor things, maybe we don't have periods for long periods of time and think that's a good thing when it's actually a bad thing. Or maybe when we're bearing children, we don't realize that our our babies are going to eat our bones if we're not eating enough healthy food, right? And there's an entity called the osteoporosis of pregnancy that is real and results in spine fractures. And so, or maybe we don't think about it until we hit perimenopause and the rate of bone resorption, which is the taking away of bone, triples because we no longer have estrogen, which leaves us with vulnerable bones. And and it is one thing for a surgeon, you ask the question, how does it affect me? Well, it affects me because when bones are like butter, it's hard to get instruments to stay in them. But I'll get over that as a surgeon. Women do not get over a major fracture. One in two women will have an osteoporotic fracture in their lifetime. And if that fracture happens to be your wrist, that's painful for three months. Or maybe it's your ankle, that's painful for three months and you're sitting around. But if you break your hip, 70% of all hip fractures occur in women. 30% of the time you die in the first year, and if you manage to live, 50% of the time you do not get to go home to your own house. And so when we think about bones and osteoporosis is translated as holes in bones, well, it's a serious matter that we all need to think about.

Michele Folan:

You know, I was with my high school friends last week, and we're all 60, 61 years old. And I was kind of surprised how many women there have not yet had a DEXA scan. When do you typically recommend we get our bones scanned?

Vonda Wright, MD:

Well, we don't get DEXA scans until later because insurance will not pay for them. Number one. And number two, we don't think about our bones. I mean, I unless you break one, nobody thinks about them. They just take them for granted. So it's not surprising to me that your girlfriends haven't had a DEXA scan or a REMs ultrasound to look at bone quality. But I get them on everybody. And I find poor bone density in 25-year-olds and 30-year-olds and 40-year-olds in women who have been doing everything right. They're lifting, they're eating, they're jumping, still poor bones. And it's a really discouraging thing. So I want everybody to get a bone density or a REMS ultrasound when they start getting their mammograms around 40. Because here's why. If we catch you with bad bones at 40, we have an entire 10-year runway to get in front of it before you are 52, the average age of your menopause. If we wait through the 40s and finally do it, you will have already lost your bone density. And it is harder to make that up than to start a decade earlier. And data from the European Uh Osteoporosis Society finds that it takes about 10 years of hormone optimization to affect fracture risk. So fine, if you catch it when you're 60, fine, we're behind the eight ball. I'd rather catch it when we're 40.

Michele Folan:

Oh, wow. Okay. So that's interesting. I did not know that about, you know, when we are taking hormone replacement, you know, like estrogen, to how long it takes to help really increase your bone mass along with all the other stuff that you're doing.

Vonda Wright, MD:

Well, what we want to do, Michele, is never let it drop, right? Why are we gonna let you lose 15 to 20 percent and then try to do something about it? Why don't we maintain it at whatever level it was, even if it wasn't great? Do you see the argument?

Michele Folan:

Yeah. I yeah, I definitely do. Yeah. And I have osteoporosis, so I was diagnosed two years ago. I am seeing improvements, so I'm doing all the stuff you tell me to do. And so it is possible. So I don't want people to think it's hopeless, but you but you gotta get on it. Oh no, it's not.

Vonda Wright, MD:

Yeah, it's not hopeless unless you do nothing. Yeah. Because one in two women will have a major fracture, right? So statistically, it's either gonna be me or you. I mean, when I say things like that, and women are looking at their girlfriends across the table, it really brings it home because otherwise it's just a statistic. Correct.

Michele Folan:

Yeah. You've brought this up and maybe on another podcast. Oh, it may have been diarrhea CEO, where you talk about the skeletal system as being an endocrine organ, and it had to do with osteoblasts. Yeah. Can you go into that a little bit? Because I find that's really interesting.

