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40s Forward: Daily Summaries Delivered
by Dr. Betsy Greenleaf
40s Forward PodcastLife after 40 isn't about slowing down—it's about leveling up40s Forward is the podcast for high-achieving men and women who want more energy, sharper focus, stronger bodies, better sex, and longer healthspan. Hosted by Dr. Betsy Greenleaf, board-certified physician and founder of the International Pause Institute, each episode blends cutting-edge medical insight with real-world strategies for optimizing midlife performance.From hormones, metabolism, and longevity to biohacking, peptides, sexual wellness, and mindset, this show delivers science without hype for people who invest in their health the same way they invest in their success.This isn't anti-aging.It's forward living.
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- 3 days ago35 min
S1E25 Burnout, Reinvention & Natural Healing After 40 with Jodi Scott
In this episode of 40s Forward, Dr. Betsy Greenleaf sits down with Jodi Scott, co-founder and CEO of Green Goo, a plant-based first aid and herbal wellness company. With a master's degree in health psychology and a background in psychoneuroimmunology, Jodi combines science, herbal wisdom, and personal experience to explore the connection between stress, healing, resilience, and whole-body wellness. Jodi built a successful business in her 30s, sold it in her 40s, and bought it back in her 50s. Along the way, she discovered powerful lessons about entrepreneurial burnout, nervous system regulation, mindfulness, and reinventing your life without losing yourself. What You'll Learn in This Episode • How Jodi transformed a family herbal remedy into Green Goo • Why chronic stress and burnout are common among entrepreneurs • How the nervous system influences physical and emotional wellness • The connection between stress, cortisol, inflammation, and skin health • Why mindfulness doesn't require hours of meditation • How to incorporate simple moments of calm into everyday life • What it takes to build, sell, and buy back a business • Why reinvention after 40 or 50 can lead to renewed purpose • How to recognize when your body needs rest and recovery • Why success shouldn't come at the expense of your health From Herbal Remedies to Green Goo Jodi's entrepreneurial journey began during pregnancy when she started questioning the ingredients in conventional first aid products. Together with her mother and sister, an herbalist, she began developing plant-based alternatives using traditional herbal infusions. What started at farmers' markets eventually grew into Green Goo, a recognizable herbal wellness brand. Jodi shares how her background in health psychology and whole-person medicine influenced her approach to developing products and building a business. The Hidden Cost of Entrepreneurial Burnout Building a successful company can be exciting, but constant pressure comes with consequences. Jodi describes the relentless fight-or-flight state many entrepreneurs experience while managing finances, employees, family responsibilities, and uncertainty. Dr. Greenleaf and Jodi discuss how chronic stress can influence sleep, mental health, inflammation, and physical well-being. Their conversation challenges the belief that pushing harder is always the answer. Sometimes the most productive thing you can do is pause. Your Nervous System Needs a Break You don't need a weeklong retreat to begin practicing mindfulness. Jodi explains how small sensory experiences can help bring attention back to the present moment. Whether you're washing dishes, walking outside, picking up your children, or simply noticing your surroundings, mindfulness can become part of everyday life. The goal isn't perfection. It's learning to recognize when you're overwhelmed and creating opportunities to reset. Building, Selling & Buying Back a Business Jodi's entrepreneurial journey has been anything but ordinary. After building Green Goo with her family, she navigated difficult business decisions, unexpected opportunities, and the challenges of selling and eventually buying back the company. Her story offers lessons about resilience, trusting your instincts, navigating uncertainty, and redefining what success means at different stages of life. Reinventing Yourself After 40 and 50 Midlife doesn't have to mean slowing down or settling. For Jodi, buying back Green Goo represented an opportunity to reconnect with her original mission and approach leadership with greater clarity. Dr. Greenleaf and Jodi explore why personal growth often requires reevaluating priorities, protecting your energy, and creating a life that aligns with your values. Key Takeaways • Success should never require sacrificing your well-being • Chronic stress can affect both mental and physical health • Mindfulness can fit into everyday activities • Building a business requires resilience and adaptability • Reinvention is possible at any age • Listening to your body is an important part of self-care • Purpose and personal fulfillment matter as much as professional achievement • Small moments of presence can make a meaningful difference Who This Episode Is For • Entrepreneurs and business owners experiencing burnout • Women navigating career changes or midlife transitions • Anyone interested in nervous system regulation and stress management • People exploring herbal wellness and natural skincare • Women considering reinvention after 40 or 50 • Anyone seeking better work-life balance and
