← BETTER! with Dr. Stephanie Estima | Strength, Body Composition & Perimenopause
BETTER! with Dr. Stephanie Estima | Strength, Body Composition & Perimenopause
The Estrogen Shortage Is Real & Your Gut Might Be Making It Worse with Esther Blum
01:06:57
Integrative dietitian, Esther Blum, unpacks the estrogen supply chain crisis, leaving women without basic hormone care, why 70% of women aren't detoxing hormones properly (and what that means for your HRT), and why eating more — not less — is the midlife prescription most women need. Plus testosterone, carbs, and the best-kept secret of the zero F's era. Watch the full episode at https://youtu.be/9_lS_8M4cs8
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- [00:00]
A
In my 20s and 30s, I would run sprints for 45 minutes and then lift for 45 minutes four days a week. Girl, I was living on bagels, coffee, diet coke and martinis and I was.
- [00:16]
B
Don't forget the cigarettes.
- [00:17]
A
Oh my God, the cigarettes. Do I freaking. If I had my druthers, I'd be like a smoking drunk. I swear. Nerd safari. I may have to swipe that. I just call it porn. I don't know.
- [00:33]
B
The pubmed porn, right? It's like, what are we going to find tonight? Bounce. Let's come back to carbohydrates.
- [00:41]
A
Having some carbohydrates with your dinner can be a super useful tool and we need to replenish our glycogen stores post workout. Otherwise it can be harder to build muscle.
- [00:53]
B
So the now every woman thinks, well, I got to have, I have to have this weighted vest and I have to have these supplements and I have to have this menopause tea.
- [01:01]
A
Believe me, I'm just as guilty. I've bought lotions and creams because I'm like, that will get rid of all my wrinkles overnight. No, it won't. It really won't.
- [01:09]
B
The female body is always looking for signs of safety and food is one of them. Food is one of the ways that we feel safe.
- [01:15]
A
Yes, and what happened to pleasure, by the way? Like, pleasure is its own nutrient.
- [01:21]
B
What do you, what do you think the best part about menopause is that nobody ever talks about it is the beginning.
- [01:28]
A
Foreign.
- [01:33]
B
Friends welcome back to another episode of better with Dr. Stephanie tis me. As always, your host, Dr. Stephanie Estima. And if the number on the scale and how many carbohydrates that you're eating in a day is something that you potentially are always thinking about, maybe even obsessing about. Been there, done that. This episode is for you. My guest today is Esther Bloom. She has spent nearly 30 years building what she calls a gaslight free zone for midlife women. She has an Ms. And a BS in clinical nutrition from NYU and Simmons and she is a CNS certified nutrition specialist and menopause specialist, a TEDX speaker and a best selling author of five books. You are going to love this show so please enjoy my conversation with Esther Blum. New lower pricing on a molecule that helps with recovery, muscle strength and energy. Hello. Sign me up. It's true. My appear containing your lithin a is now available at a new and lower price. And this is fantastic news because if you are someone concerned with recovering from your workouts, you can make progress Faster, preserving the muscle strength and endurance that you already have, and. And create more energy. This is big, big news. I have been in love with and taking Timelines mitrepure for two years now, and it contains something called urolithin A. And urolithin A helps to get rid of old, damaged mitochondria. It helps support muscle function and plays a role in creating more energy. We naturally lose our ability to produce urolithin A in the gut as we age, so supplementing with it becomes pretty much essential if we're older than 30, because we naturally tend to lose our gut diversity. Now, Timeline is a brand that I trust because it has spent well over $50 million in research, including human trials. And I'll tell you about one of them. There were participants that improved by 12% in muscle strength over four months with absolutely no change in their exercise regimen. If you want to start recovering like a boss, head over to timeline.com better. You've called the care that women receive in menopause dire. How does the dwindling supply of estrogen contribute to that?
- [04:02]
A
Well, first of all, that is completely dire. We are struggling as women just to get estrogen patches. And vaginal estrogen is now on the chopping block, basically. So, you know, there's 25 boner pills on the market, and there's never a Viagra shortage, but women can't even get the most basic menopause care.
- [04:25]
B
Why do you think that that's happening? Is that something nefarious going on? Because to your point, there's always a supply around erectile dysfunction for men. But why is that happening?
- [04:35]
A
Only about 4% of women are currently on HRT, and I think that number recently went to 5%. So we can't even accommodate, you know, the shortages. Also, there was one of the companies that was producing the patches stopped producing it. And insurance companies really have an upper hand on production of estrogen patches in particular. So there's these massive shortages happening. You know, I have driven women to Cost Plus. I've driven them to Costco, Amazon. Even Amazon right now is out of vaginal estrogen as we record this. And also there's the HRT club, although that is a membership fee. I think it's $99 a year or $12 a month. So it's really not a perfect system. And I chased the HRT club down. I said, where are you getting your patches and your supplies from? And they listed a larger parent company. But I looked yesterday, and they, too, were out of one of their Patches. And I was like, gosh, you know, this is crazy. So I'm doing a lot of advocacy work now in D.C. to help get that, you know, get the production chain that loop closed and end this cycle. Because right now it's predicted we will be out for. The shortage is going to continue for a couple years right now, the rate we're going to now. And the good news is, you know, women, more and more women are demanding that they be on estrogen patches. And it's not that medical school education has caught up. It's that women are learning more about menopause and perimenopause on Instagram, YouTube and TikTok. And they are then coming to their providers and saying, this is what I want. I've done the research. I know I need this. I have a history of osteoporosis. I. I'm hot flashing all night. I have vaginal dryness and no, no libido and no sex life. And my marriage is suffering. Give me vaginal estrogen. I'm having UTIs. Give me vaginal estrogen. So women, you know, we're the Gen Xers. I don't know if you are. I am. You know, we're the alchemists and we're saying we're not going to take this sitting down. Like, we know how to advocate for ourselves when given the right tools to do so.
- [06:54]
B
Okay, cool. All right. So since we're. We're on the HRT conversation, let's actually go there. You have a very strong position on whether or not women should start hrt. And I'm assuming just from your, you know, opening statement that you are very pro. And I. I've heard you talk about HRT being started in perimenopause rather than waiting until menopause. Can you make. Make the case for that? Especially for women who are nervous about starting too early or maybe they don't have a provider who can, who can guide them down that path. What is the case for someone starting HRT or MHT in perimenopause?
- [07:29]
A
Quite simply, the research supports it. It's not a personal bias. I do look at the research and of course there are going to be some of you listening to this saying, I can't because of xyz. I don't want to always. Your body, your choice. I just want everyone to be informed and educated. So we lose the greatest amount of muscle, which you are no stranger to. We lose the greatest amount of muscle in the shortest period of time. In the last two years of perimenopause and so that's very important because testosterone, progesterone and estrogen and DHA all support muscle growth and maintenance and prevention of loss, but they also prevent bone loss. So what women don't realize is the massive impact that testosterone has on bone health. And so when we, our testosterone levels decline in our 30s, well, most of us, or many of us are on oral synthetic birth control pills, our 20s, our 30s, and that has a significant impact in an adverse way on our bone health. So early intervention of hrt, as long as our bodies need it, you don't just blindly take it. You go with a provider who's going to work with you and test you and look at your symptoms. But it prevents arterial plaquing, the laying down of plaque in our coronary arteries. It helps optimize insulin resistance. It prevents that non alcoholic fatty liver that about 30% of menopausal women develop due to the absence of hormones. It protects white matter and gray matter in the brain. The longer we're hot flashing, the more we lose that precious white matter. It also helps prevent pelvic floor floor collapse and UTIs and atrophy. Now it's so important that actually vaginal estrogen is now considered for women postpartum who have pelvic floor dysfunction. And we also know it's quality of life. If you get a woman who is not sleeping and you put her on progesterone during the second half of her cycle, even if she's cycling, you add in progesterone days 14 to 28 and she's sleeping throughout the month. Think of the impact this has on the workforce. Think how it restores or maintains our marriages, our personal relationship, our ability to parent and be a kind human is really predicated on sleep and quality of life. So for all of those issues, that is why I'm a big fan of early intervention. Because I do see cholesterol levels come down, I do see insulin get far more regulated. When we introduce hormones. I see women sleep again and not want to kill themselves. In fact, 92% of women on HRT completely eradicated suicidal ideations. And this is the work of Dr. Luis Newson, who runs an amazing clinic in the UK. So it's, it's mental, physical, spiritual, emotional health that is again, not the one thing panacea. You have to do it in conjunction with diet, in conjunction with lifestyle, in conjunction with really curating the people in your life, developing a spiritual practice, you know, doing a full spectrum of things. But it's a very important piece of the pie. But you can't out supplement your hormones, you can't out diet your hormones. You've got to kind of do things in conjunction.
