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Mini Pause #108 | My boys get this. I didn’t.

Posted on by stephanie-estima

This week, something clicked for me in a way I can’t unsee.

I was watching my teenage boys talking about their workouts. One is all about “curls for the girls,” and the other is working on perfecting his squat form… and I had this sudden gut punch of realization:

They are being encouraged to grow. They’re being taught to build, fuel, and take pride in watching their bodies change.

I got a pang of grief for little Steph, and all of my boys’ female peers who didn’t get this memo.

When I was their age, I was counting out nine almonds for a snack.

Measuring grapes.

Believing that smaller meant better.

That’s when it hit me: the fitness industry gave boys permission to expand and taught girls to disappear.

That conditioning didn’t stay in adolescence. It followed us into midlife, and most of us are still paying the price.

WHAT

When we were sixteen, we should have been chasing strength.

We should have learned what it feels like to push, to eat, to recover, to grow. But instead, we were told to stay small.

Boys were encouraged to celebrate and feel the JOY of their bodies responding to effort.

Girls got fear.

Women were robbed of the most formative training phase of life:

Learning what muscle feels like

Watching strength accumulate

Experiencing hunger as information, not moral failure

Building connective tissue and bone while hormones were supportive

So here we are, decades later, trying to build muscle and bone in our 40s and 50s… and maybe for the first time… without the hormonal runway we were meant to have at fifteen.

And then what do we hear?

“I don’t want to get bulky.”

That sentence didn’t come from biology. It came from a lifetime of conditioning.

That muscle growth is masculine. That tissue is dangerous. That strength wasn’t for women.

It makes me feel so many things. Sadness, anger… and a righteous desire to kick some ass at the gym.

Because strength training isn’t just about lifting weights. It’s about reclaiming something that was stolen from us: the right to take up space. That should have been ours all along.

Midlife strength is emotionally loaded for women because we missed out on the developmental milestone of celebrating our pride. Our appetites. The satisfaction of watching our bodies respond.

It’s radical to unlearn shrinking and trust growth. It feels foreign, but I promise you:

Muscle is not the enemy. It’s structure. It’s posture. It’s confidence you don’t have to perform.

HOW

This week on the podcast, I talked with Dr. Doug Lucas about what’s silently sabotaging women’s strength and bone health – and it’s not your hormones.

It’s the 1100-calorie trap.

So many women (and Dr. Lucas agrees… nearly 100% of his osteoporosis patients) are living in a chronic caloric deficit.

And here’s what that does:

When your intake is too low, your body can’t build.

You lose muscle. You lose bone. You lose resilience.

Your body stops prioritizing growth and shifts into survival mode.

The tragedy is that most women do this in the name of “health.”

They’re lifting, walking, doing the right things, but starving the very system they’re trying to strengthen.

In biological terms, you’ve tipped too far toward catabolism (breakdown) and never give yourself enough substrate for anabolism (building).

That balance between breaking down and rebuilding is where true longevity lives.

NOW

Your assignment is to start reclaiming your right to build – muscle, bone, confidence, energy.

Here’s where I’d start:

Eat enough to build. Food is raw material, not moral currency.

Lift progressively. Your bones, joints, tendons, ligaments, and posture depend on it. (If you need structure, LIFT will guide you step-by-step.)

Rest intentionally. Recovery is where adaptation happens.

Reject shrinking. Every time you nourish and train for strength, you’re rewriting the story the fitness world gave you.

We may have missed our teenage bulk, but it’s not too late to invest in the wisdom, purpose, and freedom to grow that midlife offers us.

Maybe we’re not teenagers anymore.

But we are Queenagers.

And the new rite of passage isn’t fitting in, but it’s filling out the life we want.

So tell me, Queen… are you ready to build something?

 

🌟 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.

 

 

Mini Pause #87: The #1 Way Lifting Heavy Can Cause Injury (and How to Avoid It)

Posted on by stephanie-estima

Muscle sure is having her moment on social media, isn't she!

“Lift heavy, ladies!”
“Be a Muscle Mommy!”
“Build that booty!”

The cheerleading is loud, and I'm not going to pretend it isn't motivating, but something gets lost in the noise:

Strength isn't just about muscle.

When you pick up a weight, whether its a 10-pound dumbbell or a heft of racked plates, your muscles are not alone in carrying the load. Ligaments and tendons are their sisters. Articular cartilage is their cousin. They're all in this together, and they all adapt and recover on their own clocks.

If your training program only takes into account the recovery timeline of muscle, you're most likely going to outpace your connective tissue capacity.

What does this look like? The weakest links tend to complain first. Think of morning tendon stiffness, joint aches, and ligament strains.

Remember that British game show The Weakest Link?

Bad programming is like looking right at your tendons with a sassy British accent and saying, “You are the weakest link. Goodbye!”

So, this is my love letter (my soliloquy, if you will) to the entire network of tissues that keep you strong. Because if we want lasting gainzzzz (yes, with all the zs, like the gym bros say), we have to honor the whole system, not just the muscles in the mirror.

WHY

We have a variety of tissue tolerances to consider when lifting weights to help us go heavy and avoid injury.

Tissue tolerance is a tissue's capacity to absorb, transmit, and recover from load without breaking down. And here's the truth: your tissues don't give a flying F about the number on the weight. They don't see “15 pounds” or “2 plates.” They only know load, mechanical tension, acute damage, and maximum recoverable volume.

So let's look at the recovery timeline for each tissue:

Muscle

Muscle is quick to adapt. Neural gains show up in weeks. Visible hypertrophy (muscle growth) in 6-8 weeks. With rich blood flow and fast protein turnover, she thrives on regular work. Think 2-4 sessions per week for each muscle group. Nature

Tendons

These are slow alchemists. They remodel collagen at a glacial pace. If you've ever injured a tendon, you know it takes a lifetime. Think months, not days. PMCSpringerOpen

With a sparse blood supply and collagen that can be decades old, their improvements come only with steady, patient loading. PMC

Tendons love the “low and slow” approach and punish sudden spikes in effort. True changes in tendon stiffness take at least 12 weeks. SpringerOpen

Ligaments

Ligaments are the baddies that stabilize joints, and they're similar to tendons: dense collagen, slower metabolism, and slower to respond.

Think of ligaments like the introverts at the party. She wants to be there, but she takes a little longer to warm up and get comfy. (Hi, it's me!) PubMed+1

To strengthen a ligament, you want multidirectional movement: jumping, decelerating, sudden changes in direction. These movements sharpen neuromuscular control and protect your joints. ASME Digital Collection

Side Note: I would LOVE to go on a nerd safari on ligaments in a future newsletter. I'm game if you are.

Articular Cartilage

Articular cartilage is the plush cushion between your bones. She's there so your bones don't rub together, because wow that's not nice.

Unlike other tissues I've mentioned, articular cartilage has no direct blood supply of its own and minimal collagen turnover and renewal. PubMed

The only way to keep joint cartilage healthy is through consistent loading. She loves regular, moderate, and cyclic compressions, like walking, cycling, and most steady-state cardio machines. Sedentary is her downfall. PMC

HOW

Okay, Betty, it's time for you to honor all your tissues so they rise together, strong and resilient:

(Want a quick and easy program build to match each tissue's healing clock? LIFT is for you.)

1. Sequence Your Week
Muscle strength sessions can happen often (2-4 times per week per muscle group). Tendon- and ligament-heavy work (slow lifts, plyometrics, change-of-direction) need at least 48-72 hours of rest between exposures.

2. Master Form Before Load
In LIFT, our Master Form videos help you own the movement before you ever load it. Good form isn't just about looking impressive. It's how you protect your tissues and respect their tolerance.

3. Watch for the Signals
Green (Go!): Mild muscle soreness, tendons that warm up and feel fine by the next morning, and joints that feel “used” but not puffy.

Yellow (Yield): Morning tendon stiffness for more than 24 hours, lingering joint aches, or from breaking down under fatigue.

Red (Stop and Deload): Swollen or locking joints, sharp instability, night pain, tendon pain that worsens as you warm up are all signs to rest and see a professional.

NOW

Here's what you can expect when you play the long game:

  • Muscle: You'll feel fitter within 2-3 weeks with visible changes in 6-8.
  • Tendons and Ligaments: Real, durable change happens over 8-16+ weeks, with tendon stiffness improving best at >12 weeks.
  • Cartilage: Healthy cartilage loves consistency. Regular walking and rhythmic, cyclical movement keep it nourished and thriving.

Think of your body like a financial portfolio. You wouldn't put all your money in one stock and hope for the best. In the same way, your tissues thrive with a diverse portfolio of movements. Strength, cardio, recovery, and multidirectional play… it all matters.

