Integrative dietitian, Esther Blum, unpacks the estrogen supply chain crisis, leaving women without basic hormone care, why 70% of women aren't detoxing hormones properly (and what that means for your HRT), and why eating more — not less — is the midlife prescription most women need. Plus testosterone, carbs, and the best-kept secret of the zero F's era. Watch the full episode at https://youtu.be/9_lS_8M4cs8
Esther Blum, integrative dietitian and menopause expert, unpacks the estrogen supply chain crisis, leaving women without basic hormone care, while there are 25 erectile dysfunction medications on the market with zero shortages.
But the conversation goes deeper: if your gut and liver detox pathways aren't functioning first, HRT may not work the way you're hoping. Esther breaks down the gut-liver-hormone axis, explains why 70% of women aren't detoxing their hormones properly, and makes the case for eating more — not less — in midlife.
Plus: testosterone as the missing menopause hormone, why carbs at dinner might be the key to sleeping through the night, and why the zero F's era is the best-kept secret of menopause.
🎤 Episode Overview:
(00:00) Introduction
(01:31) The Estrogen Shortage Nobody Is Talking About
(06:54) The Case for Starting HRT in Perimenopause
(11:19) HRT and Connective Tissue — What Estrogen Can't Do Alone
(14:15) Testosterone: The Missing Menopause Hormone
(22:00) The Gut-Liver Axis and Why HRT Fails Without It
(29:20) What Happens When You Skip the Detox Step
(34:31) Ventilator Calories and Eating More in Midlife
(41:00) Carbohydrates, Cortisol, and Sleep
(01:00:32) The Lab Tests to Ask For
(01:03:13) One Thing to Do This Week
(01:04:27) The Zero F's Era
(01:11:00) After Party - Final Thoughts with Dr. Stephanie
📎 Resources mentioned in this episode: https://drstephanieestima.com/podcasts/ep472
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Esther Blum
00:00
In my twenties and thirties I would run sprints for forty-five minutes and then lift for forty-five minutes four days a week. Girl. I was living on bagels, coffee, diet, coke, and martinis. And I was don't forget the cigarettes. Oh my god. God, the cigarettes. Do I freaking if I had my druthers, I'd be like a smoking drunk. I swear Nerd Safari. I may have to swipe that. I just call it porn. I don't know.
Dr. Stephanie Estima
00:33
The PubMed porn, right? It's like, what are we gonna find tonight? Bom, chica, boum, boum.
Esther Blum
00:39
But let's come back to carbohydrates. Having some carbohydrates with your dinner can be a super useful tool. And we need to replenish our glycogen stores. Post workout, otherwise it could be harder to build muscle with
Dr. Stephanie Estima
00:53
So then now every woman thinks, well I gotta have I have to have this weighted vest and I have to have these supplements And I have to have this menopause tea.
Esther Blum
01:00
Believe me, I'm just as guilty. I've fought lotions and creams because I'm like, that will get rid of all my wrinkles overnight. No, it won't. It really won't.
Dr. Stephanie Estima
01:09
The female body is always looking for signs of safety, and food is one of them. Food is one of the things. One of the ways that we feel safe.
Esther Blum
01:15
Yes, and what happened to pleasure, by the way? Like pleasure is its own nutrient.
Dr. Stephanie Estima
01:20
What do you what do you think the best part about menopauses that nobody ever talks about.
Esther Blum
01:25
It is the beginning of
Dr. Stephanie Estima
01:31
Hello, hello friends. Welcome back to another episode of Better with Dr. Stephanie. Tis me, as always, your host, Dr. Stephanie Estima. And if the number on the scale And how many carbohydrates that you are eating in a day is something that you potentially are always thinking about, maybe even obsessing about. been there, done that. This episode is for you. My guest today is Esther Bloom. She has spent nearly 30 years. building what she calls a gaslight free zone for midlife women. She has an MS and a BS in clinical nutrition from NYU and Simmons, and she is a CNS, a certified nutrition specialist, and menopause specialist, a TEDx speaker, and a Best-selling author of five books. You are going to love this show, so please enjoy my conversation with Esther Blum. Uh, new lower pricing on a molecule that helps with recovery, muscle strength, and energy? Hello, sign me up. It's true, Minepure containing urolithin A is now available at a new and lower price. And this is fantastic news because if you are someone concerned with Recovering from your workouts so you can make progress faster, preserving the muscle strength and endurance that you already have, and create more energy. This is big, big news. I have been in love with and taking timelines might appear for two years now, and it contains something called Urolithin A. And urolithin A helps to get rid of old damaged mitochondria. It helps support muscle function and plays a role in creating more energy. We naturally lose our ability to produce urolithin A in the gut as we age, so supplementing with it becomes pretty much essential if we're older than 30 because we naturally tend to lose our gut diversity. Now, Timeline is a brand that I trust because it is spent well over fifty million dollars in research, including human trials And I'll tell you about one of them. There were participants that improved by 12% in muscle strength over four months with absolutely no change in their exercise regimen. If you want to start recovering like a boss, head over to timeline. com forward slash better You've called the care that women receive in menopause dire. How does the dwindling supply of estrogen contribute to that?
Esther Blum
04:02
Well first of all, that is completely dire. We are struggling as women just to get estrogen patches and Vaginal estrogen is now on the chopping block basically. So, you know, there's 25 boner pills on the market and there's never a Viagra shortage, but women can't even get the most basic menopause care.
Dr. Stephanie Estima
04:24
Why do you think that that's happening? Is that something nefarious going on? Because to your point, there's always a supply around erectile dysfunction for men. But why is that happening?
Esther Blum
04:35
Only about four percent of women are currently on HRT. And i I think that number recently went to five percent. So we can't even accommodate, you know, the shortages. Also, there was one of the companies that was producing the patches stopped producing it. And insurance companies are really have an upper hand on production of estrogen patches in particular. So there's these massive shortages happening. You know, I have driven women to Cost Plus, I've driven them to Costco, Amazon, even Amazon right now is out of vaginal estrogen as we record this. And also there's the HRT Club, although that is a membership fee. I think it's ninety-nine dollars a year or twelve dollars a month. So It's really not a perfect system and I chased the HRT club down. I said, Well, where are you getting your patches and your supplies from? And they listed a larger parent company. But I looked yesterday and they too were out of one of their patches. And I was like, gosh, you know, this is crazy. So I'm doing a lot of advocacy work now in DC to help get that, you know, get the production chain, that loop closed and end the cycle because right now it's predicted we will be out for uh the shortage is gonna continue for a couple of years right now at the rate we're going. Now and the good news is, you know, women more and more women are demanding that they be on estrogen patches. And it's not that medical school education has caught up. It's that women are learning more about menopause and perimenopause on Instagram, YouTube, and TikTok. And they are then coming to their providers and saying, this is what I want. I've done the research. I know I need this. I have a history of osteoporosis. I'm hot flashing all night. I have vaginal dryness and no li no libido and no sex life and my marriage is suffering. Give me vaginal estrogen. I'm having UTIs. Give me vaginal estrogen. So Women, you know, we're the Gen X or I don't know if you are, I am, you know, we're the alchemists and we're saying we're not gonna take this sitting down. Like we know how to advocate for ourselves when given the right tools to do so.
