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!

Air Quality: The Silent Guardian of Your Sleep and Hormonal Health

As women, particularly those of us over 40, we’re often vigilant about our diet, exercise, and mental well-being. Yet, there’s a silent factor significantly impacting our health that deserves our attention: the quality of the air we breathe, especially at night.

The Links Between Air Quality, Sleep, and Hormonal Balance

Air Quality and Sleep

  • The Hidden Disruptor: Poor indoor air quality can be a hidden disruptor of sleep. Pollutants like dust, allergens, and chemical vapors can irritate the respiratory system, leading to disrupted sleep patterns.
  • Deep Sleep and Clean Air: Studies suggest that cleaner air can enhance the quality of sleep by reducing the risk of airway irritation and facilitating easier breathing.

Impact on Hormonal Health

  • Cortisol Levels: Poor air quality can stress the body, leading to elevated cortisol levels, which can disrupt other hormonal balances.
  • Estrogen and Air Quality: Research indicates a link between air pollution and estrogen levels. Pollutants can mimic or disrupt hormonal activities, potentially affecting menstrual cycles and menopausal experiences.

Specific Concerns for Women Over 40

  • As we age, our bodies become more sensitive to environmental factors. Women over 40 may experience more pronounced effects of poor air quality on their sleep quality and hormonal health.

Strategies for Improving Indoor Air Quality

  • Regular Ventilation: Ensure your living spaces are well-ventilated. Open windows, when possible, to allow fresh air circulation.
  • Air-Purifying Plants: Incorporate plants like spider plants and peace lilies, which can naturally filter out common pollutants.
  • Mindful of Household Products: Be cautious about the use of harsh chemical cleaners and air fresheners that can degrade air quality.
  • Invest in a Quality Air Purification System: A reliable air purification system can be a game-changer, especially in bedrooms where you spend a significant part of your night.

My Home Experience

As a health-conscious woman and a professional dedicated to women’s health, wellness, and performance, I explored various solutions to clean the air in my family’s home. When I discovered the Jaspr Pro, I knew it checked all my “have to have” boxes.

It’s more than just an air purifier; it’s a complete home air purification system that intelligently adapts to my indoor environment, significantly improving the air quality in my home.

I learned so much about how air quality affects my overall health in my conversation on the Better! podcast with Mike Feldstein, founder of Jaspr. Take a listen to episode 349: Air Quality for Sleep, Recovery, and Brain Health.

Embracing clean air in our homes is not just about comfort; it’s a crucial step toward better sleep and hormonal health, especially for women over 40. As we focus on nourishing ourselves, let’s not forget the air we breathe is just as vital.

Learn more about how to improve air quality in your home with Jaspr. Use code ESTIMA to get an exclusive discount.

Warmly,

Dr. Stephanie

Mini Pause #4: How Dust Mites Disrupt Your Sleep

Dust Mites & Making Your Bed: Are You Making Your Sleep Worse?

TL,DR (too long, didn’t read)

Dust mites thrive in a warm and moist environment, which is precisely what making your bed in the morning facilitates. Dust mites worsen allergies, disrupt REM and deep sleep, cause systemic inflammation, and can drive skin irritation like eczema and dermatitis. In fact, a dust mite is probably chowing down on something yummy in your eyebrow right now. Yep, it is going to be that kind of newsletter today, my friend.

WHY

In my podcast conversation with Mike Feldstein about air quality, he mentioned something that made me have an unexpected, audible gasp while we were recording. The gasp was more of a visceral noise of disgust and was totally involuntary as the idea was so incredibly repulsive.

Mike explained that our homes are designed to be sealed tight — to filter out the cold, rain, snow, and bugs, etc. So, once something gets in, it’s hard to get out. Things like dead insect parts, dust mites, pollen, bacteria, and viruses — even our dead skin cells. All of this gets trapped in our bedding, our curtains, our carpets, and our clothing. And, if you’re not actively doing something about it, it never leaves!

I’ll pause while you, too, digest this (dead insect parts?!). Blech.

It’s nearly impossible to rid ourselves of this unless we are willing to live in homes that are penetrable to the cold, wind, moisture, and not use bedding or clothing. Which I’m pretty sure none of us are willing to do.

WHAT

Dust mites burrow themselves into any and all porous materials — carpets, mats, curtains, our hair, eyebrows, our clothing, bedding, comforters, pillows, and rugs. You name it and a dust mite has called it home. They survive by breaking down our dead skin cells into something they can eat.

They are also terrible for our health.

Dust mites worsen allergies, disrupt REM and deep sleep, cause systemic inflammation, and can drive skin irritation like eczema and dermatitis. Many people often confuse allergies with an allergic reaction to dust mites. And since this idea was so repulsive to me, I went down a bit of a rabbit hole and discovered two truly unnerving pieces of data:

  • We are not allergic to dust mites, per se. We develop an allergy to the fecal matter dust mites produce. We also develop an allergy to the dead corpses of dust mites that still reside in our mattresses.
  • Over the eight- to 10-week lifespan of one dust mite, it will produce 1,700 to 2,000 fecal particles.

I’m sorry. I know. More blech.

And even if you don’t have an allergy to them, just the visuals of the above facts are just… well, gross.

If you are someone who deals with allergies, I don’t need to tell you that they can impact your quality of life, and your sleep in particular.

