Mini Pause #13: Adopt Recovery Practices to Manage Your Energy

Ways You Can Better Manage Fatigue and Recovery During Perimenopause and Menopause

TL,DR (too long, didn’t read)

You deserve to recover. Not half-assed recovery. Full ass recovery. Using techniques like walking, thermal manipulation, and sleeping are mostly low-cost or no-cost ways to upregulate your capacity to recover. I’ve included some options I personally use, as well.

WHY

Recovery and fatigue management become essential pillars to master in perimenopause and menopause.

Truthfully, I don’t think women were ever meant to work themselves into the ground and burn out, but words like hustle and hack have made their way into common language. Women are told they are just as good as the guys are… and then oops, here we are, pulling all-nighters, saying yes when we should be saying no, and living off of a To-Do list with a bad attitude and angry at the world.

Now don’t misunderstand me – I DO want women to seek out and achieve all they desire and dream about.

Just not at the expense of health, joy, and pleasure.

Life humbles you as you age. Gone are the days of forgoing sleep for partying (or in my case studying), and you begin to cherish sleep, time alone, and a nourishing diet of food, people, and sacred spaces in your home.

Mastering recovery is key for body composition, mental grit, progression in the gym, and, dare I say… happiness at large.

You deserve to recover.
Fully.

There’s no half-assed recovery here, Bettys. We only recover with our full ass. Let’s dive in.

WHAT

SLEEP

There is no better glute builder, waist trainer, or happiness serum than a good night’s rest. It is the panacea of recovery. For perimenopausal women, sleep can evade us like the patriarchal moving target of beauty.

Our society is notoriously bad when considering our diurnal rhythms. We avoid sunlight like vampires, we eat late at night, and we bathe in artificial lights. The knock-on effects pervade our sleep quality and quantity.

Sleep affects every aspect of our lives. Mood, emotional regulation, physical repair, metabolism, glute gains, and wrinkles. For example, what happens when you only sleep for four hours for six days in a row during a particularly busy week? Your blood glucose spikes, your cells stop responding to insulin, and your glycation levels skyrocket.

Here in the Bettyverse, we want to sleep (and recover) like the goddesses we are. So, here are a few general guidelines, many low or no cost.

Go to Bed and Wake Up at the Same Time. I know this is glaringly obvious and potentially reduced to the ridiculous, but you would be AMAZED at what this does for sleep. Set your alarm clock. Do a wind-down routine an hour before bedtime. Dim the lights.

Go Outside. Rain or Shine. Again, at the risk of sounding ridiculous, going to a window is not being outside. Being in a car is not being outside. Going outside is going outside. No matter the weather, inclement or sunny. Buy some fun slip-ons and go out onto your balcony, terrace, or stoop. It doesn’t matter as long as you can see the sun.

Make Your Bedroom a Sanctuary. I talk about this in The Betty Body: invest in dark curtains, pick your laundry up off the floor, and sleep on beautiful linens. Do whatever it takes to make your bedroom feel like a resting place fit for a queen.

TEMPERATURE MANIPULATION

In our efforts at modernity, we have forgotten that humans have never existed eternally in environments that were constantly 72F / 22 C. We have baked-in mechanisms to help uplevel our capacities based on whether we are cold or hot.

Cold Plunges. Sanctioned by biohackers and optimizers alike, there’s quite a bit of literature to support getting cold regularly to uplevel mitochondrial function and augment recovery. While women do not need to get into temperatures as cold as men, we can still reap many benefits from cold water immersion. This has become one of my favorite recovery tools that I use each morning.

I outlined a few low-cost ways to cold plunge in Mini Pause #2. I also invested in a portable cold plunge tub in my home but did so only after several months of cold water immersion in my home bathtub.

I am very happy to report that this winter I never used my winter jacket once! I would go to the store, to and from the gym, and everywhere else without my winter coat. My cold tolerance has steadily improved and I am super proud of it.