Vonda Wright, MD:

Well, an osteoblast is one of the two, one of the many bone cells. There's osteocytes, which are the mature cells, the osteoclast, which comes from a bloodline of cells, actually, that is responsible for resorbing bone so your body can use the minerals, and the osteoblasts, which you mentioned, which builds bone, right? And they work in harmony. Uh, our body loves homeostasis. So we are always striving for these two cells to be working almost equally. But the reason that bones are an endocrine organ, the definition of an endocrine organ or a gland, whether it's your thyroid, your pituitary gland, or or muscle is an endocrine organ, bone, is they talk to themselves and other body parts via secreted particles, right? So secreted proteins. So bones secrete hormones called osteocalcin, so many, but the two I talk about just because it's a new concept to people, we don't need too many new words, are osteocalcin and LCN2. And for instance, here's something that that I talk about with less frequency than osteocalcin. LCN2 is a hormone produced by bone that is directly involved in satiety, meaning, do I feel hungry or not? Now, why in the world would bone be interested in whether you feel hungry or not? I have no idea. Well, it's because bone has a huge role. Yeah, bone has a huge role in your metabolism, whether it's glucose metabolism, insulin resistance, or storing the minerals you need. So of course there's going to be communication between your bone and your gut for absorption, and in the case of LCN2, your bone and your brain, so that there's an interaction saying, okay, I need more stuff, you better eat, or okay, I'm full, you better stop. Because fat, if we talk about another musculoskeletal tissue that falls in my wheelhouse, fat is noxious. And being heavy doesn't mean you have better bone because of the hormonal interactions and the inflammation that comes with that. So bone is an endocrine organ because everybody's talking. Nobody's silently living by themselves. All these organs are talking.

Michele Folan:

Okay, this is fascinating. You talk about muscle being the your aging currency, right? But it's really your bone, too, is is involved in longevity.

Vonda Wright, MD:

Oh, I never say it's very popular right now to say muscle is the organ of longevity. And I get it. I mean, really the irony is I was first a muscle scientist in a muscle lab. We studied muscle-derived stem cells, which are now called satellite cells. Listen, we did all kinds of things to those muscle stem cells to get them to work better. So I started out in a muscle lab. And so it's very popular to talk about bone muscle as an endocrine organ, which it also is. But what people forget is muscle, bone, tendon, ligament, fat, muscle stem cells, the disc in our back, all come from the same ancestor. They all had a common great-grandmother cell called the mesenchymal stem cell. So of course they communicate with each other. Of course, they are part of the whole equilibrium homeostasis system in our body. So, yes, muscle is an organ of longevity. Bone is an organ of longevity. Because when you think about it, what is muscle without its bone? It's a heaping pile of steaming metabolic tissue that just sits there like a chicken breast on the counter. But when you put some bones under it, it becomes a person, right? Yeah. Isn't that funny to think about? Yeah. It's like hamburger versus a cow. Right. The difference is bones, right?

Michele Folan:

So, Dr. Wright, we're gonna take a quick break. We come back. I want to talk a little bit about osteoporosis and jumping and impacts. Peptides aren't voodoo, they're real science. They're short chains of amino acids your body already makes, just not as efficiently as you age. And it's not just GLP1. There are peptides for longevity, anti-aging, skin, lean muscle, sleep, and recovery. But here's the key peptides don't replace a healthy lifestyle. You still need protein, whole foods, strength training, good sleep, and stress management. Peptides simply enhance the results of the work you're already doing. That's why I partnered with a peptide resource, a trusted medical team using evidence-based protocols and high-quality formulations. If you're doing all the things right and still feel stuck, peptides might be the supportive tool you've been missing. Check out the link in the show notes, create an account so that you can see all the peptides available. All right, we are back. Before we took a break, I wanted to talk a little bit about impact and jumping because I know women that get an osteoporosis diagnosis oftentimes are told not to do too much impact. How do we safely navigate this and still getting the benefits of impact for our bones?

Vonda Wright, MD:

