A Hormone-Smart Approach to Coaching Women with Dr. Stephanie Estima

If you work with women, this is an episode you won’t want to miss. Dr. Stephanie Estima is a true powerhouse in women’s health, functional fitness, and the science of female physiology. She is also a Doctor of Chiropractic and the creator of the Estima Method, a framework that works with the female nervous system, not against it. She’s also the author of The Betty Body and the host of the chart-topping podcast Better! with Dr. Stephanie, which has amassed over 5 million downloads.

 

This conversation is packed with actionable insights that every health coach should have in their toolbox—especially those supporting women through hormonal changes, brain-body optimization, and long-term health. You’ll walk away with fresh tools, powerful reframes, and maybe even a few “aha!” moments of your own.

 

Grab a pen—Dr. Stephanie drops knowledge you’ll definitely want to write down.

 

Episode Overview:

0:00 Introduction to Dr. Stephanie

03:51 Understanding Women's Wellness

05:38 The Importance of Strength Training for Women

09:23 Nutrition and Hormonal Health

13:36 Menopause and Hormone Replacement Therapy

17:07 Metabolic Health and Aging

31:36 Understanding Female Health

31:54 Reevaluating Plant vs. Animal Protein

32:44 The Importance of Protein for Muscle Mass

34:30 Navigating Vegetarian and Vegan Diets

36:00 Women's Appetite and Metabolism

37:11 The Role of Breakfast in Women's Health

38:51 Strength Training and Muscle Preservation

52:12 Hip Mobility and Fall Prevention

57:14 Advocating for Hormone Therapy

 

Connect with Dr. Stephanie Estima on:

IG: https://www.instagram.com/dr.stephanie.estima/

Web: https://drstephanieestima.com/ 

Podcast: https://www.youtube.com/playlist?list=PL6rKl_pnPLGyJYGJCdIpqfXQHEZw0o7vP 

Mini-Pause Newsletter: https://drstephanieestima.com/newsletter/ 

 

Ready to turn your passion for health into lasting impact?

Health Coach Radio is your backstage pass into the world of health and fitness coaching, hosted by Primal Health Coach Institute Coaching Director, Erin Power and powered by the legacy of founder Mark Sisson. Each episode is packed with real stories, expert strategies, and practical inspiration to help you grow as a coach and make a difference.

Curious about what’s possible for your own health coaching journey?

Visit primalhealthcoach.com to learn how Primal Health Coach Institute can help you transform lives—including your own—through the power of coaching and ancestral health.

Episode Transcript

(00:00):
All right, coaches, this is one of those episodes where I'd recommend grabbing a pen because Dr.
Stephanie Estima is about to drop some real deal insights that every health coach
Needs in their toolbox, especially if you work with women.
I learned at least 10 new things in this conversation that I did not know before.
It is an incredibly awesome conversation.

(00:20):
My guest today is Dr.
Stephanie Estima. She
's a total powerhouse in the world of women's health.
met and the brain body optimization. She's
a doctor of chiropractic with a deep background in functional neurology, met and female physiology.
But what really sets her apart is how she weaves it all into a framework that actually works with the female nervous system and not against it.

(00:40):
She's the creator of the Estima method, the author of The Betty Body, and the host of Better with Dr. Stephanie.
a chart-topping podcast with over five million downloads and counting. Her
mission is to help women live stronger, smarter, more hormonally aligned.
And on their terms.
And if that's the kind of client you work with, then this episode is for you.

(01:01):
Please enjoy.
Hi, I'm Erin Power.
I'm a health coach, a health coaching educator, and mentor, and your host of Health Coach Radio.
This podcast delves into the art, science, and business of health coaching.
Whether you're aspiring to land a coaching dream job or to embark on your own entrepreneurial adventure, we cover it all.

(01:22):
Our mission is to help you grow your career, elevate your income, change the lives of the clients who need your help.
And leave a lasting mark in this rapidly growing field.
It's time for health coaches to make an impact.
It's time for Health Coach Radio.
Hey, Dr.
Stephan Estima, I'm grateful to have you here. How are
you doing today? I am

(01:44):
great,
and I am delighted to be here.
I am too.
I listen to your podcast a lot.
And so it's really your voice is very soothing to me.
And I just take your voice to me, a voice of knowledge.
Honestly, this is how I interpret, you know, vocally you.
But I mean, you are a titan of the wellness world, especially for women.