Dr. Stephanie Estima
06:54
Okay, cool. All right, so since we're on we're on the HRT conversation, let's actually go there. You have a very strong position on whether or not women should start HRT, and I'm assuming just from your you know, opening statement that you are very pro. And I I've heard you talk about HRT being started in perimenopause rather than waiting until menopause. Can you make make the case for that Especially for women who are nervous about starting too early or maybe they don't have a provider who can who can guide them down that path. What is the case for someone starting HRT or MHT in perimenopause?
Esther Blum
07:28
Quite simply, the research supports it. It's not a personal bias. I do look at the research and of course there are gonna be some of you listening to this saying, you know, I can't because of XYZ. I don't want to always your body your choice. I just want everyone to be informed and educated. So we lose the greatest amount of muscle, which you are no stranger to. We lose the greatest amount of muscle in the shortest period of time. In the last two years of perimenopause. And so that's very important because testosterone, progesterone, and estrogen and DHAA all support muscle growth and maintenance and prevention of loss. But they also prevent bone loss. So what women don't realize is the massive impact that testosterone has on bone health. And so when we our our testosterone levels decline in our 30s, well most of us or many of us are on oral synthetic birth control pills, our 20s, our thirties, and that has a significant impact in an adverse way on our bone health. So early intervention of HRT As long as our bodies need it, you don't just blindly take it. You go with a provider who's going to work with you and test you and look at your symptoms. But it prevents Arterial plaquing, the laying down of plaque in our coronary arteries. It helps optimize insulin resistance. It prevents that non-alcoholic fatty liver that about 30% of menopausal women develop due to the absence of hormones. It protects white matter and gray matter in the brain. The longer we're hot flashing, the more we lose that precious white matter. It also helps prevent pelvic flop and UTIs and atrophy. Now It's so important that actually vaginal estrogen is now considered for women postpartum who have pelvic flora dysfunction. And we also know its quality of life. If you get a woman who is not sleeping and you put her on progesterone during the second half of her cycle, even if she's cycling, you add in progesterone days 14 to 28, and she's sleeping throughout the month. Think of the impact this has on the workforce. Think of how it restores or maintains our marriages, our personal relationship, our ability to parent and be a kind human. you know, is really predicated on sleep and quality of life. So for all of those issues, that is why I'm a big fan of early intervention because W I do see cholesterol levels come down. I do see insulin get far more regulated when we introduce hormones. I see women sleep again and not want to kill themselves. In fact, 92% of women on HRT completely eradicated suicidal ideations. And this is the work of Dr. Luis Newson. who runs a amazing clinic in the UK. So it's it's mental, physical, spiritual, emotional health that Is again not the one thing panacea. You have to do it in conjunction with diet, in conjunction with lifestyle, in conjunction with um Really curating the people in your life, developing a spiritual practice, you know, doing a a full spectrum of things, but it's a very important piece of the pie. But You can't out-supplement your hormones, you can't out-diet your hormones. You you've got to kind of do things in conjunction
Dr. Stephanie Estima
11:19
Yeah, and I would I would also add to that is is that there is a almost a diabolical role that estrogen has on connective tissue. So I've had patients who have come into the clinic that, you know, would c they were on HRT for some of any and all of the things that you just stated. but weren't doing the lifestyle piece. So weren't lifting weights. So there was no mechanical signal that was going into the tendons, ligaments, joints, and muscle. And then after a couple of months, they're like I don't know, like I feel like the hormones are not working for me anymore. Like hormones can provide a very strong signal, but you also have to pair that with a mechanical one. So you cannot actually create strong connective tissue or muscle for that matter. Like estrogen's not going to build muscle. You have to go into the you have to go to the gym and lift the weights, right? Your your connective tissue, which is largely controlled by estrogen. So the more estrogen you typically have, the more collagen turnover you have, which is great for ligaments and tendons, but only if there is mechanical signals that pair with it. Otherwise, estrogen has no direction. And what ends up happening is women who just get on HRT who are not lifting properly, not doing the mobility work and the connective tissue stuff, you tend to have you tend to actually become more susceptible to injury than less. So it is very important. Like I I totally hear what you're saying and I will also be a play devil's advocate for a second. It's like it can't like hormones cannot build nutritious plates, just like you're saying They can't lift the weights for you. They're certainly not going to remodel your cut your tendons and your ligaments without you doing something to direct how estrogen should work in the body.
Esther Blum
12:57
A hundred percent. And also, you know, it won't course correct mitochondrial dysfunction either. I mean, I can put someone on mitochondrial nutrients to support, but building muscle in the gym builds more mitochondria and really reverses a lot of aging that we see, a lot of insulin resistance.
Dr. Stephanie Estima
13:17
Yeah.
Esther Blum
13:18
Builds bone. It honestly just builds a badass attitude too. And really so
Dr. Stephanie Estima
13:23
Yeah, yeah. Even honestly, even there's limits to protein as well. Like let's just be honest. Like you just can't You just can't be throwing back protein and thinking that you're gonna build muscle. Like the protein, again, the mechanical signal from the lifting has to tell the protein what to do. Like you can have protein in the system, but if you don't have the mechanical signal from the lifting, the running, the sprinting, the things. Your your body's just gonna be like cool so you're gonna get really like you're gonna be farting and you're gonna you know and you're just gonna I mean you might have really great skin, hair, and nails, but no one's gonna want to be around you because your gut is gonna be destroyed. So I say that with love because everybody has overdone the protein. You all know what I'm talking about. Okay. So I I want to come back to hormones. Oh, I don't want to leave here yet. Let's talk a little bit about testosterone. What perimenopausal symptoms are we falsely attributing to estrogen when it's actually testosterone that's the culprit?
Esther Blum
14:15
Yeah. You know, women don't even realize that their bodies, the ovaries produce five times the amount of testosterone that they do estrogen prior to perimenopause So yes, when you can't get your ass off the couch, when you have no motivation, you're exhausted, you're kind of lethargic, kind of depressed. you're also just n very low energy, a lot of chronic fatigue, brain fog can also be low, testosterone. So because testosterone actually plays a huge role in cognition too. And so testosterone helps us feel like we're firing on all cylinders. And it gives us the energy and the motivation and the drive. And also libido because testosterone Can not only be applied to our skin topically, like on our forearms or behind the knees, inner thighs, lower abdomen, but you can also get it compounded to be applied vaginally. And vaginal, I have clients that their providers prescribe it and compound it as a vaginal only use, A to help libido, but B because the vaginal tissues are so vascularized and they're such an amazing absorption site. So some of my colleagues put all their hormones vaginally. That's their delivery system. Other people prefer testosterone topically. that's enough to get the systemic benefit. So it's really individual. And I think it really depends on your provider, how it's applied. But just knowing that there are options. If you say, well, I don't seem to absorb it well, should I switch to injections? First try it vaginally if you don't absorb it topically because not everyone does absorb it well. That's why it's also important you rotate your sites of application. Don't keep applying it to the same place. And the funny thing is, you know, I had this conversation.
Dr. Stephanie Estima
16:05
Don't apply it to where you grow hair. Pro tip.
Esther Blum
16:09
Well, inside of the wrist.
Dr. Stephanie Estima
16:11
Or maybe you have some th thoughts on that. You tell me.
