The Modern Midlife Collective

Dr. Ade Akindipe, DNP, MBA, APRN, FNP-C and Dr. Jillian Woodruff, MD, FACOG, NCMP

Welcome to The Modern Midlife Collective—where midlife isn’t a crisis, it’s a rebirth. Hosted by Dr. Ade Akindipe, DNP, and Dr. Jillian Woodruff, MD, this is the podcast for women ready to unapologetically own their power, thrive through the ups and downs of hormones, weight, and self-care, and show the world that thriving at 40 and beyond isn’t just possible—it’s your birthright. Biweekly, we bring you science-backed insights on hormones, menopause, longevity, and sexual health—real tools to empower women in midlife and beyond. With a fearless blend of functional medicine, real-life wisdom, and no-nonsense empowerment, we’re here to challenge the norms, break through the barriers, and help you step into a life of vitality, confidence, and unstoppable strength. Ready to rise? Let’s do this.

  1. 3d ago

    Episode 34: "I'm in Perimenopause — How Do I Know When It's Time to Start Estrogen?"

    I’m in Perimenopause — How Do I Know When It’s Time to Start Estrogen? Episode Overview In this solo episode, Dr. Jillian Woodruff tackles one of the most common and nuanced questions in menopause medicine: How do you know when it’s time to start estrogen? Recorded while on a family vacation on the East Coast — because some topics are too important to wait — Dr. Jillian walks through the practical clinical framework she uses every day in her practice. She covers the signals she looks for, why laboratory results alone are not enough to guide this decision, and why perimenopause is often the optimal time to begin the conversation — not years later when symptoms have already disrupted sleep, mood, cognition, intimacy, and quality of life. The episode also covers the relationship between estrogen and periods — including why estrogen can sometimes make bleeding worse in early perimenopause — the non-negotiable role of progesterone in any woman with a uterus on systemic estrogen, and a full discussion of Genitourinary Syndrome of Menopause (GSM) and why painful sex, vaginal dryness, and recurrent UTIs are treatable and should never be accepted as inevitable parts of aging. Key Takeaways You do not have to wait until symptoms become severe before discussing hormone therapy.Perimenopause is often the ideal time to begin evaluating treatment options.New symptoms matter more than isolated laboratory values.Hot flashes and night sweats are more than inconveniences and can affect overall health and quality of life.Early bone loss may be an important reason to discuss hormone therapy.Mood and cognitive changes may have hormonal contributors.Progesterone is often the first hormonal intervention considered in early perimenopause.Women with a uterus who use systemic estrogen require endometrial protection with progesterone or a progestin.Vaginal estrogen is a separate treatment category from systemic hormone therapy and has a different risk profile.GSM is common, progressive, and highly treatable. Resources Mentioned The  Menopause Society certified provider finder: www.menopause.orgSend your questions: connect@modernmidlifecollective.comWatch the video version: youtube.com/@drjillianwoodruff (available June 10, 2026)www.modernmidlifecollective.com About Dr. Jillian Woodruff, MD Dr. Jillian Woodruff, MD is a board-certified OB-GYN, gynecologic surgeon, and Menopause Society Certified Practitioner. She is the founder of Modern Gynecology & Skin in Anchorage, Alaska, and co-host of The Modern Midlife Collective podcast with Dr. Ade Akindipe, DNP. SCIENTIFIC REFERENCES AND BIBLIOGRAPHY Professional Guidelines The Menopause Society. The 2022 Hormone Therapy Position Statement of The Menopause Society. Menopause. 2022;29(7):767–794. American College of Obstetricians and Gynecologists. Hormone Therapy for Menopause. ACOG Practice Guidance and FAQ. Washington, DC: ACOG; updated 2022. SWAN Study — Vasomotor Symptoms and Duration Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015;175(4):531–539. SWAN Study — Vasomotor Symptoms and Cardiovascular Risk Thurston RC, El Khoudary SR, Sutton-Tyrrell K, et al. Vasomotor symptoms and cardiovascular risk in midlife women. Menopause. 2011;18(2):146–151. Perimenopausal Depression and PMDD History Cohen LS, Soares CN, Vitonis AF, Otto MW, Harlow BL. Risk for new onset of depression during the menopausal transition: the Harvard Study of Moods and Cycles. Arch Gen Psychiatry. 2006;63(4):385–390. Freeman EW, Sammel MD, Liu L, Gracia CR. Association of hormones and menopausal status with depressed mood in women with no history of depression. Arch Gen Psychiatry. 2004;61(1):62–70. GSM — Management and Treatment Faubion SS, Larkin LC, Stuenkel CA, et al. Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer. Menopause. 2018;25(6):596–608. Faubion SS, Sood R, Kapoor E. Genitourinary syndrome of menopause: management strategies for the clinician. Mayo Clin Proc. 2017;92(12):1842–1849. Bone Loss and Estrogen in Perimenopause Sowers MR, Zheng H, Jannausch ML, et al. Amount of bone loss in relation to time around the final menstrual period and follicle-stimulating hormone staging of the transmenopause. J Clin Endocrinol Metab. 2010;95(5):2155–2162. Perimenopause as Clinical Diagnosis — Lab Limitations Santoro N, Roeca C, Peters BA, Neal-Perry G. The menopause transition: signs, symptoms, and management options. J Clin Endocrinol Metab. 2021;106(1):1–15. Endometrial Protection — Unopposed Estrogen Grady D, Gebretsadik T, Kerlikowske K, Ernster V, Petitti D. Hormone replacement therapy and endometrial cancer risk: a meta-analysis. Obstet Gynecol. 1995;85(2):304–313.