Well, I think women are told of a lot of things based on fear, not fact, as a baseline. Okay. So to tell a woman with fragile bones that she has to sit there and protect herself with uh what is that? Bubble wrap is just wrong, right? Yeah. Because I'm gonna tell you what happens when you wrap yourself in bubble wrap and don't do anything. It's like me putting a cast on your leg. When I put a cast on your leg, within one week, that cast is loose. Do you know why? Not because the plaster stretches, it's because you lose muscle mass. And if I look at your x-ray, you will have lost bone density. Yes. Right? So sitting still and doing nothing wrapped in bubble wrap is a surefire way to get weaker. So there are lots of studies that show that even women with osteoporosis can carefully impact their bones, lift heavy weights, jump around. Now, you have to be careful. You have to work on your balance and your uh balance and equilibrium, work on your foot speed. So I will get to jumping, but the full recipe for women with osteoporosis is facts not fear, number one. Number two, if you literally are osteoporotic with a T-score of less than minus 2.5 or 3.5, you really need to have a science-based discussion of whether or not you want to be medicated. Because to sit around and say, oh my God, I don't want to take medication, okay, that is your choice. Um, but there is so much other things you need to do. I mean, I don't think we can just blanketly say, I'm not a medicine person. Well, sometimes we need to have interventions. But what are the non-medical ways? Well, even for women who want to be as air quote natural as possible, there is nothing more natural. Not yams, not uh what are the other things people like? Not tofu, not uh soybeans, nothing more natural than body identical estradiol, which is what your little ovary's been making your entire life. So women get a little hung up on it, comes as a prescription. It comes from plants, people. That's natural, and you make it. And it's critical for bones. So you must make your decision based on facts, not fear. In addition to that, we must lift heavy weights to build bone because muscle pulls on our bones. And there's a study by Belinda Beck out of Australia that shows that even women with Frank osteoporosis can be taught to learn heavy and do it safely. Number three, my own studies show that uh we can uh maintain bone density across our lifespan with impact exercise. So sorry if you're a swimmer, not as good as is hopscotch, tennis, pickle, volleyball. But you, if you haven't jumped for years, then don't try to jump off the 24-inch box that you see me jumping on commonly. You know, hop up and down on your own feet. Yeah. And so jumping, but we must learn to balance. We can learn to rebalance so that we don't fall down by standing on one leg when we brush our teeth. So it's a series of things, last of which, and we talked about this off-air, we got to feed our bones, people. Bones are 50% protein. And so it takes good nutrition to build better bone.

Michele Folan:

Okay, I've got so many questions based on the litany of things that you just said. All right, first of all, estrogen. We all know estrogen is vital. What about testosterone? What role does that play in bone strength?

Vonda Wright, MD:

Well, testosterone works uh by works uh with the osteoblast to help build bone. Testosterone is not just a sex hormone at all. That's what you know the FDA likes to tell us. It's only good for libido. But in fact, women use testosterone for muscle, for bone, for brightness of mind. And so I want women to understand, which hopefully they've heard on your show, that testosterone is not a male hormone, it is a hormone. And in fact, women make more absolute amount of testosterone than we make estrogen. It just affects us in a different way. So when I'm prescribing hormones or sending people to get their hormones prescribed, the considerations are uh systemic estradiol, preferably by a patch. If you have a uterus, progesterone, when those are when you've adjusted to those, adding testosterone, which has to be added as a gel. There is no FDA-approved female uh dosing of testosterone, which is a little bit of a problem that we're working on with the FDA.

Michele Folan:

Yeah, don't get me started on that one.

Vonda Wright, MD:

Especially Kelly Casperson and Rachel Rubin are leading the cause. And then don't forget vaginal estrogen to work on your chronic UTIs, your pelvic floor, to make everything nice and juicy like it always was. But if you're gonna tell me, if you're thinking out there, oh, she's telling me to jump, and when I jump, I'm incontinent. Yes, you are because your pelvic floor is skeletal muscle and it must be rebuilt. And if you want help with that, you put some vaginal estrogen, which helps locally. And then finally, don't forget about the collagen in your face. If you're as vain as I am, you want to keep it plumpy and uh local facial estrogen can help that. Yes, I do that.

Michele Folan:

I do that. Me too. As much as I can get away with. Yeah. Do you take collagen like a powder? No. Okay. Do you find there's any benefit to doing collagen for tendons, ligaments, bone?

Vonda Wright, MD:

You know, the data is so plus minus, that's why I don't demand it of my patients. If it was profound data, I would demand it. There are some data, but not so much that I'll say these this is one of the tenets. Is gonna harm you? Probably not. So that's where I stand today. People constantly want to argue with me about it, and I'm open to learning, but I haven't seen really big studies that make me demand it yet.

Michele Folan:

All right. No, I think that's very fair. I know a lot of women take it just, I think, for more of their their skin, but uh when just get your thoughts on that. And then on that same vein, we talk about protein all the time. Do you have preferences in terms of animal protein versus vegan?