- 1 weeks ago39 min
S1E34 Estrogen Metabolism Explained: Estrogen Dominance, Gut Health & Hormone Testing
In this solo episode of 40s Forward, Dr. Betsy Greenleaf continues her Hormones 101 series with a deeper look at estrogen metabolism, estrogen dominance, the estrobolome, endocrine disruptors, phytoestrogens, and hormone testing. Discover how your body breaks down and eliminates estrogen, why hormone balance is more complicated than high or low levels, and how your gut, liver, genetics, and environment interact with hormonal health. What You'll Learn in This Episode • What estrogen dominance actually means • Why progesterone changes during perimenopause can create symptoms • How the liver metabolizes and eliminates estrogen • The differences between 2-OH, 4-OH, and 16-OH estrogen metabolites • How the gut microbiome influences estrogen recycling • What the estrobolome is and why it matters • How plastics and endocrine-disrupting chemicals may affect hormones • Whether soy and other phytoestrogens help or hurt • The differences between blood, saliva, and urine hormone testing • How nutrition, fiber, and lifestyle support hormone health What Is Estrogen Dominance? Estrogen dominance is a popular term in functional medicine, but it isn't an officially recognized medical diagnosis. Dr. Greenleaf explains that symptoms attributed to estrogen dominance don't necessarily mean estrogen levels are too high. During perimenopause, ovulation becomes unpredictable, causing progesterone production to fluctuate or decline while estrogen may continue to surge. This changing relationship between hormones may contribute to breast tenderness, irregular bleeding, mood changes, and sleep disturbances. The goal isn't simply to lower estrogen. It's to understand the underlying physiology. How Your Liver Metabolizes Estrogen Your liver plays an essential role in processing estrogen. Through enzymes including the cytochrome P450 system, estrogen is converted into different metabolites. Three important pathways include: • 2-hydroxyestrone (2-OH): A major estrogen metabolite • 4-hydroxyestrone (4-OH): Can form reactive compounds under certain conditions • 16-alpha-hydroxyestrone (16-OH): Has different estrogenic activity Dr. Greenleaf discusses why these pathways matter and how conjugation helps prepare estrogen metabolites for elimination through urine and stool. She also explores nutrients involved in methylation, including folate and vitamin B12. The Estrobolome: Your Gut-Hormone Connection Did you know your gut bacteria can influence estrogen metabolism? The estrobolome refers to gut microbial functions involved in estrogen metabolism. Certain bacteria produce enzymes that can deconjugate estrogen metabolites, potentially allowing estrogen to be reabsorbed through enterohepatic circulation. Dr. Greenleaf explores how gut microbial diversity, dietary fiber, fermented foods, and regular bowel movements may support normal estrogen elimination. This is one reason gut health and hormone health are closely connected. Are Plastics Disrupting Your Hormones? Everyday products may expose us to endocrine-disrupting chemicals. Dr. Greenleaf discusses xenoestrogens, BPA, other bisphenols, and environmental compounds that may interfere with hormonal signaling. She also explains why a product labeled BPA-free isn't necessarily free of other chemicals with potential endocrine activity. Understanding environmental exposures can help you make more informed choices. Phytoestrogens: Is Soy Good or Bad? Soy, flaxseed, sesame seeds, legumes, and certain other plant foods contain phytoestrogens. These compounds aren't identical to human estrogen, but some can interact with estrogen receptors. Dr. Greenleaf explains why soy has been misunderstood and discusses research suggesting that whole soy foods may offer health benefits and modestly improve hot flashes for some women. Moderate consumption of whole soy foods is generally considered safe for most people, although individual medical circumstances matter. Blood, Saliva & Urine Hormone Testing Which hormone test is best? Dr. Greenleaf compares: • Blood testing: Commonly used to evaluate circulating hormone levels • Saliva testing: Has selected applications but important limitations • Dried urine testing: Can provide information about hormones and their metabolites Each method measures different aspects of hormone physiology. More testing doesn't automatically mean better care. Symptoms, medical history, timing, and clinical context remain essential. Key Takeaways • Estrogen do