    25 min
  2. May 20

    Episode 33: Why Your Doctor Says You're Fine — And Why You're Not" The Complete Protocol for Midlife Fatigue (Part 3)

    You have been exhausted. You went to the doctor. Your labs came back normal. And somehow that made it worse — because now you have no explanation, no answers, and a quiet suspicion that something is still very wrong. You are not imagining it. And this episode is where it finally gets addressed. In the third and final episode of our fatigue series, Dr. Jillian and Dr. Ade deliver the complete clinical protocol: the labs that actually reveal what is driving your fatigue, the supplement stack with the full reasoning behind every ingredient, and the exact language to use when you sit down with your provider so you walk out with something more useful than a recommendation to sleep more. This is the episode you bring to your next appointment. Free Download Fatigue Protocol Everything covered in today's episode — the complete lab panel organized by tier, the supplement stack with ingredient breakdown and dosing, patient advocacy language, and a quick-reference symptom guide — is available as a free download. Get the Complete Fatigue Protocol at modernmidlifecollective.com/fatigue Missed Parts 1 and 2? Episode 31 — Why Am I Always Tired? The Root Causes of Fatigue Part 1 Covers: sex hormone dysregulation, thyroid dysfunction, and HPA axis dysregulation Episode 32 — Why Am I Always Tired? The Root Causes of Fatigue Part 2 Covers: blood sugar dysregulation, nutrient deficiencies, and chronic low-grade inflammation Labs Discussed in This Episode Tier One — First Visit Essentials Hormones: Estradiol (E2), Free and Total Testosterone, Progesterone, DHEA-S, FSH, LH, SHBG Thyroid: TSH, Free T3, Free T4, TPO Antibodies Metabolic: Fasting Insulin, Fasting Glucose, HOMA-IR, Hemoglobin A1c, Comprehensive Metabolic Panel, Fasting Lipid Panel Nutrients: Ferritin (target 70 to 100 ng/mL), 25-OH Vitamin D (target 50 to 80 ng/mL), Vitamin B12 Inflammation: High-Sensitivity CRP (hsCRP) Tier Two — Added Based on Clinical Picture Thyroid extended: Reverse T3, Anti-Thyroglobulin Antibodies Adrenal: 4-Point Salivary Cortisol and DHEA (functional lab — typically requires a functional medicine or integrative provider) Metabolic extended: Continuous Glucose Monitor (CGM) trial Nutrients extended: RBC Magnesium, Folate, Zinc, IGF-1 Gut: Comprehensive Stool Analysis (functional lab) Supplements Discussed Full supplement collection available through Dr. Jillian's professional dispensary: https://us.fullscript.com/plans/moderngynecology-modern-midlife-collective-s-fatigue-protocol Magnesium Glycinate — sleep, nervous system support, restless legs. 300 to 400 mg at night. Magnesium Malate — daytime energy and muscle function. 200 to 400 mg with food. CoQ10 Ubiquinol — mitochondrial energy chain. Non-negotiable for statin users. 