Vonda Wright, MD:

Well, I don't care where you get it, I care that you get it, but you have to consider the quality of the protein, right? And the volume of food and calories. So when you think about a vegan diet, think about cows and bulls. They're all vegans. Cows and bulls are vegans, and they're full of muscle, but they eat all the time. It is their job to eat. So, can you get enough protein from a vegan diet? Sure, you can. You gotta friggin' eat all the time and get enough protein in, but you also must be mindful of the leucine load in your protein. Leucine is an uh essential amino acid, meaning your body can't make it. It's a branch chain amino acid, and it is the most powerful stimulator of muscle protein synthesis. And different foods have it in different quantities. The number one source of leucine is whey protein isolate that you get from milk. And the best source of whey protein isolate is mother's milk. So nature knew what it was doing when it made mothers able to produce the best kind of high-quality protein for our babies. Well, adults, we get it from obviously animals from cows. So whey protein isolate has about 12% leucine in it. And you and meat comes after that, eight to ten. All the way down at the bottom is plant-based protein, which has four to six percent leucine. So not only do you have to eat more protein because it has lower protein content, but you also have to double up on leucine. So that's my explanation. I'm not, I don't care how you get it. You can be a vegan if you want to for whatever reason. You just gotta not use as an excuse to underprotein.

Michele Folan:

All right. No, that's great advice. And and I appreciate that because that does come up all the time with my clients. And so I wanted to kind of clear that up. And you did bring up how swimming doesn't really allow for impact to do what it needs to do to build uh bone. But what about Pilates and yoga? Because those are super popular, and I think people may be doing that in lieu of lifting weights. Why do you think it's so popular? I think they find it very relaxing. Yoga. Is that the point of working out? Well, not in my mind. Addressing your people, right? Uh what are we even in the gym for, right? Yeah.

Vonda Wright, MD:

Yeah. Well, you know what? The only kind of Pilates that I mean, and I don't do, I mean, I don't do yoga unless it's hot yoga, which makes me feel like I'm running a marathon. So there are kinds of yoga that make me feel the same way. So I don't come at this from a yogi or from the perspective of having done 3,000 Pilates classes, which frankly I don't get it. But women who do do Pilates and yoga, they count their classes. Yeah. They're like, I've done 3,000 Pilates classes. Well, that's a lot, that's very expensive, people. Will it get you where you need to go? Well, when I prescribe exercise, I prescribe it, as you've read in Unbreakable, my book. The acronym is Face Your Future, F-A-C-E. Pilates and yoga fit in F, which is flexibility and joint range of motion. We must maintain that as we age so that we don't become hunched over old people shuffling along. So I am not against Pilates and yoga. Throw it in a couple times a week. Go meet your girlfriends, do whatever you do there. But it is never going to build the muscle that is going to keep you strong enough to do what you want to do when you want to do it. Because I have plenty of really skinny, fat people who only do that who end up frail.

Michele Folan:

Yeah. And I want to know you like what do you do in terms of cardio? Because I know you're you're big on lifting weights, and I am too, but I have added some cardio, more uh like sprint type cardio in here lately. What do you do for cardio?

Vonda Wright, MD:

Yeah, so let's just go down the face acronym. We already talked about F. Okay. A is aerobic, so that's cardio. Now I come from a place like everybody else. In the 80s, I was doing Jane Fonda in my living room, doing all aerobics all the time. And I was a dancer, so aerobics and dancing. And then when I quit dancing, then I started running marathons. So I am of that generation, right? Cardio all the time. FA now, I do very uh either side of the spectrum, and this is what pro athletes do. Not every workout is in the middle ground, which is what I see all the time. People are sweating it out, they're they're killing themselves, but at a moderate heart rate, and and they're doing a lot of reps. So that is not intense enough to really shift the needle, and it's too intense to prevent yourself from getting injured. So the way I prescribe it now is three hours a week of base, low heart rate base training on every app any apparatus, 181 minus your age, which is an estimate of your lactate threshold. If you come work with me directly, as some people do, uh, we measure your lactate threshold. So I'll say your heart rate in base training is 126 to 136, for instance. Three hours a week, broken up into 45-minute sessions. So there's that. Twice a week after you get done with that, you sprint your guts out. So that means not sprinting on a track like Shakira Richardson. Any apparatus will do. In fact, I think the the Alpine machine is harder than running on a on a treadmill, but you're getting your heart rate up to as fast as it will go for 30 seconds, and then you completely recover. So base training and sprint intervals. Hold on to the thought of sprint intervals. I am FAC is carry a load, lifting weights. We have to progressively learn to lift heavy. This morning I lifted, I was a deadlift day. So I haven't deadlifted in a while because I was I've been on tour for this book. So I started at a lower rate, a lower weight than I ended up with, and just progressed up in my four sets uh to heavy lifting. So F A C. See, it is the heavy lifting and the sprint intervals that I find in myself and others that cause the recomposition of your body. So if you want to go from skinny fat to lean, in my opinion, in my experience, that is the way to do it while you're managing your nutrition, because you can never out exercise what you're eating. And then FACE, equilibrium, and foot speed as fall prevention. So those are the four things, and that's how I do aerobics for myself and those I prescribe for.