- 2 weeks ago26 min
S1E33 Progesterone Explained: The Forgotten Hormone Behind Sleep, Mood & Menopause
In this solo episode of 40s Forward, Dr. Betsy Greenleaf continues her Hormones 101 series with a deep dive into progesterone—one of the most overlooked and misunderstood hormones in women's health. Most people think progesterone is simply the pregnancy hormone. But progesterone does much more. It influences brain function, sleep, mood, immune health, bone metabolism, reproductive health, and the body's response to stress. Dr. Greenleaf explores how progesterone is produced, why levels become unpredictable during perimenopause, the difference between bioidentical progesterone and synthetic progestins, and what women should understand about progesterone therapy. What You'll Learn in This Episode • What progesterone is and how your body produces it • Why progesterone often becomes inconsistent before estrogen declines • How progesterone influences sleep, anxiety, and mood • The connection between progesterone, GABA, and allopregnanolone • Why progesterone protects the uterine lining • How progesterone affects pregnancy, immunity, and bone health • The difference between progesterone and synthetic progestins • Why bioidentical progesterone isn't the same as every synthetic progestin • How progesterone interacts with estrogen and other hormones • When progesterone therapy may be appropriate • Common progesterone myths and misconceptions How Does Your Body Make Progesterone? Like estrogen and testosterone, progesterone begins with cholesterol. The steroid hormone pathway starts with cholesterol, which is converted into pregnenolone and then progesterone. Progesterone is an important part of steroid hormone production and contributes to pathways involved in producing cortisol, aldosterone, and other hormones. In women, progesterone is primarily produced by the corpus luteum after ovulation and by the placenta during pregnancy. Smaller amounts are produced by the adrenal glands. Men produce progesterone too! Why Progesterone Changes During Perimenopause One of the biggest misconceptions about menopause is that estrogen is always the first hormone to decline. During perimenopause, ovulation becomes less predictable. Because progesterone production depends heavily on ovulation, progesterone levels may become inconsistent even while estrogen continues fluctuating. These changes may contribute to: • Poor sleep • Anxiety and irritability • Mood swings • Irregular or heavy periods • Breast tenderness • PMS-like symptoms Understanding these hormonal shifts can help explain why women sometimes feel different years before their final menstrual period. Progesterone: The Brain's Natural Calming Connection One of progesterone's fascinating roles involves the brain. Progesterone can be converted into allopregnanolone, a neurosteroid that enhances GABA-A receptor activity. Think of GABA as the brain's brake pedal. It helps regulate excessive neuronal activity and contributes to relaxation and calmness. Dr. Greenleaf explores how this pathway may influence sleep, anxiety, stress resilience, and mood. She also discusses how research into allopregnanolone has contributed to treatments for postpartum depression. Progesterone and Uterine Protection Progesterone plays a critical role in regulating the uterine lining. Estrogen stimulates endometrial growth, while progesterone helps regulate that growth and prepares the uterus for pregnancy. For women with a uterus using systemic estrogen therapy, appropriate endometrial protection is essential to reduce the risk of endometrial hyperplasia and cancer. Dr. Greenleaf explains why progesterone or another appropriate progestogen may be an important component of menopausal hormone therapy. Progesterone vs. Synthetic Progestins Are all progesterone medications the same? Absolutely not. Dr. Greenleaf explains the differences between naturally occurring progesterone, bioidentical micronized progesterone, and synthetic progestins. Although these medications can act on progesterone receptors, their molecular structures and effects on the body may differ. She discusses: • Micronized progesterone • Medroxyprogesterone acetate • Prometrium vs. Provera • Differences in hormone formulations • Findings from the Women's Health Initiative • Why treatment decisions should consider formulation, dose, route, and individual risks Progesterone Beyond Reproduction Progesterone isn't just about menstrual cycles or pregnancy. Progesterone receptors are found throughout the body, including the brain, breasts, bones, skin, immune system, and cardiovascular system.