Esther Blum
16:13
Well, I was gonna say you're on such a microdose. I mean I've been using testosterone at least six years. I have zero hair on my arms, zero hair on my lower abdomen Yes, I have hair growing on my thighs, but no more than it was before. So if you're doing a low dose, you shouldn't be growing hair. But yeah, don't put it on your face, don't put it on your breast lest you look like, you know, a hairy chimp But it really doesn't if you're rotating the sights, it should not grow hair. It should not make you lose hair from your head. Those are usually from high doses. If you're growing hair on your face and you're losing it on your hair, you may be aromatizing or converting your estrogen to testosterone and adding systemic testosterone is just pouring gasoline on the fire. That's usually the problem. It's not the testosterone itself.
Dr. Stephanie Estima
17:03
And would you if you apply testosterone vaginally, like v you just said that, you know, vaginal applications of hormones, it's such a vascular area. One of the arguments around the safety of vaginal estrogen, let's say, is that it actually doesn't really get into the system. It's really just a local application. So if And I'm again pushing back here, just really wanting to explore your brilliance. So if we are now applying vaginal testosterone, is that gonna be enough to be able to get through to the level that, you know, a a woman's gonna need systemically, like throughout her whole body?
Esther Blum
17:35
Because the dosage is higher than let's say a vaginal estrogen formulation, it should. You're talking like a vaginal estrogen, for example, is a 0. 05 %. dosage. Whereas testosterone, you're getting into the multi milligrams. So it it but again it should theoretically absorb, but you do have to test your blood levels and look at your symptoms. Like are am I feeling better? No. So for some women I do see them move to injections, but I would say that's a smaller percentage of women. a greater percentage of women apply it topically and are like, man, I feel a lot better.
Dr. Stephanie Estima
18:17
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Esther Blum
22:08
Yes. So I love explaining complex biochemistry and just boiling it down to the most simple essences that we all need to know. So think of it this way. You never want your hormones to be a stagnant pond. You want them to be like a gently moving stream. So what goes in your body needs to be detoxed and metabolized and removed out. So Some ways we metabolize through digestion, through pooping out our hormones. So we should be moving our bowels every day one to two times a day. Of course, sweating is a wonderful detox and urination is a wonderful way to remove hormones. So we remove hormones, we metabolize them, I should say, in our liver. And then in our gut, there's three phases of hormone detox. Phases one and two, think of it like a washing machine cycle. It takes fat-soluble hormones and converts them to water-soluble hormones. And through your body's natural bile production, bile carries your hormones like a little sponge. It grabs them. pulls them into the gut, where then your estrobolum, which is a subset of bacteria in the gut, helps metabolize that estrogen so you can then poop it out. So A, fiber is really, really important. Like we all talk about getting, you know, at least 30 grams of fiber through flax and chia seeds, fresh fruits and vegetables with skins. But also cruciferous vegetables are a girl's best friend. Broccoli, cauliflower, artichokes, radishes, kale, brussels sprouts. Anything bitter is going to stimulate bile production. And But Esther, I thought Cale was trying to kill us. Kale, you know, wraps and all of that. But some just any bitter vegetable.
Dr. Stephanie Estima
24:11
That was sarcasm, yeah.
Esther Blum
24:13
Just for the listener.
Dr. Stephanie Estima
24:13
Like I know you got it, but if the listener's like, what is she talking about? I'm being sarcastic.
Esther Blum
24:18
I know, kale. I know. God forbid we eat vegetables and fiber.
Dr. Stephanie Estima
24:21
Well the thing that kills me, so that I love that you're saying eat cruciferous vegetables, because the thing that actually kills me about social media is that People are not eating enough fruits and vegetables as it is, and then you have these absolute tools that come on and they're like Fruits are trying to kill you. They're gonna give you a fatty liver and then you know, whatever. The the kale is trying to kill you. Look at all this look at how it has all these things in it. It's like Okay. The oxolate argument, like literally spinach is high in oxolets. All you have to do is steam them. Guess what happens? 80 to 90% of the oxalants are gone. So, I mean, there's gonna be obviously certain populations of people who are going to be more sensitive to that if you've had stones in the past, etc. But for the vast majority of us, like don't make a mountain out of a molehill, right? Like we need to be having the the green leafy vegetables.
Esther Blum
25:11
Yeah, and don't overcomplicate things. And by the way, like I look at GI Map, which is a stool test. I look at the GI maps of women before they go on their carnivore diet. And after and let me tell you that microbiome disappears or dramatically decreases. We lose our
Dr. Stephanie Estima
25:31
diversity means
Esther Blum
25:31
the diversity. So genetically, yes, there are some women who do beautifully on a carnivore diet. They are few and far between And in the women I see in practice, they don't have enough diversity and they're not eating enough bitter vegetables to stimulate bile production, which helps carry hormones out of our system so we can poop them out. So but yes, so a lot of women I see have very poor detoxification patterns. I I look at how they methylate, I look at their urinary metabolites of hormones and if we don't move our hormones through, then what happens? Well all of a sudden we say, Oh, I'm gonna go to the doctor and I'm gonna get HRT. And then all of a sudden like, oh my God, my boobs are killing me. Oh my God, I've gained five pounds of hormone puff. Oh my God, I'm weeping at commercials and like I feel like I have PMS all the time. I'm irritable. I'm like I'm worse than I was before. So That's why supporting your hormone detox really matters. So, you know, you can take supplements that have preference concentrates, you can take glutathione. Magnesium or trimethylglycine, all of those support just how your liver handles hormones
Dr. Stephanie Estima
26:54
So you mentioned phase one and two. You call those the washing machine. Did you s did you talk about phase three?
Esther Blum
26:58
I don't know if you're not going to pull it out. Phase three is the gut. That is where the estrobolum metabolizes your hormones and you can see you can get a very simple blood test called beta glucuronidase or the the GI map shows it and if it's elevated it can be a sign. It's not always a sign that you're not detoxing your estrogen, but It can be a piece of the puzzle. Sometimes it's more of a sign, an overall indicator of inflammation in the gut. But yeah, it and you'll know if you're not detoxing, because you're gonna be like, oh my God, I feel terrible. But understand this too. If you haven't been on hormones for a long time, let's say you've been in menopause a year or two, maybe more, and then you start hormones, you may gain one to three pounds of fluid or hormone puff for a few months as your body just adapts to all of a sudden having these chemical messengers back in your system. So again though, you can do all these supportive pieces. You can add some gluathione, some Cruciferous concentrates and magnesium and eat your cruciferous vegetables. Be religious about your fiber, and you'll see it will be a transitional time that does not last forever.
Dr. Stephanie Estima
28:06
And for my dark rose betties who want the explanation on beta-glucaronidase, basically when we're talking about the astro it's so interesting that you say uh I say estrobilome. You're probably right. Well I just I think that there's just like m just regional differences in terms of how we how we pronounce things. So basically what you do in the gut is you basically wrap estrogen up in a in a present, right? It's like here's the bow, get ready to poop this bow yeah, puppy out. But with beta glucaronidase, this is like for my my dark roasters who want to know detail, it basically unwraps the present. It takes the bow off of estrogen and allows the estrogen to get resorbed back into the system and into circulation, which is where you can run into some of the things that you were talking about, the breast tenderness, like the ec you know, that excess estrogen presentation.
Esther Blum
28:51
Thank you.