Michele Folan:

Okay. I love this. And I feel really good because I've been really encouraging my clients to really do more sprint type work because we come from the get on the elliptical era and do an hour on the elliptical. And I'm I that's just not that doesn't make sense to me now based on things that I've learned from you and following you.

Vonda Wright, MD:

You can do that, but you'll never move the needle. Right. You'll do the same hour on the elliptical for years, and you'll wonder why your body doesn't change.

Michele Folan:

Right. Well, and you mentioned about heavier load. And I know when I first work with clients, their propensity is to do three sets of 12 or 14 reps. And I think what you're saying is fewer reps, heavier weight. Work up to that.

Vonda Wright, MD:

Michele, people need to ask themselves what they're lifting for. If you're a marathon runner and you're lifting for endurance, then lift the lightest weight possible 30 times because you're building endurance. If you're building just to pop out big muscles, then lift for hypertrophy. What you're describing is lifting for hypertrophy. There's nothing wrong with it. But even at 10 to 15 reps, the last rep you must be at failure. Not, oh, I could do that another 30 times. You must be at failure. So you have to lift heavy enough to be at failure with those reps. But what are we lifting for in midlife and beyond? We are lifting for strength and power. It is power that predicts your fitness and longevity. That's thus heavy and then ultimately heavier with speed. Right. So you got to ask yourself what you're lifting for. Because what I find is there was a study of this. I think women underestimated how strong they were more than 50% of the time. Think about this. You go to the gym, you've got your lightweight in some pastel color that you're doing a lot of times. And then you go home and you clean your basement and you're lifting 40 or 50 pound tubs off the ground. It makes no sense to me. Why we underestimate what we're capable of? Now, what makes sense to me is if you don't want to be injured, and that's when hiring a really good trainer who understands the midlife women's body is important.

Michele Folan:

Yeah. And I've I've actually recommended, I don't know what you think about this, but I um for women that do have an osteoporosis diagnosis, is to work with a PT so that they learn proper form and function, so that they're lifting correctly. But you know, I I but I hear what you're saying. It's just sometimes we have to invest a little bit at the front end to just guide us so that we feel confident.

Vonda Wright, MD:

I think PTs are this is the way I do it, this is the way I do it in my office. For people midlife women who come in with knee pain, yeah, who haven't gotten off the couch in years but have a desire to, I send them to PT first to build their butt core and hip strength and to gain the confidence that they're not going to become wrecked. But that's mainly what it's for because they're not gonna get lifting advice from a physical therapist. That's not their job. Once they feel confident enough, they should hire a midlife personal trainer. I've got a personal trainer in the performance center. We've got excellent uh strength coaches. They're not just person, that's the other thing, ladies, listening. You need to hire a personal trainer who is more knowledgeable than just getting their certificate off the internet. You need a strength conditioning person, honestly. And I'm not trying to piss off personal trainers, but they're it's not everybody's created equally. So find somebody who is an exercise physiology major or is a strength conditioning coach, has done the harder work. Because you will get injured if somebody is lifting you for their own ego. They should be totally focused on you, knowing what midlife women are capable of, knowing why we're lifting, and the science behind endurance, hypertrophy, and strength. And eventually you're trying to learn to be able to do it yourself. Yeah, that's great advice.

Michele Folan:

Thank you for that. I I saw you have this big old heavy jump rope that you're using, this big pink thing. And I I'm so fascinated.

Vonda Wright, MD:

I it's not heavy, it's only a two-pound jump rope, it's not heavy. Yeah, but it looks awesome. Oh, I love it. And you know, everybody wants to know. Shoot, I wish I made it. I probably could have sold a thousand of them because everybody wants to know where I got it. So I'm trying to get that.

Michele Folan:

Well, if you if you get the link for that, I will put it in the show notes for for the listeners. And then the other the other quick question I had about equipment was weighted vests. Are they helpful for osteoporosis? What is your goal with with a weighted vest? Because I know you wear one.

