This week I want women with endometriosis to reflect on something that gets lost when health advice becomes “just push through it.” Endometriosis is a chronic disease affecting an estimated 190 million reproductive-age women worldwide. Pain can involve periods, the pelvis, sex, bowel movements and urination, and symptoms can affect mental health and daily functioning. There is currently no cure, but there are evidence-based medical, hormonal, surgical and supportive approaches that can help manage symptoms. And movement belongs in this conversation—but with some important honesty about the evidence. A 2025 systematic review found only 6 randomized trials totaling 251 women testing physical activity/exercise for endometriosis. Results were encouraging for quality of life, pain, mental health and pelvic-floor outcomes, but studies were small, different from one another and generally short. So “exercise cures endometriosis” would be a major exaggeration. More recently, a Norwegian randomized trial found that supervised exercise plus pelvic-floor muscle training improved current pelvic/genital pain, although it did not significantly improve the study’s worst-pain outcome. That’s exactly the kind of nuance I want us to keep: promising benefit does not equal universal cure. Your reflection Think about the last time symptoms interfered with your plan. Did you: A) force yourself through exactly what you planned, B) abandon movement completely, or C) adjust what you were doing to what your body could realistically handle that day? GOATGETheR isn’t about proving toughness by ignoring pain. It’s about learning the difference between “I don’t feel like doing this” and “my body is giving me information that should change today’s plan.” Your adjustment might mean reducing load, shortening the session, walking instead of running, changing an aggravating movement, doing your prescribed pelvic-floor/physical-therapy work, or recovering when symptoms genuinely warrant it. And persistent or severe pelvic pain deserves proper evaluation—not another TikTok telling you to stretch harder. Current international guidance treats endometriosis as something that may require individualized hormonal, surgical and multimodal management rather than one universal solution.

Menopause Is More Than Hot Flashes — What Happens to Muscle & Bone? We talk about hot flashes, periods stopping and mood changes when we talk about menopause. But while I was researching this week, I kept coming back to a different question: Why aren’t we talking to women earlier about what can happen to their muscle, strength and bones? And then I found something that surprised me even more. We actually don’t have nearly as much high-quality exercise research during the menopause transition as I assumed we did. Perimenopause isn’t simply estrogen slowly sliding downward in a perfectly straight line. Hormonal patterns fluctuate through the transition, and the menopause transition overlaps with an age when changes in body composition, muscle and bone are already occurring. Bone deserves particular attention because estrogen has an important role in regulating bone remodeling. Around menopause, bone resorption can outpace formation. Muscle is a little more complicated. Menopause, aging, physical activity, nutrition and other factors overlap, which makes it difficult to say: “This amount of muscle loss happened specifically because estrogen declined.” That’s an important distinction. WHY does this matter? Think about your body like a retirement account. You don’t wait until retirement to start saving. Muscle, strength and bone are similar. What you build and preserve in your 40s and 50s affects the physical reserve you’re carrying into your 60s, 70s and 80s. We’re not training simply because we want our arms to look good. We’re building the ability to: get off the floor, carry groceries, climb stairs, catch ourselves when we trip, tolerate a fall better, maintain independence and keep doing the things we actually enjoy. That’s a completely different reason to lift. The research gap I wasn’t expecting A 2025 systematic review asked a very specific question: Can exercise prevent bone and muscle loss during peri- and early postmenopause? Researchers searched five major databases for randomized controlled trials involving women ages 45–60 who were perimenopausal or early postmenopausal.

If somebody had told you at 30 that muscle and bone were something you were building for your 70-year-old self, would it have changed how you trained?

What Did You Learn About Your Body This Week? We started this week with a question that sounded almost ridiculous: Does pineapple actually make your vagina taste better? 😂 But look where that question took us. We went from pineapple → vaginal microbiome → normal odor → BV → douching → probiotics → actual treatment. And I think that’s exactly what GOATGETheR should do. Sometimes the question that sounds silly is the question that finally gets us learning something we probably should’ve been taught years ago. Here’s what I learned this week A healthy vagina isn’t supposed to smell like pineapple. It’s also not necessarily supposed to smell like nothing. The World Health Organization describes BV as a disruption of the normal vaginal bacterial environment. It also says vaginal cleansing, douching and putting herbs or other products inside the vagina can increase BV risk. Globally, BV prevalence among reproductive-age women has been estimated around 23–29%, although prevalence differs considerably between countries and populations. So sometimes the thing we’re trying desperately to “fix” isn’t actually broken. And sometimes there is a problem—but covering up the symptom isn’t the solution. That’s the distinction I want us leaving this week understanding. KNOW Normal physiology doesn’t automatically require treatment. Discharge changes. Smell changes somewhat. Periods, sex and other biological factors can influence the vaginal environment. That doesn’t automatically mean you’re dirty or unhealthy. But a persistent change from your normal, especially with unusual discharge, fishy/musty odor, itching, irritation or burning, deserves attention because conditions such as BV can cause those symptoms. NOTICE Here’s where this becomes personal. Can you actually describe what’s normal for you? Not what TikTok says. Not what an advertisement for feminine wash says. Not what somebody you dated made you insecure about. You. Because if we don’t know our baseline, it becomes much harder to recognize a meaningful change.

DON’T COVER THE SIGNAL Monday started with the funny question: does pineapple actually make your vagina taste better? Wednesday took us deeper: if something smells different, what does research actually say to do about it? So today I don’t want another lecture. I want us to practice something. Your challenge: Know your normal before you try to “fix” it. I think women have been trained to react to vaginal odor almost immediately. Smell something → wash harder. Notice discharge → assume something’s wrong. Sex changes the smell → panic. Period changes things → reach for a product. But that reaction can actually make it harder to recognize what your body is telling you. The World Health Organization describes BV as a disruption in the vaginal bacterial environment and specifically identifies vaginal cleansing, douching and inserting products into the vagina as risk factors. BV is also incredibly common globally: estimates put prevalence among reproductive-age women around 23–29%, although rates vary substantially between populations and countries. So we’re doing something different today. THE CHALLENGE For the next few days, don’t try to make your vagina smell like anything. Instead, notice: What’s normal for me? That can include your usual discharge, natural odor, where you are around your period, whether you’ve recently had sex, and whether there’s itching, irritation, burning or pain. We’re not obsessively tracking our vaginas. 😂 We’re learning our baseline. Because normal doesn’t need treatment. A meaningful change might. And if something does change, today’s challenge is don’t automatically cover it up. Don’t douche it. Don’t throw scented products at it. Don’t immediately decide it’s yeast and start treating yourself for yeast. Ask: “What changed—and do I actually know why?” That’s command. Not ignoring your body. Not panicking about your body. Not trying to perfume your body into submission. Paying attention before deciding what to do. Okay, but if there IS a problem… what does research say to do?