- Oct 12, 202624 min
S132 Testosterone Explained: Why Women Need It Too | Hormones 101 with Dr. Betsy Greenleaf
In this solo episode of 40s Forward, Dr. Betsy Greenleaf continues her Hormones 101 series with a deep dive into testosterone, one of the most misunderstood hormones in medicine. Testosterone isn't just about muscles, masculinity, or sex drive. Women need testosterone too! It influences the brain, bones, metabolism, cardiovascular system, skin, and sexual function. Dr. Greenleaf explores how testosterone is produced, why levels change with age, the relationship between testosterone and estrogen, symptoms of low and high testosterone, hormone testing, testosterone replacement therapy, and the science behind common testosterone myths. What You'll Learn in This Episode • Why testosterone is a human hormone, not just a male hormone • How testosterone is made from cholesterol • Where women and men produce testosterone • How testosterone converts into estrogen and DHT • Why testosterone matters for muscle, bone, brain, and sexual health • How testosterone levels change during aging and menopause • Symptoms associated with low and high testosterone • Why testosterone isn't the answer to every libido problem • What SHBG means and why total testosterone isn't the whole story • What research says about testosterone replacement therapy • Why hormone therapy requires personalized evaluation and monitoring How Does Your Body Make Testosterone? Testosterone begins with cholesterol, the building block of steroid hormones. Through a series of biochemical reactions, cholesterol becomes pregnenolone, DHEA, androstenedione, and eventually testosterone. Testosterone can then follow two important pathways: • Aromatase: Converts testosterone into estradiol, an important estrogen • 5-alpha-reductase: Converts testosterone into dihydrotestosterone (DHT), a more potent androgen Men produce most of their testosterone in the testes, while women produce testosterone through the ovaries, adrenal glands, and conversion in peripheral tissues. Why Women Need Testosterone Testosterone does much more than influence sexual desire. Androgen receptors are found throughout the body, including the brain, muscles, bones, cardiovascular system, skin, and hair follicles. Testosterone contributes to: • Muscle maintenance and physical function • Bone health • Sexual desire and arousal • Brain function and mood • Skin and hair physiology • Overall reproductive and endocrine function Dr. Greenleaf explains why testosterone deserves attention in women's health, particularly during midlife. Testosterone, Menopause & Aging Testosterone levels change throughout life, but aging doesn't automatically mean everyone needs testosterone replacement. Women may experience changes in androgen levels during their reproductive years, perimenopause, and menopause. Symptoms such as fatigue, reduced libido, mood changes, and decreased physical performance can have multiple causes. That's why evaluating the whole person matters more than treating a single laboratory number. Testosterone and Sexual Desire Can testosterone improve libido? Sometimes—but sexual desire is far more complicated than a hormone level. Relationships, emotional connection, stress, sleep, medications, mental health, and other hormones all influence sexual wellness. Dr. Greenleaf discusses evidence supporting testosterone therapy for appropriately evaluated postmenopausal women with hypoactive sexual desire disorder (HSDD). Testosterone can be a valuable tool, but it isn't a universal solution for low libido. What Happens When Testosterone Is Too High? More testosterone isn't always better. Excess testosterone can contribute to: • Acne and oily skin • Excess facial or body hair • Scalp hair thinning • Other androgen-related side effects Dr. Greenleaf also explains why testosterone metabolites and individual sensitivity influence how the body responds. Why Testosterone Testing Matters A testosterone number alone doesn't tell the whole story. Sex hormone-binding globulin (SHBG) affects how much testosterone is available to tissues. Understanding total testosterone, free testosterone, SHBG, symptoms, and clinical history can help practitioners make more informed decisions. Testosterone Replacement Therapy: What Does Science Say? For men with confirmed hypogonadism, testosterone replacement therapy may improve certain symptoms when appropriately prescribed. For women, the strongest evidence supports testosterone therapy for postmenopausal HSDD following comprehensive assessment. Hormone treatment requires individualized risk-benefit discussions, appropriate dosing, and ongoing monitoring. Natural or bioidentical does not automatically mean risk-free. Key Takeaways • Testosterone is essent
- Oct 1, 202648 min
S131 Estrogen Explained: What Every Woman Should Know About This Powerful Hormone