Vonda Wright, MD:

Well, I wear a weighted vest for surprise for a surprising reason. But weighted vests alone have shoddy data at best for building bone density alone. Weighted vest plus lifting has been found to be helpful, but lifting alone has been found to be helpful. I'm not anti-weighted vest. In fact, I'm pro-weighted vest. But weighted vests, what they really do is add about 10% load to your workout. Here, for instance, here's how it manifests in me. I wear a 20-pound weighted vest when I am on a treadmill. The work it takes me to get my heart up to 130, which is my lactate threshold, which is my base training heart rate, the work it takes is 10% less when I'm wearing this weighted vest because it adds that workload on. So you can do more with less settings on the treadmill. For instance, I can get my heart rate up with less incline and less speed when I wear my weighted vest because it adds the load. So that's one way to do it. So if you're out walking, it adds load to walking and gets more cardiovascular fitness going. Because, you know, none of us are wearing 50-pound weighted vests to actually make it a weightlifting phenomenon, right? Uh-huh. And, you know, plus, I am for women already with osteoporosis, I'm not thrilled about having weight on their thoracic spine like that, which is where compression fractures happen. So we are about ready to announce a different design that I've created that that I think will be safer for women. Plus, what do you do with the strap? Where do your boobs go? Above, below? They were designed for men, honestly. Yeah. But here is something that most people don't think about their weighted vest. I also have I have a standard weighted vest. I have this new one I've designed, but there is a weighted vest that I also use that's like a jacket vest that you would wear to a stadium when it's cold. And it has these little cinchy things on the side. And I cinch it up, and oh my God, when I first wore that in my house, I didn't take it off. And my daughter's like, Mom, you're what are you doing vacuuming the house in your weighted vest? I'm like, Bella, I don't know what to tell you, but this is like a giant hug. And then as I started looking into it, it is the same reason people sleep better with weighted blankets. Or why some children who are on the spectrum settle down when they're embraced, is it's it's because the pressure and the hug of it calms our nervous system.

Michele Folan:

Yeah.

Vonda Wright, MD:

So that is another surprising reason to wear a weighted vest during perimenopause when people are a little anxious anyway, is it can help that calming feeling.

Michele Folan:

Oh, right? That's hey, interesting. I know. Yeah, yeah. And yeah, I and I love the idea of the weighted blanket, because actually when you wake up middle of the night.

Vonda Wright, MD:

I love weighted blankets. About ruined my marriage, but we have figured that out. Because I'm my poor husband, I'm like, I love this weighted blanket. I am not scooting over towards you. I'm staying under my little half of the bed with the weighted blanket on it.

Michele Folan:

I know, right? But yeah. Oh my gosh. Okay. One one thing that comes up quite often, Dr. Wright, is blood tests. Are there certain blood tests that we should be getting in midlife to ensure that we are adequately addressing our nutrition?

Vonda Wright, MD:

I think it takes a lot of poor nutrition to affect your blood tests, like your calcium or your liver function. I mean, I think that's a really rough estimate. B12. But I think every woman should have their blood drawn at least every year. Those, you know, the longevity people I take care of, we do it every six months. Some people do it every three months if you're really on top of everything. But we need to know what your normal organ function is, your immune function. We should look at at least your testosterone. I'm not a big proponent of measuring estrogen, but we certainly can. We can look at your inflammatory markers, which we do. I mean, I do draw a lot of blood when I'm working with people one-on-one. And there are some specialized labs, but I often have people come to me and when we're preparing for surgery or something, I'll say, and what medical problems are you being treated for? What medications do you take? And they very often say, I do not have any medical problems and I take no medication. To which the follow-up question is, when was the last time you went to the doctor? Because not having a problem is not the same as not knowing you have a problem. Right. Right? Because your body's talking to you all the time through your blood, and you just don't know. So if you haven't had an annual physical, go make an appointment to have one.

Michele Folan:

Yes.

Vonda Wright, MD:

And if you want to get deep into the woods on modifying your lifestyle and the effect that it has and your lipids, then get someone who will draw your blood every six months and then do the hard work in between.

Michele Folan:

Yeah. How about vitamin D? We didn't bring that up. But vitamin D, is that something we should get levels on? What about vitamin D?

Vonda Wright, MD:

Yes, vitamin D. Okay. Most of us are low on it. And it's important for your immune system, for your brain, for helping calcium reabsorption. Vitamin D itself does not directly build bone, but it helps with calcium reabsorption. Okay.