100 to 300 mg daily. Berberine — insulin sensitivity and metabolic support. 500 mg with meals, titrate slowly. Myo-Inositol with D-Chiro-Inositol (40:1 ratio) — insulin sensitivity and hormonal balance. 2 to 4 grams daily. Ashwagandha standardized extract — HPA axis and cortisol rhythm support. 300 to 600 mg daily. Rhodiola Rosea — cognitive fatigue and stress resilience. 200 to 400 mg in the morning. Phosphatidylserine — evening cortisol reduction; wired-but-tired pattern. 100 to 300 mg at night. Methylated B Complex — neurological energy and cortisol metabolism. Critical for women on oral contraceptives, PPIs, or metformin. Vitamin D3 with K2 MK-7 — immune, hormonal, and energy support. 5,000 IU D3 with 100 mcg K2 daily with food. Omega-3 EPA and DHA — anti-inflammatory and cardiovascular support. 2 to 4 grams of combined EPA and DHA daily. Full curated supplement collection with professional-grade brands: modernmidlifecollective.com/fatigue Research Cited Women's Health (London) — 67% Fatigue Prevalence in Perimenopausal Women (n=3,000+) Menopause Journal (March 2025) — AUB, Iron Depletion and Fatigue During Perimenopause (n=2,300+) AIMS Molecular Science (2024) — Estrogens and Mitochondrial Biogenesis Frontiers in Endocrinology (2024) — Mitochondrial Dysfunction and Insulin Resistance The American Journal of Medicine (2025) — HPA Axis Dysregulation: Integrative Review PMC UK Survey (2025) — Fatigue in Treated Hypothyroidism (n=1,251; 89% abnormal fatigue) XX Midlife Women's Health Study — Stress-Fatigue Coupling Across Menopause Transition WellnessExtract Research (2025) — IL-6, TNF-alpha, and Perimenopause Inflammation Connect With Us Website: modernmidlifecollective.com Free Fatigue Protocol: modernmidlifecollective.com/fatigueInstagram: @modernmidlifecollective Email: connect@modernmidlifecollective.com Work With Dr. Jillian Modern Gynecology and Skin | Anchorage, Alaska  Instagram: @drjillianwoodruff Transcend Retreat Waitlist: https://moderntranscend.com/retreat-waitlist Website: www.moderngynalaska.com  Work With Dr. Ade Rejuvenate Health and Wellness | Anchorage, Alaska   Website: www.rejuvenatehealthak.com  Download Dr. Ade’s Metabolic Reset Cheat Sheet https://rejuvenatehealthakrlt.com/metabolic-reset  Take your Midlife Vitality Quiz https://dr-ade-the-vitality-gap-scorecard.scoreapp.com/  Instagram: @rejuvenate_health_wellness | @dr.adeakindipednp Both practices serve patients in the state of Alaska. Leave a Review If this episode or this series helped you, leaving a review on Apple Podcasts takes 60 seconds and helps other women find the show. We read every one. The Modern Midlife Collective Dr. Jillian Woodruff, MD, FACOG, MSCP x Dr. Ade Akindipe, DNP, MBA, APRN modernmidlifecollective.com

    58 min
  3. Apr 22

    Episode 31: Why Am I So Tired All the Time? (It’s Not What You Think)