So yes, lift heavy, Betty. Build muscle. But train like the queen you are: with wisdom, patience, and respect for the whole kingdom (or queendom) of tissues that carry you forward.

 

Selected sources for further reading for my dark roast Bettys:

  • Bohm et al., human tendon adaptation;
  • Heinemeier et al., minimal collagen turnover in adult tendon/cartilage;
  • Bontemps et al., early neural vs later hypertrophic gains;
  • Bader/Eckstein, cartilage thrives on moderate cyclic load;
  • Rio et al. & Holden et al., isometrics for tendinopathy
  • SprinterOpenPMC+3PMC+3PMC+3PubMed+2PubMed+2VBN

WHAT I LOVE THIS WEEK

BIOptimizers

You can nail your diet and workouts, but if your sleep is suffering, your results will stall.

A compelling study recently found that poor sleep slashed fat loss by 55% and increased muscle loss by 60%, even when calories stayed the same.

Think about these two women on the same plan. The rested one loses fat and keeps muscle while the sleep-deprived one loses the muscle she worked so hard to build (while living exhausted!).

Here's why: Poor sleep spikes hunger hormones, slows fat burning, and makes your body more likely to store fat.

That's why you need Magnesium Breakthrough from BIOptimizers. It combines all 7 essential form of magnesium to help you fall asleep faster, sleep deeper, and wake up calm, clear, and ready to kick butt.

Try Magnesium Breakthrough and use code ESTIMA for 15% off.¹


Apollo

When stress, anxiety, or poor sleep creep in, my go-to is Apollo Neuro. It's a wearable device that feels like cheating on a test for your nervous system.

Apollo uses gentle, rhythmic vibrations (vibroacoustic stimulation, for the nerds among us) to activate your parasympathetic nervous system, which is your body's natural calm mode.

The results are powerful. It helps boost heart rate variability (your body's stress-resilience score), lowers cortisol, and supports the release of serotonin and dopamine (your feel-good neurotransmitters).

Translation? You feel calmer, sleep more deeply, and bounce back from stress with strength.

The best part is it's risk-free to try with a 30-day guarantee. Strap it to your wrist, ankle, or clip it to your shirt and let Apollo guide your body back into calm.

Try Apollo Neuro now and get $60 off with code BETTER.²

Create

I used to think creatine was just for gym bros, but after 40, the rules change. We lose muscle mass faster, recovery slows, and even our mental sharpness can feel inconsistent.

Creatine directly addresses all of this, and the research for women is nothing short of incredible.

That's why I love Create's creatine gummies.

No messy powders, no chalky taste, and no “forgetting” because it's unpleasant.

These taste good and they're portable. I just throw them in my purse and I never miss a day.

Since making them part of my routine, I've noticed better strength in my workouts, faster recovery between sessions, and, honestly, clearer thinking and steadier energy throughout the day.

If you want to maintain muscle, brain power, and energy as you age, creatine isn't optional. It's foundational.

Try Create here and use code DRSTEPHANIE for 20% off.³

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

1 Here's the list of countries BIOptimizers currently ships to. Code can be used multiple times. Terms and conditions may apply.

2 Applies $60 off the Apollo wearable (no one-time limit). Valid on the device only. Cannot be stacked with other coupons, bundles, or site-wide promos. Terms and conditions may apply. Currently, Apollo is accepting orders and shipping within the United States, as well as to Canada, Europe, and Australia. Terms and conditions may apply.

³ Create only ships in the USA. The 20% discount is for new customers only. All subscription orders get free shipping. A $100 order is the free shipping threshold for one-time purchases.

 

Mini Pause #82: Bloated? Tired? Stressed? Start Here

Posted on by stephanie-estima

TL;DR

Your gut is ground zero for mood, hormones, energy, immunity… basically everything.
In perimenopause and menopause, gut health takes a hit, and it shows up as bloat, fatigue, anxiety, skin changes, weight gain, and even acne.

The key to improving digestion in midlife is multifold – there are supplements you can take before you eat, and even exercise can improve gut health!

Think of your gut like a garden — and get the right gardener (probiotics), fertilizer (prebiotics), and soil conditions (diverse food, less stress) to keep it thriving.

WHY (Our Gut Changes In Perimenopause)

In midlife, your hormones dip, your stress rises, and your digestive system gets a little… sluggish.

Estrogen, progesterone, and testosterone all rely on your gut microbiome to break down and excrete them properly. When your gut is leaky or inflamed, it can reabsorb “used” hormones (hello, estrogen dominance), leading to mood swings, tender breasts, cravings, and brain fog.

Even just the regular foods we eat on a daily basis can start causing a lot of distention, bloating and gas.

WHAT You Can Do for a Better Belly

✔ ️ Start with a Spore-Based Probiotic: Unlike most probiotics that die in your stomach acid, spores are dormant in the capsule, wake up in your intestines, and actually change the gut landscape. Using a gardener analogy, they like to pull weeds (bad bacteria), and feed the good bacteria to bring balance back to your microbiome

✔️ Add Prebiotics (The Fertilizer): These feed your good bacteria — but only if they’re targeted. Some prebiotics feed the bad guys too, so choose carefully or go with a supplement like Just Thrive’s Prebiotic that only nourishes the good flora

✔️ Eat the Rainbow: Diversity of plant foods = diversity of microbes. More color, more fiber, more phytonutrients, more microbial magic. Here I tend to follow Dr. Terry Wahls advice where she recommends 9 servings of vegetables and fruit: 3 servings of green leaves, 3 servings of sulfur rich and 3 servings of bright colors.

✔ ️ Love Your Ferments (But Don’t Rely On Them): Sauerkraut, kimchi, kefir are all amazing. They support gut health, but keep in mind most bacteria in fermented foods die before reaching your colon.

✔️ Reduce Gut Stressors:

  • Skip antibacterial sprays (they kill good bacteria too) and quit it with the hand sanitizers!!! Remember in the good ol’days when we used soap? That is the ideal way to clean your hands.
  • Go organic when you can (to avoid glyphosate)
  • Take walks, breathe, meditate — your stress hormones mess with your gut lining

Supplements That Support a Happy Gut

Once you’ve got your gut gardener (spore-based probiotic1) and your fertilizer (prebiotic) in place, there are other MVPs that can really help your gut thrive — especially if you’re in perimenopause or menopause and noticing more bloating, sluggish digestion, and food sensitivity.

1. Apple Cider Vinegar (ACV) Before Meals
A splash of raw, unfiltered ACV in water 15–20 minutes before meals can help:

  • Stimulate stomach acid (which declines with age/hormone shifts)
  • Improve protein digestion
  • Reduce post-meal bloating
  • Support blood sugar balance

➡️ Tip: Start with 1 tsp in warm water before meals, work up to 1 Tbsp if tolerated.

2. Digestive Enzymes
As we age (especially in midlife), we make less stomach acid and digestive enzymes which means even healthy meals can sit heavier than they once did.

Digestive enzyme blends help break down:

  • Protein (protease)
  • Fat (lipase)
  • Carbs (amylase)
  • Fiber (cellulase)

Look for broad-spectrum enzyme blends2, and take them before your first bite of food, if you can around 20 minutes prior to eating.

3. L-Glutamine
This amino acid is gut lining gold. It helps:

  • Repair a “leaky gut”
  • Calm inflammation
  • Support regularity

➡️ Tip: Powdered glutamine is tasteless and easy to stir into water or smoothies. Dose: ~5g/day.

4. Collagen or Bone Broth
Both contain:

  • Glycine and proline: key for gut lining integrity
  • Gelatin: helpful for soothing inflammation
  • Bonus: glowy skin + joint love

Choose grass-fed, unflavored options3, or sip on bone broth between meals.

5. Zinc + Vitamin A
Both support the regeneration of the gut lining and immune system. A deficiency in either can delay gut healing.

  • Zinc carnosine is especially studied for gut lining repair
  • Retinol (the active form of vitamin A) is gut-protective

6. Magnesium
Constipated? Magnesium can help “move things along” (gently).

➡️ Tip: Start low, go slow. Aim for 400mg daily to start. Especially if you have been under chronic stress for a long time.

🌾 Prebiotics: The Fertilizer for Your Gut Garden

If spore-based probiotics are the gardeners of your gut, then prebiotics are the fertilizer because they help feed and grow the good bugs that keep your digestion, mood, and hormones in balance.

Unlike probiotics (which are live bacteria), prebiotics are fibers and plant compounds your body doesn’t digest, but your good gut microbes love to munch on. When those good microbes eat, they produce short-chain fatty acids like butyrate, which help reduce inflammation, improve gut lining integrity, and even impact brain health.