(02:04):
And I do want to talk about women's wellness to a certain extent in this conversation, because a lot of health and wellness coaches are zeroing in on that, rightfully so.
And I know this is a question that gets asked all the time when you're on a podcast, but I would love for you to just sort of fill us in on like taking us back.
How did you how did this all start for you, creating this powerful personal brand of yours in the wellness space?

(02:28):
Oh, thank you.
Yes, so I am a doctor of chiropractic by training, and I spent 19 years in private practice.
In Toronto, Canada, seeing patients from, you know, in the downtown core, which is where my clinic was, people would travel from sort of the geogra, you know, the surrounding geographic areas.
In the clinic, it was never just, and I say just, you know, physical rehabilitation.

(02:52):
Like, certainly, we had a lot of people who would come in for back pain and neck pain and headaches and things like that.
But part of their care plan was always nutrition.
It was always fitness.
It was always recovery and stress.
So that has always been part of my
Philosophical premise in terms of what creating health looks like.

(03:13):
So, for all the health coaches that are listening, that salut philosophy. So, how
can we be health-promoting rather than just treating disease?
And so I did that for, like I said, it was a private practice for 19 years and then started a sm like, I was like, oh, this like online thing, let me just try this little nutrition program.

(03:33):
And it just blew up.
And I had also been, you know, when you're in practice for a long, when you, you know, you're a clinician for a long period of time, like loved my patients.
It was like the clinic was successful.
It was like easy.
You know, I was on like cruise control, but still felt
Like, I wasn't impacting enough people.
And as we were running nutrition programs online as well as in-house as well, I was noticing that there were differences in terms of like

(04:00):
Female results, right?
So, like, it was very stark contrast.
Like, men and women would come in and do a nutrition program, and the husband would be like, Doc, this is amazing.
I've lost 20 pounds.
You know, we'd run their labs, like testosterone's like through the room.
And then the woman was, We're doing literally like we're doing the same thing.
And I have lost one pound and I feel like I can't sleep anymore.
So, really noticed early on in physical practice and then in the online iteration of it that women and men had different.

(04:27):
Outcome.
So started playing with that.
And then it's just evolved into me really feeling like there I know that there are a lot of people now who are focusing on women's wellness.
And it's wonderful to see.
And I'm thrilled to see it.
I think more people still need to be beating that drum because women are
Absolutely, not small men.
We are not, you know, smaller archetypes of men with just pesky hormones.
So I think that it's just really evolved over time.

(04:49):
Like my audience
You know, my first book was all about menstrual cycle literacy, like how to understand your hormones through the menstrual cycle, how to change nutrition and fitness and recovery.
And now I'm in perimenopause.
Myself, I'm 47.
My audience is also in perim and menopause. So, you know,
my interests are sort of evolving with my community. And so now I'm

(05:12):
very focused in on
Some of the physiological, mental, emotional,
socioeconomic
changes that happen in perimenopause, and currently writing a book on it as well.
Oh, are you?
Oh,
incredible.
When
's that coming out?
My manuscript is due at the end of this year, so it is going to be out in we actually haven't decided yet, so it's either going to be December 26 or January 2.

(05:36):
Amazing.
Wow.
Exciting.
I'm really interested in a lot of the stuff you touched on there.
So first of all, while seeing patients in clinic, it dawned on you as
as it should, I guess.
Oh, men and women seem to respond differently to things.
Yeah, I work with women as well in my private practice health coaching, and that's what they always say.
My husband can stop thinking about Pepsi and he drops ten pounds.

(06:00):
Right,
exactly.
I
mean, you kind of touched on it at the there.
There's the hormonal aspect.
One of the things that I think about a lot is the psychos aspect. Okay,
because
I'm also in per, so yay, solidarity. Yay,
Gen
X women, we're tackling it.
Right, right,
right.
Like, who better to
tackle it than Gen X, honestly?
Absolutely.
Yep.

(06:20):
But the psychos aspect, I've been thinking about this long and hard. I'd
love to get your take on it. We came
up through the sort of processed food latch key kid era. So I personally
had to feed myself dinner and it was like hot dogs and mac and cheese.
Then through the 90 and 2000s, which is the skinny obsessed culture, dieting and cardio and salad cosmo diets, right?