Heat Exposure. Heat is another way we can augment recovery via activating heat shock proteins. I recorded a BETTER! podcast #357 on heat science for my dark roast Bettys, but here are the high-level takeaways. Heat exposure:

    • helps promote cardiovascular health
    • activates your natural endorphin system
    • helps with muscle repair and soreness
    • helps to grow muscles (useful if you are training or to preserve tissue while injured)

Many gyms offer saunas as part of their service packages. If you have room in your home, you can invest in a home sauna. If you don’t have room in your home, there are portable sauna blankets. I love this as an option because, like a blanket, it just folds up after use so it doesn’t require a dedicated space in your home.

ZONE 1 AKA WALKING

Maybe the most underrated recovery tool of all time is walking. Besides the metabolic and mood benefits, this is a great way to recover from a grueling leg day at the gym, an argument with your partner, or a bad night’s sleep.

Walking delivers oxygen and nutrients to your legs, replenishes glycogen stores in the legs, and helps to remove the build-up of metabolites like lactate that cause soreness in the first place.

I always try to go for a walk in the evening with my family in the warmer months of the year after dinner. And I always walk on the days following leg day to help reduce DOMS (delayed onset of muscle soreness). The first few minutes are uncomfortable, especially if I’m really sore, but as the blood starts moving and my legs get warmer, it becomes much more pleasant. My recovery from leg day is always better when I walk the same day or the day after that workout.

For all the Type A Bettys who need to ‘feel it,” you can certainly dial up the intensity with pace, hills, or rucking with a weighted vest or backpack.

HOW & NOW

Decide that you are worthy of recovery, rejuvenation, and rest! This may be the hardest task of them all. But trust me, you are worth it. Even if you don’t always believe that to be true. You are.

Build on sleep habits. Once you establish regular sleep/wake times (including weekends!, prioritize getting early morning light, and jeuge up your bedroom, you also can think about supplementation. I like to use magnesium supplements about an hour or so before bedtime.

Get your progesterone levels tested. This is one of the more common hormonal reasons we see sleep evade us in our 40s and 50s. Micronized oral progesterone is often the standard of care. Talk with your physician to determine if this might be an option for you, especially if you’ve mastered basic sleep hygiene and you’re still having difficulty sleeping.

WHAT I RECOMMEND: Recovery Tools

I’ve mentioned several recovery tools in today’s main article. Feel free to explore these options and determine if any may be a good fit for your lifestyle and budget. Use code DRSTEPHANIE with the links below to receive a special discount.

Question of the Week

Q: What is a solid alternative to birth control for my daughter?

I am a big fan of FAM, the Fertility Awareness Method. FAM works by tracking your basal body temperature and possibly cervical fluid secretions to determine ovulation. You can do this manually, or with modern apps. By doing a simple web search, you’ll find a plethora of information on FAM.

I often recommend a Daysy fertility tracker because it’s easy, and the app does all of the calculations for you. You take your oral temperature every morning on waking, enter menstruation days (if applicable) into the app, and it does the work for you.I love this because it’s a blend of modern science and natural cycles. You’re not taking anything exogenously that alters your natural hormone production, and it allows you or your daughter to get in touch with her unique rhythms. She will learn the length of her cycle, and eventually how her mood, sleep, and desire change throughout her menstrual cycle.

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.

P.S.

HEALTH TOOLKIT: I’ve compiled numerous resources for you on my brand new website. These resources are for my Bettys who are still cycling, experiencing symptoms of perimenopause, or going through the menopause transition. Everything I recommend, I use myself. That’s my rule. I invite you to look around!

Mini Pause #9: Focus on Muscle Movement Patterns to Avoid Injury

How to Prevent Injury While Lifting Weights

TL,DR (too long, didn’t read)

Injury prevention and muscle hypertrophy science surprisingly have a lot in common. Most of us are leaving the most effective parts of our weightlifting regimen on the table and losing out on potential progress while simultaneously setting ourselves up for injury. Doing sport-specific warm-ups, manipulating the tempo of the exercise, and training the muscle in its most elongated position is a way to maximize muscle growth and prevent injury.