Food Prebiotic Fiber Type Benefits
Jerusalem Artichokes Inulin, FOS High in potassium + iron
Asparagus Inulin Supports detox + estrogen clearance
Garlic & Onions Inulin, FOS Antibacterial + anti-inflammatory
Leeks Inulin Great for digestion and estrogen metabolism
Bananas (especially green) Resistant starch Helps feed bifidobacteria
Oats (cooled overnight) Beta-glucans + RS3 Great for cholesterol + gut lining
Apples (with skin) Pectin Supports gut lining and regularity
Chicory Root Inulin Found in many fiber supplements
Dandelion Greens Inulin Liver and gut support
Flaxseeds & Chia Seeds Mucilage + soluble fiber Helps with elimination + estrogen excretion
Cooked + cooled potatoes Resistant starch (RS3) Enhances microbial diversity

 

Supplement Alternative To Fibre

You can also add targeted prebiotic blends like Just Thrive’s Prebiotic, which uses precision oligosaccharides that only feed beneficial bacteria (not the “weeds”). This is especially useful if you're sensitive to FODMAPs or fiber-rich foods.

🏋️‍♀️ HOW Fitness Fits In

Movement is magic for your microbiome and especially in perimenopause, when digestion slows, hormones fluctuate, and stress can take over.

Here’s exactly how the right types of exercise improve gut health:

💩 1. Improves Motility (A.K.A. Helps You Poop)
Regular movement helps “massage” your intestines and keep things moving through your digestive tract. This means:

  • Less bloating
  • Fewer backup toxins
  • More regular and satisfying BMs (💃)

Even just 15–20 minutes of walking after a meal can significantly reduce post-meal bloating and gas by helping move food through the system.

🌬️ 2. Lowers Gut-Damaging Stress Hormones
Chronic cortisol messes with your gut lining, leading to:

  • Leaky gut
  • Sluggish digestion
  • Mood and sleep issues

Gentle movement like:

  • Strength training
  • Pilates
  • Walking in nature
  • Yoga or breathwork

…helps calm the nervous system, reduce cortisol, and support the gut-brain axis.

🦠 3. Increases Microbial Diversity
Moderate exercise has been shown to increase the number and diversity of good gut bugs, especially those that produce butyrate, a powerful anti-inflammatory short-chain fatty acid.

This is key for:

  • Reducing belly fat
  • Improving insulin sensitivity
  • Calming gut-related inflammation

Too much cardio, though, especially when paired with under-eating or chronic stress, can have the opposite effect causing inflammation and damaging the gut lining.

💪 4. Enhances Nutrient Absorption
Muscle contractions improve blood flow to the gut which means your body can:

  • Digest food more efficiently
  • Absorb more nutrients
  • Detox more effectively

It also improves lymphatic drainage, which helps remove waste and toxins from the body faster.

✅ NOW: 3 Easy Gut-Loving Steps Today

  • Start a spore-based probiotic: Look for something like Just Thrive Probiotic (I love their gummies!)
  • Eat 30+ plants a week: Aim for fruits, veggies, legumes, spices, herbs. More diversity = better microbial diversity.
  • Ditch your chemical cleaners: Swap antibacterial sprays for vinegar + essential oil blends to protect your good gut flora.

WHAT I LOVE THIS WEEK

The Midlife Muscle Secret We've Been Ignoring Too Long

Can we talk about something that might surprise you? Creatine isn't just for gym bros – it's actually one of the most important supplements we midlife women should be considering.

Here's why you should start taking creatine NOW: after 40, we lose muscle mass rapidly, our brain energy tanks, and recovery becomes painfully slow. Creatine directly addresses all three. It fuels our muscles, supports cognitive function (hello, brain fog!), and helps us bounce back faster from workouts.

Create's creatine gummies make this so much easier than choking down chalky powders. Finally, a form that doesn't make you feel like you're drinking sand! The research is crystal clear – creatine helps preserve lean muscle, improves strength, and even supports mood stability during hormonal fluctuations.

Ladies, we've been missing out on one of the most researched, effective supplements available. Our muscles, our brains, and our energy levels deserve this support.

Get 20% off Create's Creatine Gummies with code DRSTEPHANIE at https://trycreate.co/DRSTEPHANIE.4

 

Why Your Achy Joints Aren't Just “Part of Getting Older”

Let me tell you about something that's quietly revolutionizing my recovery routine – and it's not another supplement or gadget. It's Incrediwear's bamboo charcoal-infused fabric that actually increases blood flow and reduces inflammation.

Here's why this matters for us: midlife brings achy joints, slower recovery, and that persistent stiffness we pretend isn't happening. Whether it's my knees protesting after workouts, my elbows aching from too much tennis, or my feet screaming after long days, these aren't just “getting older” issues – they're circulation and inflammation problems.

Incrediwear's socks, knee sleeves, and elbow supports work by increasing blood flow at the cellular level. No compression, no weird sensations – just better circulation that helps reduce pain and speed recovery. I wear their socks during travel and sleep, and honestly? The difference in how I feel the next day is remarkable.

Get 20% off Incrediwear with code DrSteph20 at https://incrediwear.com/.

 

The Real Reason You're Tired (And It's Not What You Think)

Ever wonder why that afternoon energy crash hits harder now, or why your skin looks tired despite expensive serums? The answer might be happening at the cellular level – specifically, in your mitochondria.

New research reveals that after 40, our cellular powerhouses start accumulating damage faster than our bodies can clear it out. This mitochondrial decline affects everything from energy and muscle strength to skin health and recovery time. But here's the fascinating part: there's a compound called urolithin A that can actually help activate our cells' natural cleanup process.

Most of us can't produce meaningful amounts of this compound naturally, even if we're eating pomegranates daily. The science behind why this happens – and what we can actually do about it – is pretty eye-opening.

Read the full article to discover how supporting your mitochondria could change how you age from the inside out.

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

1 Ships worldwide. Offer available for all orders, however only on first time subscriptions.

2 Code can be used multiple times, does not ship to Canada.

3 One use per customer, on first time orders or first time subscriptions. Ships everywhere, however shipping times variable based on location.

4 Create only ships in the USA. Offer available to new customers only. Exclusively for new customers only. All subscription orders are free shipping, $100 order is free shipping threshold for one-time purchases.

Mini Pause #81: Why Most Back Pain Has Nothing to Do with Injury

Posted on by stephanie-estima

Why Most Back Pain Has Nothing to Do with Injury

Back pain isn’t about what happened—it’s about how often. According to spine biomechanics legend Dr. Stuart McGill, most chronic pain stems from repeat stress and poor recovery, not big traumatic events. The good news? His “virtual surgery” method has helped thousands heal without ever going under the knife.

WHY

Back pain isn’t random. It happens when your body exceeds its tipping point—whether from too much sitting, poor lifting mechanics, or chronic overtraining without enough recovery. Think: micro-traumas stacked on top of each other until something gives.

Dr. McGill breaks it down: “Anatomy loads the gun. Exposure pulls the trigger. Psychology determines how you recover.”

Translation? It’s a combo of structure, habits, and mindset.

WHAT 

💥 Stress Concentration: The body thrives on stress—but too much, especially in one area (like your lower back), leads to injury. Whether you sit slouched all day or push deadlifts beyond your limits, repetitive stress without recovery leads to tissue damage.

⚠️ Deadlifting Twice Your Bodyweight? That trendy internet advice could break your back—literally. Muscles may adapt fast, but your bones and discs? Not so much.

🔁 Repetition Hurts: You don’t need a big trauma. Daily habits (like sitting poorly or moving with poor core stability) wear down the spine over time—especially the discs and facet joints.

🚷 No Rest, No Repair: Even fitness fanatics can sabotage healing. That daily elliptical sesh might feel like stress relief, but it’s often what prevents healing.

HOW

✅ Virtual Surgery Protocol: Pretend you’ve just had back surgery. Rest. Walk a little. Rest again. Slowly rebuild with intentional, low-load movement. Dr. McGill’s “virtual surgery” has helped 95% of patients (originally told they needed surgery) fully recover—no scalpels required.

🏗️ Proximal Stability = Distal Power: Your core is your foundation. If it’s weak or unstable, everything else suffers—from your hips to your knees to your neck.

🔁 Smart Core Training: It’s not about crunches. Think “core stiffening” that stabilizes your spine while allowing safe movement—like bird dogs, planks, and McGill’s Big 3.

📚 Want to nerd out? Read Dr. McGill’s Back Mechanic—a patient-friendly guide that teaches you to assess and fix your pain (without surgery).

 

 

NOW

Audit Your Habits: Notice how you sit, stand, lift, and move. Are you stable through the core or compensating with your spine?

Try “Virtual Surgery”: Take 3–5 days to really rest. Then gradually reintroduce pain-free movement.

Stabilize First, Move Second: Build your core like a battleship, not a canoe. You’ll move with more power—and way less pain.

