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Tag: bone density

Mini Pause #93: If getting up hurt this morning, this is for you.

Posted on by stephanie-estima

TL;DR

If your first few steps in the morning suddenly feel like you’re walking on knives… congrats! You have what I am lovingly calling a sleeping injury.

You know, something that popped up out of the blue in midlife that would have never happened in your 20s before your body needed an engraved invitation to function at a bare minimum?

Welcome to the era where collagen turnover moves at the speed of continental drift and your fascia files a formal HR complaint every time you dare to stand up.

Today, we’re talking specifically about plantar fasciitis (or more accurately, plantar fasciopathy).

WHY

Your fascia doesn’t track macros. It tracks load, repetition, and how many times you’ve sprinted in bad shoes while late for school pickup. You can stretch, eat your protein, lift heavy weights, and still wake up one morning unable to walk to the bathroom without cursing the gravitational pull that requires you to be vertical.

Plantar fasciitis is the #1 cause of heel pain and ranks in the top 10 issues women deal with in perimenopause and menopause.

Under a microscope, chronic plantar heel pain shows collagen wear-and-tear (“fasciosis”) rather than classic inflammation. Your fascia is the exhausted overworked intern of your musculoskeletal system – underpaid, under-rested, and starting to crack. PubMed

Women are the chosen ones. Perimenopause is like a years-long endurance test to see what we’re really made of… at least that’s what I’m telling myself because there HAS to be a reason we’re playing whack-a-mole with our midlife ailments!

Here’s the kicker (because I know you’re loving all this great news): As estrogen falls, your tendons and fascia lose elasticity and resilience.

Estrogen normally keeps collagen supple and tissues hydrated. Without it, those tissues become stiffer and slower to repair – so any repeated load (heels, chasing kids, strength training) can push your fascia past its limit. With no warning. PubMed Central+2BioMed Central+2

Babies, Parties, and Ugly Shoes

If you’ve had kids, pregnancy, post-partum, and perimenopause make a charming tag team. Weight gain in pregnancy plus ligament laxity (relaxin) flattens the arches and can permanently lengthen the foot, raising plantar‑fascia strain. PubMed Central+1

I remember my foot went up an entire size in the 2 years following the birth of my children! Add in years of narrow shoes or heels, and, well… you get the picture. PubMed Central+1

Now, ya girl here loves her a good pointy heel in a dress when the time and occasion call for it. So I’m not saying never wear heels! I’m just saying, can we choose shoes with a wide base (where the toes are) and no heel most of the time?

It's like our diet. It's not like you can never have chocolate. It’s no problem when your diet is made up of primarily good protein, fruits, and veg.

I have recently discovered a brand of shoes, Saguaro (use code BETTER for 10% off!), that are both cute and inexpensive (my fave combo!) that I am using for everything – leg day, walks, and my Z2 stairmaster cardio days.

Now, usually functional footwear is ugly (sorry not sorry), but these are so good I even have buy-in from my husband, who, if you know him, has a pretty sizeable sneaker collection.

Put Ya Dang Feet Up

Other big risk factors for plantar fasciitis are obesity, long hours on hard floors, and tight calves (reduced ankle dorsiflexion).

And again, women are over‑represented in many standing occupations like nurses, waitresses, flight attendants, etc, so get yourself some good shoes ASAP. PubMed

 

HOW

In my clinic, the telltale sign of plantar fasciitis was tenderness at the medial calcaneal tubercle (inner side of the heel bone). Or, I could reproduce the pain – and risk an ear-piercing scream from my patient – by lifting the big toe back for the windlass test. NCBI

Once that was confirmed, we started rehabbing.

Fix Your Footwear

  • If your shoes taper like a carrot, they’re strangling your fascia. Swap out the narrow ballerina flats with a wide-toe box. Minimize heel wearing for now.

Stretch It Out

  • Do that windlass stretch. Sit down, cross the sore foot over the other knee, grasp the toes, and pull them up. Hold for 10-20 seconds, 10 reps, 2-3x/day. PubMed+1

Load It Slowly

  • You can’t ice your way out of a load problem. Do high-load heel raises with your toes on a towel (for dorsiflexion). Do 3 sets of 8-12 reps at a slow tempo and add weight as tolerated. PubMed
  • You can add intrinsic foot work like short-foot holds (press the ball of your foot down without curling your toes) or towel curls to support the arch, which acts as your fascia’s bodyguard. PubMed Central

Help It Along

  • Use kinesiotape for the first 3-7 days to unload the fascia. You’ll likely need a practitioner’s help. BioMed Central
  • Wear circulation socks if morning pain is brutal. I like the ones from Incrediwear (use code DRSTEPH20 for 20% off)
  • Do some gentle rolling with a lacrosse or yoga ball

 

NOW

Here’s your 2-week Mini Pause protocol for plantar fasciitis:

Days 1-3

  • Switch to a wide toe box shoe for everyday life (code BETTER for 10% off)
  • Do the windlass stretch 10× (10–20 s) morning & evening and roll foot 1–2 minutes after stretches. PubMed
  • Apply taping if first‑step pain is high and re‑tape every 48–72 h for up to one week. BioMed Central
  • Sleep in circulation socks (code DRSTEPH20 for 20% off)

Days 4-7

  • Start high‑load heel raises with towel under toes: 3×/week, 3×8–12 slow reps (add a backpack or weighted vest for load). PubMed
  • Add short‑foot holds (10×10 s) daily. PubMed Central
  • Avoid long static standing and any heel‑dominated shoes. OUP Academic

Week 2

  • Keep stretching daily; continue heel‑raise progression.
  • If mornings are still rough, try a night splint for 2–4 weeks. MLTJ

Still >5/10 pain with first steps after 2–3 weeks of consistency?

Book a doctor’s visit (chiropractor or physical therapist preferred if you have one!) to confirm the diagnosis, optimize loading, and look at more aggressive care.