(06:40):
It was
like the Cosmo diet to get a hotter man, do eat four grapes. And yeah,
okay. I know.
By the way,
it's so triggering to me that cottage cheese made a comeback because it's like I still have trauma from the cottage cheese era of the 80s.
But anyway, it's fine.

But this psychos piece, women, so now we're getting this narrative (06:55):
okay, now I have to strength train and eat a ton of protein, and it's such a mism from our programming. What do you
think about that? Like, how
do you, how do you
rec that with your clients or your patients? Are you
finding that they're open to it? Or are
you getting some pushback from them as well?
I think it
's a mixed bag.

(07:16):
To your point, we all grew up in the cardio section of the gym.
Like, you know, I the way that I actually paid for my professional schooling was I was a step instructor.
So I was
like.
st instructor, I did Ta Bo I was teaching Hi Lo and Taib. If you remember,
if anyone who's of that generation remembers, like Ta was the big thing, like that kickboxing kind of class.
So, we all sort of grew up, it's like more cardio, more cardio, more cardio, more cardio.

(07:37):
And so, now to tell these women who've grown up on the treadmill, like, hey, actually, you should be lifting some iron, like you should be pumping iron, it's a, it's a,
I think for some women, it can be difficult because there are myths that continue to persever, right? So
it's this idea of like, oh, I don't want to get bulky. I
just want to be toned.

(07:57):
you know, the other the other I would say more legitimate concern is injury.
So if you don't have like a neural, like a a really good my you know, sort of a mind
A motor patterning that's really like, you know, solidified and good technique.
Yeah, your tendons and your ligaments and your muscles, you are certainly more susceptible to injury when you're 40 and 50 than

(08:18):
when you were in you when you were twenty and thirty and the bounce back is not as as quick.
So I do think that there is some hesitancy around it and this is why I like to talk about
Technique manipulating tempo as a way to actually progressively overload.
Like it doesn't, I know, I know that there's lots, like there's t-shirts that say like lift heavy, you know, swear word, right?

(08:39):
Like lift heavy stuff.
Which is great, but there are also other ways that you can grow muscle that don't actually involve prog always increasing the weight.
Like you can manipulate
Sets, you can manipulate reps, you can manipulate tempo.
Like, there's all these different ways in the gym to do that.
So, long way of saying, yes, I do encounter that probably as often as you do.

(09:01):
And once we can get
Women around this idea that you're not going to get ball, even if you, it's like, you know, if you play soccer one afternoon with your kids, trust me, you're not going to be Cristian Ronaldo. Like,
you're not just going to accidentally fall.
It's like just because you drive your car to the grocery store, you're not an F1, you know, like you're not a NAS car driver, you know.

(09:23):
So it really is very, very difficult.
just from a hormonal composition perspective for women to become a quote unquote bulky.
I would actually I mean, maybe this is going down a bit of a separate rabbit hole.
But I would actually push back on that idea of like, what's so bad about being bulky?
I know.
What's the definition of bulky anyway?

(09:44):
You know what it is?
Taking up space.
So why are we so
afraid to take up space?
Right.
So there's like another little like, oh, you're afraid of being bulky?
Why?
What's wrong with that?
100
%.
So
if you were bulky, if you had like slightly bigger quads.
Like, what's gonna happen?
You like, actually, I'll tell you something.
It actually happened this morning.
I was training my back, my ear pods in, whatever.

(10:07):
I had this older gentleman come up to me.
It's like the big, the best compliment you can ever give a woman who loves to lift weights.
He was like, you know what?
It's so unfortunate that you're training your back.
And I, I'm sorry.
I had to finish my sign, my pardon.
He's, you know, because you can't see it.
I am standing behind you, and I can literally see every single muscle rippling as you're.
I was doing like a single arm lat pull

(10:27):
down.
And he's like, I, you just have to see your back.
Can I take your phone and videotape your back for you?
Oh, wow.
He's like 75.
You know, like, he's such a lovely old man.
Of course, you can, you know?
And he's like, I just want you to know that it looks incredible.
And it's like for a wo I mean, it's such a compliment.
I mean, for a woman who all I want is to get jacked and bulky, you know, it's like that is that is such a wonderful compliment.