 

 

WHAT I LOVE THIS WEEK

Calocurb: The Natural GLP-1 Hack That's Actually Backed By Science

Ladies, I'm always skeptical of supplement claims, but this one had me diving deep into the research – and I'm genuinely impressed. Meet Calocurb, featuring patented Amarasate® from New Zealand hops that works with your body's own GLP-1 system.

Here's what caught my attention: this isn't some gentle nudge to your metabolism. Clinical trials show Calocurb cranks up your natural GLP-1 production by up to 600% within an hour. That's the same hormone those expensive prescription weight-loss drugs target, but we're talking about a natural extract that's been safely used for centuries.

The mechanism is brilliant – bitter taste receptors in your gut (yes, you have taste buds there too!) respond to specific compounds in these hops, triggering a powerful release of appetite-suppressing hormones. The result? An 18% reduction in caloric intake and genuine appetite control that you can actually feel working.

What I love most is the speed. No waiting weeks to see if it's “working” – users report feeling satisfied faster and experiencing real appetite suppression within that first hour. It's like having a biological off-switch for those relentless food thoughts we all know too well.

The research is solid, the results are measurable, and honestly? It's refreshing to see something that actually does what it claims to do.

If you haven't already listened, check out our recent podcast episode with Calocurb CEO Sarah Kennedy.

Try Calocurb today and get 10% off your first order with code DRSTEPHANIE – exclusively at the official Calocurb website www.calocurb.com.¹

Fresh Pressed Olive Oil

My favorite olive oil comes direct from the harvest at award-winning farms. You can try your first bottle free and pay just $1 shipping

If you want to enjoy the ultimate in olive oil, remember these four words: the fresher the better. Olive oil is at its zenith of delicious flavor and nutritional potency when it’s fresh-squeezed at the farm. Store-bought olive oils can’t compare. That’s why my favorite source of extra virgin olive oil is T.J. Robinson’s Fresh-Pressed Olive Oil Club. Robinson searches the world for the best olive oils from the latest harvests at gold-medal-winning artisanal farms. Then he rushes his oils right to your door so you can enjoy them on your favorite dishes at peak flavor and nutritional goodness.

Once you try these olive oils, bursting with harvest-fresh taste and aroma, you’ll never go back to store-bought oils that sit on a store shelf for months or years growing stale or even rancid. So you can discover the difference yourself, T.J. will send you a $39 bottle free if you’ll pay just $1 to help cover shipping. Claim your free bottle and discover how olive oil is meant to taste. No commitment to buy anything, now or ever.

Click Here for Your $39-Bottle-for-a-Buck²

 

BiOptimizers

Why 80% of Women Are Magnesium Deficient (And What Actually Works)

Iff you're struggling with sleep, stress, or that stubborn midlife weight, your magnesium status might be the missing piece. Here's the thing – most magnesium supplements barely get absorbed, leaving you deficient despite your best efforts.

Enter BIOptimizers MagBreakthrough, featuring seven different forms of magnesium that actually work. Why does this matter for us? Declining estrogen wreaks havoc on our magnesium levels, affecting everything from sleep quality to insulin sensitivity to cortisol regulation.

This isn't your basic mag supplement. Each form targets different pathways – magnesium glycinate for deep sleep, magnesium malate for energy production, and magnesium taurate for heart health. It's like having a precision tool instead of a hammer.

The difference is real: better sleep, reduced anxiety, improved muscle recovery, and yes – better metabolic function. When your cells finally get the magnesium they're craving, everything starts working better.

Get 15% off BIOptimizers MagBreakthrough with code ESTIMA at bioptimizers.com – because you deserve supplements that actually deliver.³

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

1 Ships within the USA and Canada (at an extra shipping cost). Offer available to new customers only. Exclusively for first-time orders. Not eligible for subscription orders. Terms and conditions may apply.

2 Offer available to US customers only. Terms and conditions may apply. For any inquiries, reach out to [email protected]

3 Offer not available to Canadian customers. Terms and conditions may apply.

Mini Pause #74: Sports for Longevity

Posted on by stephanie-estima

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

I am all about a life well-lived.

I have been intrigued recently about sports that increase and improve longevity, and delightfully, sports like tennis, pickleball, badminton, squash, and cross-country skiing are among this list.

They can significantly boost longevity by improving cardiovascular health, enhancing cognitive function, supporting muscular strength, and, perhaps most importantly, fostering social connections.

WHY

A few weeks ago – I was playing tennis one morning and got to speak with one of the players in the court next to me after our session. He is 75, plays 5 days a week for 2 hours a day. I was literally in awe of him (and his serve!)

The same thing has happened to me on the cross country trails in the winter. I am lapped by smiling elderly women and men who are just flying through the course.

They are potent reminders of how I want to age. And if they have figured it out by playing tennis or skiing, I am all over it.

Movement diversification is a crucial element to aging well. Just like a diversified financial portfolio can protect our investments, movement diversification is also important.

What makes these sports so special is they specifically combine multiple factors associated with aging well:

  • Aerobic exercise
  • Coordination
  • Strength
  • And social interaction

I would also add that racquet sports add an element of strategy. You have to be thinking about setting up to hit the ball well, but also what you can hit that wins points. It keeps you mentally sharp.

Racquet sports also use a lot of side to side motion. Nerds like me refer to this as the coronal plane which is sorely lacking in everyday life. This side to side motion keeps tendons and ligaments in the ankles, knees and hips healthy, and it also helps develop core strength, another crucial component for aging well.

WHAT 

Here's a fun summary of the benefits of these sports:

Racquet Sports (Tennis, Pickleball, Badminton, Squash):

    • Improves cardiovascular endurance and heart health.
    • Enhances cognitive skills such as strategy, quick decision-making, and hand-eye coordination.
    • Strengthens major muscle groups, maintaining overall muscular health.
    • Fosters social connections, reducing stress and promoting mental health.

That last point, while simple, is hard to overlook. It's simply a delight to have friends who share the same interest as you, and you can connect while exercising together. In this way, pickleball or tennis is the medium by which you are connecting with others, and getting a good workout is just a side benefit.

Cross-Country Skiing:

    • Superior aerobic conditioning and cardiovascular health due to full-body engagement.
    • Low-impact activity preserving joint health.
    • Enhances balance, coordination, and core strength, which are crucial for injury prevention and daily functional activities.

If I may be so bold (and expect more on this in the future), with all the hype around muscle, what seems to be lost is that in order to age well, you MUST, I repeat, MUST preserve your joints.

You can’t develop muscle if the joint is destroyed.

Joints are the unsung hero of aging well. No joints, no muscle. Period.

This is why I love cross country skiing over all other types of skiing. The injury risk is so low, the impact is low, and it is just you, the sound of snow crunching under your feet, and the random sounds of birds, and babbling brooks that have not yet frozen over. It is heaven on earth.

 

HOW

If you are a gym girlie like me and perhaps looking to diversify your movement portfolio in your training sessions, you can also integrate some sport specific training for these sports to augment your physical literacy required to do them well.

For Racquet Sports Training:

    • Agility drills (lateral movements, footwork patterns on a ladder are great).
    • Strength training emphasizing legs, core, and shoulders (lunges, rotational core exercises, overhead presses, Pilates).
    • HIIT and jump training to boost speed and power (think switch lunges, jumping squats, or one footed jumping patterns on and off plyo boxes
    • Balance exercises to prevent falls and improve court mobility.

Cross-Country Skiing Training:

    • Endurance training through steady state running, cycling, or rowing.
    • Core stabilization exercises (planks, side planks, Russian twists, Pilates).
    • Upper-body strength training (pull-ups, push-ups, rowing movements).
    • Balance and coordination drills, including single-leg balance and proprioceptive exercises.

NOW

Your easiest 3 next steps:

1. Try a Beginner Session: Find local clubs or groups to try these sports.

2. Add Cross-Training: Start with simple strength or balance routines to complement the sports.

3. Commit Socially: Engage a friend or group to enhance motivation, enjoyment, and accountability.

 

WHAT I RECOMMEND

Red Light Therapy for Face & Neck 

Your skin doesn’t lie. As estrogen dips during perimenopause, changes in your face and neck can feel sudden and defeating.

But what if a simple, at-home light ritual could visibly brighten your complexion and help you sleep better?

Learn why red light therapy is more than a skincare trend—it’s a hormone-friendly tool to support your entire body through the midlife shift.

Click here to dive into the research and how-tos in our latest article.

 

Maui Nui Venison Snacks

If you’ve ever wished for a high-protein snack that supports your hormones and your metabolism without weighing you down—this is it.

I’ve found a protein source that checks every single box for us midlife Bettys: wild-harvested venison sticks from Maui Nui. With an unbeatable protein-to-calorie ratio (10g of protein in just 55 calories!) this lean, seriously delicious meat outperforms conventional beef in every way—more micronutrients, better blood sugar support, and none of the inflammatory junk.