WHY

One of the more contemptuous/common reasons for women shirking away from lifting heavy weights is the fear of injury. Especially women who are new to lifting and are unsure of their form and technique. I agree with this fear insofar as women in perimenopause don’t heal as quickly as they once did. When ligaments and tendons are injured it can take more time than skeletal muscle to heal because of blood flow variations to these tissues.

So, you want to avoid injury AND maximize muscle gains at the same time. And it’s entirely possible.

I want to talk to you today about maximizing muscle hypertrophy and avoiding injury and the commonalities of these two strategies.

WHAT

Before you start lifting any weights at all, think about how you can best direct neural attention to the muscles in question. You want to ask: “What are going to be the best movement patterns to prime the muscles for my weight workout?

Anatomically, nerves and blood vessels travel beside each other through the body, so where (neural) attention goes, energy (blood) flows.

Warm-ups have classically been thought of as five or 10 minutes on the treadmill, which isn’t a bad idea–it just isn’t a great one if you are going to be lifting weights. A good warm-up up is specific to the movement patterns in question.

Muscle-Specific Warm-Up Sets [*]

Let’s say it’s leg day and you’re going to be squatting with weights today. Irrespective of the kind of squat or the machine you might be using, you want to prime the body for the squatting motion.

What better way to prepare your body for squats than… well… with squats?!

Body weight squats, Smith machine squats (with no weight), or back squats with a barbell with no plates on it are EXCELLENT choices for a warm-up if weighted squats are on the menu.

If you’re scheduled for some pull-ups, why not start with assisted pull-ups on a machine?

If you are going to be deadlifting, why not deadlift just the bar?

Make your warm-up sets the same movement you’re planning to do with weights. This is going to reinforce the neuromechanical patterning needed to execute the movement well, and you’re more likely to perform the movement properly with little to no weight.

The other objective of a muscle-specific warm-up set [*] is to get you sweaty and ready to work. So typically I like to perform three or four sets of a warm-up before the weights get serious. I progressively add on a bit of weight each time.

Because these sets are lower in weight, you can execute them with higher repetitions. I like to add a bit of weight to each set to gradually increase the intensity of the exercise. We are not trying to go to failure, simply ramping up the neural stimulus for when you’re ready to lift heavy.

Sample warm-up set for leg day

  • Walking Lunges, bodyweight only: 20 reps per leg
  • Walking Lunges, 10 lbs: 15 reps per leg
  • Walking Lunges, 25 lbs: 12 reps per leg

Sample warm-up set for back day

  • Assisted Pull-Up Machine, 130lbs: 20 reps
  • Assisted Pull-Ups, 70 lbs: 15 reps
  • Assisted Pull-Ups, 45 lbs: 10 reps

(Remember, the assisted pull-up machine is “easier” the heavier the weight, so as the weight gets lighter, the harder it gets.)

The pattern you may already be noticing is to start with little to no weight and rep out as many full range-of-motion reps as you can with excellent form. Each progressive warm-up set gets slightly more difficult. When your warm-up is complete, you should feel warm, slightly dewy (aka you’re sweaty!), and ready to work.

Tempo / Time Under Tension

Another important consideration for injury prevention is that you can replicate the effects of heavier weights by manipulating the tempo of the exercise [*].

Specifically, by elongating the eccentric phase of the movement.

One of the biggest mistakes I see in the gym–whether it’s squats, bicep curls, or shoulder exercises–is the focus on the concentric phase of the movement.

People often just focus on when the muscle is shortening (and even count the rep on the concentric) and short-change themselves on the eccentric phase of the motion [*].

An easy example here is biceps. The concentric is the first part of the movement when the muscles are shortening; the eccentric is when you’re lengthening the muscle back to the starting position.

Now be honest, how many people have you seen only focus on the first part of the curl, only to drop the weight back down and completely ignore the eccentric lowering?

Now be even more honest–does this sound like your form?!