    Do you feel exhausted all the time—even after sleeping?Like your energy just isn’t the same anymore… and no one can explain why? In this episode of The Modern Midlife Collective, Dr. Jillian Woodruff and Dr. Ade Akindipe break down midlife fatigue—why it’s so common in perimenopause and menopause, what’s actually happening in your body, and why “just pushing through” isn’t the answer. This isn’t normal tiredness.This is persistent, unexplained fatigue—and it’s often a combination of hormonal shifts, stress, sleep disruption, and metabolic changes happening at the same time. In this episode, you’ll learn: The difference between tiredness vs true fatigueWhy estrogen decline affects cellular energy production (mitochondria)How progesterone impacts sleep and nighttime anxietyThe role of testosterone in motivation, stamina, and mental clarityWhy thyroid dysfunction is often missed in womenWhat most doctors miss when only testing TSHHow chronic stress disrupts your cortisol rhythm (HPA axis)What “wired but tired” really meansWhy high-achieving women feel depleted—even when life looks “fine” ✨ You are not lazy.✨ You are not unmotivated.✨ Your body is responding to real physiological changes. If you’re in your 40s, 50s, or beyond and feel like your energy has completely changed—this episode will help you understand why. 🎧 Listen now—and don’t miss Part 2, where we break down exactly how to test, evaluate, and fix what’s driving your fatigue. 📩 Have questions or topics you want us to cover?Email us at connect@modernmidlifecollective.com #MidlifeFatigue#Perimenopause#Menopause#HormoneHealth#WomensHealth#ChronicFatigue#ThyroidHealth#AdrenalHealth#WomenOver40#ModernMidlifeCollective

    33 min
  4. Apr 8

    Episode 30: Why Women Live Longer—But Age Worse (And What to Do About It)

    Women live longer than men—but often spend more years in poor health. So what’s missing? In this episode of The Modern Midlife Collective, Dr. Jillian Woodruff and Dr. Ade Akindipe unpack the critical difference between lifespan and healthspan—and why so many women are living longer but not necessarily living well. This conversation challenges the traditional narrative around aging and shifts the focus toward what actually matters: quality of life, metabolic health, muscle preservation, and hormonal balance. We explore how ovarian aging, hormonal shifts, and metabolic changes uniquely impact women in midlife—and why many mainstream health strategies fail to address these realities. If you’ve ever felt like the wellness world is full of noise, trends, and conflicting advice, this episode brings you back to what truly moves the needle. ✨ Living longer is not the goal. ✨ Living well is. ✨ And that starts with understanding how your body changes in midlife. In this episode, we discuss:  The difference between lifespan and healthspan—and why it matters for women  Why women live longer but experience more chronic disease  How ovarian aging impacts overall health and longevity  The role of estrogen decline in metabolic and cardiovascular health  Why muscle is one of the most important factors in healthy aging  The connection between insulin resistance and midlife disease risk  How strength training supports longevity and metabolic health  The truth about “biohacking” and why more isn’t always better  Where hormone therapy fits into long-term health strategies  What actually moves the needle for aging well after 40 The truth about women’s longevity Longevity is not just about adding years to your life. It’s about preserving strength, function, independence, and vitality. For women, that means shifting the focus from quick fixes and trends to foundational health strategies that support the body through hormonal and metabolic transitions. Because aging is inevitable. But how you age is not. 🎧 If this episode resonated with you, share it with a woman who wants to feel strong, capable, and supported as she ages. 📩 Have a topic you want us to cover? Email us at connect@modernmidlifecollective.com  #MidlifeWomen #MenopauseMatters #Healthspan #WomenOver40 #HormoneHealth #AgingWell #MetabolicHealth #LongevityForWomen #Perimenopause #StrongAtAnyAge

    45 min
  5. Mar 25

    Episode 29: GLP-1s and Hormones: What Your Doctor Isn’t Telling You About Taking Both