What if estrogen isn't simply a "female hormone" or something that disappears during menopause? In this solo episode of 40s Forward, Dr. Betsy Greenleaf continues her Hormones 101 series with a deep dive into estrogen—one of the most misunderstood hormones in the human body. Estrogen influences far more than reproduction. It plays important roles in the brain, bones, cardiovascular system, skin, sexual health, urinary health, metabolism, immune function, and even the mitochondria that help power your cells. Dr. Greenleaf explores how estrogen is made, the different types of estrogen, what happens during menopause, bioidentical hormones, estrogen metabolism, hormone replacement therapy, and why decades of fear surrounding estrogen deserve a closer look. What You'll Learn in This Episode • What estrogen actually does throughout the body • Why both women AND men need estrogen • How cholesterol is used to make steroid hormones • How stress can influence hormone production and reproductive function • The difference between estradiol (E2), estrone (E1), estriol (E3), and estetrol (E4) • How testosterone can be converted into estrogen through aromatase • Why estrogen continues to be produced after menopause • How body composition can influence estrogen levels • How estrogen affects the brain, bones, heart, skin, vagina, bladder, and sexual health • What "bioidentical estrogen" actually means • Why different hormone delivery methods have different effects and risks • How the Women's Health Initiative changed the way women and physicians viewed hormone therapy • Common myths about estrogen and menopause How Does Your Body Make Estrogen? Estrogen doesn't simply appear in the ovaries. The steroid hormone pathway begins with cholesterol. Cholesterol is converted into pregnenolone, which can travel through pathways leading to progesterone, DHEA, testosterone, estrogen, and other steroid hormones. Through an enzyme called aromatase, testosterone can be converted into estradiol. Aromatase is found in tissues including the ovaries, fat, brain, skin, bone, placenta, and cardiovascular system. This is one reason estrogen doesn't completely disappear after menopause—and why men need estrogen too. Estrogen Is a Whole-Body Hormone Estrogen receptors are located throughout the body. In the brain, estrogen influences neurotransmitters, mitochondrial function, glucose metabolism, neuronal connections, mood, memory, and cognition. In bone, estrogen helps regulate the balance between bone breakdown and rebuilding. Declining estrogen during menopause contributes to increased osteoporosis and fracture risk. Estrogen also affects collagen, skin, cardiovascular function, vaginal tissue, bladder health, sexual function, and urinary symptoms. That's why menopause can feel like so much more than hot flashes. Bioidentical vs. Non-Bioidentical Estrogen "Bioidentical" describes molecular structure—not whether a hormone came from a pharmacy or compounding pharmacy. Bioidentical estradiol has the same molecular structure as estradiol produced by the human body, and many FDA-approved hormone products contain bioidentical estradiol. Compounded hormones can also be bioidentical, but "bioidentical" does not automatically mean compounded, safer, or more effective. Estrogen can also be delivered orally, transdermally, vaginally, or by other routes, each with different pharmacologic effects and risk profiles. Why Did Estrogen Become So Feared? The 2002 Women's Health Initiative dramatically changed public perception of menopausal hormone therapy. Headlines focused on breast cancer, stroke, and cardiovascular risk, leading many women to stop hormone therapy and many clinicians to become reluctant to prescribe it. Dr. Greenleaf discusses why the type of hormones studied, age of participants, timing of therapy, and differences between study groups matter when interpreting those findings. Estrogen Myths Estrogen is not simply a reproductive hormone. Men need estrogen too. Menopause doesn't mean the body suddenly stops benefiting from estrogen. And the relationship between estrogen and breast cancer is more complex than saying "estrogen causes cancer." G
- Sep 20, 202642 min
S1E30 Hormones 101: What They Are, How They Work & Why They Matter After 40
What if the fatigue, weight changes, brain fog, poor sleep, anxiety, low libido, or changes in your workouts aren't simply signs of getting older? In this solo episode of 40s Forward, Dr. Betsy Greenleaf goes back to the basics with Hormones 101—a foundational guide to what hormones actually are, how they communicate throughout the body, and why understanding them becomes increasingly important after 40. This episode kicks off a deeper hormone series exploring estrogen, progesterone, testosterone, thyroid hormones, cortisol, insulin, DHEA, oxytocin, growth hormone, and more. What You'll Learn in This Episode • What hormones actually are and how they communicate with your cells • Where hormones are produced throughout the body • How hormonal feedback loops maintain balance • Why hormones affect much more than reproduction • How hormones influence mood, memory, metabolism, sleep, skin, bones, and libido • Why hormonal