Better! with Dr. Stephanie – Episode Summary

Episode Title: Eat, Exercise & Recover Through Your Menstrual Cycle with Dr. Sarah E. Hill
Host: Dr. Stephanie Estima
Guest: Dr. Sarah E. Hill
Date: September 29, 2025

Episode Overview

This episode of Better! with Dr. Stephanie centers on understanding, optimizing, and honoring the female menstrual cycle. Dr. Stephanie Estima interviews Dr. Sarah E. Hill, evolutionary psychologist and author of The Period Brain, to unpack the science and practical applications of “two brains” across the menstrual cycle: the follicular (estrogen-dominant) and luteal (progesterone-dominant) phases. Together, they debunk cultural and scientific minimization of hormonal impact, discuss why PMS is more prevalent today, and offer actionable strategies for nutrition, fitness, recovery, and self-care—empowering women (and the men who love them) to embrace, rather than “power through,” their cycles.

Key Discussion Points and Insights

1. The Menstrual Cycle: Two Halves, Two Brains

[05:34 - 08:19]

• Follicular Phase (Estrogen-Dominant):

  • High energy, increased social and sexual interest
  • Heightened ability to discern and select high-quality mates (testosterone markers)
  • Outward-focused behavior – risk-taking, novel experiences, seeking rewards

• Luteal Phase (Progesterone-Dominant):

  • Inward-facing, energy conservation, safety, and connection
  • Lower sexual drive, increased focus on relationship maintenance and security
  • Physiological preparation for possible pregnancy (endometrial growth, immune changes)

“Our body sort of works together to coordinate two distinct sets of activities… sex, which is required for reproduction, and pregnancy. Our brain and our whole body gears together to work together to solve each one of these two problems.” — Dr. Sarah Hill [05:29]

2. How Hormones Shape Attraction & Relationship Dynamics

[08:19 - 17:12]

• Mate Selection:
  • Estrogenic phase: Women prefer traits associated with "good genes" (masculinity, dominance, immune strength).
  • Luteal phase: Preferences shift toward partner investment and connection.
  • Sexual desire adapts—more for conception vs. more for relationship maintenance (“maintenance sex”).

"In the follicular phase, women place heightened emphasis on qualities related to 'good genes' ... cues related to testosterone." — Dr. Sarah Hill [08:52]

• Orgasm & Sexual Motivation:
  • For women, the “reward” from sex isn’t necessarily orgasm; it’s context-specific (connection, mood, etc.).
  • Men’s sexual motivation is reliably tied to orgasm.

“For women, the reward value from sex doesn’t come from orgasms. It comes from whatever their goal was... The female brain uses sex more instrumentally.” — Dr. Sarah Hill [17:37]

3. PMS, Evolutionary Mismatch, and Societal Norms

[21:45 - 35:54]

• Why is PMS so Pervasive Now?
  • Modern society ignores the inherent cyclical nature of women’s biology, enforces “male” standards of consistency.
  • Routine advice on energy, diet, exercise ignores increased needs during the luteal phase.
  • Cultural minimization and pathologization of normal cyclical variability (PMS as “pathology” rather than a feature).

“Our idea of what it means to be human is based on a male ideal, right? And the male way of being is that there's one size fits all… but that's just not true for women.” — Dr. Sarah Hill [29:38]

• Role of Cellular Resilience:
  • Inflammation and lack of cellular flexibility worsen PMS symptoms.
  • Modern lifestyle erodes capacity to adapt to hormonal fluctuations (poor sleep, low-quality diet, little sunlight/exercise/social connection).

4. Nutrition and Exercise Across the Cycle

[38:11 - 54:11]

• Nutrition Adaptations:
  • Basal metabolic rate increases by 10–11% in the luteal phase (150–200+ extra calories/day).
  • Digestive changes: slower transit, increased need for nutrients, particularly amino acids for endometrial building.
  • Strong recommendation to trust hunger, especially for whole, minimally processed foods; increase protein (animal or plant-based) during the luteal phase for satiety and tissue needs.

“Our body, in building the endometrial layer, is an absolute HOG for amino acids ... So it can feel really scary to be told, like, hey, you are actually less able to put on muscle mass during this time.” — Dr. Sarah Hill [38:38]

• Exercise Modifications:
  • Strength and muscle gains are maximized when heavy lifting occurs in the follicular phase.
  • Luteal phase: shift to lighter exercise, yoga, walking; prioritize recovery.
  • Ignore “one size fits all” advice—modulate intensity and volume according to cycle.

“I shifted to focus all of my strength training and the higher resistance cardio to the first half of the cycle… As soon as I got the temperature rise, I stop with the weights and I shift to more of a walking and yoga. And what happened after three months is I got stronger.” — Dr. Sarah Hill [45:24]

• Recovery:
  • Luteal phase requires increased attention to sleep, stress management, and gentle movement.
  • Wearable tech often reflects this with decreased “readiness” or recovery scores—don’t misinterpret this as failure but as a signal for more rest.