Michele Folan:

All right. I just wanted to make sure I asked you that. You know, Dr. Wright, you're a wife, mother, author, surgeon. Yes. Absolutely a leader in this space. What are your own non-negotiables for staying strong physically, mentally, and emotionally?

Vonda Wright, MD:

I go to bed every night by 9:30 and I'm up at five. This weekend it meant leaving a wedding early, and my husband was not that happy about it, but it's a non-negotiable for me. So sleep wake times, sleep go-to-bed times and wake times. Number one. Number two, I am really conscious about the protein I eat, eating a fibrous carb diet, not a simple carb diet. I'm not against carbs, it just has to be the right kind of carbs. And then I have completely cut out sugar in my life. Although, to be honest, I had bought my husband some little ice cream things and I ate one. It's a 70 calorie, the tiniest little ice cream thing you've ever seen. But it's not the calories, it's the sugar that I really didn't want. But I most days I do not eat any kind of simple sugar at all because it's it's huge for inflammation. Women are surprised when they take my advice and get off it because they they feel so much less inflamed. They're less painful. So those are non-negotiables. Uh non-negotiables are when I'm not writing books and sitting at my desk for six months at a time, uh, a lifting, preferably three to four times a week. And then uh I follow my own advice. In fact, the workout in this book, the lifting workout in page 251 of this book is the last one I did. Oh. I mean, it's I've I've given you my last heavy workout, work my last six-week heavy lifting workout, just as an example. So I actually just do what I tell people to do in this book.

Michele Folan:

So your book, Unbreakable, A Woman's Guide to Aging with Power, you wrote it for midlife women, I believe. But would a my daughter, who is they're they're 28 and 30, would they benefit from reading this book right now?

Vonda Wright, MD:

Absolutely, because it's my goal never to lie to my daughters, who are your daughter's age, right? We have we have a blended family of six children. So between my daughters and my daughters-in-law, there are six women in our family who are having their one is 18, but the rest of them are having their children right now. It is my goal never to lie to them. Meaning, I want them to be able to do whatever they want to do when they want to do it, but unless, unless I help the world solve for this perimenopause thing, they're gonna hit a wall like I did. And so my goal for them is to set their standards during this critical decade that they're in. I call the critical decade 35 to 45, when you still have enough estrogen to make profound change in your lifestyle and and your and your body composition. So uh this book can be for everyone, it's specifically for really 35 and beyond, but it's it's fabulous information and not only for women, but for the men who love them. Yes, yes.

Michele Folan:

I and I I love that. I I and so I do a newsletter, and I'm gonna put your your book in my newsletter and just suggest this hey, if you're buying it for yourself, have have your guy also read it because I think I I think men have a lot to learn too in in terms of what's going on at this stage of life.

Vonda Wright, MD:

Oh, Michele, do you know that it's estimated by Mayo and by Louise Newsom that 70% of all midlife divorces, meaning divorces after 25, 30, 35 years of marriage, can be attributed at least in part to a gap in understanding between what the guy is going through and what the woman is going through. Because think about it. Women don't even know what they're going through by themselves, let alone to communicate it. And men, when they're feeling low or they have erectile dysfunction, they go to the doctor, they get hormones, they get their ED pill, and then they trot home thinking that everything's gonna be better, not realizing that for their partners in perimenopause and menopause, that sex feels like razor blades. Their brain is starved of estrogen and testosterone, and that there needs to be communication about what's actually going on. It's not that you stopped loving this person, it's that physiologically you're a different person. Yeah. So if we can save some marriages by this work we're doing, it would be worth it.

Michele Folan:

Absolutely. All right, on that note, Dr. Von der Wright, where can the listeners find you and your wonderful work?

Vonda Wright, MD:

Yeah, so every single day I'm on Instagram, which is Dr. Von to Wright. I have a YouTube channel with by the same name, which has all kinds of long form because 90 seconds is never going to be enough. I have a podcast called Hot for Your Health. Listen, I am everywhere. And then, of course, if you want to know my deep thoughts get Unbreakable on Amazon or any bookseller has it actually.

Michele Folan:

Yes, absolutely. I will put all the links in the show notes. Dr. Von da Wright, thank you, thank you, thank you for being here and speaking to my audience. Um, this was so delightful, and I'm happy you're here. Thank you for having me. Thank you for listening. Please rate and review the podcast where you listen. And if you'd like to join the Asking for a Friend community, click on the link in the show notes to sign up for my weekly newsletter where I share midlife wellness and fitness tips, insights, my favorite finds, and recipes,