changes often become noticeable after 40 • The roles of estrogen, testosterone, progesterone, and thyroid hormones • Why hormones never work independently • How stress, nutrition, sleep, inflammation, the microbiome, and genetics interact with hormones • Why hormone therapy should be individualized What Are Hormones? Think of your body as an enormous company with trillions of employees. Your cells perform different jobs, but they need a way to communicate. Hormones are those messengers. Produced throughout the body, hormones travel through the bloodstream carrying instructions that influence growth, repair, metabolism, blood sugar, bone health, sleep, hunger, mood, sexual desire, reproduction, and much more. Hormones don't do the work themselves—they tell your cells what to do. Your Body Is an Endocrine Network Hormones don't come only from the ovaries or testes. The brain, pituitary, hypothalamus, thyroid, adrenal glands, pancreas, ovaries, testes, fat tissue, intestines, kidneys, heart, bones, and muscles all participate in this sophisticated communication network. Dr. Greenleaf explains hormonal feedback loops using the analogy of a thermostat: the body constantly senses what it needs and adjusts its signals to maintain balance, or homeostasis. Hormones Are Life Hormones Estrogen isn't just about periods and reproduction. Testosterone isn't just about muscle and sex drive. Progesterone isn't only about pregnancy. These hormones influence the brain, bones, cardiovascular system, metabolism, immune function, mood, energy, sleep, skin, pelvic health, and more. Thyroid hormones also play an essential role in metabolism, temperature regulation, heart rate, digestion, hair, skin, nails, brain function, and energy production. Why Everything Can Feel Different After 40 Hormones rarely disappear overnight. They fluctuate and change over time. That may show up as: • Fatigue • Weight gain • Anxiety or mood changes • Brain fog or memory changes • Aching joints • Low motivation • Lower sex drive • Sleep disruption • Skin changes • Workouts that suddenly don't seem to work These symptoms aren't always caused by hormones—but hormones interact with nearly every system involved. Don't Chase Hormones—Chase Physiology One of Dr. Greenleaf's most important messages is that hormone optimization is about more than simply replacing a number on a lab test. Nutrition, sleep, stress, movement, genetics, inflammation, environmental exposures, medications, trauma, and the microbiome can all influence how your body produces, processes, and responds to hormones. That's why hormone therapy isn't one-size-fits-all. Do You Need Hormone Replacement Therapy? Hormones can be a valuable tool, but Dr. Greenleaf emphasizes individualized decision-making. Whether to start hormone therapy, continue it, or eventually stop should involve an informed conversation about your symptoms, health, risks, goals, and quality of life—not a blanket recommendation that everyone should or shouldn't take hormones. Key Takeaways • Hormones are chemical messengers affecting nearly every body system • Hormonal health is about much more than reproduction • Estrogen, progesterone, testosterone, and thyroid hormones have widespread effects • Hormonal changes can contribute to symptoms after 40 • Hormones interact with sleep, stress, nutrition, inflammation, and the microbiome • Hormone therapy should be personalized • Understanding your hormones can help you better understand your body Who This Episode Is For • Women and men over 40 noticing changes in how they feel • Anyone navigating perimenopause, menopause, or andropause • People experiencing fatigue
- Sep 8, 202629 min
S129 The More Mindset: How to Reinvent Your Life After 40 with Diana Pagano
In this episode of 40s Forward, Dr. Betsy Greenleaf sits down with Diana Pagano, international keynote speaker, two-time national bestselling author, action-driven mindset coach, and entrepreneur who helps people break through barriers and create exponential results in business and life. As a first-generation Mexican-American and former single mother, Diana's journey from adversity to achievement led her to become fascinated with mindset, human behavior, and one powerful question: Why do some people move forward despite setbacks while others remain stuck? Together, Dr. Greenleaf and Diana explore how the stories we tell ourselves shape our lives, why it's never too late to reinvent yourself, and how changing your mindset—combined with intentional action—can open possibilities you may have stopped believing were possible. What You'll Learn in This Episode • Why it's never too late to change your life • How your internal narrative can keep you stuck • Why focusing on what went wrong can reinforce negative patterns • How to shift from a victim mindset toward personal responsibility • Why looking inward doesn't mean blaming yourself • How your beliefs influence what you notice and pursue • Why manifestation requires more than positive thinking • How clarity, intention, and