Dr. Stephanie Estima
28:51
That was beautiful Okay. So that was just for I have my light roaster dark like my light roast beddies that are like just tell me what to do. I don't care about all the signs, but I also have to always think about my dark roasters like tell me the mechanism Tell me what you mean by that. Okay. So okay, so if a w okay, so just back to this gut liver piece for a second. So if you if a woman's gut is a mess, right? We know that in perimenopause and menopause, obviously the gut really changes. So let's say she starts HRT anyway. what happens to her? Like walk us through the clinical picture of someone who's not opening up her detox pathways and fixing her gut. What's gonna happen?
Esther Blum
29:27
Well she could have those symptoms I was mentioning like the, you know, water retention or breast tenderness or irritability, but she should also have I don't want to say it's d dire and like You have to do all these tests to know. But I mean, A, you will you will know because your body will tell you if you're not detoxing, well, you're gonna just not feel like yourself. But God willing, I mean most women I see, they're like, Well, I did, you know, I have gained some weight, but man, I'm sleeping better. Or it like all my half lashes are gone. I mean, I had a client that would lay out her clothes before bed. She would lay out three different outfits. before bed and she had to change three times a night. And when she came to me, she was like, she had a hoodie on it pulled over and was just like So she was a shell of herself. Once we got her sleeping, it was like the lioness came back out. And her weight loss didn't happen right away. But she was present in her own life again. So I just want to like put the message out there that this is not some dark, horrible rabbit hole and it's all gonna go south the minute you try. Just create space for the fact that yes, it may take your body a little bit of an adjustment, just as it would with any new medication you try, it may take your body a little time to recalibrate and adjust. But the other good thing is, you know, I've had women just by cleaning up their gut and their inflammation, getting them on a whole foods diet. getting them more fiber, getting you know, rid of bacterial overgrowth, getting rid of gluten for a lot of women. That has cleared up hot flashes without any hormonal intervention whatsoever. And that clears out brain fog because leaky gut connects to a leaky brain. Our brain is a direct reflection of what's happening in our gut, not only our hormones. So I want to also paint the picture of optimism that incredible things happen and we can lose that nanopod and we can become more sensitive to insulin. Just flipping our ratios and getting in more protein and fibrous carbs versus a lot of women I see super high carb They're eating what I call ventilator calories, which is like the amount of calories my bedridden patient survived on in the hospital on a ventilator. Like my patients are eating less calories than they were. They're eating nine hundred calories a day saying, Why aren't my adrenals functioning? And why is my thyroid so shut down? Because you're not even fueling your body with the right ratios of macros and the right amount of calories. Like women I see, I rarely have to diet them down. I'm spending far more time dieting them up and saying Eat a hundred calories a day extra every day this week and then in two weeks you're gonna have two hundred extra calories a day and then and really bumping up their calories to fe and they don't believe me. They're like, I'm gonna gain all this weight. And I'm like, no, we're repairing your metabolism, getting like it's an apple. It's
Dr. Stephanie Estima
32:39
I'm asking you to eat an extra apple. That's it's a hundred calories. Exactly. No, I actually I wanna I wanna pause there because I think that this is so important. You touched on it before, but I actually think that it's worth highlighting here because it's come up twice now. You said, you know, like a lot of women when they first get on hormone therapy, they can have weight gain. Yeah. Like that's That's the worst effing thing that could ever happen to a woman. Like, hello, you're not sleeping. Hello, your marriage is like hello, you cannot function as a human in your life because because of this loss of so why is it that we always the goalpost is always weight loss, right? It's like, okay, just you're gonna temporarily maybe you're gonna have a little bit of extra you know, junk in the trunk. But your body is gonna recalibrate. Like it's like this wake-in is like the worst thing. Like, oh I got off I got off it because I was gaining weight. And then just now, you know, you mentioned that you have to actually get people to have more calories Because people are so deathly afraid of gaining weight. And I think that women, this is, I mean, a great opportunity in perimenopause. to shuck this idea that the only thing that matters for our health is our weight. It's like that's all we do. That's all we think about. Oh, I'm I can't have an extra apple a day because I'm gonna gain weight. It's like who who cares? You're you're gonna have fiber from that and you're gonna have the a diponect. You're gonna have all the things that come with the apple and you're gonna have better mu you know your metabolic adaptation. Oh god, okay, I'm I'm gonna step off my okay. This is your podcast this is your time. I will I will step off my my my soapbox because I'm about to I feel myself getting pulled into a rant But but let's talk about calories. Let's talk about calories in midlife. Like how does it change for women? I want to talk about protein and carbohydrates specifically with you. But let's start off with total calories. What do you see for women in perimenopause in terms of their caloric consumption? That needs to change. Like what's the habit that needs to die that they were doing in their twenties and thirties that no longer can happen in their forties and fifties
Esther Blum
34:41
We the habit and I speak from personal experience, I'm sure you have this too. In my twenties and thirties, I mean I would be an hour and a half in the gym. I would do running I would run sprints for forty-five minutes and then lift for forty five minutes four days a week. I was living on bagels, coffee, diet coke, and martinis. And I was Don't forget the cigarettes. Oh my god. If I had my brothers, I'd be like a smoking drunk, I swear. Now I look at a martini and I feel hungover.
Dr. Stephanie Estima
35:22
Yeah, you're like, uh, I'm not gonna sleep tonight.
Esther Blum
35:24
I'm not gonna sleep tonight. F that. But but right, so I was so low calorie and under muscled. I was very thin. I was, you know, probably ten 15 pounds lighter than I am now, but I had I was so under muscled. Even though I was lifting, I was not.
Dr. Stephanie Estima
35:39
But that's it, but that's it. But that's it right there. It's the thin, like okay, thin, what was thin? What was thin? Your adipose tissue is probably relatively the same, but you didn't have the same muscle like you have more muscle mass now than you probably had then. You have more bone density now than you had then, right? Yes.
Esther Blum
35:57
All that diet coke was not doing me any favors or my bones. And don't forget the coffee. Yes. Right? And so in midlife the game changed.
Dr. Stephanie Estima
36:07
There was also Ephedra. You could take Eph they had Ephedra on the I mean, do you remember this? Like it's crazy. Like I remember taking these fat burners that were like effet I just had this like flash memory in like I think it was like a GNC or something. They would sell like ephedra like it's like my heart was my poor heart trying not to have a heart attack Because this, you know, you could just get Ephedra fat burners off the shelf, right?
Esther Blum
36:32
It's crazy, crazy times.
Dr. Stephanie Estima
36:34
Yeah.