Bottom Line

Plantar fasciitis isn’t a forever injury. It’s a tissue tolerance problem. Basically adaptive biology in a bad mood.

Load it right, support it smartly, and remember that the goal is to future-proof your facia so your next decade isn’t spent limping before coffee.

 

Sending you soft heels,

Dr. Stephanie

 

WHAT I'M LOVING THIS WEEK

BiOptimizers Magnesium Breakthrough¹

A few years ago, I hit that “tired and wired” era. I’d be at the clinic treating patients all day, squeeze in my training, be full-on with the kids, and then collapse into bed exhausted after winning bedtime battles… and then… nothing.

My brain would rev like a Formula 1 car. I’d wake up in the morning and feel sore as hell from my workout and be completely demotivated to get out of bed, let alone back to the gym.

As a practitioner, it was a lightbulb moment. I need magnesium, and I needed it fast.

Ever since, I have taken magnesium nightly after dinner – non-negotiable. Within a week of starting, I wasn’t clenching my jaw. I wasn’t waking up at 3 AM replaying my to-do list. My muscles were ready to go crush a lift.

Now, not all magnesium is created equally. Most supplements only cover one or two forms, which is like giving your body a screwdriver when it needs a toolbox.

I use Magnesium Breakthrough from BIOptimizers because it has all seven forms of magnesium I want.

For women in midlife, cortisol is a moving target, and sleep feels like an Olympic event. Magnesium is your ticket to downshifting your nervous system without wine or willpower. It’s like an exhale in a capsule.

Try BIOptimizers and get a good rest. Be sure to use code ESTIMA for 15% off.

 

Attn: Grace Hybrid Pads2

Periods and bladder leaks… excuse me, but why did nobody warn us about this absolute faceplant of a combination?!

Perimenopause can lead to the return of high school-level period chaos, like the encore performance no one wanted. Add in some post-baby, midlife pelvic floor weakness, and you’ve got yourself a real party.

But period products aren’t made to absorb bladder leaks and the bladder leak products don’t deal with the menstrual cycle needs, and honestly… who wants to feel like they’re in a diaper in their 40s?!

Attn: Grace’s Hybrid Pads have become my default recommendation for women who whisper about bladder leaks or wild periods that have never met a calendar they couldn’t defy.

I absolutely love the women behind Attn: Grace because they treat midlife bodies like the sophisticated, powerful, sometimes unpredictable systems they are. They are all about keeping dignity as a top priority.

I want you to feel cared for, not managed or shoved to the side. You deserve these shockingly comfortable pads that keep all the toxins far away.

Try Attn: Grace’s Hybrid Pads now, and check out their full collection to get exactly what you need for the body you have right now. Use code ESTIMA20 for 20% off your first order on attngrace.com

 

Manukora Honey

When I was deep in postpartum recovery, I became obsessed with immune resilience and gut repair. The clock had started on 20+ years of kids counting on me to show up, and getting sick was not something I would have time for anymore.

I dug into the research (some people scroll Instagram, I scroll PubMed – don’t judge) and found that my kale and kombucha weren’t going to be enough anymore. I needed honey… and not just any honey. Manuka honey.

Manuka honey is unique because it contains methyglyoxal (MGO), a compound that gives it antimicrobial and anti-inflammatory power. Clinical data backs it to support wound healing, oral bacteria balance, and stronger gut mucosa.

Sign. Me. Up!

I keep a jar of Manukora MGO 850+ Manuka Honey on my counter and guard it like liquid gold. If I’m feeling ambitious, I’ll stir a spoonful into a cup of tea or a bowl of oatmeal. If I’m any level of rundown, I’m SO not above just downing it straight off the spoon.

The taste is WILD… earthy, floral, and caramel-y. It’s like medicine that forgot to taste like a punishment.

Every batch of Manukora honey is tested for purity and MGO levels, and every jar has a scannable QR code that traces it right back to the hive.

Biohacking on a spoon? Get yours now to save up to 31% plus $25 worth of free gifts with the Starter Kit, which comes with an MGO 850+ Manuka Honey jar, 5 honey travel sticks, a wooden spoon, and a guidebook!

 

🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

 

 

Disclaimer: The information included in a newsletter, email, or on drstephanieestima.com is intended solely for educational purposes. It does not replace a direct relationship with your licensed medical provider and is not intended to diagnose, treat, cure, or prevent any disease.

Affiliate Disclosure: Products mentioned in a newsletter, email, or on drstephanieestima.com, may be part of an affiliate agreement in which Dr. Stephanie Estima receives a small commission on the sale of an item you purchase.

Notes:

1. Use code ESTIMA for 15% off

2. Use code ESTIMA20 for 20% off your first order

 

 

Mini Pause #88: Can vibration protect your bones and tendons?

Posted on by stephanie-estima

Have you ever seen those vibrating platforms tucked away in the corner of the gym? It might look gimmicky, but I promise it's not a shakeweight situation. Research shows that whole-body vibration (WBV) is actually a goldmine for your tendons, ligaments, and bones.

I had one in my clinic for years, and it was a staple in rehab and prehab. I still use it every day.

It is right for you? Hop in my Jeep, keep your arms and legs inside the vehicle at all times, and please do not feed the animals any of your emergency granola.

We're going on a nerd safari!

WHY

Midlife comes with a few big realities:

  • Tendons heal slower
  • Joints feel stiffer
  • Bones aren't as forgiving as they used to be
  • Injuries take longer to recover
  • Bone density is a group project, and you're stuck doing all the work

I hate to be the one to bring you all this delightful news, but I love you too much to keep the truth from you.

WBV (remember: whole-body vibration) is a gentle wake-up call to your tissues. It's a way to stimulate healing and repair without pound-pound-pounding on your poor joints.

For women in midlife navigating perimenopause and menopause, this can be a game-changer.