action work together • Why imposter syndrome can affect even highly accomplished people • How purpose can create motivation beyond money or external success The Stories We Tell Ourselves Have you ever thought, "It's too late for me," "This always happens to me," or "I'm just unlucky"? Diana explains how repeatedly focusing on these narratives can influence what we notice and how we respond to opportunities. She discusses the reticular activating system and why consciously shifting your focus can help you recognize possibilities that were there all along. Dr. Greenleaf shares a revealing exercise in which she wrote down significant events from her life—only to realize she had focused almost entirely on the difficult ones while overlooking marriage, children, and other positive milestones. Sometimes changing your life begins with changing what you're paying attention to. Look Inward Without Blaming Yourself When relationships, careers, or businesses go wrong, it's easy to focus entirely on what someone else did. Diana challenges listeners to ask: "What part did I play?" That doesn't mean accepting blame for someone else's behavior. Instead, it means identifying what you can learn, where boundaries may have been needed, and what you can do differently moving forward. Taking ownership of what you can control gives you the power to change what happens next. Manifestation Requires Action Positive thinking alone isn't a strategy. Diana explains that achieving a goal requires getting specific about what you actually want, developing enough belief that it's possible, imagining what taking action looks like—and then doing the work. Whether you're building a business, writing a book, finding love, or reinventing yourself after 40, clarity creates direction and action creates results. Breaking Through Imposter Syndrome Do you need another degree, credential, or accomplishment before you're "qualified" to pursue what you want? Diana shares her own struggle with imposter syndrome while writing her book. Eventually, she recognized that her lived experience, coaching work, and the transformations she had witnessed had value. Your story doesn't have to be more dramatic than someone else's to matter. The More Mindset Diana's book, The More Mindset, explores the tools and strategies she has used personally and with hundreds of coaching clients to identify hidden blocks and move through difficult periods of life. Her message is simple: Don't wait for the money, relationship, career, or perfect circumstances to give yourself permission to be happy or pursue more. Start now. Key Takeaways • Reinvention doesn't have an age limit • Your internal narrative influences your actions and opportunities • Personal responsibility creates power to move forward • Focusing on what went right can change your perspective • Big goals require clarity, belief, intention, and action • Imposter syndrome shouldn't determine your potential • Purpose creates fulfillment that achievement alone cannot • You are capable of pursuing more at any stage of life Who This Episode Is For • Women wondering if it's too late to start over • Anyone navigating a career, relationship, or life transition • Entrepreneurs struggling with confidence or self-doubt • People experiencing imposter syndrome • Anyone feeling stuck by past experiences • Wo
- Aug 21, 202628 min
S1E28 Why You Can't Lose Weight After 40 with Dr. Sherry Brewer
In this episode of 40s Forward, Dr. Betsy Greenleaf sits down with Dr. Sherry Brewer, double board-certified physician in internal medicine and integrative medicine, certified functional medicine practitioner, founder of Body by Alchemy, and author of Why You Can't Lose Weight. Dr. Brewer knows weight-loss resistance personally. During perimenopause, while navigating divorce, exercising intensely, eating a Paleo diet, and seemingly doing everything "right," she gained about 20 pounds. That experience sent her searching beyond the traditional calories-in, calories-out model. Together, Dr. Greenleaf and Dr. Brewer explore why the strategies that worked in your 20s and 30s may stop working after 40—and how hormones, stress, sleep, muscle, blood sugar, nutrition, and the gut microbiome can influence metabolic health. What You'll Learn in This Episode • Why eating less and exercising more can backfire in midlife • How perimenopause and menopause change metabolism • Why intense exercise may raise blood sugar when the body is already stressed • How under-eating can contribute to weight-loss resistance • Why protein becomes increasingly important after 40 • The importance of preserving and building muscle • Why extreme intermittent fasting may not be ideal for every woman • How sleep deprivation affects blood sugar and metabolic health • Why whole foods and processed foods can affect the body differently • How the gut microbiome may influence metabolism and weight Why Calories In, Calories Out Isn't the Whole Story Calories matter, but Dr. Brewer explains why metabolism is far more complicated than