Esther Blum
36:34
It's unbelievable. Yeah, you were strung out on Ephedra and Yeah, but you look damn thin. Yeah. And and but look at what's happening on the red carpet now since and listen, I think GLP's absolutely have time and place, but I think GLPs and celebrities who are already thin should be not allowed on the red carpet. I just think the media is and and bodies are now trending. Like now thin bodies are trending. Oh, now we're supposed to have booties. Like bodies are never supposed to be trending. We're not trends. We're physical humans. It doesn't make any sense. So midlife bodies, you know, the problem isn't that our metabolism slow down because the research consistently shows our metabolic rate does not slow down, but we do. And and we're losing muscle, which okay, that can slow down our resting metabolic rate, but we're not exercising the way that our we're not stimulating the muscle the way that our bodies really need in midlife for longevity and for mitochondrial production and for sleep. And so The approach that you teach your ladies, I teach my ladies, is to refuel properly and you know get uh get up to sixteen hundred, get up to eighteen hundred calories. Because you're lifting heavy enough and you're moving your body more and your appetite returns because you can digest your proteins now and you're not a farty windbag all day and you know You can absorb your nutrients, you know? So
Dr. Stephanie Estima
38:11
Yeah, yeah, yeah. Because you've you have a better gut, right? It's like you can have all the protein in the world, but if you do not have the digestive enzymes to break those baddies down, th it's just gonna pass right through you, right? You have to also I mean that's Okay, so let's actually talk about protein. You talk about more protein, more carbohydrates. This is legit the opposite of what women who are of our age have been told our entire lives, right? So why does it feel like everything kind of falls apart, right, when we get to Men and Pause? It's like, oh now I can't do this and now I gotta have I gotta quit my job so I get all my protein in for the day. Like why why why does it feel like everything is like flipped upside down on its head
Esther Blum
38:50
Because, you know, when our estrogen and progester our estrogen 's on a roller coaster ride, while our progesterone and testosterone tank. So So many women come up to me and they're like, I have gained ten pounds in a month. Like I can't even tuck my stomach into my pants every morning anymore. Like they're waking up with this huge menopause overnight. And it it does. It comes on very suddenly. It's not necessarily a slow creep. So we're caught by surprise and so we panic and we go back to the only tool we've ever been taught, which is to starve ourselves pretty much. And to not get enough nutrients and it feels terrifying to fuel our bodies. It feels unsafe to fuel our bodies because we think, oh my God, I'm just gonna gain more wheat and I've got to stop it in its tracks.
Dr. Stephanie Estima
39:41
Here's something nobody told me when I was grinding through every training session on willpower alone, that your brain runs on ketones. It already knows how to use them and it makes them. The problem is it can only access ketones after days and days and weeks and weeks of strict keto and most of us aren't doing that and I also don't recommend that you do that either. And this is where kinetic comes in. It's drinkable Ketones. It's not a diet. You don't have to be following a ketogenic diet to take it. It's not a protocol. It's just the fuel that your brain and your body already prefer, delivered directly without the restriction. I drink it before training almost every day, and I also take it before long recording sessions or just generally before anything that requires me to be sharp. And it requires me to be present. So there's no crash, there's no jittery energy from coffee that makes you feel like you're running from something. Just clean, sustained mental output. If you have been white knuckling your focus, it's definitely not a discipline problem. It might just be a fuel problem. Try it out for yourself by going to drinkkinetic. com. Forward slash better and use code better for fifteen percent off your purchase. That's D-R -I -N-K -K -E-N -E-T-I-K dot com forward slash better.
Esther Blum
41:03
The key is to talk ourselves down from the tree and say, okay, what am I doing now? What's working and what's not working? Well, what a lot of women are still holding on to is the really high intensity prolonged cardio. And they're doing it with zero cortisol. Their cortisol is circling the drain. So their body's running on empty. and burning muscle, not fat. So instead, if I can get them to walk, just walking is the most underrated exercise on the planet, which is just walking outside of nature. Does not overtax your body, does not deplete your cortisol, enables your body to be in a more recovery, restful movement or recovery kind of movement. And then gentle, slow tempo, strength training with a minute or two of rest in between. And then if you are someone who loves Sprinting, you know, in a 20 to 30 minute like gentle bike ride, just sprint, you know, once every five minutes. Do it gently, spread it out. Or if you're on your rock, you want to do a 30-second sprint. you know, every five minutes. That's enough to get the job done. We actually can work smarter and not harder during this time, which to me is glorious. Like I have so much more free time now that I don't have to spend hour and a half in the gym four at a time.
Dr. Stephanie Estima
42:26
And also the psychological hype up, like the hype up girl that you need to be for yourself every day to do that I mean it is very very difficult. The other thing I wanted to add on, like I think that walking is the GOAT. Okay. It is the greatest of all time for your joints specifically. So I, you know, you know that I love to talk about muscle. Of course, muscle is so important. But the thing that's often forgotten about in the perimenopausal and menopausal space I find is joint health. Like you can't really build muscle if your hips and your knees are gone. If you don't have those joints, you can't do anything. Right, if you don't have shoulders, you can't push up or pull up or do anything, right? So walking feeds your joints like the joint That 's actually, fun fact, nerd little nerd safari, if you don't mind me just saying so, is that our joints are avascular. They don't have their own blood supply. The only way you get nutrients into a joint is through pumping, right? So every time you walk, there's compression, right? You compress the knee joint, you compress the spinal joints, you see all the joints of the body, they get compressed And then as you step off, they release. And then in that vacuum is where you're able to have the nutrients come into the joints. So this is why I think it's a couple of years ago, I don't know if people still say it, but they'll say like sitting is the new smoking. And while I don't necessarily like smoking is terrible, like obviously don't smoke, but don't be sedentary because that is the fast track to degeneration of your joints.
Esther Blum
43:56
Yes. And you will see what you reap you sow. So you will see now as you're a midlifer, you will look around you, you can see who's been taking care of their bodies and who hasn't. Yeah. They move differently, their energy's completely different. And it it really adds up. And the good news is though, is that even if you've been, you know, you've fallen off track. I too struggled for quite a while with strength training when I was really struggling with Lyme and mold and agnomyiosis, it definitely took a back seat. But Now I'm lifting again, but your muscles do come back. You do have memory. You can rebuild. Like it's never too late. I mean you could build muscle in your nineties. There is research that has shown and proven this. So It is never too late to start and get your groove back.
Dr. Stephanie Estima
44:47
Yeah, and if you're injured or you are dealing with something like lime or mold, like take take some comfort in the idea that You're when you're lifting, so let's say you've built up some type of muscle reserve, we'll say, and then you lose it because you've been injured and you've had to stay away, or you weren't able to because of mold or lime like you were talking about. Your muscles actually have these little protein factories that they create, which is why it's so hard to create to build mu it takes it's years and years and years to build it, but once it's built, it's like you have these little factories that can just create them. Those factories don't die when you're inactive, right? Which is why maintaining muscle is far easier than building it. Because you just have to stimulate the the protein factories like s some of the time. It's usually like 30% less than what it actually takes to build the muscle. So if you're injured or you have some type of therapy or you're not able to for whatever reason, you can actually get there faster because you already have the infrastructure in the muscle to drive the muscle growth. So again, little nerd safari as I mentioned, but just also wanted to give people a little bit of like comfort because I used to be so terrified if I took any time off of working out. that I was gonna lose all my gains, I was gonna lose all my progress, but you don't. You get it back much faster than if you're just a newbie, you know, starting out for the first time.
Esther Blum
46:02
Nerd Safari. I may have to swipe that. I just call it porn. I don't know.
Dr. Stephanie Estima
46:09
The PubMed porn, right? It's like, what are we gonna Fun tonight. Bound chicka boum boum. Okay. So let's let's come back to let's come back to carbohydrates because this is the other one. This is the other one that so many ladies I feel get wrong. So for the woman who is afraid of carbohydrates, how do we get her on board?