(10:53):
So
I would actually challenge any woman who's listening, whether you're a health coach or you just love this podcast and you're like, I want to learn how to live better and optimize my health.
You know, there's nothing, even if you wanted to, it's like 98% of the female population cannot get bulky without exogen help. But
even if you're in the 2% that did, like, what's wrong with that?

(11:14):
What's wrong with taking up space and having a little bit more muscle?
Like, do you know how gorgeous muscle looks on a woman?

So, this is actually what I'm talking about (11:19):
the psychos piece. So,
I, because it's.
Yeah, what if you were more substantial?
What
if you were
strong?
What would why is that not okay?
So, asking those kinds of questions, this is really in the purview of the health coach.
We have a sort of limited scope of practice, and we're not meant to be dealing with people's blood tests and diagnoses.

(11:44):
That's not our realm.
But the way they feel about things, the way they perceive, and
Sort of advocate for themselves is in our purview.
So I want to share my perspective with you.
You just made me think of this.
I like to encourage women to eat robust.
Meals.
This is one of my sort of brand things.
I'm not going to get into it, but it's like, you, we do a lot of yogurt and protein bars and little snacky type meals that I think are a holdover from our dieting programming.

(12:11):
And I try to get my clients to eat robust actual meals all the way to satiety.
It's just one of the things I try to get them to do because I trying to get them to repair their relationship with food and what have you appetite.
And they're so wor about eating a robust meal because it's not ladylike. I'm
not supposed to eat a meal that's the same size as my husband's meal. And I say

(12:32):
to them, why not?
Why not?
Why robust nourish is one of the most feminine energies I can think of. You
're a reproductive powerhouse, or you were. Maybe
not anymore, but you were.
And so robustly nourishing yourself, being robustly strong.
Like to me, the more I think of it, this is feminine energy.
Feminine energy is strong and round and robust, I think.

(12:54):
And wanting more.
And always wanting more.
I think that that's also like that in that insatiable desire for more, I think is also part of that
feminine energy
as well.
Yeah.
Okay, now we're seeing now we're into the weeds because I believe that women, especially these Gen X women that are now in the era coming through the menopause transition, we are

(13:14):
Generally unsatiated, if in matter speaking.
We didn't get what we wanted in our careers, whatever.
We've never eaten proper meals.
We've been dieting since we were 15 years old.
We're generally, generally unsatiated.
And I want to return, like.
This appetite, this sat, generally speaking, is really the feminine energy. I want to
help women sort of recreate and reconnect. Because I think

(13:36):
about the menop transition, well, we are out of our reproductive era.
Fair enough.
But a reproductive woman is one of the most resilient things in the universe, really.
We have to be.
And we come through that.
That's who we were.
That's who we are.
So anyway, there's a robustness and a resiliency that I think is the pure expression of feminine energy.
It's just that it hasn't been well practiced.
We've been really practiced on the shrinking, starving, hiding away.

(14:00):
Yeah.
Yeah.
I think that this maybe shift from being as skinny as possible to being as strong as possible.
It's like strong over skinny.
And when you're looking at your diet
instead of framing it like, what are all the things I need to exclude, maybe
to be in a
caloric deficit or to stay slim or whatever.
look at your plate or the food available to you and saying, what are the things I absolutely need to include in order to survive? I

(14:28):
think that there's a very it's subtle, like I'm almost saying the same thing. But
I think that, that perspective is
a very healthy one.
So rather than, oh, I can only have ten grapes or whatever, what do I need to include?
Maybe I need to include grapes and almonds and maybe some cotton cheese, maybe not.
But what is it that I need to include in this snack or in this meal?

(14:48):
That is going to make me thrive.
And certainly, when we're talking about this in the context of muscle hypertrophy, which is just
fancy talk
for like growing muscle, your muscle, can you build muscle in a caloric deficit?
Yes.
You can, technically.
However, is it much easier for you to build when you're giving your muscle actually substrate, when you're giving your muscle the building blocks?