HOW

Here's the science of how WBV works:

  • Tendons and Ligaments:
    Vibration creates micro-stretching at the cellular level, stimulating fibroblasts (cells that make connective tissue) to make more collagen (the scaffolding of these tissues). It also boosts nitric oxide (NO), which helps improve blood flow to areas that rarely get it. Over time, tendons actually stiffen in a good way, making them stronger and more resilient.
  • Bones:
    WBV acts like mini-impact training. Vibrations activate bone-building cells (osteoblasts), improve fluid flow through bone canals (for my dark roast Bettys, if you want to go down the rabbit hole of the lacunar-canalicular system, that is what I'm referencing), and even suppress the cells responsible for breaking done bone. It's like sneaking in bone density training without jumping, sprinting, or lifting heavy. But psst… don't stop lifting heavy!
  • Balance and Neuromuscular Control:
    WBV triggers rapid muscle contractions, sharpening your stability. More balance means fewer falls, which translates to fewer fractures. Even if you're not tippy right now, it's smart to get on top of it before your tippy years hit.

In my clinic, I used a plate to help rehab Achilles or patellar tendinopathies, rotator cuff injuries, chronic ankle or knee sprains, and osteoarthritis with joint stiffness.

Aside from acute injury, the women who will benefit most from WBV are those with tendon pain, osteopenia, osteoporosis, joint pain, or anyone who can't yet tolerate high-impact training.

NOW

So, should you and your girlfriends all Secret Santa vibration plates to one another this year?

I'm a big proponent of a vibration plate, and I use my Power Plate every day. In my weekly training, I am doing a lot of high-impact activities like sprinting and weight lifting, so vibration helps prevent injuries and improve tissue tolerance.

The connective tissue and bone benefits overlap because the same signals of mechanical load, nitric oxide release, IGF-1, and collagen synthesis are shared across tissues. WBV is like giving your musculoskeletal system a gentle “shake” that wakes up repair pathways without over-stressing them.

Now, WBV is not a replacement for progressive overload (weights > plates). But it's an incredible add-on or bridge. Here's how I'd recommend using it:

  • Use it during rehab if your tendons, ligaments, or joints aren't ready for a heavy load yet.
  • Layer it into your bone-health strategy if you're at risk of osteoporosis.
  • Add it as a primer to improve circulation, healing, and balance before lifting or sprinting.

It's like a little love note to your muscles, tendons, and bones that says, “I see you. I'm taking care of you. I want you with me for the long haul.”

I'm curious. Have you ever tried standing on a vibration platform? Did it feel like a helpful tool, or just like a fancy washing machine?

 

Shake it up, baby.

Dr. Stephanie

 

P.S. Have you saved your spot for the first session of my YES coaching program? I'm offering the first live coaching session completely free, and when you sign up, you'll unlock a special discount code for the rest of the program.

YES is my framework for optimal muscles, metabolism, meals, hormones and more in midlife. It's a deep dive into the protocols I use for myself and my clients.

Together, we'll explore how to build bone density and protect it for decades ahead, why your hormones, recovery, and metabolism need a seat at the table, and how to eat like you're building something (because you are!).

Oh, and we'll be doing a full session on the truth about cardio. Let's make sure you're doing what's most effective and not wasting your time.

YES makes you a mega-promise: No quick fixes. We're building a foundation that will carry you powerfully through midlife and beyond.

Sign up for the first live coaching session of YES, totally free here.

WHAT I LOVE THIS WEEK

The Sleep Technology That Ended My “Sleep Divorce”

Read my full story about the way this affected my marriage.

For two years, hot flashes kept me and my husband in separate bedrooms. I tried every trick in the book. Cooling pillows, fans, even ice packs. But nothing worked consistently until I started using Eight Sleep's Pod 5 with Hot Flash Mode. I'm not exaggerating when I say it changed everything.

The Pod 5 uses precision temperature control to keep my side of the bed icy-cool while keeping his side warm. When a hot flash hits, I can tap the app and instantly activate the emergency cooling. It often prevents the flare before it fully wakes me up.

Clinical data shows Pod 5 reduces hot flashes by 52%, but here's what it actually gave me:

  • One extra hour of quality sleep per night
  • Mornings where I actually feel like myself
  • My marriage. No joke.

For the first time in years, we're comfortably sleeping in the same bed all night long.

If hot flashes or night sweats are stealing your peace, this is the solution I trust.

Get $350 off and free 30-day returns on the Pod 5 Ultra with code DRSTEPHANIE.¹

Sweet dreams, Betty!


The Protein That Actually Tastes Like Food (Not Powder)

Why do most protein powders taste like chalky disappointment? I've tried countless brands that promise “great flavor” that are actually barely edible.

The only protein powder you’ll find in my kitchen is Equip’s Prime Protein.

It's a 100% grass-fed beef isolate with the same nutrient profile as 4 ounces of steak. I’m talking about protein, collagen, and micronutrients that support joint health and recovery. The beef source means better amino acid absorption compared to plant proteins and none of the dairy allergens that can trigger gut issues.

I blend Prime into my morning smoothies, mix it into my protein oats, and bake with it all the time. The chocolate flavor makes incredible protein muffins that taste like dessert. It even passed the taste test with my kids.

Okay, now here’s the really fun news. Until September 23, your code DRSTEPHANIE gets you exclusive access to Equip’s flash sale on Prime Protein and Prime Bars.

Your blood sugar, your gut, and your taste buds all got together and told me you’re going to love it.²

The Recovery Secret That's Been Hiding in Plain Sight

There's a product that has come out of the woodwork and completely, unexpectedly revolutionized my post-workout routine.

It's Incrediwear's bamboo charcoal-infused gear, and I'm not messing around when I say it has flipped my recovery on its head.

After aggressive pickleball sessions or sprint intervals, my knees used to ache for days. Now, I slip on their knee sleeve immediately after training and that lingering soreness is dramatically reduced.