Esther Blum
46:29
For the woman who hasn't looked at a carb in a long time, you've got to ramp up slowly or you will gain weight because carbohydrates help you retain water. I mean that is part of their metabolic or biochemical composition I should say. So if you have been low carb for a long time, you want to ramp up slowly and your target would be a hundred grams to start. and then build up from there. And I say, you know, add in a quarter cup of cooked starch a day and then half a cup, you know, from a sweet potato or, you know, some legumes or quinoa or rice or fruit just start adding in and ramping up very slowly. The thing most women don't understand or realize is that carbohydrates and activate the conversion of T4 to T3, which is a very it's a wonderful metabolic support and will help you in the fat loss department. But here's another benefit is perimenopausal women, you know, I would say eighty, eighty-five percent are struggling with sleep and insomnia where they're falling asleep but they're waking up at night. And they're waking up with cortisol spikes or they're waking up with hypoglycemia. So eating carbohydrates with your dinner in particular. God forbid, have a cup of cooked starch like s again, sweet potato, plantains, rice, quinoa, white potatoes. Those that you're going to get a bump in insulin. You're going to pair it with protein and fibrous veggies, but you'll still get an insulin bump. And what that does is it tamps down your cortisol. It's antagonistic to cortisol for dark roasters out there. So It's going to help you sleep. You don't wake up in the middle of the night because you're you're blunting that cortisol response. Now, estrogen and progesterone can also support that, but having some carbohydrates with your dinner can also be a super useful tool and we need to replenish our glycogen stores post workout. So You you know, otherwise it can make your workouts exhausting and it can be harder to build muscle without optimizing your carbohydrates. So how do you figure out your own unique carb tolerance You log your food, can use a free app like MyFitnessPal. I'm sure Apple has some. And you log your food and you see how many grams of carbs you're eating and you look at your symptoms and saying, well, how's my hunger? How's my energy? How are my cravings? How are my workouts? How's my sleep? And you look at all those metrics. And I I do like to get women generally one-to-one ratio of protein to Total carbohydrates, which is not the same as net carbohydrates. So if a woman's eating 130 grams of carbs I like her to have 130 grams of total carbs and when you deduct the fiber from that you get a hundred grams of net carbs. So and that's not a huge amount of carbs. A lot of my women bump up and they'll have, you know 150 grams of carbs, 130 grams of protein. It it really depends on how strenuously they're working out.
Dr. Stephanie Estima
49:50
Yeah, and I think for the woman who's been, let's say, low carb, keto or whatever, carnivore for years who's been having in some cases less than fifty grams of carbohydrates a day, like that hundred is a big like you're essentially two Xing, right? Like you're doubling their you're doubling that intake. So I I like your I like your thought there around slow and steady, right? Slow is steady and s and and s and steady is slow. So I I like that s graduated approach there. I think that that'll probably ca you know really help with the digestion, the bloating, and just allowing your body to to assimilate. But the other like I think you mentioned it, I think it's really important to also track your performance. Especially at the gym if you're someone who likes to gamify numbers and you're looking to improve your numbers volume over time. Maybe you're looking to improve your, you know, the the the speed at which you run a a mile, something like that, or you're sprinting the distance that you travel. Carbohydrates are essential. Like it is the it is, you know, carbohydrates break down into glucose. It is the molecule of life. It is the main fuel that your body works on. So yes, ketones are great. I use ketones all the time. Had some ketones actually before we started this podcast. But I also Uh you know, I just love, love, love carbohydrates for what it does for performance in the gym, mental clarity, as you're talking about mood, sleep, all the things that that a lot of women struggle with. And I asked this to a lot of guests on the show because this is the one resistance that I often come up against. Like, oh carbs, I don't know. You know, like I had a woman come up to me at the gym a couple of weeks ago. m Ms maybe a month ago now and she was asking me like oh how do how do I look the way that I do? Like how do I have like such a full you know she was like how do you have such a big booty and such a flat stomach and this was her question. And I we were talking for a little bit And I was essentially eating like double the calories that she was. Like I think she was taking in like 1100 calories. I was eating double that and almost triple the amount of carbs. that she was. And so I think that I I think that w women will be well served to just, you know, like just try. You know, like maybe you're having fifty grams a day. Maybe maybe this week you're gonna have like sixty. You know, it's like you know, very it's like what we were talking about with the reverse dieting before. You're like, we're just getting you to have a hundred extra calories a day. So maybe you're just gonna increase your gram carbohydrate count by 10, right? That's still only, you know, really it's with like 40 calories if I'm doing my math correctly there. Right. So it's not, it's not that big of a deal. It's not that it's not, you know, but it is gonna slowly allow your body like, oh there's more food here. Oh, I feel safe. Which is something that you said before that I wanted to come back to. You said like women, you were talking about like eating as a safety metric and I think that that is so true. Like safety, the female body is always looking for signs of safety. And food is one of them. Food is one of the ways that we feel safe.
Esther Blum
52:35
Yes.
Dr. Stephanie Estima
52:37
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Esther Blum
54:53
You know, what happened to pleasure, by the way, like Pleasure is its own nutrient. And you know, I I w one of my clients last week, you know, I keep trying to remove the words good and bad. from her and she's like, I fell off the wagon. I said, What if there was no wagon? Have you ever considered that? And just it's just a spectrum. You're going to overeat calories some days and under-eat others. It's just how it balances out over the course of the week. And if we took something simple and stopped overcomplicating it, we'd free up so much more real estate and it's not good or bad. We don't need to feel naughty or I'm having a cheat meal. What if you just had the piece of carrot cake for dessert and then the next day either walked a little more or cut calories by a hundred or two hundred calories just for that day and then you're evened out? It just It doesn't have to be this huge performance, you know? It really doesn't. It's just a conversation.
Dr. Stephanie Estima
55:56
You've been in the menopause space now, what, twenty eight?
Speaker 3
56:00
Yeah. Yeah.
Dr. Stephanie Estima
56:01
Yes. Yeah. Okay. So the menopause like right now I see the the menopause industry is sort of like exploded, right? Like it's like there's influencers and there's supplements and there's Sw brand like everything, right? Everything is like the what's the term menow washing, right? It's like, oh there's this there's this tea. But we're gonna call it a menopause tea and we're gonna charge five times the price for it So I my question to you it's a bit, I'm gonna call it salacious. Is this helping women or is this menopause movement will say, doing what diet culture did to weight loss, which is like turning a systematic failure into a personal you know, a personal failure and a personal shopping problem. Right. So then now every woman thinks, Well, I gotta have I have to have this weighted vest and I have to have these supplements and I have to have this menopause tea and I have to you know, like is this Like, are we doing women dirty by this sort of explosion of, you know, m this menopause industry we'll call it?