(15:10):
Like we don't eat protein just because we want to eat protein, we eat protein for the amino acids, right?
So can we?
what do we have to make sure that we're including so that we are getting that like all of our amino acid requirements so that we can build
muscle
And
I'm sure it's been said before on this podcast and elsewhere, but as we are aging, like by weight, the musc I like to include them the skeletal system, like I like the musculos system by weight.

(15:37):
Your bones, essentially, your ligaments, your tendons, and your muscles are the largest by volume and weight in the body.
And so, if we can optimize for the musculoskeletal system, then we can think about instead of
you know, being skinny at 70, which, you know, if you're just concerned about aesthetics, like Newsflash, being skinny when you're 70 is not a really great look.
you're going to look pretty frail.

(15:58):
But if you have muscle to fill, right, to fill the skin, that is a if we're just talking aesthetics, it's a better look.
But if we're talking from the point of mobility, metabolic function,
optimizing even our own endogenous production of hormones.
Because yes, in the menopause transition, our reproductive hormones fall off a cliff.

(16:19):
Lose our estrogen, as you very well know, progesterone and testosterone.
But you can also be dosing those.
You can also be endogenously producing those every time that you're weight training.
You will have a lift in your testosterone and your estrogen production.
Those are anabolic hormones and they're required.
Actually, the more muscle you have, the more we need those in circulation.
Yeah, a couple things from the sort of social, like the psychos, as you've been talking about, but also from a physiological perspective as well, as you are

(16:47):
Tapping into that feminine energy of always wanting more, I would invite you to think about how can I also think about more muscle,
more tissue.
more bone
density,
more organ density.
Like how can we also want more of those things as well and not lose them?
Exactly.
So that this bring this brings to mind the conversation of wanting to feel lighter on the scale, which is another holdover from our

(17:09):
Misguided youth.
I have this fantasy, I'm sure you do too, where we go to the doctor for our annual check and they make us get an E machine instead of on the scale.
And they say, oh,
or they just do a waist-to-hip measurement.
Point eight.
Fantastic.
We don't care what you weigh.
It's just the ratio of how you look is important.
Yeah.
Or the ratio in terms of visceral fat that you're taking is more important than the weight on the scale.

(17:31):
Yeah.
Yeah.
Or imagine the doctor saying, Oh, Sally, you've lost two pounds of muscle mass and lean body mass since we last saw you, so I going to need you to put that back on, like, just completely
changing
like
f univers. I had never heard.
You actually just taught me something I've never heard before, and I'm so excited.
The endogenous production of estrogen and testosterone makes sense to me, but the estrogen during

(17:51):
Strength training.
Can you say
more about that?
How does that?
Yeah, sure.
The way that women and men actually build muscle is interesting.
I mean, again, we're not little men.
We actually build muscle a little differently.
So, men, as we know,
10 to 20, usually times more testosterone than women have.
And so women rely on the testosterone that we do have, which is again 10 to 20 times less.

(18:14):
But estrogen and other growth factors are part of the way that we actually create that anabolic environment for muscle to grow.
So when we are weight training.
we are going to naturally pulse things like insulin-like growth factor, IGF, which is a growth factor that helps to stimulate bone and muscle growth.

(18:34):
And for women, one of the ways that we're actually maybe I'll say and we're always comparing ourselves to men.
Oh, we have less testosterone, we have less.
But in with IGF, this is actually we can actually reach peak release of IGF much faster than men. So we
typically will reach it at about 20 to 30 minutes of moderate or high intense activity.

(18:56):
Whereas with men, it takes about double that, so it's something like forty to sixty minutes in order to reach that growth of that of that or peak of that growth factor, I should say.
So women use estrogen and growth factors to make up for the lack of testosterone that we have in order to grow muscle.
So we still grow muscle.
But we're using slightly different pathways to do so.

(19:17):
And so when you are lifting weights, usually for testosterone, depending on how fit the person is, you'll have a rise of
Something like the fitter you are, the shorter the rise.
Unfortunately, that's just what happens.
But you'll have, you know, as you're li, you know, after a lift session, anywhere from, you know, if you're super fit, something like 12 hours.
versus all the way up to like forty-eight hours, you'll have sort of a rise in testosterone, and the same is true for estrogen as well.