For women in our perimenopausal and menopausal years, we’re typically struggling with sleep. Allergens like dust mites only hinder sleep quality and quantity even more.

Overnight, while tucked in your sheets, you naturally generate heat and sweat. If you’re suffering from night sweats or hot flashes, this further increases the heat and vapor produced overnight. Ovulation and the onset of your period are also natural times in your cycle where core body temperature rises and increase the heat and moisture you produce.

Your bedding, pillows, and mattress absorb this excess heat and moisture, essentially serving up a gourmet feast to dust mites.

HOW

While we can’t get rid of dust mites entirely, there are some ways we can reduce their impact on us.

  • Washing your linens weekly on a allergen cycle

This cycle typically has a higher temperature and the wash cycle is longer, with the intention of killing allergens embedded the sheets (the dust mites and their poop). I typically add a ¼ cup of vinegar to the load, too.

  • Unmake your bed!

I know many a guru has touted the benefits of making your bed in the morning, and you love the hit of dopamine that occurs when you can check off a to-do box first thing in the day. But, given that women have more times in our life where we run hot, we know this contributes to the dust mite population in our home.

Instead of pulling the covers up when I’m making my bed, I started layering them at the bottom of the bed. It’s still “making” the bed, just in a different way. I’m letting the bulk of the mattress air out and get cold.

  • Crack open a bedroom window in the morning (especially if it is near your bed)

In the morning when I wake up, I pull all the covers off the bed and I open the window right next to my bed while I head downstairs to have a coffee and cold plunge. This way I give my bed around 30 minutes of a fresh blast of air from outside and allows for any heat and moisture to evaporate.

This is when air pollution and pollen counts are generally low, so it’s a great time to air out the bedroom with fresh air.

  • Buy a mattress vacuum

I have this one from Amazon and while the sheets are in the laundry, I will vacuum the mattresses.  It is actually shocking the amount of dust and debris it captures.

  • Invest in an air purifier like Jaspr

This is a medical grade device used in dentist offices and commercial buildings that’s now available to purchase for family homes. I have one running in my bedroom at all times and on vacuum days because I know things are getting disrupted and thrown up into the air, I use the “turbo” setting which is a deep clean of the air that runs for about 15 minutes.

I started noticing a difference in my sleep after about three days of having the unit in my bedroom. My Oura ring was telling me I was getting more deep sleep and my chronically low HRV, while still not the greatest, jumped by about 10 points after just three days of use.

Using the Jaspr has been the easiest (laziest?) way I have ever contributed positively to my health. (If you’re interested in a unit for your own home, use my code ESTIMA to get a discount.)

NOW

Push the image of the dust mites and all their disgusting glory out of your mind and choose any of the above options in the “HOW” section.

You can start small, and work your way up from the no-cost options (unmaking your bed, opening a bedroom window in the morning) up through the cost options that are right for you.

Which dust mite intervention are you going to start with? Reply to this email and let me know!

Question of the Week

Q: How many calories are ideal pre-workout?

One of our Bettys asked about pre-workout calorie intake. She’d heard Dr. Molly Malloof, who I also admire, recommend just 150 calories. She then asked if I agreed with that recommendation or would suggest a larger meal?

CALORIE DECISION MATRIX

A few things can inform this decision: What time are you working out? What kind of workout is it? How long will your workout be? What is the intensity of the workout?

Most of my workouts are early in the morning. While I used to almost exclusively work out fasted, I have changed my mind on this because of the noticeable difference being fed has on my performance in the gym.

For a weight lifting workout I always like to have more carbohydrates and protein 45 minutes to an hour before I get to the gym.

So my pre-workout will include either my overnight oats recipe (which you can find here), or simply steel cut oats with a scoop of protein powder, a banana, and a coffee. This clocks in at around 350-400 calories.

I find 150 calories a little on the light side as a means to enhance my performance at the gym. Although this might work well for her and her schedule and workout format. My weight workouts are on the longer side, about 75 minutes. When I do legs, it’s closer to two hours.

LISTEN TO YOUR BODY

Some of you have mentioned that you do not like to eat first thing in the morning and the literature seems to support that with respect to cardio. There’s not much difference on body composition whether you are fasted or fed. So, you do you, boo.

However, for lifts, eating before you work out can augment your energy and performance during said lifts. Does that mean you are doing it “wrong” if you do not eat? No. We gotta do what we gotta do based on the constraints of our lives. A fasted workout is better than no workout at all.

If you are someone who wants to play with a pre-workout and you exercise in the morning, start small first and see how you feel.

Here’s a small sampling of options to try when you don’t want to feel like there is a brick in your stomach in the morning:

  • One banana & 1 Tbsp nut butter
  • One or two rice cakes with peanut butter & jelly
  • Overnight oats
  • Protein shake with milk and berries
  • Add a CorePower drink to your coffee
  • Greek yoghurt with berries
  • Sourdough bread with lox and cream cheese (this is my son’s favorite!)

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: PELUVA

You build all your weightlifting workouts on the foundation of good foot mechanics. This allows full articulation and range of motion in your feet and leads to better ankle mobility, knee tracking and hip mechanics. Since our feet comprise about 25% of the bones in our body, having a shoe with minimal correction during a lift session is super important.

My choice for a minimal shoe is Peluva. They’re functional and good looking. Use code DRSTEPHANIE to get 10% off your purchase.