Podcast Summary: Better! with Dr. Stephanie Episode Title: Is Eating Less & Training More Hurting Your Hormones? A Perimenopause Reset with Dr. Stacy Sims
Release Date: September 8, 2025
Host: Dr. Stephanie Estima
Guest: Dr. Stacy Sims

Main Theme & Episode Purpose

This in-depth episode is a masterclass on recovery, hydration, and self-care for women navigating perimenopause and menopause. Dr. Stephanie welcomes back Dr. Stacy Sims, an international exercise physiologist, to focus on why “eating less and training more” can backfire for women in this life stage—specifically as it relates to hormonal health, performance, recovery, sleep, and longevity. The conversation is laced with actionable advice and debunks common myths, highlighting the unique needs women have as they age and their hormones shift.

Key Discussion Points & Insights

1. Recovery: Why It’s Critical (Especially for Women in Perimenopause)

• Stress & Adaptation: Exercise is a stressor causing breakdown; it’s recovery, not the exercise itself, that leads to positive adaptation.

  “A lot of people don't realize…the exercise stress is the breakdown. So you need recovery to actually get stronger and adapt.”
  – Dr. Stacy Sims [04:45]

• Acute vs. Chronic Recovery: Acute recovery is immediately post-exercise; chronic recovery is about sleep, fueling, and overall periodization.
• Perimenopausal Challenges: Fluctuating estrogen/progesterone disrupts all systems (bones, muscles, nervous system), intensifies the "tired but wired" feeling, and lengthens recovery time.
• Sympathetic Overdrive: Nagging fatigue and poor sleep are often due to increased sympathetic nervous system activity.

2. Progesterone, Estrogen, & Sleep

• Progesterone’s Role: It’s anti-inflammatory, counters estrogen, and influences sleep, vagal tone, and parasympathetic drive.

  “When we start losing or not having as much progesterone, we do see an absolute change in our ability to get into a deep restful sleep as well as a change in sleep architecture.”
  – Dr. Stacy Sims [09:10]

• Sleep Disruption: One of the first symptoms women notice in perimenopause is altered sleep, often before they recognize it’s due to hormones.

3. External Stressors: The “Stress Sandwich”

• Many women in midlife face layered stress: teenage children, aging parents, work.

  “Women are just really great at just piling another thing into the backpack.”
  – Dr. Stephanie Estima [12:52]

4. Sleep Optimization for Women

• Circadian Rhythms: Women’s melatonin rises and falls earlier than men’s; fighting natural sleepiness results in worse sleep.

  “Our circadian rhythms really work on a different…day, night rhythm than what our male partners do.”
  – Dr. Stacy Sims [14:30]

• Practical Tips: Find your natural sleep onset window, cool/dark room, mindfulness, yoga nidra (non-sleep deep rest), L-theanine, cold tart cherry juice before bed promotes melatonin.

  “Cold tart cherry juice…increases your body's own melatonin production and rides the wave…” [16:10]

• Adaptogens: Ashwagandha and (sometimes) Rhodiola can help; Schisandra may actually stimulate.

5. Caffeine Sensitivity in Perimenopause

• Many women become more sensitive to caffeine and its effects on sleep and mood; possibly linked to changing neurotransmitter profiles.

  “Most women become more sensitive to caffeine. Why? Not sure. But…there's an interference or maybe a change in dopamine and adenosine receptors…”
  – Dr. Stacy Sims [19:14]

6. Active Recovery, Deloads, & Mobility

• Active Recovery: Light walking, swimming, gentle mobility work promote nutrient delivery and metabolic waste removal.

  “Walking's great…it really does facilitate more of a metabolic recovery.”
  – Dr. Stacy Sims [23:22]

• Mobility’s Importance: With hormonal changes, tendon and joint health decline, so mobility work is critical to prevent soft tissue and joint injuries (e.g., plantar fasciitis, frozen shoulder).
• Injury Risk: Injuries become harder to recover from with age; prevention and mobility are crucial.

7. Cold Plunges & Sauna: Female Physiology

• Cold Plunges:
  • Ice-cold water is too stressful for women due to their unique thermoregulation; cooler (not icy) water (~10–13°C/45–55°F) is optimal.
  • Wait at least 5 hours post-training before cold plunging to avoid blunting training adaptations.

  “Men can get all…the responses from ice water. But when women get into ice…it creates such a strong sympathetic drive…it's too much of a stress for women.”
  – Dr. Stacy Sims [30:04]

• Sauna/Heat:
  • Women tolerate and benefit from sauna more effectively than men.
  • Sauna post-exercise extends training adaptations (hypertrophy and cardiovascular benefits), increases blood volume, BDNF, and heat tolerance (helpful for hot flashes).