(19:44):
As we are increasing these anabolic hormones, as you know, when we're training, you can sort of
In, I guess, in a way, like self-dose.
Like, you can go into your own internal pharmacy and give yourself the hormone therapy.
Now, I'm not saying that you shouldn't take hormone replacement therapy.
That's not
I'm a big fan of it.
When it's indicated for me, I will absolutely be on it as well.

(20:07):
But you can also activate your own internal pharmacy of hormone production through mechanical tension, through lifting weights.
Fascinating.
And you're not, this is a very personal question, you're not yet on hormone therapy.
And we said when it's indicated for you, so that's based on symptoms.
That's what takes us to the doctor to get the hormones.
Address.
Yeah,

(20:27):
I watch my, I do labs about
twice a
year.
And then I also, for hormone replacement therapy, I think it's also important not to really be super fixated on labs because especially as a woman in perimenopause.
She is very much a moving target.
Like some months she's high, some months she's low.
So I'm also watching for clinical symptoms.
And for a lot of women in perim, you'll find that progesterone is the first thing that.

(20:52):
You'll start that a woman will start taking.
And then, because estrogen is a little bit, a little bit funny.
Like I said, some months you produce a lot of it, and some months you don't.
So you're sort of on this wild roller coaster until menopause.
So a lot of practitioners.
will play with estrogen, but it is easier in some ways, it's easier to be in menopause because you're just like you're constant.

(21:14):
Like you
have no,
you know, your production of estrogen is relatively
constant.
But for me, it'll probably like I'm watching my progesterone now.
Like my progesterone's it's it's getting to the point where I'm like, all right, as soon as I see any deficit in sleep
if I'm starting to notice anxiety, if I'm raging more, if I'm feeling like I just don't have the capacity to deal with the regular demands of my life, that will be my first option.

(21:37):
I love that.
Yeah, I cannot wait to be through it.
I'm just like, I'm looking forward to it.
I see these 54-year-old queens on Instagram that are like,
oh,
th. It's
like, I cannot wait for that.
But for now,
we're
just holding on.
The bes br of menopause, per. Okay, follow-up questions
on that. So, a couple that I want to think

(21:58):
about. First of all,
Let me know if this is even in the realm of something that you are interested in talking about.
But we want women to eat more protein.
And with animal protein comes cholesterol, and women are concerned about cholesterol and cholesterol.
Maybe it becomes a little bit chaotic during the met, too. However, cholesterol
is also crucial for manufacturing hormones. Right? So, do you think this

(22:21):
is just a
hunch I have, and I'd love for you to speak on it. Like, the women have been eating.
Insanely low amounts of animal protein for too long.
Like it's four ounces of chicken on a salad for lunch, and that's it sometimes, or
collagen
coffee.
We're chronically low on animal protein, chronically low on cortex cholesterol.
Do you think this is having an effect on our hormone levels?
Or is it
not a

(22:41):
factor?
100%.
Yeah, 100%.
I think the average American woman eats something like 40 to 60 grams of protein a day.
Which is.
Far and which I think is in line with the RDA.
I think it's in line with the recommend the recommended daily allowance.
However, again, it's like
What do we want to eat to survive versus thrive?
Like, I'm not here just to survive, right?

(23:03):
So, I think a general rule, I eat animal proteins every day.
I generally like to have about a gram of protein per pound of body weight.
I actually usually I'm a little higher than that, so I'm about a buck
It depends on where I am in my cycle, but somewhere between a buck thirty five and a buck forty, let's say.
So 135 to 1 pounds. I probably
consume 160-ish,

(23:26):
170-ish grams
of protein. Yeah.
Amazing.
Animal and otherwise.
So I used to be actually, this is where something that I've actually changed my mind on.
It used to like, no, animal proteins.
They're the most bioav. They're
the, you know, all
like
they're the most protein. Like they have
the full constitution of the amino acids.
And I think that what we're sort of seeing in the literature now is that, yes, animal proteins do have an advantage in terms of bioavailability over plant proteins.

(23:54):
They're slightly less
bioavailable.
But you can still get pretty damn close with plant proteins as well.
So a lot of vegan and vegetarian bodybuilders who look fantastic.
And even if you not if you don't have des.
To become a bodybuilder.
I think we can learn a lot from the bodybuilding community because they really do manipulate food.
It's a science
in that community.

