Perimenopause and Menopause: Exercise, Strength, and Holistic Wellness with Dr. Jessica Shepherd

Dr. Jessica Shepherd, OB-GYN and Chief Medical Officers at Hers, and Pvolve’s Clinical Advisor, is a leading expert in women’s health, specializing in perimenopause and menopause. She has dedicated her career to helping women navigate midlife with confidence, combining evidence-based medicine with holistic care. 

Dr. Shepherd shares insights on the importance of exercise during perimenopause and menopause, practical strength-training tips, and how women can support their bone, heart, and hormonal health. She also highlights the value of digital health platforms like Hers, which provide personalized treatment options and resources, empowering women to feel strong, supported, and confident through every stage of life.  

Why is exercise especially important during perimenopause and menopause?

Exercise is imperative during the perimenopause and menopausal transition as muscle mass is significantly declining during these years. Lean muscle mass declines 3 to 5% every decade and with the loss of estrogen, there is a compounded effect on the loss of muscle. The loss in estradiol is still believed to be the most important contributor in menopause-associated loss of muscle mass.

What are the most common challenges women face with their bodies and energy during this stage of life?

Women will often feel a decline in energy as there is change in metabolism, often changes in thyroid levels, and also the body’s ability to utilize glucose which can cause inflammation and deplete energy. The challenge faced by women in perimenopause and menopause is that it is a whole body experience in which every part of the body is experiencing change due to the decline in estrogen, progesterone and testosterone.

How does strength training, like Pvolve’s Menopause Strong program, support women during perimenopause and menopause?

There are changes to the entire body in perimenopause that can be experienced as pain, loss of lean muscle mass, and loss of bone density. This can lead to increased risk of fractures, and ligament injury. These symptoms can have a profound negative impact on the quality of life of postmenopausal women. That is why programs such as Menopause Strong are essential for movement and muscle strengthening.

Are there specific types of movement or exercises you recommend for maintaining bone, heart, and hormone health?

Strength training, mobility work, and adding progressive load is what I recommend for a strong foundation. Pvolve’s programming specifically focuses on these areas, and is designed to support bone density and muscle mass. Adding in weight loads and cardiovascular movements keeps the heart strong, while mobility and recovery help to regulate hormones by reducing inflammation and stress on the body. Together, they create the most powerful formula for longevity and balance.

How can women modify their workouts safely as their bodies change?

As our bodies change, it’s essential to listen closely and adjust intensity, recovery, and resistance. Women can focus on proper form, progressive strength training, and active recovery days to prevent injury while still challenging the body. The goal isn’t to do less - it’s to move smarter and in sync with your physiology.

Beyond exercise, what role does holistic care play in supporting women through perimenopause and menopause?

Movement is only one part of the equation. Nutrition, sleep, stress management, and community all play a vital role in balancing hormones and improving well-being during perimenopause and menopause. Taking a holistic approach allows women to support both their physical and emotional health through this transition.

Why has menopause been historically overlooked within the health sector? Why does it finally seem to be getting attention now?

For too long, women have been forced to navigate an outdated healthcare system that's often impersonal, inconvenient, and dismissive – a system that was not built for them. I’ve been an OB/GYN for more than 20 years, and I know that transforming the healthcare experience for women starts with increasing access to care and providers that can walk alongside women through every phase of life.

Menopause impacts 100% of women, with over 30% experiencing moderate-to-severe symptoms. The current state of menopause care in the US reflects the exact kind of dynamic the Hers platform was built to respond to: a condition impacting millions, access to treatment plans that can be tailored to the individual, and a challenging set of barriers keeping women from finding those treatments.

How does access to digital health platforms like Hers help women navigate this stage of life?

Through Hers, women will be able to find a care that fits seamlessly into their lives. Care that’s built on trust, safety, and convenience. As one of the largest and fastest-growing digital health platforms, Hers can help change the way women all over the world experience healthcare and enjoy their lives. Hers is introducing access to a new line of treatment plans built specifically for women experiencing perimenopause and menopause.

Based on their health history and personal preferences, women can work with a provider to get a combination of treatments tailored to them. If eligible, their personalized treatment plan could include estradiol, a hormone naturally made in the body, to help alleviate symptoms of menopause like hot flashes and night sweats. It may also be combined with progesterone to help protect the uterine lining and improve sleep quality.

What are a few practical tips women can implement today to feel stronger, more energized, confident?

One of the best ways to help women feel stronger and more energized is to create community in order for them to build confidence with women who are going through similar situations.

Are there common misconceptions about exercise or health during perimenopause and menopause that you’d like to clarify?

One of the misconceptions of exercise in perimenopause and menopause is that strength training and resistance training will bulk up muscle and change body definition. This is a misconception. Lean muscle mass continuously declines over the course of years in a woman’s body, and muscle is the organ of longevity and needs to be built in order to stay strong. Strength and resistance training will create more muscle mass - not bulk - and women should be encouraged to incorporate weight training into exercise routines.

What’s your advice for women who may feel uncertain about starting a new exercise or health plan during this stage of life?

While the journey through perimenopause and menopause can be complex, it is also an opportunity to reclaim and reinvent yourself. And best of all, have fun while doing it. You have the power to define who you want to be in this next, fiercest phase of life.