In the spirit of truth and transparency, I always used to do this too!

I made it all about how much weight I could curl or squat or deadlift and who gave a flying fish about lowering it slowly!! I’d slam it on the weight rack to let everyone know I was there, thank you very much. This is known as the ego running the show.

Let’s come back to squats because I know my Bettys like to work on their juicy peaches. The eccentric is the first part of the squat: the descent. The concentric is getting back up. So many of us shortchange ourselves and don’t think about lengthening the time of the eccentric as a way to build muscle [*].

But you can absolutely (and often by necessity have to) use lighter weights when slowing down the weights so you can focus on the eccentric part of the movement. It’s the harder part of the movement because you’re elongating the muscle and at the same time increasing the force production to get the muscle back up again.

For those of you who like to load plate after plate on a bar, or derive a lot of satisfaction from lifting heavy, take note that slowing down the tempo and focusing on the eccentric is going to humble you in some surprising ways.

I actually would cry when I started training this way because I thought “I was not working hard enough.” This was my ego dying a hard and brutal death, friends. To save yourself some gym heartache, lighten up the weight, master the eccentric, and watch your gains go through the roof!

Work the Weakest Point of The Movement

One of the best ways to prevent injury is by training up the weakest point of the movement [*] [*] [*]. It also happens to be the best position to drive muscle growth, which is why full range of motion is so important for both injury prevention and technical skill to grow muscles.

In all cases, this is when the muscle is stretched and at its longest. NO exceptions.

  • Squats: It’s at the bottom of the movement.
  • Lunges: It’s at the bottom of the movement.
  • Pull-Ups: It’s at the bottom of the movement.
  • Chest Press: It’s at the bottom of the movement.
  • Push-ups: It’s at the bottom of the movement.
  • Bicep Curls: It’s at the bottom of the movement.

I hope you are seeing a pattern here! When the muscle is stretched the most, it tends to be the weakest. It’s where the movement sucks the most.

This is why the full range of motion matters. If you’re squatting to 90 degrees of knee flexion, it is ok, but not great at tensioning out the glute as much as if you were dipping below 90 degrees.

And if full range is an issue (maybe there is a foot or ankle mobility issue, or an arthritic condition), then keep the weights light and work on restoring full range of motion. Go see your chiropractor or physio, and for the love of Cleopatra do the mobility exercises they are giving you!

It’s here, in the last few degrees of motion, where you leave so much of your goals on the table. If you could set your ego aside, tempo your workout to focus on the eccentric, and get into the longest position possible–all while using lighter weights–I’m confident in saying that you will make extraordinary progress in your muscle pursuit AND prevent injury.

HOW & NOW

  • Whatever your current program is, keep it. You’re just going to modify the tempo and depth of movement a bit.
  • Add in a warm-up set before you start adding any weights.
  • Shift your attention to the eccentric (lengthening) part of the movements in all your exercises. Slow it down by counting in your head. Start with a four-count descent.
  • Try to execute all your exercises with full range of motion: go all the way down, and then (and only then!) shorten the muscle again to come back up.
  • Compare and contrast the fatigue and pump you generate by simply priming the nervous system, changing the tempo, and working the weakest point of the muscle.

Question of the Week

Q. What is your approach now to IF (intermittent fasting)?

I’ve modified my stance on fasting somewhat over the past few years. I still think it’s a good tool for caloric restriction, weight loss, and overall health.

I typically fast for about 10 to 12 hours a day, with the bulk of that being sleep (I sleep for nine hours of that).

WHAT DO WE KNOW FOR SURE?

What I take issue with is how it has been perversely distorted as the ONLY tool that can help women, and how women are punishing themselves with this tool. It seems to be masquerading as a socially acceptable eating disorder.

Online influencers like to talk about autophagy as a hallmark of fasting, with autophagy of course being just the equivalent of your roomba vacuuming up cellular junk in the body. The problem with this is we have no real way of measuring autophagy.