(24:14):
So you don't have to be you don't have to have any aspirations to be a bodybuilder, but I'd just like to derive like lessons that we can take from physique competitors.
So animal or plant proteins are going to get you there.
I think low cholesterol has been linked to degenerative deficits in terms of cognitive, like, you, subjective or moderate cognitive impairment.

(24:34):
So we do need sort of a base level of cholesterol.
A lot of women do, without changing much in their diet in that perimenopausal transition, will start to see cholesterol creeping up.
I think what is more important than looking at because what will happen is they'll go to their doctor and their doctor will just sort of read across the line.

(24:55):
They'll say, okay, 250.
Oh, there's an H there for high.
Okay, your cholesterol is high.
So they won't actually look at what their HDL is, what their LDL is.
Are they looking at an LDL particle number?
Are they looking at A? So they don
't look at the entire picture. That's
the first thing.
And I would say the second thing is, again, coming back to muscle, what we often find is that there is a propensity for

(25:23):
a ch in the way that we are metabolizing food as we age. So
we become more insulin resistant,
meaning
that as we age
the amount of insulin that we tend to output from the pancreas increases because our bodies are less efficient at pulling the glucose out from
From the plasma, from the blood circulation.

(25:45):
So we start to see increase more and more and more insulin as an attempt to drive the glucose into the cells, right?
So this can also contribute to this cholesterol number.
So if you are starting now to accumulate
if you are starting to have a higher output from the liver, let's say, of some of these, you know, you have a higher glucose output and therefore now you have higher insulin.

(26:09):
And now we don't know what to do with all of this.
We don't know what to do with all this excess glucose.
We start making actually fatty liver, right?
So we start we start storing it as fat and it starts to kind of accumulate in the viscera on top of the organs or the viscera.
This is what drives up.
This is essentially what drives up our cholesterol level.
So again, the contraction of our muscles.

(26:31):
One of the beautiful things about the muscles is that they can take up glucose in an insulin-dependent and independent manner.
So whether insulin is present or not.
So the more you can activate this contractile tissue, the better you're going to be able to control that insulin output, let's say, because your muscles can start to sop up the excess glucose that's in the system.

(26:53):
And then, therefore, that will have a knock-on effect to your lipids, right?
So, all that to say, eat animal protein, eat your plant protein, and lift, because that is going to probably be the
The two biggest things that you can do consuming proteins, whether they're animal or plant-based sources, as well as stimulating that contractile
tissue.
Your
muscles to control some of the labs that we see go wonky in per and menopause.

(27:19):
Hey, it's
Erin, co-host of Health Coach Radio.
I've trained men and women of all different body types and skill levels and take it from me, women are made for strength.
They may just have a different way of getting there than men do.
With the Primal Health Coach Institute's Strength Training for Women Specialist Certification, you'll be able to address the needs, challenges, questions, and goals most relevant to women.

(27:44):
You'll learn how to design a training program, and then you'll develop one.
You'll also learn how to co-create individual eating strategies for clients and how to navigate potentially sensitive topics like menopause.
reproductive cycles, hormone-related dysfunction, and diet culture.
If you want to empower women to become fitter and stronger, then visit primalhealthco.com

(28:06):
and learn more about our specialization in strength training for women.
I love that.
That was an awesome sort of jaunt through the mechanism of action of all this stuff, which I think is useful for health coaches to know.
So when their clients come to them and say, my doctor says I'm pre-diabetic and my cholesterol is too high.
And so should I eat low carb?

(28:28):
Should I eat low fat?
Like, you know, they're
Really compartment, like really compartmentalizing detrimentally the different sort of biochemical silos, I guess, but it is all intertwined, right?
So here's why we need to eat animal protein, here's why we need to
lift weights and take walks to manage our blood to glucose response, what have you, because it's all kind of you know, there's just this in sort of inherent quote unquote breakdown of the cyst the whole metabolic system, just a slowing or not slowing, I hate that word, changing of it, changing of it as we engage, but it's all

(28:59):
Resolvable if we can, if we can put together the actions that kind of resolve the big picture metabolic dysregulation that's happening.
It's interesting.
It's cool
to think about it
There was also a study.
I'll find it for you.
You can put it in the show notes.
I think that
They looked at the metabolic rate
of 6, people.
Yes,
yes. It's
like from 20 years old.