    If you're in midlife and taking a GLP-1 medication like Ozempic, Wegovy, Mounjaro, or Zepbound—and you're also on hormone replacement therapy (HRT)—this is a conversation you need to hear. Because there’s something most women aren’t being told… 👉 These medications may be interacting in ways that affect your hormones, metabolism, and overall safety. In this episode of The Modern Midlife Collective, Dr. Jillian Woodruff and Dr. Ade Akindipe break down the science behind GLP-1 medications and hormone therapy, including how drugs like semaglutide and tirzepatide impact digestion, medication absorption, and weight loss in perimenopause and menopause. You’ll learn how GLP-1s can improve metabolic health, insulin resistance, and visceral fat, while hormone therapy supports estrogen balance, energy, and body composition—and why combining them may lead to even better results. But here’s the critical piece most providers are missing… GLP-1 medications slow gastric emptying, which may reduce the absorption of oral progesterone, potentially impacting endometrial protection and uterine health. This episode connects the dots between hormones, weight loss medications, gut health, and midlife metabolism—so you can make informed, empowered decisions about your care. 💫 💡 In This Episode, We Cover:  GLP-1 medications explained (Ozempic, Wegovy, Mounjaro, Zepbound)  Hormone replacement therapy (HRT) in perimenopause and menopause The link between estrogen, metabolism, and weight gain in midlife How GLP-1s affect digestion, gut motility, and medication absorption Risks of oral progesterone while on GLP-1 therapy Safer options like transdermal estrogen, progesterone IUD, and vaginal progesterone Muscle loss with GLP-1s and how to protect lean body mass Nutrition, protein intake, and strength training for midlife women 5 essential questions to ask your doctor ✨ Who This Episode Is For:  Women in perimenopause or menopauseAnyone taking or considering GLP-1 weight loss medicationsWomen on hormone therapy or estrogen therapyThose struggling with weight gain, belly fat, insulin resistance, or low energyWomen who want to optimize their metabolic health and longevity💬 The Bottom Line GLP-1 medications and hormone therapy are two of the biggest tools in modern women’s health—but they don’t work in isolation. Understanding how they interact can help you protect your hormones, metabolism, and long-term health. You deserve care that connects all the dots. 💕 📩 Have Questions? We’d love to hear from you.If you have questions, concerns, or topics you want us to cover, email us at: connect@modernmidlifecollective.com You’re not alone in this—we’re learning, navigating, and thriving together. 💫

    40 min
  6. Mar 11

    Episode 28 — Why You’re Bloated in Midlife: Gut Health, Estrogen & Metabolism Explained

    If you’ve started feeling bloated, heavy, or uncomfortable after meals—even though you’re eating the same way you always have—you’re not imagining it. In this episode of The Modern Midlife Collective, Dr. Jillian Woodruff continues her conversation with functional nutritionist Ashley Koch to explore how digestion, hormones, and metabolism intersect during midlife. This is Part 2 of our conversation about midlife metabolism, where we focus on one of the most common concerns women experience during perimenopause and menopause: changes in digestion. As estrogen fluctuates, it influences far more than reproductive health. Hormonal shifts affect gut motility, microbial diversity, inflammation, insulin sensitivity, and even how the body processes hormones through the digestive system. Many women begin noticing new symptoms such as bloating, slower digestion, food sensitivities, and increased inflammation—often without realizing these changes are tied to hormonal and metabolic shifts. This episode connects the dots between gut health, hormone regulation, stress, alcohol, nutrition, and metabolic stability, offering both science and practical strategies to support the body during this stage of life. ✨ Your body is not failing.✨ It is adapting to hormonal and metabolic changes.✨ And understanding those changes allows you to respond with strategy instead of frustration. In this episode, we discuss: Why digestion often slows during perimenopauseHow estrogen influences gut bacteria and microbial diversityThe connection between gut inflammation, insulin resistance, and visceral fatWhy many women develop new bloating or food sensitivities in midlifeHow chronic stress and cortisol disrupt digestion and gut balanceWhat alcohol does to estrogen metabolism, sleep, and inflammationThe difference between soluble and insoluble fiber—and why both matterWhy plant diversity supports a healthy gut microbiomeHow protein intake protects muscle and metabolic stabilityWhy resistance training is essential for insulin sensitivity and metabolic healthWhy hormone therapy may help—but works best alongside lifestyle supportThe truth about midlife digestion and metabolism Many of the symptoms women experience in midlife—bloating, slower digestion, metabolic shifts—are not random. They are signals that the body is responding to hormonal changes. When we understand what is happening physiologically—in the gut, in our muscles, and in our hormones—we can support the body more effectively. Because midlife is not decline.It is recalibration. 👩‍⚕️ Guest: Ashley Koch, Functional NutritionistWebsite: www.ashleyknutrition.com Ashley specializes in helping women improve metabolic health, gut function, and hormone balance through personalized nutrition and lifestyle strategies designed specifically for midlife physiology. 🎧 If this episode resonated with you, share it with a woman who’s wondering why her body suddenly feels different. 📩 Have a topic you want us to cover?Email us at connect@modernmidlifecollective.com #MidlifeWomen #GutHealth #HormoneHealth #Perimenopause #MetabolicHealth #WomenOver40 #FunctionalNutrition #ModernMidlifeCollective

