Managing Menopause and Beyond with Michelle Tollefson, MD, FACOG


Photo by Derick McKinney on Unsplash

Episode Summary

Menopause typically affects women in their mid-forties and fifties. Brought on by a decline in estrogen levels, this transitional period can often lead to challenging, uncomfortable symptoms such as hot flashes, insomnia, vaginal dryness, mood changes, and increased visceral fat.

Michelle Tollefson, MD, FACOG, is an obstetrician gynecologist, expert in lifestyle medicine, and a professor at the Metropolitan State University of Denver. Additionally, Michelle is a breast cancer survivor who experienced early menopause while undergoing chemotherapy treatments.

In this episode, she shares lifestyle strategies for managing menopausal symptoms, especially for women without the option of hormone replacement therapy. “I think so many women just say, ‘Well, I’m menopausal now and so I know I won’t sleep well, and I know I’ll leak urine, and I know that I’ll have vaginal dryness.’ So it’s really saying that there’s a different way to age.”

Michelle offers prescriptive advice on weekly physical activity, pelvic floor muscle exercises, sleeping techniques, and the types and quantities of whole foods that can help alleviate symptoms of menopause. Beyond this, Michelle delves into why exactly the body is experiencing these changes and how each lifestyle pillar aids at the physiological level.

Listen to the full episode to discover what might be disrupting your sleeping pattern, how the microbiome contributes to abdominal weight gain, and why mitochondria matter in menopause.

Here are the details of our conversation:

[00:01:11] Michelle’s journey in lifestyle medicine and breast cancer survivorship

[00:03:22] The hormonal “crash”

[00:05:21] An overview of lifestyle and menopause

[00:08:39] Teasing apart chemotherapy side effects and menopause symptoms

[00:09:34] Dietary advice for menopause symptom management

[00:11:43] Understanding the microbiome, inflammation, and weight gain

[00:13:16] This not that: what to eat to control menopause symptoms

[00:14:59] What kind of exercise and how much

[00:18:33] Which muscles to target in physical activity

[00:20:27] Genitourinary Syndrome of Menopause (GSM)

[00:25:18] How to address urinary leakage with your physician

[00:29:28] Reasons for fatigue and how to approach sleep

[00:33:20] Healthy aging trajectories

[00:37:55] The PAVING Program and workbook

Episode Notes

Dr. Michelle Tollefson is a lifestyle medicine expert and obstetrician-gynecologist. She is a pioneer in women’s health and lifestyle medicine and a professor at Metropolitan State University of Denver. She is the editor-in-chief of the textbook Improving Women’s Health Across the Lifespan and co-authored PAVING a Woman’s Path through Menopause and Beyond with Drs. Frates and Comander. Dr. Tollefson was one of the first physicians ever trained as a wellness coach. She is an international speaker, women’s health consultant, mother to three kids, and a breast cancer survivor/thriver.


Visit Michelle’s website at

Learn more about the PAVING the Path to Wellness program here

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