Esther Blum
57:01
I think it's a really mixed bag. Some products, yes. I mean, if you see products that are not transparent and just want to sell you a proprietary blend, no, that's a red flag. That's a true lack of transparency. And Believe me, I'm just as guilty. I've bought lotions and creams because I'm like, that will get rid of all my wrinkles overnight. No, it won't. It really won't. I too have fallen prey. But You know, at the same time, is it opening up the conversation and the awareness? Also, yes. And I think that's a really positive sign. So What's the antidote to falling down the mennow washing well is to work with a provider who is hormone literate, who isn't going to just write you a prescription for birth control and tell you to have a glass of wine Who isn't going to tell you to change sex positions when your libido is low or do what my provider did was hand me a prescription for Xanax and a copy of the Kabbalah and then told me to put it under my pillow when I couldn't sleep. Oh, that was so special. Oh wow. You better believe that went into my TED talk. I was like, oh, we that was like gaslighting with a capital G So yes, you want to find providers that are going to custom tailor, you know, and and educate you and be like, are you sleeping? What is your stress management like? Does the thought of sex make you want to run screaming? Or like, how do you feel in your body right now? What are your aches and pains? What's your stress like? You know, we're We're also at this age where we have teenagers at home, we have aging parents. It's a really and our careers are at the top because we finally earned our stripes and all of this. So the demands and the pressure are incredible and It's so wonderful when a provider even asks us questions like that and can just sit and and say you know, just help you flush out and process what's happening. Most women don't even know how badly they're feeling because they don't have time. They're just muscling through and gritting their teeth and being like Yes, this sucks. I feel like absolute dog poop, but I've had gotta go pick up my kids before I head to my job and then I've got to squeeze in a workout and then I have to drop meals off to my parents. You know, it's just There's a lot happening. So if we can just increase our awareness and make one or two gentle ads at a time and work with someone who's really gonna track us. be like, hey, can you just add in like two ounces of protein at your breakfast to what you're already eating? Can you, you know, prep some food ahead of time or order food delivery you know, order some roast chickens and order some bags of lettuce, some spinach or hyoxalite, or, you know, fresh vegetables that are already cut up. Or just have to steam them. You just have to steam them. You just have to steam them.
Speaker 3
01:00:04
Yes.
Esther Blum
01:00:04
Yes, exactly. So like, you know, just ways to strategize how to uh eat a rhinoceros which is one bite at a time.
Dr. Stephanie Estima
01:00:15
I love that. I love that. Okay, so we wanna also make sure that women are not blaming themselves because I think that like I do that, right? When something goes wrong, I'm like, what did I do? How what that was my first thought. Like what did I contribute to this gargantuan mess? So if someone is we have a woman in a doctor's office, let's say, what are some labs that maybe she wants to ask for if her doctor hasn't already offered them
Esther Blum
01:00:42
So I love to do a comprehensive thyroid panel, and that is not just a TSH. TSH is thyroid stimulating hormone. That is one marker for thyroid function. We want to do T3, reverse T3, T4. We want to do TPO, which is your thyroid antibodies. I have told many clients they have had Hashimoto's and their doctors did not because they never look at their TPO and it's very easy. to miss hypothyroidism because perimenopause has a tremendous amount of the same symptoms.
Dr. Stephanie Estima
01:01:20
Yeah. So I've had doctors refuse. So I've had I've given patients, here's the thyroid panel that you go with. And then the patient will come back to me and say, my doctor won't run these. And I'll be like, why? She's like, well all and I I I realized this a couple years into when I was in this space, is like, oh, it doesn't actually change the doctor's care. Like they're just gonna give you syntheroid, right? But it doesn't change their care, so why would they test for it? And they don't know what to do with those results anyway. Like if she does have hashes, that doesn't r for most um not all, but many medical doctors don't know what what to do with that. Like they're like, yeah. Yeah, some antibodies, it's normal. It's like, no, no antibodies. That's the normal amount. None.
Esther Blum
01:01:59
Zero. Or they may just need T three. Maybe it's just a conversion issue too. Right. Which is again is why we need to eat those carbs, ladies, is to support thyroid and adrenal function. So full thyroid panel. I love cardiac risk factors. I love looking at insulin. which is a cardiac risk factor, insulin, fasting insulin, glucose, and A one C. But I also look at homocysteine, I look at APOB, I look at CRP, C reactive protein. These are potentially predictors for coronary artery disease. I also look at obviously cholesterol and triglycerides. Every doctor runs that. Serum, red blood cells, zinc, and magnesium, supremely helpful. Ferritin and iron, that's another indicator of thyroid function.
Dr. Stephanie Estima
01:02:49
Yeah, yeah, great.
Esther Blum
01:02:50
Those are, yeah, some just very good foundational tests, DHEA sulfate, estradiol, progesterone. free and total testosterone. Those are also really good tests. You can look at FSH if you want to see where you are in perimenopause or menopause. All of that is very helpful.
Dr. Stephanie Estima
01:03:09
All right, so let's land the plane. We have a woman who is I'll give you a couple clinical scenarios. So woman who is completely overwhelmed right now. Okay, so she's exhausted, she's confused, she has nowhere to start. What is the one thing she needs to do this week?
Esther Blum
01:03:23
Just start adding protein at breakfast. Get thirty to forty grams of protein at your breakfast so that you can fuel your day. You don't have the three PM crash. You get your serotonin and dopamine up, which are very feel-good tran neurotransmitters in the brain. You regularly examples.
Dr. Stephanie Estima
01:03:42
What's thirty to forty grams? What does that look like for you?
Esther Blum
01:03:44
That would be at least a cup of cottage cheese. That could be a three quarter cup of Greek yogurt with a scoop of protein powder. That could be two scoops of protein powder. Two whole eggs plus two whites. or two eggs plus two ounces of smoked salmon, all of that will bring you to at least 30 grams of protein. But you can also have steak or leftover chicken or burgers. Like your stomach doesn't care what you're doing.
Dr. Stephanie Estima
01:04:19
typical. Yeah. But I also sometimes when I'm like, nope, I'm gonna have last night's salmon. I'm gonna have last night's grilled salmon. That's what I feel like this morning. Oh, I love that for breakfast. I
Esther Blum
01:04:29
love having salmon for breakfast. It's so yummy
Dr. Stephanie Estima
01:04:32
What do you what do you think the best part about menopause is that nobody ever talks about?
Esther Blum
01:04:37
It is the beginning of our zero Fs era where we step into our greatest power and actually energetically Your ovaries have wound down the party. So that creative energy goes to your heart and it goes to your brain. So you are so much more able to just be in your absolute power and the estrogen 's gone, even if you replenish it, it's at much lower levels than your body's making. So with that comes a loss in filter you are clear about what you will and won't tolerate. This is why the divorce rate is so high in midlife because women say The person I was and married in my twenties is not the person I am or married now in my fifties. And first start hormones, ladies, before you go down the divorce path. But for some women, the divorce is just genuinely a sign of their growth or just not being aligned with their partners anymore. But I I think it is absolutely my favorite time in life now. I'm fifty-five and in four more days I'm gonna hit my official menopause marker and I'm like, wow. I am sleeping through the night. My digestion is so much better. I've lost the blow. I've lost like 10 pounds And I just feel so much better. And I eat a lot, ladies, I don't skimp on calories. Like People make fun of me because I will really I'm like, no, keep feeding the Esther like more food, please. I really do not eat like a bird ever, ever.