The science is fascinating. The bamboo charcoal fibers increase blood flow at the cellular level without compression. You're getting faster healing, reduced inflammation, and you don't have to worry about feeling squeezed like a sausage.

Their socks have become a non-negotiable for travel and recovery days to keep my circulation flowing naturally. I'm not above wearing them to bed, either!

With Incrediwear, better circulation is working behind the scenes. It's not magic – it's science. It's smart fabric technology supporting what your body already wants to do: heal and recover efficiently.

Try Incrediwear with code DrSteph20 for 20% off. Your joints will thank you!³

🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

1 Ships to US, Canada, UK, Mexico, EU, and Australia Terms and conditions may apply.

2 Ships worldwide. Code valid on first-time orders or first subscriptions (unless a special sale is running). Terms and conditions may apply.

³ Ships internationally. Terms and conditions may apply.

 

Mini Pause #71: Why Are Women So Afraid to Build Muscle?

Posted on by stephanie-estima

TL; DR (Too Long; Didn't Read)

Women often shy away from muscle building due to misconceptions around bulkiness and outdated beauty standards.

We unpack where this came from, why being skinny is not a good look in midlife (and beyond), and why this can be detrimental to our health as we age.

Strong>>>Skinny!

WHY

The pursuit of being “small”—primarily through excessive cardio—can lead to detrimental long-term health effects, especially as we age.

Being small in midlife—if I may be so frank—is just not a good look.

But prioritizing muscle isn't just about aesthetics; it's essential for your health, longevity, and overall quality of life.

The bulking myth continues to persist, and I see it taking many different shapes: even in the new wave of women embracing weights, we still see women eating small quantities of food, doing too much cardio, and shying away from lifting heavier weights or muscle growth.

I had a woman on Instagram tell me recently that building muscle means we have to eat soooooo much food!! If we just focus on strength, then you can have strong muscles, but they won’t be big!

😳 I found this incredibly bizarre and alarming. What is wrong with full, round, juicy muscles on a woman?

What is wrong with eating to give your muscles a reason to grow?

And then I realized it's the fear of being too big / too bulky / too much, but it has presented now as a different form.

WHAT 

1. Misguided Beauty Standards: Today's mainstream beauty ideals, heavily influenced by media and celebrity portrayals, rarely showcase women with pronounced muscle definition.

Popular culture often celebrates being skinny with minimal muscle visibility, reinforcing the idea that muscles detract from femininity. We see it on trashy magazine covers, the “before” and “afters,” or when medications like GLP-1s are intentionally mismanaged.

This widespread portrayal of skinny over strong contributes significantly to misunderstandings about what a truly healthy, strong female body can and should look like, leading many women to undervalue strength training and muscle development.

I personally want my glute-sized shoulders and a quad sweep that makes grown men weep. I LOVE it when I can see my muscles. I have a few goals in life: be a better mother to my kids, learn to perfect a winged eyeliner, and to be jacked and tanned.

All still a work in progress. 😉

2. The Bulk Myth: Many women fear becoming bulky from strength training.

The irony, of course, is that this is so very unlikely for 98% of the female population. Building significant muscle mass is extremely challenging for women.

Women naturally produce significantly lower levels of testosterone, the primary hormone responsible for muscle growth, compared to men.

Additionally, while essential for health, female hormones like progesterone don't significantly contribute to muscle hypertrophy.

Muscle building in women typically results in improved shape, enhanced strength, and vital protection for bones and joints—not bulkiness. I have been trying to get jacked naturally for years now—and it hasn’t happened yet… although a gal can continue to dream!

3. The Language Trap: Common phrases like “long and lean” or “toned” misrepresent how muscles actually function and adapt.

Muscle length is genetically predetermined, with specific origin and attachment points on the skeleton that remain constant throughout life.

Training can and will certainly influence muscle strength, overall size, and visible definition by affecting muscle fiber thickness and body fat levels.

However, NO exercise or stretching can physically elongate muscle beyond its genetically set parameters. Understanding this helps dispel myths that often discourage women from engaging in effective strength training.

And don’t even get me started when I hear “long, lean, and toned” all together in one sentence!

4. Muscle as a Long-Term Investment: Unlike rapid fat-loss strategies, building muscle is a gradual and strategic process that requires:

  • consistent strength training;

  • proper nutrition, including sufficient protein for muscle repair and growth;

  • balanced carbohydrate intake for energy;

  • adequate healthy fats for hormone production;

  • quality sleep for optimal recovery’

  • targeted supplementation to address specific nutrient gaps;

  • and diligent stress management practices;

… all sustained consistently over years. Building muscle is a game of centimetres. It is energetically expensive to build more muscle, and we must have the proper environment to maximize this.

5. The Consequences of Muscle Loss: Ignoring muscle strength leads to numerous health risks, including:

  • Decreased bone density: Muscles stimulate bone growth and strength through load-bearing activities, helping to prevent osteoporosis and reducing fracture risks as we age.

  • Poor glucose regulation: Muscle tissue plays a crucial role in glucose uptake and metabolism. Losing muscle mass can significantly elevate the risk of insulin resistance and type 2 diabetes.

  • Loss of proprioception: Reduced muscle strength and joint mobility impair proprioception (the body’s ability to sense its position and movement in space), heightening the chance of falls and related injuries.

  • Weakened immune function: Adequate muscle mass and regular resistance training support immune health by promoting anti-inflammatory responses and enhancing overall resilience.

  • Compromised mental health: Muscle strength is closely linked to cognitive function and mental well-being. A decline in muscle mass and strength can negatively impact mood, cognitive clarity, and overall mental health.

6. Cardio's Impact on Muscle: Excessive cardio elevates cortisol, adrenaline, and norepinephrine levels, creating a prolonged catabolic state.

Cortisol, a stress hormone, signals the body to break down muscle protein for energy, particularly during extended periods of physical stress or calorie deficits.