- [11:20]
B
Yeah. And I would also add to that is that there is a, almost a diabolical role that estrogen has on connective tissue. So I've had patients who have come into the clinic that, you know, would. They were on HRT for some of any and all of the things that you just stated, but weren't doing the lifestyle piece, so weren't lifting weights. So there was no mechanical signal that was going into the tendons, ligaments, joints and muscle. And then after a couple of months, they're like, I don't know, like, I feel like the hormones are not working for me anymore. Like, hormones can provide a very strong signal, but you also have to pair that with a mechanical one. So you cannot actually create strong connective tissue or, or muscle for that matter. Like, estrogen is not going to build muscle. You have to go into the, you have to go to the gym and lift the weights. Right. Your. Your connective tissue, which is largely controlled by estrogen. So the more estrogen you typically have, the more collagen turnover you have, which is great for ligaments and tendons, but only if there is mechanical signals that pair with it. Otherwise estrogen has no direction. And what ends up happening is women who just get on hrt, who are not lifting properly, not doing the mobility work and the connective tissue stuff tend to have. You tend to actually become more susceptible to injury than less. So it is very important. Like I, I totally hear what you're saying, and I will also be play devil's advocate for a second. It's like it can't, like hormones cannot build nutritious plates just like you're saying they can't lift the weights for you. They're certainly not going to remodel your, your tendons and your ligaments without you doing something to direct how estrogen should
- [12:56]
A
work in the body 100%. And also, you know, it won't course correct mitochondrial dysfunction either. I mean, I can put someone on mitochondrial nutrients to support, but building muscle in the gym builds more mitochondria and really reverses a lot of aging that we see. A lot of insulin resistance builds bone. It honestly just builds a badass attitude too. And really.
- [13:23]
B
So, yeah, yeah, even, honestly, even there's limits to protein as well. Like, let's just be honest, like, you just can't, you just can't be throwing back protein and thinking that you're going to build muscle like the protein. Again, the mechanical signal from the lifting has to tell the protein what to do. Like, you can have protein in the system, but if you don't have the mechanical signal from the lifting, the running, the sprinting, the things your, your body's just been like, cool. So you're going to get really, like, you're going to be farting and you're going to, you know, and you're just going to. I mean, you might have really great skin, hair and nails, but no one's going to want to be around you because your gut is going to be distracted, destroyed. So I say that with love because everybody has overdone the protein. You all know what I'm talking about. Okay, so I, I want to come back to hormones. I don't want to leave here yet. Let's talk a little bit about testosterone. What perimenopausal symptoms are we falsely attributing to estrogen when it's actually testosterone that's the culprit?
- [14:16]
A
Yeah. You know, women don't even realize that their bodies, the ovaries, produce five times the amount of testosterone that they do estrogen prior to perimenopause. So, yes, when you can't get your ass off the couch, when you have no motivation, you're exhausted, you're kind of lethargic, kind of depressed. You're also just very low energy. A lot of chronic fatigue. Brain fog can also be low testosterone. So because testosterone actually plays a huge role in cognition too. And so testosterone helps us feel like we're firing on all cylinders. And it gives us the energy and the motivation and the drive and also libido. Because testosterone can not only be applied to our skin topically, like on our forearms or behind the knees, inner thighs, lower abdomen, but you can also get it compounded to be applied vaginally and vaginal. I have clients that their providers prescribe it and compound it as a vaginal only use A, to help libido, but B, because the vaginal tissues are so vascularized and they're such an amazing absorption site. So some of my colleagues put all their hormones vaginally. That's their delivery system. Other people prefer testosterone topically. That's enough to get the systemic benefits. So it's really individual. And I think it really depends on your provider how it's applied. But just knowing that there are options, if you say, well, I don't seem to absorb it, well, should I switch to injections first? Try it vaginally. If you don't absorb it topically because not everyone does absorb it well. That's why it's also important you rotate your sites of application. Don't keep applying it to the same place. And the funny thing is, you know, I had this conversation.
- [16:06]
B
Don't apply it to where you grow hair. Pro tip. Well inside of the wrist. Or maybe you have some thoughts on that. You tell me.
- [16:13]
A
Well, I was going to say, you're on such a microdose. I mean, I've been using testosterone at least six years. I have zero hair on my arms, zero hair on my lower abdomen. Yes, I have hair growing on my thighs, but no more than it was before. So if you're doing a low dose, you shouldn't be growing hair. But yeah, don't put it on your face, don't put it on your breasts, lest you look like, you know, a hairy chimp. But it really doesn't. If you're rotating the sites, it should not grow hair. It should not make you lose hair from your head. Those are usually from high doses. If you're growing hair on your face and you're losing it on your hair, you may be aromatizing or converting your estrogen to testosterone. And adding systemic testosterone is just pouring gasoline on the fire. That's usually the problem. It's not the testosterone itself.
- [17:03]
B
And would you, if you apply testosterone vaginally, like you just said, that, you know, vaginal applications of hormones, it's such a vascular area. One of the arguments around the safety of vaginal estrogen, let's say, is that it actually doesn't really get into the system. It's really just a local application. So if, and I'm again pushing back here, just really wanting to explore your brilliance. So if we are now applying vaginal testosterone, is that going to be enough to be able to get through to the level that, you know, a woman's going to need systemically, like throughout her whole body?
- [17:36]
A
Because the dosage is higher than, let's say, a vaginal estrogen formulation. It should, you're talking like a vaginal estrogen, for example, is a 0.05% dosage, whereas testosterone, you're getting into the multi milligrams, so it, but again, it should theoretically absorb. But you do have to test your blood levels and look at your symptoms. Like, am I feeling better? No. So for some women, I do see them move to injections, but I would say that's a smaller percentage of women, A greater percentage of women apply it topically and are like, man, I feel a lot better.