simple math. Food quality, insulin response, meal timing, circadian rhythms, stress, sleep, muscle mass, and the microbiome can all influence how the body responds to what we eat. For women who have spent years restricting calories, simply eating even less may not be the answer. Dr. Brewer discusses how she sometimes uses a gradual "reverse dieting" approach to increase intake. Are You Eating Enough Protein? One of the biggest mistakes Dr. Brewer sees is women starting the day with too little protein. A couple of eggs, oatmeal, yogurt, fruit, or granola may sound healthy, but she recommends focusing on approximately 30–40 grams of protein at the first meal. And breakfast doesn't have to look like breakfast. Leftover dinner, fish, vegetables, or other protein-rich whole foods can work just as well. Intermittent Fasting, Muscle & Menopause Intermittent fasting can be useful, but more isn't necessarily better. Dr. Brewer cautions against routinely eating one meal a day or severely restricting eating windows if it makes it difficult to consume adequate protein and preserve muscle. Muscle is metabolically important. It supports bones, glucose regulation, body composition, and healthy aging—making resistance training especially important during and after menopause. The Midlife Exercise Mistake More cardio isn't always better. Dr. Brewer identifies three common problems she sees in women struggling with body composition: • Under-eating • Over-exercising • Not lifting heavy enough weights As hormones change, the body may become more sensitive to stress. Strength training, recovery, adequate nutrition, and sleep may be more beneficial than continually adding more high-intensity exercise. Sleep May Be the Missing Metabolic Tool Sleep isn't optional when it comes to metabolic health. Dr. Brewer shares her own continuous glucose monitoring experiences showing how dramatically her glucose levels can change after inadequate sleep. Prioritizing sleep may be one of the simplest—and least expensive—strategies for supporting blood sugar, metabolism, energy, and weight management. Don't Forget the Gut Dr. Brewer performs microbiome testing on her patients because gut health may reveal issues even when someone doesn't have obvious digestive symptoms. She discusses dysbiosis, microbial diversity, digestion, inflammation, fiber intake, estrogen metabolism, and how medications, antibiotics, menopause, and other factors can alter the microbiome. Key Takeaways • Weight-loss resistance after 40 is not simply about willpower • Chronic calorie restriction may work against your goals • Prioritize protein and preserve muscle as you age • Strength training becomes increasingly important in menopause • Extreme fasting isn't appropriate for everyone • Whole foods should form the foundation of your diet • Sleep has a powerful effect on metabolic health • Gut health may be an overlooked piece of weight-loss resistance Who This Episode Is For • Women gaining weight despite eating healthy and exercisin
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About 40s Forward
40s Forward PodcastLife after 40 isn't about slowing down—it's about leveling up40s Forward is the podcast for high-achieving men and women who want more energy, sharper focus, stronger bodies, better sex, and longer healthspan. Hosted by Dr. Betsy Greenleaf, board-certified physician and founder of the International Pause Institute, each episode blends cutting-edge medical insight with real-world strategies for optimizing midlife performance.From hormones, metabolism, and longevity to biohacking, peptides, sexual wellness, and mindset, this show delivers science without hype for people who invest in their health the same way they invest in their success.This isn't anti-aging.It's forward living.
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It's a free AI-powered email that summarizes new episodes of 40s Forward as soon as they're published. You get the key takeaways, notable quotes, and links & mentions — all in a quick read.
How does the 40s Forward podcast summary work?
When a new episode drops, our AI transcribes and analyzes it, then generates a personalized summary tailored to your interests and profession. It's delivered to your inbox every morning.
Is this an official 40s Forward product?
No. Podzilla is an independent service that summarizes publicly available podcast content. We're not affiliated with or endorsed by Dr. Betsy Greenleaf.
Can I get summaries of other podcasts too?
Absolutely! The free plan covers up to 3 podcasts, any in the catalog. Basic raises that to 15, Pro to 40 and Max to 100. Browse our full catalog at /podcasts.
What topics does 40s Forward cover?
40s Forward covers topics including Fitness, Health & Fitness, Alternative. Our AI identifies the specific themes in each episode and highlights what matters most to you.
Start getting 40s Forward summaries tomorrow morning.
Free forever for up to 3 podcasts. No credit card required.
Free forever for up to 3 podcasts. No credit card required.