Does 16 hours of fasting raise autophagy levels more than a 12-hour fast? If so, by how much? We have no idea, and anyone who tells you 16 hours is better than 12 is straight-up lying.

They have no idea of how to quantify “better” because we cannot measure it. And let’s pretend we could measure autophagy–is more always better? When do we move from beneficial to harmful? And how does this apply to women?

WHAT’S THE END GOAL?

What I know with certainty is that women feel like they must do more, more, more. Which coincidentally and ironically comes from a place of less. Does fasting for 24 hours make sense for most women?

I think a lot about the pressures on women and it’s always: Get thinner! Be Younger! Do More with Less!

I wonder if fasting culture is just a version of that. A wolf, disguised as a health influencer, hiding in sheep’s clothing. Telling you IF is the tincture to solve your problems, and in the end, you do lose: your period, your hair, and the joy that comes from eating food with others.

Women don’t eat enough as it is. I have seen way too many women fast for 16 hours only to complain about belly weight that won’t budge, weight loss that won’t happen, losing their hair, and yet still terrified of calories.

My current approach includes eating when I wake up. I front load the majority of my calories so that I’m finished eating by about 5 pm. The only “rule” I try to follow is I try to stop eating 3 hours before bedtime so it doesn’t affect my sleep.

If I am paying attention, this usually means I’m eating for about 12 hours. When I’m in my luteal phase, I eat for more like 14 hours, fasting for 10. But I’ve stopped paying attention to it. I just kind of naturally fall into this rhythm of eating.

IS IT THE BEST TOOL?

Fasting is one of many tools, and like many tools, it can be taken to the extreme and become a distress. So I like it, but put an asterisk on it. Not everyone should be fasting, especially if it feels overly restrictive and you hate it.

Patients with obesity and other chronic diseases can tolerate longer fasts with good results but most women with a normal BMI should not be engaging in any kind of 24-hour+ fasting practices. Especially if you want to build muscle.

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: Jaspr

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What you’re breathing inside your home affects your sleep, energy, and overall health. I recently invested in an air purification solution with commercial-quality HEPA filtration and real-time air quality monitoring with Jaspr and the effects on how my family feels inside our home have been profound.

Listen: Don’t miss my conversation with Jaspr founder Mike Feldstein on the Better! podcast. We cover a lot of ground, including the critical link between air quality and cognitive health.
Read: This week’s bonus article on drstephanieestima.com looks at the links between air quality, sleep, and hormonal balance.
For You: Visit Jaspr and use code ESTIMA to get an exclusive discount.

P.S.

FREE WORLD SLEEP DAY WEBINAR-LIVE!

Topic: Women & Sleep: How Hormones Affect Your Rest and Recovery

Join Us! Friday, March 15, 9:30-10:30 a.m. Pacific Time

What: Join me and Dr. Dave Rabin, M.D., Ph.D., co-founder and Chief Medical Officer of Apollo as we discuss one of the most-requested topics from our communities: how women’s hormones affect their sleep and how women can best support their health through life’s transitions. We’ll talk about cycles, infradian and circadian rhythms, how to improve your sleep at every life stage, and much more.

Bonus! Get YOUR personal questions answered.

Can’t Make It? Be sure to register even if you’re unable to join live to receive the recording in your inbox.

Register Here! World Sleep Day Webinar

Win! One webinar registrant will win a free Apollo wearable!

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  • Day 1: Women’s and Men’s Hormones
  • Day 2: Thyroid and Adrenals
  • Day 3: Nutrition and Weight
  • Day 4: Nervous System Dysfunction
  • Day 5: Mental Health
  • Day 6: Functional Medicine
  • Day 7: Self Empowerment

Who: I’m thrilled to be one of the featured presenters among 40+ interviews with doctors, psychiatrists, psychologists, researchers, scientists, functional medicine experts, acupuncturists, and bestselling authors. They’ll be presenting effective, science-backed ways for you to foster hormone health.

Register Here! 2024 Hormone Super Conference