- [18:18]
B
Okay, you're smart enough to know when something's not working. Like when you start avoiding foods, when your stomach feels like it's fighting you after every meal, or when you look six months pregnant at the end of every day, even though you are definitely not. Okay, here's the thing. These are not random symptoms. Your gut impacts everything from your digestion to your brain function to your energy levels. And that is why my family and I love the Just Thrive probiotic. Unlike other brands that make big promises and fall apart, Just Thrive is the only probiotic clinically proven to arrive in your gut 100% alive. So that means for you that you are going to get real results from taking it. Like better digestion, healthier immunity and more energy to tackle your day. But don't just take my word for it. Try Just thrive probiotic for 90 days and see how much better you feel. It comes in capsules or my favorite, the berry flavored gummy. And if you don't notice a difference, they will refund every penny even if the bottle is empty. For over a decade, Just Thrive has been helping thousands of people take control of their health with science backed solutions so that you can help feel better. From their award winning probiotic to their full line of gut, immune and brain health supplements, Just Thrive is ready for you to help you live your healthiest life. Start your risk free 90 day trial today@justthrivehealth.com better and you're going to save 20 off of your first order. That's just thrivehealth.com and use the code better for 20 off your first order. You are probably drinking enough water. You are probably not replacing what your body is actually losing. Here is what nobody told you. As estrogen drops in perimenopause, your kidneys become less efficient at holding on to sodium. I mean it's so cruel. Which means that your electrolyte needs go up right at the exact moment that most women are still operating on that strategy. Like drink more water, stay hydrated, stay hydrated. Low sodium is pretty sneaky and it's hard to kind of put your finger on it. Can look like fatigue, brain fog, headaches after workouts, that afternoon crash that you've been blaming on poor sleep. It feels like your body's failing you, but it isn't. It's your body asking for something very specific, which is salt. This is why I drink element every single day. I usually do it before training, so I'll put half of a sachet in my water before training or I'll do it when I'm really sweating. So after a really big sprint session, one packet in my water is going to give me a thousand milligrams of sodium, 200 milligrams of potassium and 60 milligrams of magnesium and I usually half that. So there's no sugar, there's no junk, just the minerals that actually move the needle. You are building something special here, your body. So you have to fuel it properly, my friend. Head over to drink and element.comforward/better and receive a free sample pack with any order. That's drinklmnt.com forward/better. Let's talk about the gut liver access as it relates to hormone therapy because this is something I don't see a lot of people talking about. You've, you've said that you don't think that HRT is going to work in like 70%. I think that's the number of women unless their detox pathways are, are functioning first. So most women who are listening, I mean we have a very educated audience. But for, let's say that someone doesn't understand what that means, what are our detox pathways? Why do we need to open them up? And then how is that going to facilitate a better use case for hrt?
- [22:08]
A
Yes. So I love explaining complex biochemistry and just boiling it down to the most simple essences that we all need to know. So think of it this way. You never want your hormones to be a stagnant pond. You want them to be like a gently moving stream. So what goes in your body needs to be detoxed and metabolized and removed out. So some ways we metabolize through digestion, through pooping out our hormones. So we should be moving our bowels every day, one to two times a day. Of course, sweating is a wonderful detox and urination is a wonderful way to remove hormones. So we remove hormones, we metabolize them, I should say, in our liver and then in our gut. There's three phases of hormone detox, phases one and two. Think of it like a washing machine cycle. It takes fat soluble hormones and converts them to water soluble hormones. And through your body's natural bile production. Bile carries your hormones like a little sponge. It grabs them, pulls them into the gut, where then your estrobolome, which is a subset of bacteria in the gut, helps metabolize that estrogen so you can then poop it out. So a fiber is really, really important. Like we all talk about getting, you know, at least 30 grams of fiber through flax and chia seeds, fresh Fruits and vegetables with skins, but also cruciferous vegetables are a girl's best friend. Broccoli, cauliflower, artichokes, radishes, kale, Brussels sprouts. Anything bitter is going to stimulate bile production.
- [23:57]
B
But, Esther, I thought kale was trying to kill us.
- [23:59]
A
Well, I wouldn't say you need to eat the massive, massive amounts and have, like, kale wraps and all of that, but some. Just any bitter vegetable.
- [24:12]
B
That was sarcasm. Yeah, Just for the listener. Like, I know. You got it, but if the listener's like, what is she talking about? I'm being sarcastic.
- [24:18]
A
I know, Kayl. I know. God forbid we eat vegetables and fiber.
- [24:22]
B
Well, the thing that kills me so that I love that you're saying eat cruciferous vegetables, because the thing that actually kills me about social media is that people are not eating enough fruits and vegetables as it is. And then you have these absolute tools that come on, and they're like, fruits are trying to kill you. They're going to give you a fatty liver. And then, you know, whatever the. The kale is trying to kill you. Look at all this. Look at how it has all these things in it. It's like, okay, the oxalate argument. Like, literally, spinach is high in oxalates. All you have to do is steam them. Guess what happens. 80 to 90% of the oxylates are gone. So, I mean, there's going to be obviously certain populations of people who are going to be more sensitive to that, if you've had stones in the past, et cetera. But for the vast majority of us, like, don't make a mountain out of a molehill. Right. Like, we need to be having the green leafy vegetables.
- [25:12]
A
Yeah. And don't overcomplicate things. And by the way, like, I look at GI map, which is a stool test. I look at the GI maps of women before they go on their carnivore diets, and after. And let me tell you, that microbiome disappears or dramatically decreases, we lose our
- [25:31]
B
diversity means the diversity. We.
- [25:33]
A
We lose our beneficial bacteria when they don't have fiber to eat. So. So genetically, yes, there are some women who do beautifully on a carnivore diet. They are few and far between. And in the women I see in practice, they don't have enough diversity, and they're not eating enough bitter vegetables to stimulate bile production, which helps carry hormones out of our system so we can poop them out. So. But yes. So a lot of women I see have very poor detoxification patterns. I look at how they Methylate. I look at their urinary metabolites of hormones, and if we don't move our hormones through, then what happens? Well, all of a sudden we say, I'm going to go to the doctor and I'm going to get hrt. And then all of a sudden, like, oh, my God, my boobs are killing me. Oh, my God, I've gained five pounds of hormone puff. Oh, my God, I'm weeping at commercials. And I feel like I have PMS all the time. I'm irritable. I'm like, I'm worse than I was before. So that's why supporting your hormone detox really matters. So, you know, you can take supplements that have cruciferous concentrates. You can take glutathione, magnesium, or trimethylglycine. All of those support just how your liver handles hormones.
- [26:54]
B
So you mentioned phase one and two. You call those the washing machine. Did you talk about phase three? I don't know if.
- [26:59]
A
Yeah. Phase three is the gut. That is where the estrobolome metabolizes your hormones. And you can see, you can get a very simple blood test called beta glucuronidase, or the GI map shows it. And if it's elevated, it can be a sign. It's not always a sign that you're not detoxing your estrogen, but it can be a piece of the puzzle. Sometimes it's more of a sign, an overall indicator of inflammation in the gut. But yeah. And you'll know if you're not detoxing, because you're gonna be like, oh, my God, I feel terrible. But understand this, too. If you haven't been on hormones for a long time, let's say you've been in menopause a year or two, maybe more, and then you start hormones. You may gain one to three pounds of fluid or hormone puff for a few months as your body just adapts to all of a sudden having these chemical messengers back in your system. So again, though, you can do all these supportive pieces, you can add some glutathione, some cruciferous concentrates and magnesium, and eat your cruciferous vegetables, be religious about your fiber. And you'll see it will be a transitional time that does not last forever.
- [28:07]
B
And for my dark rose Bettys who want the explanation on beta glucuronidase, basically, when we're talking about the estro, it's so interesting that you say. I say estrobolome.
- [28:15]
A
You're probably right.
- [28:17]
B
Well, I just. I think that there's just like. Just Regional differences in terms of how we. How we pronounce things. So basically what you do in the gut is you basically wrap estrogen up in a. In a present, right? It's like, here's the bow. Get ready to poop this puppy out. But with beta glucuronidase, this is like, for my. My dark roasters who want to know detail, it basically unwraps the present. It takes the bow off of estrogen and allows the estrogen to get resorbed back into the system and into circulation, which is where you can run into some of the things that we're talking about, the breast tenderness, like the, you know, that excess estrogen presentation.
- [28:51]
A
Thank you. That was beautiful.