    35 min
  7. Feb 25

    Episode 27 - Stop Telling Women to Just Lose Weight: What’s Really Driving Midlife Weight Gain

    “Just lose weight.” How many women have heard that — without anyone asking why the weight is there? In this powerful episode of The Modern Midlife Collective, Dr. Jillian Woodruff sits down with functional nutritionist Ashley Koch to unpack what’s really driving weight gain in perimenopause and menopause — and why the old advice of “eat less, move more” often fails midlife women. Midlife weight gain is not a character flaw. It’s often a physiological shift. As hormones fluctuate, insulin sensitivity changes, muscle mass declines, stress increases, sleep quality drops, and the gut microbiome shifts — your metabolism adapts. And when those shifts aren’t properly evaluated, women are often dismissed instead of investigated. This episode challenges outdated weight-loss messaging and replaces it with evidence-based, compassionate insight. ✨ Your body isn’t broken. ✨ It’s responding to real metabolic and hormonal changes. ✨ And it deserves curiosity — not criticism. In this episode, we discuss: Why irregular periods and heavy bleeding can be metabolic warning signsHow insulin resistance develops in perimenopauseWhy thyroid dysfunction is frequently missed or undertreatedThe role of visceral fat as a hormonally active tissueHow the gut microbiome shifts during midlifeWhy calorie restriction alone fails many women after 40The importance of protein intake and muscle preservationHow strength training improves metabolic stabilityWhen hormone therapy may support metabolic healthThe truth about midlife weight gain Weight gain after 40 is rarely about willpower. It’s about hormones, metabolism, inflammation, stress physiology, and muscle loss interacting at the same time. When we understand the biology, we stop blaming ourselves — and start making smarter, more sustainable choices. Because thriving at 40 and beyond isn’t just possible — it’s your birthright. 👩‍⚕️ Guest: Ashley Koch, Functional Nutritionist Website: www.ashleyknutrition.com 🎧 If this episode resonated with you, share it with a woman who’s been told to “just lose weight” — and deserves better answers. 📩 Have a topic you want us to cover? Email us at connect@modernmidlifecollective.com #MidlifeWeightGain#Perimenopause#Menopause#HormoneHealth#WomensHealth#InsulinResistance#ThyroidHealth#MetabolicHealth#Over40Health#VisceralFat#MuscleAfter40#FunctionalNutrition#WeightLossAfter40#ModernMidlifeCollective

    32 min
5
out of 5
5 Ratings

About

Welcome to The Modern Midlife Collective—where midlife isn’t a crisis, it’s a rebirth. Hosted by Dr. Ade Akindipe, DNP, and Dr. Jillian Woodruff, MD, this is the podcast for women ready to unapologetically own their power, thrive through the ups and downs of hormones, weight, and self-care, and show the world that thriving at 40 and beyond isn’t just possible—it’s your birthright. Biweekly, we bring you science-backed insights on hormones, menopause, longevity, and sexual health—real tools to empower women in midlife and beyond. With a fearless blend of functional medicine, real-life wisdom, and no-nonsense empowerment, we’re here to challenge the norms, break through the barriers, and help you step into a life of vitality, confidence, and unstoppable strength. Ready to rise? Let’s do this.

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