Additionally, elevated adrenaline and norepinephrine can further amplify this catabolic effect by promoting the mobilization of muscle glycogen and amino acids, ultimately leading to decreased muscle mass and compromised muscle preservation.

HOW

💪 Prioritize Resistance Training: 

  • Include regular strength workouts focusing on progressive overload, so you’re gradually increasing the weight, sets, or repetitions to challenge your muscles and stimulate growth continuously.
  • Emphasize compound movements like squats, deadlifts, presses, and rows to maximize muscle recruitment and efficiency.
  • Think of resistance training as the kind of person you want to marry and have a long-term relationship with. You’re in it for the long haul, through it all, through thick and thin.

🚴🏻‍♀️ Do Strategic Cardio: 

  • Opt for brief, intense cardio sessions (e.g., sprints or high-intensity interval training) 1–2 times weekly to support muscle growth rather than hinder it. Short, intense cardio sessions help improve cardiovascular fitness and metabolic function without creating prolonged stress that can lead to muscle breakdown.
  • For the fun step or Zumba classes, bike rides, or other Zone 2/3/4 activities: date them. They are super fun and novel, and you can switch them up to your heart’s delight.

💋 Rethink Beauty Ideals: 

  • Embrace strength as beauty, and being strong over skinny.
  • The benefits of muscle long-term include improved bone density, joint health, metabolic rate, and functional independence, ultimately contributing to a higher quality of life and better aging outcomes.

NOW

➡️ Audit Your Routine: Replace excessive cardio with balanced strength training and targeted cardio sessions.

➡️ Nutrition Adjustments: Ensure adequate protein and carbohydrate intake to support muscle growth.

➡️ Consistency: Adopt a long-term mindset, understanding that muscle growth is a slow and steady process. It is more important to be consistent than it is to have the “perfect” routine.

What I Recommend

MIDLIFE WEIGHT CHANGES? CORRECT THIS HIDDEN MINERAL GAP NOW.

Do you struggle to lose weight, despite following a healthy diet?  It's because our food has changed a lot over the past 70 years! Fruits, veggies, and other whole foods aren’t as nutritious as they used to be and are deficient in essential minerals, directly related to pesticide use and farming practices. And when you’re short on minerals, weight loss gets a lot harder. There are two reasons: metabolism and hormone balance.

  • To learn more about minerals and how they can support weight loss in midlife, read my new article here.
  • BONUS! BEAM Minerals is offering 25% off site-wide, through May 26. Go to beamminerals.com/BETTER and use code MEMORIAL25 at checkout.

💥 KICK OFF SUMMER WITH SPECIAL DISCOUNTS

BiOptimizers: Maximize every meal—digest better, absorb more, and feel the power of next-level enzymes and magnesium.

  • 20% off site-wide through May 27; use code ESTIMA at checkout

  • Link HERE

BodyBio: Midlife game-changer: balance your omegas, fight inflammaging, and feel the relief.

  • 20% off unlimited use sitewide through May 27; discount auto-applied at checkout

  • Link HERE

BON CHARGE: From effortless beauty boost to recovery tool, explore red light therapy options that fit into your morning scroll or post-workout stretch.

  • 25% off sitewide through May 26; discount auto-applied at checkout

  • Link HERE

OneSkin: One powerhouse peptide, discovered by women and backed by science—this is skincare and haircare that actually works in midlife.

  • 15% off through May 26; use code DRSTEPHANIE at checkout. PLUS, choose your free travel-size gift:

    • Spend $125, get 1 free travel-size item (up to $42 value)

    • Spend $215, get 2 free travel-size items (up to $80 value)

    • Spend $275, get 3 free travel-size items (a $117 value)

  • Link HERE

Qualia: From energy-boosting NAD to inflammation-fighting senolytics for longevity to helping you get the sleep your body needs—these smart supplements do it all.

  • Up to 75% off through May 26; use code STEPHANIE at checkout. PLUS, FREE Gift Eye Mask. (This offer applies to the first shipment of subscription orders.)

  • Link HERE

Sunlighten: Sweat smarter—glow, recover, and recharge in an infrared sauna. It's the best health investment I’ve ever made.

  • Get up to $1,700 off + FREE shipping through May 31; use code DRSTEPHANIE at checkout

  • Link HERE

‼️ Want these discounts all in one place for the holiday weekend? Download the PDF!

SUMMER HYDRATION FLAVOR BURST

🍋 Lemonade that checks ALL the electrolyte boxes? Yes, please! I’m loving the new Lemonade Salt flavor from LMNT. It just debuted and is available for a limited time. Grab this new flavor at drinklmnt.com/drestima and get a free Sample Pack with your purchase!

🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

Mini Pause #67: Natural Ways to Boost Bone Density

Posted on by stephanie-estima

TL; DR (Too Long; Didn't Read)

Maintaining bone density naturally becomes crucial as we age due to shifts in bone metabolism.

Osteopenia, the gradual loss of bone density, is a decades-long process that accelerates significantly during perimenopause and menopause, increasing the risk of osteoporosis.

Bones are dynamic tissues consisting of cortical (outer shell) and cancellous (inner, marrow-rich) bone, both of which change significantly with age.

Increasing bone density through strength training, plyometrics, walking, and adopting nutritional strategies is essential for maintaining overall health, regulating metabolism, and achieving optimal body composition.

WHY

Bone density naturally declines as we age because osteoclastic activity (bone breakdown) outpaces osteoblastic activity (bone formation). This process accelerates dramatically during perimenopause due to hormonal changes, particularly declining estrogen levels.

Estrogen supports bone density by inhibiting osteoclast activity (reducing bone breakdown) and promoting osteoblast activity (enhancing bone formation), thereby maintaining a balanced bone remodeling process.