- [28:54]
B
Okay, so that was just for. I have my light roaster dark. Like my light roast Betties that are like, just tell me what to do. I don't care about all the signs, but I also have to always think about my dark roasters. Like, tell me the mechanism.
- [29:05]
A
Tell me what you mean by that.
- [29:07]
B
Okay, so. Okay, so if. Okay, so just back to this gut liver piece for a second. So if. If a woman's gut is a mess, right? We know that in perimenopause and menopause, obviously, the gut really changes. So let's say she starts HRT anyway. What happens to her? Like, walk us through the clinical picture of someone who's not opening up her detox pathways and fixing her gut. What's going to happen?
- [29:28]
A
Well, she could have those symptoms I was mentioning, like the, you know, water retention or breast tenderness or irritability. But she should also have. I don't want to say it's dire and, like, you have to do all these tests to know, but, I mean, a. You will. You will know because your body will tell you if you're not detoxing, well, you're going to just not feel like yourself. But God willing, I mean, most women I see, they're like, well, I did, you know, I have gained some weight, but, man, I'm sleeping better. Or like, all my hot flashes are gone. I mean, I had a client that would lay out her clothes before bed. She would lay out three different outfits before bed, and she had to change three times a night. And when she came to me, she was like. She had a hoodie on and pulled over and was just like. So she was a shell of herself. Once we got her sleeping, it was like the lioness came back out. And her weight loss didn't happen right away, but she was present in her own life again. So I just Want to, like, put the message out there that this is not some dark, horrible rabbit hole and it's all going to go south the minute you try. Just create space for the fact that, yes, it may take your body a little bit of an adjustment, just as it would with any new medication you try. It may take your body a little time to recalibrate and adjust. But the other good thing is, you know, I've had women just by cleaning up their gut and their inflammation, getting them on a whole foods diet, getting them more fiber, getting, you know, rid of bacterial overgrowth, getting rid of gluten. For a lot of women, that has cleared up hot flashes without any hormonal intervention whatsoever. And that clears out brain fog, because leaky gut connects to a leaky brain. Our brain is a direct reflection of what's happening in our gut, not only our hormones. So I want to also paint the picture of optimism that incredible things happen and we can lose that menopause and we can become more sensitive to insulin. Just flipping our ratios and getting in more protein and fibrous carbs. Versus a lot of women I see super high carb. They're eating what I call ventilator calories, which is like the amount of calories my bedridden patients survived on in the hospital on a ventilator. Like, my patients are eating less calories than they were. They're eating 900 calories a day, saying, why aren't my adrenals functioning? And why is my thyroid so shut down? Because you're not even fueling your body with the right ratios of macros and the right amount of calories. Like women I see, I rarely have to diet them down. I'm spending far more time dieting them up and saying, eat 100 calories a day extra every day this week, and then in two weeks, you're going to have 200 extra calories a day and really bumping up their calories. And they don't believe me. They're like, I'm going to gain all this weight. And. And I'm like, no, we're repairing your metabolism.
- [32:38]
B
Getting like, it's an apple. It's. I'm asking you to eat an extra Apple. That's. It's 100 calories.
- [32:45]
A
Exactly.
- [32:46]
B
No, I actually, I want to. I want to pause there because I think that this is so important. You touched on it before, but I actually think that it's worth highlighting here because it's come up twice now. You said, you know, like, a lot of women when they first get on hormone Therapy. They can have weight gain. Yeah, like, that's the worst effing thing that could ever happen to a woman. Like, hello, you're not sleeping. Hello, your marriage is. Hello, you cannot function as a human in your life because. Because of this loss. So why is it that we always. The goal post is always weight loss, right? It's like, okay, just. You're gonna temporarily, maybe you're gonna have a little bit of extra, you know, junk in the trunk, but your body is gonna recalibrate. Like, it's like this weight gain is like the worst thing. Like, oh, I got. I got off it because I was gaining weight. And then just now, you know, you mentioned that you have to actually get people to have more calories because people are so deathly afraid of gaining weight. And I think that women. This is, I mean, a great opportunity in perimenopause to shock this idea that the only thing that matters for our health is our weight. It's like, that's all we do. That's all we think about, oh, I can't have an extra apple a day because I'm going to gain weight. It's like, who cares? You're going to have fiber from that and you're going to have the adiponectic. You're going to have all the things that come with the apple, and you're going to have better, you know, your metabolic adaptation. Oh, God. Okay, going to step off my. Okay, this is your pod. This is your time. I will. I will step off my, my, my soapbox because I'm about to. I feel myself getting pulled into a rant. But, but let's talk about calories. Let's talk about calories in midlife. Like, how does it change for women? I want to talk about protein and carbohydrates specifically with you, but let's start off with total calories. What do you see for women in perimenopause in terms of their caloric consumption that needs to change? Like, what's the habit that needs to die that they were doing in their 20s and that no longer can happen in their 40s and 50s?
- [34:42]
A
The habit. And I speak from personal experience, I'm sure you've had this, too. In my 20s and 30s, I mean, I would be an hour and a half in the gym. I would do running. I would run sprints for 45 minutes and then lift for 45 minutes four days a week. Girl. I was living on bagels, coffee, Diet Coke and martinis. And I was.
- [35:08]
B
Don't forget the cigarettes.
- [35:09]
A
Oh, my God, the cigarettes. Do I freaking. If I had my druthers, I'd be like a smoking drunk. I swear, now I look at a martini and I feel hungover.
- [35:22]
B
Yeah, you're like, ugh, I'm not gonna sleep tonight.
- [35:24]
A
I'm not gonna sleep tonight. F that. But. But right, So I was so low calorie and under muscled. I was very thin. I was, you know, probably 10, 15 pounds lighter than I am now. But I had. I was so under muscled, even though I was lifting, I was not.
- [35:40]
B
But that's it. But that's it. But that's it right there. It's the thin. Like. Okay, thin. What was thin? What was thin? Your adipose tissue's probably relatively the same, but you didn't have the same muscle. Like, you have more muscle mass now than you probably had then. You have more bone density now than you had then, right?
- [35:58]
A
Yes. All that Diet Coke was not doing me any favors. Or my bones. And don't forget the coffee. Yes, right. And so in midlife, the game changer.
- [36:08]
B
There was also ephedra. You could take a. They had ephedra on the. I mean, do you remember this? Like, it's crazy. Like, I remember taking these fat burners that were like, if I just had this like, flash memory in, like, I think it was like a GNC or something, they would sell, like, ephedra. Like, it's like my heart was my poor heart trying not to have a heart attack. Because this, you know, you could just get ephedra fat burners off the shelf. Right. It's crazy, crazy times. Yeah.
- [36:35]
A
It's unbelievable. Yeah. You were strung out on ephedra and. Yeah, but you look damn thin. Yeah. And. And, but look at what's happening on the red carpet now since. And Listen, I think GLPs absolutely have time and place, but I think GLPs and celebrities who are already thin should be not allowed on the red carpet. I just think the media is. And bodies are now trending. Like, now thin bodies are trending. Oh, now we're supposed to have booties. Like, bodies are never supposed to be trending. We're not trends. We're physical humans. It doesn't make any sense. So midlife bodies. The problem isn't that our metabolisms slow down because the research consistently shows our metabolic rate does not slow down, but we do. And. And we're losing muscle, which. Okay, that can slow down our resting metabolic rate. But we're not exercising the way that our. We're not stimulating the muscle the way that our bodies really need in midlife for longevity and for mitochondrial production and for sleep. And so the approach that you teach your ladies, I teach my ladies, is to refuel properly and, you know, get, get up to 1600, get up to 1800 calories because you're lifting heavy enough and you're moving your body more and your appetite returns because you can digest your proteins now and you're not a farty wind bag all day and you know, you can absorb your nutrients, you know, so.