  “If you get into the sauna for 10 to 20 minutes after a hard training session, you're extending that training stress just by the mechanisms…”
  – Dr. Stacy Sims [40:38]

  • Protocol: 10+ minutes, 60–80°C (140–175°F); rehydrate slowly afterward for maximal benefits.

8. Hydration & Electrolytes

• Role of Hormones: Estrogen and progesterone regulate sodium and fluid retention; as estrogen drops, thirst and sodium retention decrease, leading to “muted thirst.”

  “We have to be very cognate that what we are drinking works with our physiology. And we're consciously aware that we have to drink.”
  – Dr. Stacy Sims [52:35, 00:00]

• Electrolyte Guidelines: Post-training, aim for 360–400mg sodium + ~200mg potassium per 16oz/0.5L water; long workouts need a 2–4% carb solution (5–7g carb per 8oz) for optimal absorption.

9. Relative Energy Deficiency in Sport (RED-S) & Chronic Undereating

• Low Energy Availability: Chronic undereating (1200–1300 calories) undermines every system: impairs brain function, sleep, bone density, muscle growth, recovery, and even mental health.

  “As soon as you get up to start doing some chores, you need some more calories…People forget that their body isn't inert and it needs fuel.”
  – Dr. Stacy Sims [55:51]

• Symptoms: Poor sleep, brain fog, persistent fatigue, lack of training progress, and altered body composition.
• Fix: Increase energy intake gradually, focusing on fueling around training; aim for 40–45 kcal/kg body weight (sedentary minimum: 30 kcal/kg fat free mass).
• Myth-Busting: Eating more (when underfueling) often results in improved body composition, energy, and training results.

Notable Quotes & Memorable Moments

• On Women’s Recovery Needs:
  “You will find you're not recovering as well as you used to and you can't hit it as hard as you used to.”
  – Dr. Stacy Sims [05:45]

• On Sleep Disruption in Perimenopause:
  “One of the very first things that people going through perimenopause will notice is a disruption in sleep…and they're not tuning into the fact that there's a change in our hormones which is really interfering…”
  – Dr. Stacy Sims [09:44]

• On Cold Plunges:
  “Ice is too cold. If we talk about cool water, then we're onto something for women.”
  – Dr. Stacy Sims [30:47]

• On Sauna Benefits:
  “Ten minutes a few times a week in a sauna is one of the longevity hacks that does work for women.”
  – Dr. Stacy Sims [39:31]

• On Chronic Undereating:
  “People forget that their body isn't inert and it needs fuel.”
  – Dr. Stacy Sims [55:51]

• On Muted Thirst:
  “We have to be very cognate that what we are drinking works with our physiology. And we're consciously aware that we have to drink.”
  – Dr. Stacy Sims [52:35, 00:00]

• On the Importance of Eating Enough:
  “The easiest fix is to eat.”
  – Dr. Stacy Sims [60:25]

Useful Timestamps for Key Segments

• 04:45 – Acute vs. chronic recovery, impact of perimenopause on adaptation
• 09:10 – Progesterone and sleep
• 12:38 – The “stress sandwich” of midlife women
• 14:30 – Circadian rhythm differences; sleep optimization strategies
• 16:10 – Use of tart cherry juice/cool fluids for sleep
• 19:14 – Caffeine sensitivity in perimenopause
• 23:22 – Active recovery, mobility, injury risk in midlife
• 30:04 – Cold plunges: why women need “cool” not “cold”
• 40:38 – Sauna post-training for extended training stress and adaptation
• 42:33 – Specific sauna protocols for women
• 44:22 – Electrolytes and hydration: what women need post-exercise
• 52:35 (and again at 00:00) – Muted thirst in perimenopause
• 55:51 – Low energy availability, RED-S explained
• 61:51 – How to safely increase calories post-chronic dieting
• 64:15 – Adjustments for perimenopausal women wanting hypertrophy

Actionable Takeaways

• Prioritize recovery, not just training—rest, sleep, and mindfulness are as important as workouts.
• Mind your sleep: Identify your early sleep window, use L-theanine or cold tart cherry juice, and embrace sleep hygiene.
• Hydration isn’t just about water: Add sodium and potassium, especially after sweating or sauna; don’t rely on thirst cues.
• Cold plunges: Opt for “cool” water (10–13°C/45–55°F), and avoid immediately post-exercise unless acute recovery is needed.
• Embrace sauna: 10–20 minutes post-workout, 60–80°C; rehydrate slowly afterward.
• Don’t under-eat: Gradually increase energy intake around training—chronic low energy is damaging to health and fitness, especially after 40.
• Mobility work and active recovery: Crucial as you age to prevent injury and maximize gains.

Final Thoughts

This episode is essential listening for women who want to optimize their health and performance before, during, or after menopause. The takeaway is clear: more is not always better—smart recovery, proper fueling, tailored hydration, and respect for the female body’s unique physiology are secrets to thriving, not just surviving, in midlife and beyond.