Plus, Maui Nui is dedicated to safe and sustainable practices; both the animals and the land they graze on are treated with the utmost respect.

Click here to learn more about my #1 protein go-to snack. (Both myself and my family are obsessed with them!)

By the way, supplies are limited by the nature of their work, so they sell out FAST.

 

LMNT's Lemonade Salt

It's easy to forget that our sweat isn't just water. But why is it that we only down a glass of water after finishing a workout or running around on a hot day? Our sweat consists of water and sodium, potassium, and magnesium.

So next time you're reaching for that glass of water … remember to replenish electrolytes too.

My new summer hydration obsession is LMNT's Lemonade Salt. With zero sugar, artificial ingredients, or junk found in conventional sports drinks – and with the right amount of minerals – it checks all the electrolyte boxes. I feel hydrated and more energized within minutes of taking it. Plus I love LOVE the taste!

Click here to grab this new flavor and get a free Sample Pack with your purchase.

Hurry, though, this flavor is only around for a few more weeks!

 

 

 

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

Mini Pause #73: Pelvic Floor Health in Midlife

Posted on by stephanie-estima

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

Pelvic floor health significantly impacts midlife women's quality of life, affecting issues like urge, stress, and fecal incontinence.
It is the number one predictor for entrance into a nursing home. More than sarcopenia, osteoporosis or any other health risk we typically think of for women.

WHY

The pelvic floor is a powerful group of muscles that supports your bladder, bowel, and uterus. Yet, many women are unaware of its importance until problems arise. Conditions like urinary urgency, leaking when sneezing or coughing, fecal incontinence, and constipation are common, significantly impacting daily comfort and confidence.

The pelvic floor muscles differ from say, a bicep muscle, in that they are ALWAYS working. They are part of your core muscles, and literally keep your organs from falling out.

WHAT 

  • Urge Incontinence: A sudden, uncontrollable need to urinate, often associated with weakened pelvic floor muscles or bladder irritation.  It can almost feel like a Pavlovian response, like having to pee the second you come home, or washing your hands under water.
  • Stress Incontinence: Leaking urine during activities that put pressure on the bladder, such as coughing, sneezing, jumping, or laughing.
  • Fecal Incontinence: Inability to control bowel movements due to weakened pelvic floor muscles or nerve damage.
  • Pregnancy and Delivery: Hormonal changes and physical strain during pregnancy and childbirth can stretch and weaken these muscles.
  • Hormonal Changes: Declining estrogen and testosterone in perimenopause lead to reduced muscle tone, elasticity, and tissue integrity. Note, when I say tone here I mean it to represent the neuromuscular integrity of the muscle.  Meaning, the strength (or lack of strength) in which the nerves are innervating and powering up the muscles.  I am definitely NOT referring to fitness influencer word salad that roughly translates to “looking in shape”.
  • Tight Pelvic Floor: Chronic tension or hypertonic pelvic muscles can lead to constipation, difficulty emptying the bladder or bowel, and discomfort during intercourse.

HOW

  • Tight Pelvic Floor: Chronic tension or hypertonic pelvic muscles can lead to constipation, difficulty emptying the bladder or bowel, and discomfort during intercourse
  • Kegel Exercises: Strengthen weakened pelvic floor muscles to reduce stress and urge incontinence. Practice consistently and with correct technique. For the record, I prefer the term Puss-Ups. These exercises are essentially a contraction of the pelvic floor muscles (think about pulling “in” and “up”), an isometric hold, and then a release.
  • Hypopressive Exercises: Gentle abdominal breathing and postures that reduce intra-abdominal pressure and naturally strengthen the pelvic floor. I absolutely love these. Lying on your back, on an inhale, pull the navel “up and under” the ribcage, as if you were trying to bring it towards the spine. Hold for several seconds and release.
  • Relaxation Techniques: Diaphragmatic breathing, yoga, and guided pelvic relaxation exercises can ease tension in an overly tight pelvic floor. I am a big fan of child’s pose, or happy baby pose in yoga for this.
  • Proper Toilet Posture: Using a squatty potty or raising your knees helps relax pelvic floor muscles, making bowel movements easier. This helps to relieve strain, align the sacrum and coccyx (the tailbone) and reduce transit time of the bowel movement.
  • Physical Therapy: Specialized pelvic floor physical therapy can provide targeted exercises, biofeedback, and manual therapy to balance strength and flexibility.

NOW

  • Assess your pelvic floor: Notice symptoms like leaking, urgency, constipation, or discomfort. Discuss these with your healthcare provider. I want to acknowledge that this topic is cloaked in shame and it may be difficult to discuss what is happening with someone. However, I am going to firmly encourage you to ensure this discussion takes place. Left unmanaged, incontinence only gets worse, the strength of the muscles will continue to weaken without a proper therapist, program or proper hormones.
  • Implement a pelvic health routine: Integrate daily Kegels or relaxation exercises, depending on your specific needs. There are apps that you can download that also can be a great companion to strengthen your pelvic floor daily!
  • Consult a specialist: Seek support from a pelvic floor physiotherapist for personalized assessment and tailored treatment.

What I Recommend

The Midlife Protein Trap: Why You’re Eating Right But Still Feeling Off

Feeling bloated, tired, or like your metabolism hit the brakes? It might not be your hormones (or at least, not just your hormones).

In my latest article, I reveal the hidden digestive issue that’s quietly wrecking your protein absorption, energy levels, and muscle tone during perimenopause. This one’s a game-changer, especially if you’ve been upping your protein but still feeling off. I also share my go-to solution that’s helping women feel stronger, leaner, and less gassy (you're welcome).

Get all the facts and my top recommendation by clicking here.

 

MassZymes

If you’re looking for digestive support during perimenopause and menopause, then check out MassZymes by BiOptimizers.

It is a 100% plant-based, full-spectrum digestive enzyme that helps your body break down protein more efficiently (so you actually absorb the nutrients you’re eating). Many women report less bloating, more energy, and improved recovery after meals and workouts.

Visit BiOptimizers and use code ESTIMA to get 10% off your order.

 

AG1 Big Update Alert!

I’ve been drinking AG1 for years as it’s the absolute easiest way to supplement my diet on the go. I never have to worry if I’m getting all my bases covered because they are if I’m drinking this.

If your schedule is often too packed to prepare meals that give you all the whole foods, vitamins, minerals, and probiotics you need, AG1 is your answer. It’s incredibly clean, nutritious, delicious, and is meant to be enjoyed daily.

I’m so thrilled to see AG1 raise the bar (again) and can’t wait for you to try their Next Gen formula…

Head to drinkAG1.com/stephanie to try the new formula and get a FREE Welcome Kit, a bottle of AG D3K2, and 5 upgraded travel packs with your first order.

 

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

Mini Pause #54: 10 Ways to Put Your Health First

Posted on by stephanie-estima

I'm switching things up this week to bring you my best resources to help you navigate the year ahead (and well beyond). For those of you new to the Bettyverse, welcome! I'm delighted you're here. And for my longtime followers, thank you for your continued support.

FREE RESOURCES

Mini Pause: If you're reading this, you've already signed up for my Mini Pause newsletter. There are now 54 issues (!) offering information, education, and practical takeaways on topics relevant to midlife, especially perimenopause and menopause.

  • You can browse all the newsletters and blog articles in the catalog here.

BETTER! with Dr. Stephanie: Next week, I'll air the 400th episode of my podcast! It's truly a labor of love to talk with experts and bring you fresh perspectives on meals, muscle, mindset, hormones, and much more. Take a listen!

  • Did you know I offer a Personalized Podcast Playlist? Take a short quiz (only four questions) to get a playlist targeting what's most important to your health.
  • Have you seen the podcast on YouTube? It's a different experience to watch me and the guests interact during the show. Try it!

PREMIUM MEMBERSHIP

EVEN BETTER! If you already love the podcast, this private community offers exclusive access and perks. You'll get early and ad-free weekly podcasts; candid post-podcast commentary; “She Said, She Said” episodes with Cynthia Thurlow, ND (we spill some tea in these talks!); “Ask Me Anything” episodes (recorded & live); my solo shows, where you get my unfiltered views and recommendations along with tips to help you build habits and routines that support your goals; bonus content; and exclusive discounts on my favorite brands.

  • Check out subscription options here.

YES! YOUNGER, ENERGIZED & STRONGER

New Coaching Program: I'm back to LIVE teaching this year with the debut of an 8-week program designed exclusively for women in perimenopause and menopause. With my focus and formal education in nutrition, exercise physiology, and biomechanics, I'm tailoring the program to suit women within three distinct pillars: Younger targets mitochondrial health and biological aging; Energized targets metabolic health; and Stronger targets female-specific biomechanics and weight-lifting. We'll discuss hormones, nutrition, movement, strength, and mindset. You'll also learn real-life strategies for increasing energy, reducing brain fog, and managing stress.