- [38:12]
B
Yeah, yeah, yeah, because you've, you have a better gut, right? It's like you can have all the protein in the world, but you, if, if you do not have the digestive enzymes to break those baddies down, it's just going to pass right through you. Right? You have to also. I mean, that's okay. So let's actually talk about protein. Yeah, you talk about more protein, more carbohydrates. This is legit. The opposite of what women who are of our age have been told our entire lives, right? So why does it feel like everything kind of falls apart, right when we get to menopause? It's like, oh, now I can't do this and now I gotta have, I gotta quit my job. So I get all my protein in for the day. Like, why, why, why does it feel everything is like flipped upside down on its head?
- [38:51]
A
Because, you know, when our estrogen and progesterone, our estrogen's on a roller coaster ride while our progesterone and testosterone tank. So, so many women come up to me and they're like, I have gained 10 pounds in a month. Like, I can't even tuck my stomach into my pants every morning anymore. Like they're waking up with this huge menopause overnight. And it does, it comes on very suddenly. It's not necessarily a slow creep. So we're caught by surprise. And so we panic and we go back to the only tool we've ever been taught, which is to starve ourselves pretty much and to not get enough nutrients. And it feels terrifying to fuel our bodies. It feels unsafe to fuel our bodies because we think, oh my God, I'm just going to gain more weight and I've got to stop it in its tracks.
- [39:42]
B
Here's something nobody told me when I was grinding through every training session on willpower alone, that your brain runs on ketones. It already knows how to use them and it makes them. The problem is it can only access ketones after days and days and weeks and weeks of strict keto. And most of us aren't doing that. And I also don't recommend that you do that either. And this is where kinetic comes in. It's drinkable ketones. It's not a diet. You don't have to be following a ketogenic diet to take it. It's not a protocol. It's just the fuel that your brain and your body already prefer. Delivered directly without restriction. I drink it before training almost every day and I also take it before long recording sessions or just generally before anything that requires me to be sharp and requires me to be present. So there's no crash, there's no jittery energy from coffee that makes you feel like you're running from something. Just clean, sustained mental output. If you have been white knuckling your focus, it's definitely not a discipline problem. It might just be a fuel problem. Try it out for yourself by going to drinkkinetic.com forward/better and use code better for 15% off your purchase. That's D R I n K K E N e t I k.com better.
- [41:04]
A
The key is to talk ourselves down from the tree and say, okay, what am I doing now? What's working and what's not working? Well, what a lot of women are still holding onto is the really high intensity prolonged cardio. And they're doing it with zero cortisol. Their cortisol is circling the drain. So their body's running on empty and burning muscle, not fat. So instead, if I can get them to walk, just walking is the most underrated exercise on the planet, which is just walking outside in nature does not overtax your body, does not deplete your cortisol enables your body to be in a more recovery, restful movement or recovery kind of movement. And then gentle, slow tempo strength training with a minute or two of rest in between. And then if you are someone who loves sprinting, you know, in a 20 to 30 minute like gentle bike ride, just sprint, you know, once every five minutes. Do it gently, spread it out. Or if you're on your rock, you want to do a 30 second sprint, you know, every five minutes. That's enough to get the job done. We actually can work smarter and not harder during this time, which to me is glorious. Like I have so much more free time now that I don't have to spend an hour and a half in the gym at a time.
- [42:27]
B
And also the psychological hype up, like the hype up girl that you need to be for yourself every day to do that, I mean it is very, very difficult. The other thing I Wanted to add on, like, I think that walking is the goat. Okay. It is the greatest of all time for your joints, specifically. So I, you know, you know that I love to talk about muscle. Of course. Muscle is so important. But the thing that's often forgotten about in the perimenopausal and menopausal space, I find, is joint health. Like, you can't really build muscle if your hips and your knees are gone. If you don't have those joints, you can't do anything. Right. If you don't have shoulders, you can't push up or pull up or do anything right? So. So walking feeds your joints. Like, the joints, actually. Fun fact, little nerd safari, if you don't mind me just saying so, is that our joints are avascular. They don't have their own blood supply. The only way you get nutrients into a joint is through pumping. Right. So every time you walk, there's compression. Right. You compress the knee joint, you compress the spinal joints, all the joints of the body, they get compressed, and then as you step off, off, they release. And then in that vacuum is where you're able to have the nutrients come into the joints. So this is why I think it's a couple years ago. I don't know if people still say it, but they'll say, like, sitting is the new smoking. And while I don't necessarily like, smoking is terrible. Like, obviously don't smoke, but don't be sedentary, because that is the fast track to degeneration of your joints.
- [43:57]
A
Yes. And you will see what you reap, you sow. So you will see now, as you're a midlifer, you will look around you. You can see who's been taking care of their bodies and who hasn't. They move differently, their energy's completely different, and it really adds up. And the good news is, though, is that even if you've been, you know, you've fallen off track, I, too, struggled for quite a while with strength training when I was really struggling with Lyme and mold and adenomyosis, it definitely took a backseat, but. But now I'm lifting again. But your muscles do come back. You do have memory. You can rebuild. Like, it's never too late. I mean, you can build muscle in your 90s. There is research that has shown and proven this. So it is never too late to start and get your groove back.
- [44:47]
B
Yeah. And if you're injured or you are dealing with something like Lyme or mold, like, take. Take some comfort in the idea that you're when you're lifting. So let's say you've built up some type of muscle reserve, we'll say. And then you lose it. You've been injured and you've had to stay away or you weren't able to because of mold or Lyme like you were talking about. Your muscles actually have these little protein factories that they create, which is why it's so hard to create, to build. It takes it's years and years and years to build it. But once it's built, it's like you have these little factories that can just create them. Those factories don't die when you're inactive. Right? Which is why maintaining muscle is far easier than building it, because you just have to stimulate the protein factories. Like, some of the time, it's usually like 30% less than what it actually takes to build the muscle. So if you're injured or you have some type of therapy or you're not able to for whatever reason, you can actually get there faster because you already have the infrastructure in the muscle to drive the muscle growth. So again, little nerd safari, as I mentioned, but just also wanted to give people a little bit of, like, comfort because I used to be so terrified if I took any time off of. Of working out that I was going to lose all my gains, I was going to lose all my progress. But you don't. You get it back much faster than if you're just a newbie, you know, starting out for the first time.
- [46:03]
A
Nerd safari. I may have to swipe that. I just call it porn. I don't know.
- [46:10]
B
The pubmed porn, right? It's like, what are we going to find tonight? Bounce. Okay, so let's, let's come back to. Let's come back to carbohydrates, because this is the other one. This is the other one that so many ladies I feel get wrong. So for the woman who is afraid of carbohydrates, how do we get her on board?