Bones aren't just structural; they actively secrete hormones such as osteocalcin. This influences metabolism, insulin sensitivity, muscle function, and overall body composition.

WHAT

  • Cortical Bone: Dense outer shell providing structural support.

  • Cancellous Bone: Porous, spongy interior housing bone marrow, essential for metabolic and structural roles.

As we age, cancellous bone density decreases, making bones more susceptible to fractures.

Bone-derived hormones like osteocalcin regulate metabolism by enhancing insulin secretion and sensitivity, promoting glucose uptake by muscle tissue, increasing energy expenditure, and improving overall metabolic health and body composition.

Bones are the scaffolding of the body, but they are also active endocrine organs.

HOW

Practical ways to increase bone density naturally:

  • Strength Training: Increases mechanical load on bones, stimulating osteoblastic activity. Aim for consistent, progressive resistance exercises. 💪

  • Plyometrics (Jumping Exercises): Improves bone density through high-impact activities, encouraging stronger bone formation. Examples include jump squats, box jumps, jumping jacks, skipping rope, and squat jumps. I personally love to do plyos on a step (complete with my leg warmers and off-the-shoulder top). ‼️

  • Walking: Regular weight-bearing activity is gentle yet effective for maintaining and improving bone density. 👟

    • Try Magnesium Breakthrough and use code ESTIMA to get 10% off.

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  • Nutrition: Ensure adequate intake of magnesium, vitamin D, vitamin K2, and protein to support bone formation. 🦴

  • Sunlight Exposure: Enhances vitamin D synthesis, crucial for calcium absorption and bone health. ☀️

NOW

➡️ Choose one of the above that you are currently not doing and start integrating these bone-strengthening practices into your routine immediately.

➡️ Schedule regular strength and plyometric training sessions, daily walks, and supplements into your calendar or set reminders on your phone! This is one of my best tips for remembering to get all these little habits dialled in.

What I Recommend

TAME STRESS WITH THE RIGHT COLLAGEN

Stress does number on your body. Cortisol, the primary stress hormone, directly breaks down collagen, leading to deterioration of skin and connective tissue. Chronic stress not only accelerates collagen breakdown but also disrupts skin barrier function, leading to increased water loss and dryness. High stress elevates cortisol, promoting glycation, which causes collagen fibers to stiffen, resulting in skin wrinkles and dullness over time.

That's why you want a bioactive collagen that effectively counters the effects of stress!

  • Avoid Heat Degradation: High temperatures can break down collagen into less effective amino acids, reducing digestibility and bioavailability. Heat degradation creates cross-links within the collagen structure, making it more gelatin-like, less soluble, and harder for the body to absorb. This is why controlled low-heat processing, like Health Nag’s patented laser technology, preserves collagen’s full bioactivity and effectiveness.

  • Choose Hydrolyzed: Non-hydrolyzed collagen is ineffective because it’s too large to be absorbed. Hydrolyzed collagen is broken down into small peptides that cross the gut lining and are bioavailable to support collagen synthesis in skin, joints, and other tissues. Hydrolysis is key for any collagen to exert real benefits.

🍏 Health Nag’s collagen offers the most unique gel form I’ve seen on the market. And wow!—the delicious green apple flavor doesn’t disappoint. And just in time for spring and summer, Health Nag launched its bioactive collagen jelly in individual packets. Super convenient when you’re on the go or traveling! Learn more and try it HERE. Use code DRSTEPHANIE to save 10%.

KICK-START YOUR PERFORMANCE, ENERGY & FOCUS

I’ve been turning to ketones regularly in the morning before my workouts. Ketone-IQ gives me the fuel I need to power my favorite strength moves in the gym. Check out these mainstay benefits:

  • Appetite Control: Helps manage hunger by promoting a state of satiety. (Pro tip for my Bettys who find it hard to eat before early morning workouts.)

  • Energy & Focus: Provides a fast and steady energy source that crosses the blood-brain barrier. (I have the energy to focus on my workout and also maintain mental clarity to plan and think through my workday.)

  • Performance & Recovery: Enhances physical endurance and speeds up recovery by supporting mitochondrial function. (I don’t cut corners when it comes to recovery, but I do like the benefits of recovering more quickly and efficiently.

💥 Try Ketone-IQ (with or without caffeine) in several flavors: peach or green apple for me, please! Visit https://ketone.com/STEPHANIE to get 30% off your first subscription order. No code needed; discount automatically applied at checkout.

🌟 Love these recommendations? Find more resources to support your health in midlife in my Health Toolkit!

Mini Pause #61: The Best Compound Exercises For Perimenopausal Women

Posted on by stephanie-estima

TL; DR (Too Long; Didn't Read)

Strength training is essential for perimenopausal women to maintain muscle mass, metabolic health, and keep you looking like the snack you are.

The best compound exercises for overall muscle hypertrophy include squats, hip thrusts, lunges, deadlifts, overhead presses, and pull-ups.

Focusing on the eccentric phase, pausing in the lengthened position, and using progressive overload is gnarly…but will maximize results. I've included exercises and modifications that can be done at the gym or at home to suit your space and equipment.

WHY are Compound Movements So Important?

And when I say compound, I DO NOT mean squatting paired with an overhead shoulder press, or some other silly combination of movements (I will go on a rant about these another day).

Working on eccentric control and progressive overload can help prevent injury–which, in addition to muscle growth, is a primary lifting objective in midlife.

If you want to maintain mobility, independence, and a strong physique, resistance training is non-negotiable. As estrogen and testosterone levels fluctuate during perimenopause, muscle loss—partially due to the reduced activation of satellite cells—and bone density decline become real concerns.

For my Dark Roast Bettys: Satellite cells are specialized muscle stem cells responsible for muscle repair and regeneration. They are located between the muscle fiber membrane and its surrounding connective tissue. When muscles experience stress or damage—such as from strength training—satellite cells activate, multiply, donate, and fuse with existing muscle fibers to repair and grow stronger muscles. This process is essential for muscle hypertrophy, allowing muscles to recover and grow after training.