  • If you missed the first FREE introductory session on Jan. 14, you can watch the replay here and decide if it's for you. Doors are open until Jan. 21, when we'll dive into the course programming. Register here and use code JANUARY to drop the cost to $497.

HEALTH TOOLKIT

Body, Mind & Life: I get asked all the time about the supplements I take, the skincare I use, the tech that helps me train and recover, and overall ways to improve resilience and feel great at this stage of life. I've curated my favorites in an online toolkit for you. These are products I actually use that have helped me build supportive routines. I've partnered with amazing brands to get you discounts on every item. Take a look!

FOLLOW ALONG

  • Instagram: I'd love to see you on my social page. I share workouts, recipes, health tips, excerpts about my life, and much more. It's a bright, fun place to be.
  • Website: My website is information central. It includes all the items I've listed above plus other sections. Last year, we developed special sections for the podcast's 5th-anniversary giveaway and an online holiday gift guide. So, be sure to visit often!

What I Recommend

How Red Light Can Ease Perimenopause & Menopause Symptoms

Perimenopause and menopause can come with some unwelcome changes to how you look and feel. From sleepless nights to thinning hair, dry skin, and even changes in bone health, you could start to feel like your body is no longer your own. But what if an effortless, non-invasive treatment could help you start feeling like yourself again?

Enter red light therapy. Backed by research, this drug-free, largely hands-off practice has shown promise in improving some of the most unnerving symptoms of hormone changes, potentially improving sleep, reducing inflammation, supporting hair growth, promoting bone health, and even rejuvenating skin.

I take you through the reasons I recommend red light to my Bettys in this article.

Mini Pause #53: Fat Loss Basics-Tucking Into Calories & Hunger

Posted on by stephanie-estima

Fat Loss Basics: Tucking Into Calories & Hunger

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

Fat loss is relatively easy to figure out, and somewhat harder to execute.

In this issue, you’ll figure out your maintenance calories and how much to reduce your calories by in order to target adipose tissue.

And if you don’t want to do it alone, I can help. (Read to the end to see how!)

WHY

The one question I get most often, especially when it pertains to strength, is “How do I do this when my primary goal is to lose fat? I’m totally game for building muscle, but is there a way to do both at the same time?”

The other version of this I get is: “Should I lose the fat I want first and then embark on a muscle-building program?”

There persists a fear around body fat, even for a short period of time, and I hope that these Mini Pause newsletters (that you’re sharing with your friends, right?) help to educate you and shine a light on the beliefs (however correct or incorrect they may be) are driving your behaviors.

I’m a BIG fan of efficiency and momentum. Meaning, that if I’m going to dedicate resources like my attention to something, I want it to work.

Not sort-of work.

Work.

For most of us, we can think about approaching fat loss and muscle building in phases. You can, technically, build muscle in a fat-loss phase but it is orders of magnitude more difficult to do than to approach each goal separately.

If I told you to learn French and Italian at the same time–could you do it? Sure. But over time, you are going to mix up the languages. One language becomes more dominant than the other, making the weaker language more difficult to access.

The same is true for body goals. You can do them at the same time, but it will be slower.

Let’s focus on fat loss. Given that it is still January, I suspect many of you are at least slightly more interested in fat loss right now.

WHAT

So first, let’s state the obvious. Whenever we are talking about weight loss, what we really want to zoom in on is fat loss.

I’m assuming you are not trying to reduce density in your bones, weight or volume of your brain, or your muscles–all, of course, have weight to them.

It is the adipose tissue you want to get under control. Especially the adipose tissue that begins to migrate to your midsection in your 40s.

The first thing to do when embarking on a fat loss journey? Get a sense of what kind of caloric intake you currently have and ask yourself if it’s having a net zero effect on your weight.

You have to determine how many maintenance calories are required to either gain or lose weight.

There are a couple of ways to do this. The first method (1) is longer and more accurate; the second method (2) is faster and less accurate.

  • Keep a food journal for one to two weeks. Literally track every lick, taste, and bite. Include the weekends and the stress eating. Everything. Because if you can see after a week or two that nothing happens to your weight, then you can accurately estimate your maintenance calories.
  • Use an online calculator to estimate how many calories you burn right now, with your current level of activity.

HOW

After you figure out your maintenance calories, you can figure out how to reduce your calories so that you’re coming in with a net calorie deficit. That’s when you start tapping into stored fat as your energy fuel.

This is what fat loss entails. Weeks of a caloric deficit under your maintenance calories.

It’s boring. Sorry, not sorry.

You can start with a certain percentage below your maintenance calories. I honestly like to be gentle here, but research indicates that as long as you’re getting enough protein, you can safely decrease your calories to 25% less than your maintenance calories. I recommend something a little less than 25%, and if needed, you can ramp up.

I’m always a fan of taking a long-term view of fat loss, muscle gain, and managing things like hunger.

And you’re going to be hungry when you’re in a fat loss phase. Expect it.

What percent of a caloric decrease you can tolerate and maintain comes down to a few key things:

Is your nutrition already dialed in?

  • Are you already lifting weights and eating sufficient protein?
  • What’s your current body composition?
  • What’s your current fitness level?
  • Have you engaged in a fat loss phase previously? How successful was it?

NOW

If you have a fat loss goal this year, start here:

  • Figure out your maintenance calories
  • Decide by how much you are going to reduce your caloric intake
  • Expect hunger with slight to moderate discomfort

If you don’t want to do this alone, I’m starting a brand new program on Jan. 14 that addresses this very issue (along with muscle-building).

You’re invited to participate in the first class for FREE.

In this 8-week program, you’ll learn you to figure out your calories, what your caloric deficit should be for you, as well as how to begin to build muscle and implement healthy habits not only for this year but also for life.

This is my first coaching cohort in over two years (!) and I’m so excited to get going again!

➡️ If you’d like to join me and a group of like-minded women, reply YES to support@drstephanieestima.com, and you’ll get all the details!

Say YES! to Feeling Younger, Energized & Stronger

YES is my new eight-week program designed to help you lose fat, gain muscle, and feel your most vibrant. We’ll focus on mitochondrial health, metabolic health, nutrition, biomechanics, and strength training specifically for women.

I'll be leading you through the program during weekly LIVE coaching calls, as well as tools and a community space for you to interact with other women.

To participate, reply to support@drstephanieestima.com with the word YES in the subject line to join the first session for FREE, and I’ll send you all the details.

YES starts with the FREE first session on Tuesday, Jan. 14 at 7 p.m. ET

  • The first class is my gift to you with no obligation to continue.
  • If you'd like to join the first session, but can't make that date and time, let me know in your “YES” response and I'll send you the replay.

What I Recommend

Increase Resilience, Improve Cellular Health & Manage Hormonal Changes

TRY COLD PLUNGING

I've been talking to you about the benefits of cold water immersion therapy for well over a year now. It took me a while to take the plunge (pun intended!), but when I did, I went all in…albeit one extremity at a time! And I don't want you to miss out on the benefits like improved sleep, balanced energy and mood, sharper focus, and reduced stress.

  • My first podcast guest of 2025 was Marie Bodine, a cold performance and mindset who's also a level 2 certified Wim Hof Method instructor and a Spartan athlete. Take a listen to BETTER! episode #398 for a cold water “how-to” guide.
  • Read about how cold water immersion helps ease perimenopause and menopause symptoms in this article.
  • Find out what I recommend for women when it comes to cold plunging: time, temperature, warming up afterward, and more in this newsletter.

➡️ If you're ready to try cold plunging at home, visit Coldture and use code DRSTEPHANIE to save $200. Culture also offers financing, a 30-day risk-free trial, and free shipping,

EMPOWER YOUR CELLS

Wouldn't you like to feel renewed in the New Year? With Timeline’s Mitopure®—a rare postbiotic called Urolithin A—you absolutely can.

Mitopure® (in capsules or powder form) supports your health at its foundation and encourages cellular renewal. It's clinically proven to target the effects of age-related cellular decline.

This means you'll have more energy, better workouts, and faster recovery, and you'll be preserving your health, mobility, and strength as you age.

Mitopure® also empowers your cells to replenish your skin from the inside out, which makes their skincare line so effective I can't do without The Serum morning and night.

➡️ Timeline's New Year's discount is going on now for a limited time. Visit Timeline to get 33% off nutrition and skincare.

BALANCE YOUR HORMONES

Hear from more than 20 women’s health experts–including me!–to get science-backed solutions, practical tools, and daily practices to manage your menopausal journey.

➡️ Click HERE to register for the FREE Menopause Redefined Summit, happening January 21–24, 2025.