- [46:29]
A
For the woman who hasn't looked at a carb in a long time, you've gotta ramp up slowly or you will gain weight. Because carbohydrates help you retain water. I mean, that is part of their metabolic or biochemical composition, I should say. So if you have been low carb for a long time, you want to ramp up, up slowly. And your target would be 100 grams to start and then build up from there. And I say, you know, add in a quarter cup of cooked starch a day and then half a cup, you know, from a sweet Potato or, you know, some legumes or quinoa or rice or fruit, just start adding in and ramping up very slowly. The thing most women don't understand or realize is that carbohydrates in activate the conversion of T4 to T3, which is a very. It's a wonderful metabolic support and will help you in the fat loss department. But here's another benefit is perimenopausal women. You know, I would say 80, 85% are struggling with sleep and insomnia or they're falling asleep, but they're waking up at night. And when they're waking up with cortisol spikes or they're waking up with hypoglycemia. So eating carbohydrates with your dinner in particular, God forbid, have a cup of cooked starch like again, sweet potato, plantains, rice, quinoa, white potatoes, those that you're going to get a bump in insulin. You're going to pair it with protein and fibrous veggies, but you'll still get an insulin bump. And what that does is it tamps down your cortisol. It's antagonistic to cortisol for you dark roasters out there, so it's going to help you sleep. You don't wake up in the middle of the night because you're blunting that cortisol response. Now, estrogen and progesterone can also support that, but having some carbohydrates with your dinner can also be a super useful tool. And we need to replenish our glycogen stores post workout so you, you know, otherwise it can make your workouts exhausting and it can be harder to build muscle without optimizing your carbohydrates. So how do you figure out your own unique carb tolerance? You log your food. Can use a free app like my Fitness Pal, I'm sure Apple has some. And log your food and you see how many grams of carbs you're eating and you look at your symptoms. It's saying, well, how's my hunger, how's my energy, how are my cravings, how are my workouts, how's my sleep? And you look at all those metrics. And I do like to get women generally one to one ratio of protein to total carbohydrates, which is not the same as net carbohydrates. So if a woman's eating 130 grams of carbs, I like her to have 130 grams of total carbs. And when you deduct the Fiber from that, you get 100 grams of net carbs. So, and that's not a huge amount of carbs. A lot of my women bump up and they'll have, you know, 150 grams of carbs, 130 grams of protein. It, it really depends on how strenuously they're working out.
- [49:51]
B
Yeah. And I think for the woman who's been, let's say, low carb keto or whatever carnivore for years, who's been having in some cases less than 50 grams of carbohydrates a day, like that hundred is a big, like you're essentially two xing, right. Like you're doubling there, you're doubling that intake. So I like your, I like your thought there around slow and steady, right? Slow is steady and, and, and, and steady is slow. So I, I like that graduated approach there. I think that that'll probably, you know, really help with the digestion, the bloating and just allowing your body to, to assimilate. But the other, like, I think you mentioned it, I think it's really important to also track your performance, especially at the gym. If you're someone who likes to gamify numbers and you're looking to improve your numbers volume over time, maybe you're looking to improve your, you know, the, the, the speed at which you run a mile, something like that, or you're sprinting the distance that you travel. Carbohydrates are essential. Like, it is the, it is, you know, carbohydrates break down into glucose. It is the molecule of life. It is the main fuel that your body works on. So, yes, ketones are great. I use ketones all the time. Had some ketones actually, before we started this podcast. But I also, you know, I just love, love, love carbohydrates for what it does for performance in the gym. Mental clarity, as you're talking about, mood, sleep, all the things that a lot of women struggle with. And I asked this to a lot of guests on the show because this is the one resistance that I often come up against. Like, oh, carbs, I don't know, you know, like, I had a woman come up to me at the gym a couple weeks ago, maybe a month ago now, and she was asking me like, oh, how do, how do I look the way that I do? Like, how do I have like such a full, you know, she was like, how do you have such a big booty and such a flat stomach? And this was her question. And I, we were talking for a little bit and I was Essentially eating, like, double the calories that she was like. I think she was taking in, like, 1100 calories. I was eating double that and almost triple the amount of carbs that she was. And so I think that. I think that women would be well served to just, you know, like, just try, you know, like, maybe you're having 50 grams a day. Maybe. Maybe this week you're gonna have, like, 60. You know, it's like, you know, very. It's like what we were talking about with the reverse dieting before. You're like, we're just. Just getting you to have a hundred extra calories a day. So maybe you're just going to increase your gram carbohydrate count by 10. Right. That's still only, you know, really, it's like 40 calories, if I'm doing my math correctly there. Right. So it's not. It's not that big of a deal. It's not that it's not, you know, but it is going to slowly allow your body like, oh, there's more food here. Oh, I feel safe. Which is something that you said before that I wanted to come back to. You said, like, women, you were talking about, like, eating as a safety metric, and I think that that is so true. Like safety. The female body is always looking for signs of safety, and food is one of them. Food is one of the ways that we feel safe.
- [52:35]
A
100%, yes.
- [52:38]
B
All right, friends, there are a few major verticals that you should be investing in for better skin. First, a gym membership. We all know that training and cardio is great for your skin. Orgasms.
- [52:49]
A
Hello.
- [52:49]
B
Obviously. And a great skincare line that makes your skin look and perform like younger skin. Now, when it comes to your face, specifically, as you age, skin tends to become thinner. It produces less collagen. The proliferation and turnover goes at a slower rate, and it accumulates more damage with time. Now, in the world of dupe culture, this is where I firmly believe in investing in the right technology and the right brands. And one skin is the first peptide proven to reverse skin's biological age. The scientists there analyzed key aging biomarkers in human skin samples before and after treatment in the lab. And they found that the OS1 face cream that has that OS1 peptide increases epidermal thickness, supports collagen biosynthesis pathways. So for my nerds out there, this is the COL1A1 pathway. And it promoted cellular proliferation, or that skin turnover. And when it comes to your eyes, which are typically five times thinner than the rest of your body, using their OS1 eye cream, which is formulated with the highest concentration of that OS1 peptide. This is going to help target the accelerated eye aging that many of us see at the molecular level. There was a recent 12 week clinical study on the OS1 eye cream and it was recently published in the International Journal of Cosmetic Science. And the researchers there found significant improvements in appearance, in hydration, in under eye elasticity, firmness and skin barrier function. And they also noted decreases in fine lines and wrinkles under eye puffiness and dark circles. This has been a skincare line that I have been using for the better part of two years and I swear by it for you. If you want skin that looks and behaves younger, I want you to head over to OneSkin Co Better and use code better for 15% off your first purchase.
- [54:54]
A
You know what happened to pleasure, by the way? Like, pleasure is its own nutrient. And you know, I, one of my clients last week, you know, I keep trying to remove the words good and bad from her and she's like, I fell off the wagon. I said, what if there was no wagon? Have you ever considered that? And she just, it's just a spectrum. You're going to overeat calories some days and under eat others. It's just how it balances out over the course of the week. And if we took something simple and stopped over complicating it, we'd free up so much more real estate. And it's not good or bad. We don't need to feel naughty or I'm having a cheat meal. What if you just had the piece of carrot cake for dessert and then the next day either walked a little more or cut calories by 100 or 200 calories just for that day and then you're evened out. It just, it doesn't have to be this huge performance, you know, it really doesn't. It's just a conversation.
- [55:57]
B
You've been in the menopause space now what, 28 years?
- [56:01]
A
Yeah.
- [56:01]
B
Ish.
- [56:02]
A
Yes.
- [56:02]
B
Yeah. Okay, so the menopause, like right now I see the, the menopause industry is sort of like exploded, right? Like, it's like there's influencers and there's supplements, there's brand, like everything, right? Everything is like the, what's the term? Mena. Washing, right? It's like, oh, there's this, there's this tea, but we're going to call it a menopause tea. We're going to charge five times the price for it.
- [56:26]
A
So I.
- [56:26]
B
My question to you, it's a Bit. We'll call it salacious. Is this helping women or is this menopause movement? We'll say doing what diet culture did to weight loss, which is like turning a systematic failure into a personal, you know, a personal failure and a personal shopping problem. Right. So then now every woman thinks, well, I gotta have. I have to have this weighted vest and I have to have these supplements and I have to have this menopause tea, and I have to, you know, like, is this, like, are we doing women dirty by this sort of explosion of, you know, this menopause industry, we'll call it?