Dr. Stephanie Estima
01:06:16
I really love that because I think that we do have to reframe, like often see on social media it's like when I hit perimenopause, my whole life fell apart and it's like Listen, I'm not I'm not saying that that's not true. And that is true for a lot of women, even if you're doing all the right things. And Not but. And it can also be one of the best like some if you've ever had anything difficult happen in your life In the moment, it feels like absolute hell. But once you're past it, you're like, I am so grateful for that because I figured out who I was, what I was made of. And I got through it and now I'm on the other side of it and it's like now it's rainbows, right? So sometimes, yes, going through the transition can be difficult, and I'm not trying to minimize it and I think that there's a story, and I I find this is more with social media influencers rather than like people, but they're like, Perry menopause is the worst. Buy my you know, whatever, hormone balancing sheet or whatever. And I and I I just I just love this idea of like, hey, yes, this is gonna be difficult, but you can do difficult things because you are Fucking badass. And on the other side of it, it's exactly everything that you just said. I'm sleeping well. I feel good in my body. I am no I'm I'm in my zero F's era. And that veil has lifted. And now all of my creative energy, I love that you said that. It's in my heart and it's in my brain. And now I can focus on Instead of being in service to others, which is typically what we do, and with love. Like I have spent years being a mother and loved every minute of it and a wife and all the things And now as I myself, I'm in parimenopause myself, moving through this, I am very excited about all of that creative energy and being able to focus it. in all the places that that delight me, that I that I choose, you know?
Esther Blum
01:08:06
Yes. And it it really it really is glorious when you get to fill your own bucket again. When your kids leave for college, you know, I know a lot of parents are devastating, but devastated, but I'm also like Also remember that you actually get to get up in the morning and don't have to take care of anybody else. Like you, it's glorious. Like
Dr. Stephanie Estima
01:08:27
Yeah.
Esther Blum
01:08:28
It's so it's so so so nice. And you think, oh my gosh, I I have free time again because I'm not preparing meals for everyone else. I'm not You know, prioritizing everyone else, I get to prioritize me again. And it's a real return to the self. And a real new chapter of like, well, who am I now? And who do I wanna be? And do I have to keep grinding and hustling or is that era done for me? Can I just focus on what feels most aligned and true to me and trust my intuition? And trust my body because we have partnered through this massive hormone and neuroendocrine storm together So, like, what does that look like on the other side for me? And just holding possibility for incredible growth and freedom and travel and opportunity. And you know, I'm blessed in that like for me, my husband and I, we're like, this is Shangri -La. I mean, we're just hanging out, having a ball. We hang out in the hot tub. We light fire. Sometimes we're just quiet and don't talk to each other. You know, we're reading or what and it's just but it's so nice. It's like we're dating all over again and we remember who we were before we had a son And, you know, it's just we're able to actually be attentive to each other without the stress of parenting every single day because that is really hard on a marriage, is parenting.
Dr. Stephanie Estima
01:09:49
Yeah, yeah.
Esther Blum
01:09:50
And it's awesome. It's a gift. I love being a mom, but I also love just the calmer nature of not having a teenage son at home.
Dr. Stephanie Estima
01:09:58
I love that too. No, it's like it's been the greatest privilege of my life to watch my boys grow up and they're still growing up. And I also I can also see that too. I can also see myself enjoying like you know, long delicious mornings if I so choose. Long, uninterrupted times at the gym because I gotta get home before this time and that. So uh I love that. All right, Tommy. Just wait. I am talking the days. Yeah. So where can people find more about you? I know I understand that you just did a TED talk. I don't know if it's going to be out by the time this conversation comes out, but where can people find more about you and your work?
Esther Blum
01:10:33
Please hang with me on Instagram at gorgeous Esther and you can go to my website esterblum. com. I have a free gift top Hormone tests that every perimenopausal woman needs to know. And yes, re DM me with any questions. I do work one-on-one with clients, and I have a podcast called The Midlife Realignment.
Dr. Stephanie Estima
01:10:55
All fantastic. We'll all be in the show notes. Thank you, Esther. This was a delight. Thank you. Welcome to the after party where we have A little party about what I loved, what I didn't love about the conversation today. So uh I thought that this was a great conversation. I thought that the conversation around beta glucaronidase, that's my l my dark roasters, that's what we were talking about with estrogen being repackaged and reabsorbed back into the system. I thought that that was really great and I thought that the whole comment around the idea that if you are on HRT but you don't have your detox pathways open and functioning optimally, that it's not going to be as optimal as maybe you're hoping. I thought that that was a really good A distinguishing feature. We haven't really talked about it too much on the show. I definitely loved the conversation about like cigarettes and martinis. Like You know, we sometimes we have this nostalgia for the eighties and nineties and like as she was talking, I'm like, oh my god, they had ephedra You know, they had ephedra on the shelves for purchase for humans. And they didn't titrate it for men and women. Like I was taking like the same dose that the guy next to me was having. And it's like Do I am I having a heart attack? Can I smell burnt toast? That's a total Canadian reference, by the way. Tell me the Canadians that are listening if you get that. That's from the the CIBC commercials where they're like He smells burnt toast. He must be having a stroke. Anyway, I but I digress. So cigarettes and martinis, I loved that. And the other thing I really liked was the two concepts. Actually there's three concepts that were sort of like a through line of the entire conversation and that was that women are like, you know, so afraid sometimes of gaining weight that they will not want to s go on or stay on hormones because of that initial bloat that sometimes can happen. It's like, is that we we gotta really We gotta really work to fix that. It's like, honey, you are not sleeping, your marriage is falling apart, you're snapping at everyone, you're miserable in your own skin. Like maybe we're gonna have a ten pound weight gain for a couple of weeks as the body recalibrates. Like that's totally fine. And I my c my heart breaks for people like that too, because I think we've I mean we've all we've all been conditioned in some way to have this idea that you just cannot age, you cannot gain weight, you must be thin all the time. Like that is so th shoved down the throats of women. So I can I I understand and I empathize with it as well. And I what I really want is I want to help more women make peace with that, right? Because if you can get on hormone therapy and that's gonna measurably improve the quality of your life, but you're gonna be temporarily heavier. Like, yeah, worth it. Totally worth that trade-off. The other thing that I I like that she was talking about when we were talking about food was I actually wrote it down in my notes. She didn't say this, but I wrote down uh I wrote down vitamin P Pleasure, right? Like we forget that pleasure is also a nutrient, which is what she said, and I love that. I think that thinking about I mean my favorite breakfast breakfast of all time is like sourdough toast, avocados, and like an omelet on the on it. And I just could not it's just not you can't have it without the sourdough. It just doesn't make sense. And so I love I love food and and all all many different but sourdough is like my that is my love language is sourdough bulls. So uh I just think that this idea of also eating for pleasure is something really beautiful as well. Overall loved, loved, loved the conversation With her, let me know what you thought. What is gonna be your big what is gonna be your big takeaway? You're gonna have a little bit more carbs maybe? Are you gonna think about vitamin P, vitamin pleasure, a little bit. Are you going to be thinking about weight training maybe a little bit more than the hours of a cardio than we all kind of grew up doing? I want I'm interested. Let me know. Leave us a comment on Spotify or Apple or wherever you listen to the show. And until next time, my friend, I bid you adieu. I hope you enjoyed today's episode. And now I must give you the obligatory legal and medical disclaimer. This podcast, Better with Dr. Stephanie, is for general information only. The advice and recommendations we discuss do not replace medical, chiropractic, or any other primary healthcare providers' advice, treatment, or care. In the consumption of this podcast, There is no doctor-patient relationship, and the use and implementation of the information discussed are at the sole discretion of the listener. Please take this information to your primary healthcare provider to make the best choice for you. Remember, I am a doctor. But I am not your doctor. And these episodes are meant for educational purposes only.
Esther Blum
01:15:23
You are hilarious. You need like a stand-up routine on the side. Oh my God.