5. Micronutrient & Supplement Considerations

[66:54 - 71:18]

• Key Nutrients:
  • Vitamin D (sun exposure or supplement)
  • Omega-3 fatty acids (cellular plasticity)
  • Magnesium (often deficient; supports relaxation, reduces symptoms)
  • Maintain a diverse, minimally processed “hunter-gatherer-style” diet.
  • Carbohydrates: Trust your body’s cravings if nourished with whole foods.
  • No strong evidence for or against seed cycling, but safe to experiment.

“Eating a whole foods diet, whether or not you include animal protein, is totally up to you. But increasing protein ... by eating protein sources ... I always up my protein intake a little bit during this time.” — Dr. Sarah Hill [45:24]

6. Special Considerations: Perimenopause & Hormone Therapy

[80:05 - 84:46]

• Perimenopause Transition:

  • Progesterone production becomes erratic; estrogen remains unopposed at times.
  • Symptoms may worsen (those with severe PMS may have a tougher transition).

• Action Steps:

  • Increase cellular resilience (nutrient-dense diet, movement, sleep, stress reduction).
  • Don't fear hormone therapy—bioidentical progesterone and estrogen are different from synthetic progestins (e.g., birth control), and evidence doesn't link them with higher cancer risk when properly administered.

"Anything that you can do to increase your resilience to hormonal changes is going to make it a lot easier… And don’t be afraid of hormones, like actual hormones." — Dr. Sarah Hill [80:05, 84:15]

7. The Research Gap and the Need for Change

[75:35 - 78:21]

• Women’s health research is vastly insufficient—many studies only include women in follicular phase or exclude women altogether.
• There’s a dire need to study and support female physiology across the entire menstrual cycle and lifespan.

“Women's health is about the health of women, period.” — Dr. Sarah Hill [75:49]

Notable Quotes & Memorable Moments

| Timestamp | Quote | Speaker | |-----------|-------|---------| |05:29 | “Our body sort of works together to coordinate two distinct sets of activities… sex... and pregnancy. Our brain and our whole body gears together to work together to solve each one...” | Dr. Sarah Hill | |08:52 | “During the first half of the cycle ... women tend to place a heightened emphasis on qualities related to what we would call like good genes ... cues related to testosterone.” | Dr. Sarah Hill | |17:37 | “The reward value for sex for women doesn’t come from orgasm. It comes from whatever their goal was... The female brain uses sex more instrumentally.” | Dr. Sarah Hill | |29:38 | “Our idea of what it means to be human is based on a male ideal, right?... But that's just not true for women.” | Dr. Sarah Hill | |45:24 | “Increasing protein intake ... for all of the building activities of the luteal phase in response to progesterone, the best way... is by eating protein sources.” | Dr. Sarah Hill | |55:59 | “Estrogen and testosterone... have us firing on all cylinders. It makes sense this would be a really great time to learn complex movements.” | Dr. Sarah Hill | |75:49 | “It's really time that we start to understand that women's health is about the health of women... beyond uterus island.” | Dr. Sarah Hill | |80:05 | “Do anything you can to increase your resilience to hormonal changes ... Anything that you can do to increase your resilience... is going to make it a lot easier.” | Dr. Sarah Hill |

Actionable Takeaways

For Listeners Seeking Practical Changes:

• View the luteal phase as a feature, not a flaw: Adapt nutrition, training, and self-care to cyclical needs rather than fighting them.
• Increase caloric intake and protein in the luteal phase to meet increased metabolic and tissue-building demands.
• Shift heavy resistance training to the follicular phase; use the luteal phase for active recovery, mobility, and gentler exercise.
• Prioritize sleep, stress reduction, and recovery, especially premenstrually.
• Nourish your body with whole, minimally processed foods—trust hunger and cravings within this context.
• In perimenopause, focus on building resilience through lifestyle—and consider evidence-based, individualized hormone therapy if appropriate.

Additional Resources

• Dr. Sarah Hill’s New Book: Period Brain
  Find at sarahehill.com or anywhere books are sold.
  Instagram: @SarahE.Hill.PhD

• Follow Dr. Stephanie Estima and explore more episodes on actionable evidence-based women’s health strategies.

Episode Timestamps for Key Topics

• 05:29 – Understanding the “two brains” of the menstrual cycle
• 08:52 – How attraction and partner preferences shift across the cycle
• 17:37 – Sex, reward, and connection: how motivation changes for women
• 25:46 – The evolutionary mismatch: why modern PMS is epidemic
• 38:38 – Nutrition and exercise modifications for the luteal phase
• 45:24 – Protein needs and muscle building insights
• 55:59 – Training methodologies: skill learning, injury, and hormonal environments
• 66:54 – Micronutrient considerations; seed cycling debate
• 75:35 – The women’s health research gap
• 80:05 – Navigating perimenopause and hormone therapy options

Tone & Style

Thoughtful, evidence-rich, compassionate, and empowering—both Dr. Stephanie and Dr. Hill challenge cultural and fitness narratives to advocate for honoring the lived experience of women’s cycles, embracing differences, and using self-knowledge as a tool for health and vitality.