- [57:02]
A
I think it's a really mixed bag. Some products, yes. I mean, if you see products that are not transparent and just want to sell you a proprietary blend, no, that's a red flag. That's a true lack of transparency. And believe me, I'm just as guilty. I've bought lotions and creams because I'm like, that will get rid of all my wrinkles overnight. No, it won't. It really won't. I too have fallen prey. But, you know, at the same time, is it opening up the conversation and the awareness also? Yes, and I think that's a really positive sign. So what's the antidote to falling down? The Menno washing well is to work with a provider who is hormone literate, who isn't going to just write you a prescription for birth control and tell you to have a glass of wine, who isn't going to tell you to change sex positions when your libido is low or do. What my provider did was hand me a prescription for Xanax and a copy of the Kabbalah and then told me to put it under my pillow when I couldn't sleep. Oh, that was so special.
- [58:09]
B
Oh, wow.
- [58:09]
A
You better believe that. Went into my TED Talk, I was like, oh, that was like gaslighting with a capital G. So, yes, you want to find providers that are going to custom tailor and educate you and be like, are you sleeping? What is your stress management? Like, does the thought of sex make you want to run screaming? Or like, how do you feel in your body right now? What are your aches and pains? What's your stress like? You know, we're also at this age where we have teenagers at home. We have aging parents. It's a really. And our careers are at the top because we finally earned our stripes and all of this. So the demands and the pressure are incredible. And it's so wonderful when a provider even asks us questions like that and can just sit and Say, just help you flush out and process what's happening. Most women don't even know how badly they're feeling because they don't have time. They're just muscling through and gritting their teeth and being like, yes, this sucks. I feel like absolute dog poop. But I've got to go pick up my kids before I head to my job, and then I've got to squeeze in a workout, and then I have to drop meals off to my parents. You know, it's just. There's a lot happening. So if we can just increase our awareness and make one or two gentle ads at a time and work with someone who's really gonna track us. Be like, hey, can you just add in, like, 2 ounces of protein at your breakfast to what you're already eating? Can you, you know, prep some food ahead of time or order food delivery? You know, order some roast chickens and order some bags of lettuce, some spinach, or high oxalate or, you know, fresh vegetables that are already cut up.
- [60:01]
B
Or steam them. You just have to steam them. You just steam them.
- [60:05]
A
Yes, exactly. So, like, you know, just ways to strategize how to eat a rhinoceros, which is one bite at a time.
- [60:16]
B
I love that. I love that. Okay, so we want to also make sure that women are not blaming themselves, because I think that, like, I do that, right when something goes wrong, I'm like, what did I do? What was my first thought? It's like, what did I contribute to this gargantuan mess? So if someone is. We have a woman in a doctor's office, let's say, what are some labs that maybe she wants to ask for if her doctor hasn't already offered them them?
- [60:43]
A
So I love to do a comprehensive thyroid panel. And that is not just a tsh. Tsh, Thyroid stimulating hormone. That is one marker for thyroid function. We want to do T3, reverse T3, T4. We want to do TPO, which is your thyroid antibodies. I have told many clients they have had Hashimoto's and their doctors. Doctors did not, because they never look at their tpo. And it's very easy to miss hypothyroidism because perimenopause has a tremendous amount of the same symptoms.
- [61:21]
B
Yeah, I've had doctors refuse. So I've had. I've given patients. Here's the thyroid panel that you go with. And then the patient will come back to me and say, my doctor won't run these. And I'll be like, why? She's like, well, and I realized this a couple years into when I was in the. This space is like, oh, it doesn't actually change the doctor's care. Like they're just going to give you Synthroid, right? It doesn't change their care, so why would they test for it? And they don't know what to do with those results anyway. Like, if she does have Hashis, that doesn't for most, not all, but many medical doctors don't know what, what to do with that. Like, they're like, yep, yeah, Some antibodies, it's normal. It's like, no, no antibodies, that's the normal amount.
- [61:59]
A
None, zero. Or they may just need T3. Maybe it's just a conversion issue too. Right. Which, right again is why we need to eat those carbs, ladies. It's to support thyroid and adrenal function. So full thyroid panel. So full thyroid panel. I love cardiac risk factors. I love looking at insulin, which is a cardiac risk factor. Insulin, fasting insulin, glucose and A1C. But I also look at homocysteine, I look at APOB. I look at CRP, C reactive protein. These are potentially predictors for coronary artery disease. I also look at obviously cholesterol and triglycerides. Every doctor runs that serum. Red blood cell. Zinc and magnesium, supremely helpful. Ferritin and iron. That's another indicator of thyroid function.
- [62:49]
B
Yeah, yeah, great.
- [62:50]
A
Those are, yeah, some just very good foundational tests. DHEA sulfate, estradiol, progesterone free and total testosterone. Those are also really good tests. You can look at FSH if you want to see where you are in perimenopause or menopause. All of that is very helpful.
- [63:10]
B
All right, so let's land the plane. We have a woman who is. I'll give you a couple clinical scenarios. So woman who is completely overwhelmed right now. Okay? So she's exhausted, she's confused, she doesn't know where to start. What is the one thing she needs to do this week?
- [63:24]
A
Just start adding protein at breakfast. Get 30 to 40 grams of protein at your breakfast so that you can fuel your day. You don't have the 3pm crash, you get your serotonin and dopamine up, which are very feel good neurotransmitters in the brain. You regulate.
- [63:42]
B
Give me examples. What's 30 to 40 grams? What does that look like for you?
- [63:45]
A
That would be at least a cup of cottage cheese. That could be three quarter cup of Greek yogurt with a scoop of protein powder. That could be two scoops of protein powder. Two whole Eggs plus two whites or two eggs plus two ounces of smoked salmon. All of that will bring you to at least 30 grams of protein. But you can also have steak or leftover chicken or burgers. Like your stomach doesn't care.
- [64:12]
B
What you said you can have steak for breakfast. I mean, you know, I love it. I know. But in we know we tend to have like, eggs and cottage. These are very breakfast typical.
- [64:21]
A
Yeah.
- [64:21]
B
But I also sometimes when I'm like, nope, I'm gonna have last night's salmon. I'm gonna have last night's grilled salmon. That's what I feel like this morning.
- [64:28]
A
Oh, I love that for breakfast. I love having salmon for breakfast. It's so yummy.
- [64:33]
B
What do you. What do you think? The best part about menopause is that nobody ever talks about it is the
- [64:38]
A
beginning of our zero F's era, where we step into our greatest power. And actually, energetically, your ovaries have wound down the party. So that creative energy goes to your heart and it goes to your brain. So you are so much more able to just be in your absolute power. And the estrogen's gone. Even if you replenish it, it's at much lower levels than your body's making. So with that comes a loss in filter. You are clear about what you will and won't tolerate. This is why the divorce rate is so high. Midlife. Because women say, the person I was and married in my 20s is not the person I am or married now in my 50s. And first start hormones, ladies, before you go down the divorce path. But for some women, the divorce is just genuinely a sign of their growth or just not being aligned with their partners anymore. But I think it is absolutely my favorite, favorite time in Life. Now I'm 55, and in four more days, I'm going to hit my official menopause marker. And I'm like, wow, I am sleeping through the night. My digestion is so much better. I've lost the bloat. I've lost like £10. And I just feel so much better. And I eat a lot, ladies. I don't skimp on calories. Like, people make fun of me because I will really. I'm like, no, keep feeding the Esther. Like, more food, please. I really do not eat like a bird ever. Ever.
