Holley Fueled Nutrition Podcast · Holley Samuel

Nutrition & Training for Peri & Post Menopause with Melissa Azzaro RDN, LD

·1 hr 11 min·5 clips

Melissa Azzaro reveals how running the New York City Marathon led her to quit her advertising job and become a dietitian.

This episode features registered dietitian Holly Samuel interviewing fellow dietitian Melissa Azzaro, known as "The Hormone Dietitian," to discuss nutrition and training for athletes navigating perimenopause and postmenopause. Azzaro specializes in women's health, working with conditions like PCOS and endometriosis, and shares her personal journey through surgical menopause after a hysterectomy. The conversation defines perimenopause as a transition lasting up to 12 years, marked by symptoms like shorter cycles, heavy bleeding, sleep disturbances, and mood changes, while menopause is a single day one year after the final period. Azzaro explains that progesterone often declines first, affecting sleep and calmness, while later stages involve skipped periods and symptoms like hot flashes and fatigue. She details her own experience with a radical hysterectomy in December 2022 and the subsequent importance of pelvic floor physical therapy and increased protein for recovery. A key topic is the common frustration among athletes who find their usual diet and exercise routines no longer prevent body fat gain, particularly around the midsection. Azzaro attributes this shift to factors like declining estrogen, increased insulin resistance, lower testosterone, and high cortisol from life stressors. The discussion emphasizes that building muscle becomes difficult post-menopause, but maintaining lean mass through strength training is achievable and crucial. Azzaro shares that she lost over 52 pounds by prioritizing heavy weightlifting three times weekly and significantly increasing her protein intake, now eating over 2,000 calories daily to support her activity. She advises athletes to move away from chronic underfueling and excessive cardio, highlighting that muscle mass naturally declines after age 30 without targeted effort. For protein, she recommends roughly 0.7 to 1 gram per pound of body weight, aiming for about 120 grams daily for maintenance, and suggests eating protein first in meals to manage blood sugar. A surprising insight is that surgical menopause creates a sudden, severe hormonal shift compared to the brain's gradual adaptation over a decade in natural menopause. Azzaro notes that fat distribution changes, with less stored in the hips and thighs and more in the abdomen as estrogen drops. She also mentions that collagen in coffee, canned tuna, and doubling typical protein portions are practical strategies to increase intake. The episode challenges the common advice of "doing more mileage and eating less," advocating instead for a mindset shift towards eating to support workouts and build strength. The tone is conversational and educational, blending personal anecdotes with professional advice in a supportive, myth-busting manner. This episode is ideal for female endurance athletes in their mid-30s and beyond who are noticing changes in performance, body composition, or energy levels. Listeners interested in practical nutrition adjustments and strength training integration will find it valuable, while those seeking basic running nutrition tips without a hormonal focus might skip it.

As heard by us

A practical menopause conversation for athletes focused on better fuel and stronger training.

The episode treats peri- and post-menopause through a sports nutrition lens, with Holly Samuel and Melissa staying close to the practical levers that still matter: protein, wound healing, strength work, body fat shifts, and eating enough to keep training supported.

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Why you'd press play

You want menopause advice that respects your training load.

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