EVEN BETTER! Premium Membership

HERE'S WHAT'S NEW for members this week:

🧬 Dr. Stephanie gets (quite) candid about obesity and genetics in her SOLO episode.

💪 Dr. Stephanie and Nathalia Melo talk about women's strength training and realistic fitness goals on the podcast. You don't want to miss the after-show comments (exclusively for Premium Members!)

DON'T MISS OUT! Join other like-minded Bettys in a community where you can get exclusive access and resources.

  • Early and ad-free weekly BETTER! podcasts.
  • Post-podcast commentary!
  • Insights from the guest discussions coupled with recommendations you can use to build habits and routines that support your goals.
  • “Ask Me Anything” episodes.
  • “Dr. Stephanie SOLO” shows.
  • Action guides. Coming in 2025!
  • Bonus content.
  • Exclusive discounts on favorite brands.

Subscribe HERE to find a membership option that fits your budget.

Mini Pause #21: How Caloric Deficits Impact Your Bones, Muscles & Tendons

Posted on by stephanie-estima

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

Caloric deficits impact the trajectory of women’s bone density and muscle mass. Caloric deficits also can impact women’s height, ability to build muscle, and menstrual cycle. We must reframe our thinking from being as skinny as possible to being as strong as possible.

WHY

Oh, look! I have more to say about chronic caloric deficits. Hold my beer.

Just kidding. I never drink the stuff. But… I have been thinking about chronic caloric deficits and the impact it has on a woman over her lifetime. Specifically, I want to talk about not getting enough calories in and how seriously it affects your bones, muscles, tendons, and joints, and injury risk.

Last week, I touched on the idea that eating in a caloric deficit can have deleterious effects not only on your gainz, but also on other important areas of female health like menstruation, bone health, brain health, and hormone production.

Let’s tuck into this a bit.

WHAT

One of the things I couldn’t shake after writing last week’s Mini Pause #20 is that most of us have been on some kind of diet for all of our lives. That means that for many women, we have been trying in some form or another to starve ourselves skinny. So at best, we have underestimated our calories thinking we are in a deficit, and at worst, we’ve fostered a real, chronic caloric deficit that impacts organ function and tissue remodeling and maintenance.

I wanted to expand on last week’s newsletter because it has real consequences on our body’s ability to function normally.

Most obviously, chronic caloric restriction is going to affect the regularity and cadence of our menstrual cycle. I write about this extensively in The Betty Body and why women are still getting periods (no matter how irregular they may be).

If your body fat percentage is too low, you run the risk of depriving yourself of ovulation, which is the main point of your menstrual cycle. In doing so, you also deprive your body of progesterone. This sex hormone is only produced when you ovulate.

Progesterone has wide-sweeping effects on the body like promoting good sleep, calming anxiety centers in the brain down, and supporting thyroid function–all three of which perimenopausal women tend to struggle with.

But there are other, perhaps more deleterious effects of prolonged caloric deficits, such as the effects it has on your bones and muscles.

Young women who under-eat and have lost their menstrual cycle as a result of over-dieting are at risk for developing irreversible damage to their skeletal system because 90% of our bone mass peaks at about 18 years of age [*]. This means that without adequate nutrition, a teenager who is undereating will impair her bone strength; change the architecture of the bone itself, causing it to have a higher affinity for bone fractures; and can even change her final height [*]. It puts this young woman at a higher risk of vertebral fractures throughout the rest of her life, even if she resumes normal eating patterns.

Having seen my fair share of vertebral fractures in my clinic, this is something you want to avoid at all costs. It is painful and disruptive, and the rehab is incredibly difficult from both a physical and mental point of view.

Amenorrheic episodes (months without ovulation) also impact your anabolic hormones like estrogen. Without a regular menstrual cycle, you would be considered hypoestrogenic, which is not too dissimilar to what we see in the final stages of perimenopause and menopause.

In both age groups, we see a fraying of the bone architecture, an increased susceptibility to fractures, and reduced bone strength. We want bones that are more “bendable” to withstand the forces on them. The more brittle and less “bendy” a bone is, the more likely it is to snap.

The other deleterious effect chronic caloric deficits have are on our body’s ability to repair and grow new muscle tissue. Muscle is so much more than aesthetic, as you know. Undereating is associated with impaired myofibrillar and sarcoplasmic muscle protein synthesis [*], compared to training with optimum energy availability.

Being on a chronic diet for YEARS is going to measurably impact your muscle mass, bone density, injury risk, and organ health. And it will catch up to you eventually.

HOW

I wish I could snap my fingers and wake us all up from the collective spell of wanting to be skinny, but the truth is, each of us will have our own paths to this awakening. What I can say to the well-intentioned woman (possibly the one reading with a touch of cynicism who gets what I’m saying intellectually but emotionally still desires to be small) is that your worth is not what the scale says.

If you have a lot of muscle mass, you are likely going to be heavier than whatever arbitrary number you have in your head. That number by the way has been subtly implanted from reading Cosmo, Teen Cosmo, and whatever other junk we grew up reading.

Think deeply about the images of thinness growing up. Women in perimenopause know this intimately because if you are around the same age I am, you grew up with Kate Moss and the advent of the grunge and heroin-chic look.

I distinctly remember as a teenager who was studying fashion magazines, that my body was just not built like the girls on these pages. I have thighs that are always going to touch. I have hips made for childbearing. I am just built differently.

Of course, these physical qualities have been in vogue as of late, which also just goes to show you the standards of beauty are always changing. So find the beauty in your own damn self and stop looking for external validation. Love your freckles, your scars, your hair color. Because soon stars will take out their BBLs, strong Roman noses will be the new ideal, and thin eyebrows will be back.

Point is–the house always wins. So be the house. Not the player.

NOW

  • Play India Arie’s “Because I Am a Queen”
  • Think about your relationship with food and dieting and what messages your daughters and sons are receiving. Is it good? Bad? Neutral
  • Contrast that with how you would like to show up for yourself, your family, and your community.
  • Can you experiment with eating a little more? What if you started with simply 100 calories more of protein? Could you make that work?

Q: I know I need more calories in my luteal phase. Can I increase fat? Or do I need to add more carbs?

Short and to the point for Divie3 from Instagram today.

Yes, if you are hungrier you definitely need more calories. I usually recommend something like 10 to 15 percent more than you are eating in your follicular phase. The first thing is to make sure your protein intake is adequate. Typically something like 1g of protein/per ideal pound of body weight. After that you can dial up fat or carbs; whatever tickles your fancy!

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: Red Light Therapy

I’ve added another component of light therapy to my recovery practice. (Yes, that's really me lying on it in the photo).

While my Bettys know how much I rely on science when it comes to all things wellness, I’m going to admit that the PEMF Mat by Bon Charge both soothes and energizes in ways I wasn’t expecting–and I loved it right away.

It’s a pulsed electromagnetic field mat that works with your body’s natural magnetic field and uses bioactive wavelengths combined with red and near-infrared light. An additional far-infrared light component warms your body.

You can use the PEMF Mat during yoga, stretching, or grounding while lying down. You can even read a book or take a nap. The Mat’s programming allows you to choose sleep, grounding, focus, or meditation and relaxation.

And ever searching for ways to be more efficient, I combined my Red Light Face Mask and Red Light Neck & Chest Mask with time on the PEMF Mat. It’s a triple win for wellness. Speaking of triple, the PEMF Mat now comes in three sizes: a sitting pad, a demi size, and the full size.

View the entire Red Light Therapy Collection here and use code DRSTEPHANIE to save 15% off sitewide.

Mini Pause #10: How to Grow Muscles Without Lifting Heavier

Posted on by stephanie-estima

Injury Prevention, Part 2

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

In last week’s Mini Pause #9, I talked about ways you can maximize muscle growth and simultaneously prevent injury. Today’s issue continues to explore how to maximize muscle growth without lifting heavier.

Full range of motion—defined as your range of motion that is not restricted and is pain-free—is one of the most effective ways to maximize muscle gains and future-proof your body for injury. Other variables like increasing volume (both in rep and set number), as well as decreasing the time in between sets, are other ways to increase the intensity of the exercise without lifting heavy weights.

WHY

In Mini Pause #9, we discussed the similarities between injury prevention and muscle hypertrophy, and, like most things, it turns out I have more to say about it.

In addition to doing a sport-specific warm-up, working the eccentric and the longest point of the muscle there are a few other variables I’d like to discuss that will help you on your muscle-building journey to becoming comfortable with lifting without injury.

We often hear online that women should lift heavy sh*t. I agree. And, I recognize that many women our age grew up on cardio machines and may not have the neuromechanical integrity or muscle memory to do this well without getting injured.

We must think about improving our strength before we work on power [*].