- [66:17]
B
I really love that because I think that we do have to reframe, like, often. See, on social media. It's like when I hit perimenopause, my whole life fell apart. And it's like, listen, I'm not I'm not saying that that's not true. And that is true for a lot of women, even if you're doing all the right things and not. But. And it can also be one of the best. Like, some. If you've ever had anything difficult happen in your life in the moment, it feels like absolute hell. But once you're past it, you're like, I am so grateful for that because I figured out who I was, what I was made of, and I got through it. And now I'm on the other side of it and it's like, now it's rainbows, right? So sometimes, yes, going through the transition can be difficult. And I'm not trying to minimize it. And I think that there's a story. And I find this is more with social media influencers rather than, like, people. But they're like, perimenopause is the worst buy my, you know, whatever hormone balancing sheet or whatever. And I. And I. I just. I just love this idea of like, hey, yes, this is gonna be difficult, but you can do difficult things because you are fucking badass. And on the other side of it, it's exactly everything that you just said. I'm sleeping well. I feel good in my body. I am. No, I'm. I'm in my zero Fs era. And that veil has lifted of my creative energy. I love that you said that. It's in my heart and it's in my brain. And now I can focus on. Instead of being in service to others, which is typically what we do, and with love. Like, I have spent years being a mother and loved every minute of it and a wife and all the things. And now as I myself, I'm in perimenopause myself moving through this. I am very excited about all of that creative energy and being able to focus it in all the places that. That delight me, me that I. That I choose, you know?
- [68:07]
A
Yes. And it. It really. It really is glorious when you get to fill your own bucket again when your kids leave for college. You know, I know a lot of parents are devastating but devastated. But I'm also like, also remember that you actually get to get up in the morning and don't have to take care of anybody else like you. It's glorious. Like, it's so. It's so, so, so nice. And you think, oh, my gosh, I have free time again because I'm not preparing meals for everyone else. I'm not, you know, prioritizing everyone else. I get to prioritize me again. And it's a real return to the self and a real new chapter of like, well, who am I now? And who do I want to be? And do I have to keep grinding and hustling? Or is that era done for me? Can I just focus on what feels most aligned and true to me and trust my intuition and trust my body? Because we have partnered through this massive hormone and neuroendocrine storm together. So, like, what does that look like on the other side for me? And just holding possibility for incredible growth and freedom and travel and opportunity. And I'm blessed in that, like, for me, my husband and I, we're like, this is Shangri La. I mean, we're just hanging out, having a ball. We hang out in the hot tub. We. We light fires. Sometimes we're just quiet and don't talk to each other. You know, we're reading or. And it's just. But it's so nice. It's like we're dating all over again and we remember who we were before we had a son. And, you know, it's just. We're able to actually be attentive to each other without the stress of parenting every single day. Because that is really hard on a marriage, is parenting.
- [69:50]
B
Yeah. Yeah.
- [69:51]
A
And it's awesome. It's a gift. I love being a mom, but I also love of just the calmer nature of not having a teenage son at home.
- [69:59]
B
I love that, too. No, it's like, it's been the greatest privilege of my life to watch my boys grow up, and they're still growing up. And I also. I can also see that, too. I can also see myself enjoying, like, you know, long, delicious mornings if I so choose long, uninterrupted times at the gym because I gotta get home before this time and that. So I love that.
- [70:18]
A
All right, so for you, just wait.
- [70:20]
B
I. I am the days. Yeah. So where can people find more about you? I know, I understand that you just did a TED Talk. I don't know if it's going to be out by the time this conversation comes out, but where can people find more about you and your work?
- [70:34]
A
Please hang with me on Instagram at Gorgeous Esther, and you can go to my website, estherblom.com I have a free gift. Top hormone test that every perimenopausal woman needs to know. And yes, DM me with any questions. I do work one on one with clients and I have a podcast called the Midlife Realignment.
- [70:56]
B
All fantastic. Will all be in the show notes. Thank you, Esther. This was a delight.
- [71:00]
A
Thank you
- [71:03]
B
welcome to the after party where we have a little party about what I loved, what I didn't love about the conversation today. So I thought that this was a great conversation. I thought that the conversation around down beta glucuronidase, that's my, my dark roasters. That's what we were talking about with estrogen being repackaged and reabsorbed back into the system. I thought that that was really great. And I thought that the whole comment around the idea that if you are on HRT but you don't have your detox pathways open and functioning optimally, that it's not going to be as optimal as maybe you're hoping. I thought that that was a really good distinguishing feature. We haven't really talked about it too much on the show. I definitely loved the conversation about like cigarettes and martinis. Like, you know, we sometimes we have this nostalgia for the 80s and 90s and like, as she was talking, I'm like, oh my God, they had ephedra. You know, they had ephedra on the shelves for purchase for humans and they didn't titrate it for men and women. Like I was taking like the same dose that the guy next to me was having and it's like, do I, am I having a heart attack? Can I smell burnt toast? That's a total Canadian reference, by the way. Tell me the Canadians are listening if you get that. That's from the, the CIBC commercials where they're like, he smells burnt toast. He must be having a stroke. Anyway, I, but I digress. So cigarettes and martinis, I loved that. And the other thing I really liked was the two concepts. Actually, there's three concepts that were sort of like a through line of the entire conversation and that was that women are like, you know, so afraid sometimes of gaining weight that they will not want to go on or stay on hormones because of that initial bloat that sometimes can happen. It's like, it's like that we, we got to really, we got to really work to fix that. It's like, honey, you are not sleeping, your marriage is falling apart, you're snapping at everyone, you're miserable in your own skin. Like maybe we're going to have a 10lb weight gain for a couple of weeks as the body recalibrates. Like that's totally fine. And I, my, my heart breaks for people like that too because I think we've, I mean we've all, we've all been conditioned in some way to have this idea that you just cannot age. You Cannot gain weight. You must be thin all the time. Like that is, is so shoved down the throats of women. So I can, I, I understand and I empathize with it as well. And I, what I really want is, I want to help more women make peace with that. Right. Because if you can get on hormone therapy and that's going to measurably improve the quality of your life, but you're going to be temporarily heavier, like. Yeah, worth it. Totally worth that trade off. Off. The other thing that I, I like that she was talking about when we were talking about food was I actually wrote it down in my notes. She didn't say this, but I wrote down, I wrote down vitamin P. Pleasure. Right? Like, we forget that pleasure is also a nutrient, which is what she said. And I loved that. I think that thinking about, I mean, my favorite breakfast of all time is like sourdough toast avocados and like an omelette on, on it. And I just could not. It's just not. You can't have it without the sourdough. It just doesn't make sense. And so I love, love, I love food and all many different, but sourdough is like my, that is my love language is sourdough bulls. So I just think that this idea of also eating for pleasure is something really beautiful as well. Overall. Loved, loved, loved the conversation with her. Let me know what you thought. What is going to be your big. What is going to be your big takeaway? You're going to have a little bit more carbs, maybe? Are you going to think about vitamin P, vitamin pleasure? A little bit. Are you going to be thinking about weight training? Maybe a little bit more than the hours of the cardio than we all kind of grew up doing. I want, I'm interested. Let me know. Leave us a comment on Spotify or Apple or wherever you listen to the show. And until next time, my friend, I bid you at you. I hope you enjoyed today's episode. And now I must give you the obligatory legal and medical disclaimer. This podcast, Better with Dr. Stephanie, is for general information only. The advice and recommendations we discuss do not place medical, chiropractic or any other primary healthcare provider's advice, treatment or care in the consumption of this podcast. There is no doctor patient relationship and the use and implementation of the information discussed are at the sole discretion of the listener. Please take this information to your primary healthcare provider to make the best choice for you. Remember, I am a doctor, but I am not your doctor and these episodes are meant for educational purposes. Only.
- [75:24]
A
You are hilarious. You need like a stand up routine on the side. Oh, my God.