However, during perimenopause, the decline in estrogen and testosterone can reduce the efficiency of satellite cell activation, making muscle recovery and growth more challenging.

This is why progressive overload, eccentric training, and proper recovery strategies become even more critical to maintaining and building muscle mass.

Strength training–particularly compound movements that are multi-joint and multi-muscle movement patterns–stimulates muscle growth, improves joint stability, and supports overall metabolic function.

WHAT are the Most Effective Compound Lifts for Muscle Hypertrophy?

Compound lifts engage multiple muscle groups and joints at once, making them the most efficient way to train for hypertrophy. It also means that the motor coordination and pattern can be more difficult to master because there is a LOT happening at once.

Here are the must-do movements:

1️⃣ Squats: The reigning Queen of lower body exercises, squats work the quads, hamstrings, glutes, and core. Variations include:

  • Barbell Back Squat (gym)
  • Goblet Squat (home/gym)
  • Bulgarian Split Squat (home/gym)
  • Wall Sit (home, isometric strength focus)

2️⃣ HIP THRUSTS: Essential for glute development, hip thrusts also engage the hamstrings and lower back.

  • Barbell Hip Thrust (gym)
  • Dumbbell Hip Thrust (home/gym)
  • Glute Bridge (bodyweight, home/gym)

3️⃣ LUNGES: A unilateral movement that improves balance, coordination, and strength.

  • Walking Lunges (gym/home)
  • Reverse Lunges (knee-friendly)
  • Step-Ups (home/gym, great for stability and strength)

4️⃣ DEADLIFTS: A total-body movement that strengthens the posterior chain, including hamstrings, glutes, and back. IF you want a deep line in your back muscles, this is how it's done:

  • Conventional Deadlift (gym)
  • Romanian Deadlift (hamstring focus)
  • Kettlebell Deadlift (home/gym)
  • Sumo (yes these count, despite arguments online)

5️⃣ OVERHEAD PRESS: A compound upper-body movement that also engages the core and rotator cuff of the shoulder in addition to the deltoid

  • Barbell Overhead Press (gym)
  • Dumbbell Shoulder Press (home/gym)
  • Landmine Press (joint-friendly variation)

6️⃣ PULL-UPS: Though primarily an upper-body movement, pull-ups engage the entire posterior chain, including the glutes and core.

  • Assisted Pull-Up (band or machine)
  • Negative Pull-Up (Jump up to the top of the bar and slowly lower / eccentric focus)
  • Scapular Retractions while Deadhanging

HOW Can You Implement These Exercises at Home or in the Gym?

✅ Focus on the Eccentric Phase: Lower the weight slowly (3-4 seconds down) to increase muscle tension and stimulate growth.

✅ Pause in the Lengthened Position: Hold at the bottom of squats or lunges for 2-3 seconds to build strength and stability.

✅ Use Progressive Overload: Lift heavy for YOU. Approaching muscle failure is the goal in a range of motion you can own. Gradually increase resistance by adding weight, increasing reps, or adjusting tempo.

✅ Recovery Matters: Prioritize protein intake, sleep, and mobility work to support recovery and maximize results. Aim for 1.8-2.2g of protein per kg of ideal body weight daily.

NOW: 3 Simple Steps to Start Today

1️⃣ Pick 2-3 of these compound movements and add them to your routine 2-3x per week.

2️⃣ Slow down the eccentric phase and pause at the bottom to increase strength and stability.

3️⃣ Track your weights and aim for small increases weekly to keep progressing.

What I Recommend

Give Your Cellular Health Some Attention

You may not give your cells much thought, but they do the steady work of keeping your body systems healthy at a foundational level. You can help support that work with BodyBio.

For nearly 30 years, this family-owned company has depended on research and science to lead the way. Their focus on cellular health—especially phospholipids that provide the building blocks of your cell membranes—has resulted in products proven to support your brain, gut, stress levels, skin/hair, immunity, and detoxification.

Some of my favorites:

  • Balance Oil: This healthy fat supplement (omega 6 +3) includes two essential fatty acids, Linoleic and Alpha Linolenic Acid, that can support healthy aging, which means strengthening cell structure, keeping mitochondria working, and supporting cellular stability. I prefer the liquid I can throw in a smoothie or protein shake.
  • PC: A liposomal phospholipid complex that can help brain function and mental clarity, digestion, energy, and your body's detox processes. This comes in a handy liquid, too, as well as softgels.
  • Fish Oil: This blend of phospholipid-based 3:1 DHA/EPA essential fatty acids and caviar extract create an anti-inflammatory effect throughout the body. Win!

🌷During the BodyBio early spring sale, you'll get 20% off sitewide through Tuesday, March 18.

Click HERE to peruse the BodyBio products and find those that may be a fit for you. The discount will be automatically applied at checkout.

Health Optimisation Summit Comes to Austin

It’s official! I’m speaking at the Health Optimisation Summit in Austin, Texas! I'll be talking about perimenopausal strategies like muscle, meals, and stress management.

Europe’s biggest health event lands in Austin on April 12-13. You'll hear game-changing health insights from nearly 40 industry-leading experts covering topics from biohacking and nutrition to functional and preventative medicine.

Spend two full days at the Palmer Events Center surrounded by Paleo-inspired wisdom, innovative health tech, and a community that feels like family.

If you purchase your ticket now and use code DRSTEPHANIE, you'll save 10% on VIP or General Admission.

Mini Pause #12: The Power of Plyometrics

Posted on by stephanie-estima

Plyometrics for the Win! Improve Your Bone Density, Balance, Coordination, Muscle Growth & Insulin Sensitivity

TL,DR (too long, didn't read)

Plyometrics help to drive bone density, balance, coordination, and muscle growth. They help to improve insulin sensitivity–and make you feel like Wonder Woman!