So, here are a few more ways you can think about growing muscle without adding on weight.

Your goal, eventually, is to progress and lift heavier with time. The key word is eventually. There is no rush, and you can take your sweet time learning. Learn the movement pattern the right way the first time and you will enjoy muscle mommy injury-free status.

WHAT

Full ROM

Building on Mini Pause #9’s idea of working the muscle at its weakest point, your range of motion both for the muscle and the joint is an imperative tool for staying in the gym. You want to get all those muscle gains and prevent injury.

Said another way, if you cannot perform the full range of motion as God and your joints intended, you are missing out on a lot of potential muscle gains [*], as well as future-proofing your body for injury.

This isn’t rehab my Bettys; this is even better. It’s prehab—getting the movement patterning right the first time so that you evade injury and grow the muscle in a safe and controlled way.

If you are dealing with osteoarthritis, rheumatoid arthritis, or any other arthritide [*] for that matter, full range of motion to preserve the joints [*] in question is the absolute name of the game.

In treating my patients with rheumatoid arthritis, the weight on the bar was the least important aspect of working out. It was not important at all. My focus was all about answering the question: What range of motion can this person do without restriction and pain? Then, building on range from there.

Whether you’re a beginner in the gym or someone with 10,000 hours clocked, exploring your range of motion can be how you tweak your routine to stimulate muscle growth AND improve capsular and joint integrity.

Let’s explore this with shoulder training.

Photo 1: Dumbbell lateral raise parallel.

If you’re like me and want glute-sized delts, most of your shoulder work should be focused on the side deltoid muscle, because that is what gives presence to the shoulders when looking at them head-on. (Plus, if you’ve set up your programming correctly, your front and rear delts are going to be hit during chest and back days).

What does full range of motion look like for the lateral deltoid? This is going to, in part, depend on the health of your shoulders.

Let’s assume this is a dumbbell lateral raise. If you are dealing with an injury, you might aim to lift them to about parallel. Something like photo 1.

As you nurse the injury, or if lifting to parallel becomes easier and you feel ready to progress, instead of graduating to a higher weight, keep the same weight, but lift it higher than parallel.

In photo 2, my arms are abducting now to greater than 120 degrees. This is incredibly difficult, and in doing this, you may even need to drop the weights to do the motion properly.

You can continue the movement arc to the top. You want to think about the range of motion for the muscle, and not just simply the movement. You lift until you don’t feel your delts anymore, and it’s all upper traps (this will usually happen north of 120 degrees of abduction with the elevation of the arm shifting from primarily the deltoid to the traps).

Photo 2: Dumbbell lateral raise abduction more than 120 degrees.

Volume

Another way you can accelerate injury recovery and muscle growth without lifting heavy weights is through increasing volume [*]. Meaning, either increasing the repetitions per set or increasing the total number of sets performed.

When intensity is equated [*], we see similar gains in both individuals repping out heavy weights for fewer reps or sets compared with lighter weights with more reps and/or sets.

The signal to the muscle is similar [*] when lifting heavy weights vs. lifting lighter but for many more reps. As long as you get close to failure, you’re going to achieve a similar result.

I often do this in week 4 of my cycle. In my book, The Betty Body [*], I talk about reps in the 15- to 30-rep range with lighter weights to accommodate some of the inflammation many women feel around their cycle.

Truth be told, I will also do this when I haven’t slept well or just am not in the mental space to lift heavy.

Rest Time Between Sets

Another way to manipulate the intensity of your workout without adding weights is to decrease the rest time in between your sets. This works well (read: you will feel the burn!) if you are increasing your volume of the reps in the set.

The burn you feel in the muscle toward the end of a set is an accumulation of metabolic debris and stress. We often rest between sets to allow for this debris to clear and for the muscle to be fresh and ready for its next set.

There’s a lot of discussion about the ideal time to rest between sets, but generally, here are a few good indicators:

  • Your heart rate has returned to baseline or near baseline (I use a polar heart rate monitor for this).
  • Any accessory muscles used in the movement also feel good (e.g., the lower back muscles during a squat, the biceps during a pull-up, or the triceps during a chest press).
  • The target muscles themselves feel ready to work again.

This is probably going to fall in the one- to five-minute range depending on the recovery items above. Decreasing your rest time is another way to elevate the intensity [*] of the workout.

HOW & NOW

  • Keep your training program the same—no need to change anything!
  • Drop the weights (and your ego telling you not to try anything new!) and explore your current range of motion with every movement. Your range is going to be defined as the most movement through an arc that is not restricted or is pain-free.
  • Work your current range of motion with lighter weights while dialing up your volume. Increase your reps from anywhere from 15-30 reps. For example, if your current reps are 15, bump it up to 20. You also can add one more set to your current set split. If you’re currently doing three sets, make it four.
  • One more way to ramp up your intensity is to decrease the rest time between sets. To do this, use your phone as a timer and just see what your current rest time is with your workouts this week. You can start by decreasing this time by 30 seconds next week.

Question of the Week

Q: How can women avoid dyslipidemia during menopause?

If you are starting to see your lipid levels start to climb in menopause, there are a few ways to help improve this. First, we can think about the variables we can control and then perhaps the variables we cannot.

VARIABLES YOU CAN CONTROL

In the Mini Pause #6, I discussed the changes we see in body composition in our 40s through menopause. Some of the suggestions I outlined were:

Consider the composition of your calories.

  • In my book, The Betty Body, I detail a female-centric ketogenic diet for women looking to lose weight, and more specifically, lose visceral fat.
  • The ketogenic diet (high fat, moderate protein, and low carbohydrate) has been shown to improve all measures of body composition including body weight, body mass index, waist circumference, fat mass, fat-free mass, lean body mass, visceral adipose tissue, and body fat percentage

Lift weights with the intention of putting on muscle mass.

  • As we have been discussing, you can lift heavy, or you can lift lighter while controlling the eccentric, increasing the volume of reps and sets, and working the weakest part of the muscle to maximize muscle gain.
  • Work until the muscle is done like dinner.

Exercise snack your way through the day.

  • We are designed to have a lot of low-grade activity throughout the day. If you are someone who sits at a desk for several hours a day, consider investing in an under-desk treadmill and a convertible desktop stand to be able to get some consistent walking through the day. It doesn’t need to be fast: 1.0 to 1.5 mph is plenty!

For improving lipids specifically, I have a few more recommendations that have a good amount of robust literature to support them:

  • Consume phytoestrogenic foods [*]. Once demonized, phytoestrogens are a great choice for peri and postmenopausal women alike. Phytoestrogens can potentially reduce atherosclerosis and atherosclerosis-related diseases through multiple mechanisms like regulating lipid metabolism, lowering cytokine levels, and improving the coagulation/fibrinolysis system.
  • Dose up your Omega 3s. It’s well established that Omega-3s are anti-inflammatory, cardioprotective, and sensitize the body to insulin [*]. I like a minimum dose of 2g, and I often take experimental doses much higher than this. (Check out BodyBio, my new favorite Omega 3s. Use code DRSTEPHANIE for a discount.)
  • Take antioxidants like dark berries and green leafy vegetables to combat oxidative stress. The highest antioxidant content is found in almonds, artichokes, blackberries, blueberries, cherries (sour), chocolate (yay!), cloves, coffee (double yay!), cranberries, grape juice, cranberry juice, pomegranate juice, pecans, raspberries, spinach, strawberries, and walnuts.

VARIABLES YOU CANNOT CONTROL

For the things you cannot control, this is most obviously going to be the amount of sex hormones you produce as you age. Specifically, estradiol.

During a woman’s fertile life, the average level of total estrogen is 100–250 pg/mL. Estrogens are produced primarily in the ovaries via a process that uses low-density lipoprotein cholesterol (LDL-C) as a substrate. In menopause circulatory LDL-C can no longer be utilized to synthesize estrogen. This is, in part, why menopause is associated with increased blood LDL-C levels and enhanced cardiovascular risk.

Speaking to your doctor about hormone replacement therapy is a great (dare I say necessary) option for regulating lipids in our postmenopausal life.

I can tell you with certainty that when my hormone levels begin to drop, or I am symptomatic, I will be seeking this out in addition to the lifestyle factors I teach and write about.

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: Mitopure

Improve your cellular health with Mitopure's Urolithin A, a postbiotic nutrient. It works directly on your mitochondria to improve energy production that naturally lags as you age. Mitopure also impacts your muscle strength and endurance. Learn how and use code DRSTEPHANIE to get 10% off either the soft gels or the powder stick packs.

P.S.

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I don't want you to miss this FREE opportunity to learn all about your hormones from more than 40 experts, including me! You'll be learning effective, science-backed ways to foster hormone health. Tune into this online event March 18 to 24, 2024. Register Here! 2024 Hormone Super Conference