WHY

Let’s continue the Mini Pause series on type 2 fiber training. Last week I spoke about Speed Training (Mini Pause #11 if you missed it!). This week I want to dive into plyometrics, which uses burst and explosive power.

Plyos are another way to train fast-twitch muscle fibers, and like speed training, these can also be done with high or low impact.

We spoke last week about the anabolic and hormonal effects of speed training. Training the top end of your cardiometabolic capacity matters as much as training our bottom end (Zone 2). Plyometrics presents an awesome opportunity to train type 2 fibers and preserve power and neural recruitment.

WHAT

Plyometrics have been shown to drive several desirable results in the body namely:

Stronger Bones & Connective Tissues

In women of all ages, burst activities like jumping and plyometrics have been shown to improve bone density [*] and reduce the incidence of lower-body injury in female athletes [*]. This has also been demonstrated in menopausal and post-menopausal women [*], as well.

Considering women are most likely to develop osteopenia and eventually osteoporosis, this should be the biggest motivator for the preservation of bone health as you age.

Better Coordination & Proprioception

Technically, there are a lot of things happening when you initiate a jump:

  • the neural recruitment of desired muscles via the efferent motor nerves,
  • your joint position sense in the starting position,
  • your brain predicting where you will end up in space at the end position,
  • the kinetic energy stored and released in the muscle cell,
  • the muscle sensors detecting stretch and deformation as you jump,
  • and, of course, the flexibility of the joints being used to work through their full range of motion.

That’s a lot! When you train your neuromuscular system through jumping, you improve your balance and coordination, and your proprioception (which is your unconscious sense: it is how you know where your joints are without looking at them).

As women age, in combination with osteopenia, they also lose joint position sense, which can contribute to tripping and falling.

Anabolic / Muscle Growth

Plyometrics have demonstrated a strong signal for muscle growth [*]. So whether you are training plyometrics alone, or combining with resistance training [*], this is a great way to continue to build muscle in your 40s, 50s, and beyond.

Insulin Sensitivity

Power and burst training both have been shown to help improve insulin sensitivity [*]. The short burst of explosive power drives insulin receptors normally hiding in the cell to the cell surface to be able to acquire more glucose for energy production.

You Feel Like Wonder Woman!

I don’t know about you, but when I can jump onto a plyo box or complete squat jumps, I feel like a beast. And isn’t that at least part of the point of power training? To make you feel…. well… powerful? I walk just a little bit taller when I finish.

HOW

Plyometrics can be done both at higher and lower impact levels. If you are uneasy jumping or nursing an injury, rebounders are a great option as they absorb most of the ground reactive forces of landing. You also can perform plyometrics in a swimming pool.

Beginner

  • Bunny Hops: Standing with your feet slightly apart, knees are not locked out, find a hallway or a corridor, and “hop” or “jump” as high as you can while traveling forward slightly. Just in time for Easter! Feel free to practice this on your easter egg hunts.

Intermediate

  • Bunny Hop Switches: This is essentially a one-legged Bunny Hop that alternates between the left and the right foot. Lift your left leg (bending the knee so it’s as high as your hip) with the right leg on the floor, hop four times on the right foot, and then switch legs. Repeat down the corridor.

Advanced

  • Box Jumps: You know now that being advanced is just mastering the basics and executing them well. This plyo is essentially a “giant” bunny hop with height and flexion. Start with a low box (they start as low as six inches). Stand in front of the box. Bend your knees deeply and pause at the bottom to remove all kinetic energy from the Achilles. Explode up and land on the box with both feet.

NOW

Add plyos to your next workout after you’re warmed up. I typically add them onto the end of a weight training workout that is not legs. If I’m training shoulders or back, I can insert a quick 10-minute plyo finisher at the end.

Question of the Week

Q: What is your go-to lunch?

I don’t like to have to think too hard about lunch. I usually throw together a salad that has a good amount of protein and fat. I prep lots of different salad items on a Sunday so I can toss them together for the week. I try to think about my food from the following verticals: fiber, protein, fats, and carbs. I organize my fridge shelves to support each of these goals.

  • Base: I have glass Tupperware in my fridge with pre-cut lettuce. I like crunch, so usually this is a cabbage or coleslaw mix. Romaine hearts also make the cut, and if I’ve run out of all of the above, then I take sauerkraut from the jar and use that!
  • Protein: This is usually slow-cooked pulled chicken that I spice with Lebanese spices, but this could be ground beef or turkey, or leftover protein from dinner the night before.
  • Carbs: I love to add potatoes or rice. And I love them cold. The other thing I’ve been enjoying lately is my homemade sourdough croutons. When my sourdough bread gets stale, I cut it up, marinate with olive oil and salt, and bake the pieces at 325F for 8 to 10 minutes.
  • Fats: Bacon bits, ranch salad dressing, olive oil, avocados, or nuts.
  • Herbs: I really love dried herbs, and I’m pretty liberal with their use. Herbs de Provence, Zaatar, Everything but the Bagel, sesame seeds, Rosemary leaves, Herbamare…. I love it all!

YOUR TURN!

I'll be answering your questions every week right here in the Mini Pause! Let me know what's on your mind. I'll be checking for both questions and feedback at support@drstephanieestima.com.

WHAT I RECOMMEND: Embr Labs

Conversation in the Bettyverse often lands on thermoregulation during perimenopause and menopause. You’re either too hot (flushes!) or too cold. I’ve been searching for a solution for you and finally found it in the Embr Wave 2.

You wear this device on your wrist. (I love mine in rose gold because it looks like a gorgeous bracelet!) The Embr Wave 2 stimulates the nerves that sense temperature, so with the push of a button, you can change how hot or cold you feel. Consider it your personal thermostat.

Learn more about its science at https://embrlabs.com. If you're intrigued, use code DRSTEPHANIE for 15% off.