(29:19):
9%.
Yes.
And there was
no change in metabolic rate between 20 and 60. They did start
to see a stepwise decrease after 60.
So if you're a woman or man in 45, 55, there's not a really big change that's happening in your metabolism, but you can look at what's happening in your
lifestyle.

(29:40):
Yeah.
What tends to happen is we're a little bit we tend to be more sedentary.
We tend to sit at the end of the night.
We instead of going for a walk, let's say, after dinner or whatever, what have you.
So there is this sort of creeping the propensity to move less increases as we age.
So I think that that's like a little sneaky thing as well, which is why looking at steps is actually really important.

(30:02):
Not the ten you don't need to get ten thousand, you know, whatever.
I don't you know, but you need to be you need to be moving somewhere between seven and eight thousand steps a day.
That seems to be the magic number.
That reduces like all-cause mortality and, you know, all of those things.
So I would say, yes, our metabolism
Stays relatively unchanged over the course of our lives.

(30:24):
And then, of course, 60, 6, 70, we do start to see some decline, but it's not that much.
It
's tiny. It
's not like, oh, it drops off 10%. It
like, okay, you get like a couple percent you knocked 0.
percent.
Yeah.
Is what that research
study said.
Insane.
Okay.
But
I think you're right.
So I think that there's, in a manner of speaking, it's a coincidence.
Hear me out.
I going to flesh this out.
So

(30:44):
Women get to midlife, they feel like their metabolism is slowing down, which it's not.
It objectively is not.
But
They're under-muscled, and they're sort of behaving in ways through food and lifestyle and exercise that are sort of encouraging the dysregulation of their already kind of dysregulated metabolic function.

(31:05):
And also menopause symptoms are interesting because like for example, one of my big menopause symptoms, per symptoms, was low mood and body pain.
So, you think I want to go to the gym when I'm feeling down and my toes hurt?
Like, no.
Right?
Yeah, yeah.
So, there's, there's, it's so there's what's interesting about is there's so many moving parts.
I think health coaches are able to put these pieces together for people and help them advocate for themselves in different ways, like go get the trainer, go get your hormone therapy.

(31:30):
We'll talk about food.
Maybe you have a dietitian or whatever you're working with.
I think it's crucial.
for the female health consumer of a certain or any age, any era, as far as I'm concerned, to fully understand the totality of how their body works.
And we have the opportunity to help folks.
Understand, seek to understand if they want to, how that all works.
Yeah, 100%.

(31:52):
So, to circle back on plant protein, real quick, I heard this on a podcast this week.
And it made me question my own bias, which my own bias is toward animal protein and away from plant protein.
But the estrogenic, estrogenic est oh, I going to screw with this word.
Estrogenic.
Estrogenic.
Estrogenic properties of soy, which previously were sort of touted as a downside, might actually be beneficial

(32:18):
as estrogen starts to
fly the coop.
Is that a
thing?
Yeah, it's a phytoestrogen.
So it mimics, so it can bind into the estrogen receptor and weakly activate it.
So, which is really lovely if you're losing your estrogen.
The other thing that I'll just mention with platinum proteins, so my bias used to be like, oh, it's not a complete, like you really need to do your jurisprudence in order to get the complete set of amino acids if you're vegetarian.

(32:42):
Now that doesn't change, but in terms of
Efficaciousness in the gym.
My bias used to be animal proteins every day and all day.
Like that's really where you like where you're going to get all your gains from because it's more bioav and all the amino acids, et cetera. But we
actually don't
See that in the literature.
So, what there, and I'll send you a couple studies just to.

(33:04):
If there's any nerds listening, I'm sure that there are a few of them.
It's like nerd nam. I'll
send you all the links if you want.
But no change in muscle mass.
So they had looked at, they had a couple different arms of the study.
One was given like euc, so across both arms of the study, same calories.
One was given animal proteins like a whey.

(33:25):
Another was given plant proteins like a soy, let's say.
And then over the course of the studies, no change in strength.
Gains, no change in their ability to put on muscle mass.
So it seems that when we're talking about hypertrophy, the most important thing is that you're stimulating the tissue, which means you've got to get to the gym.
That's
Sort of like you can't just eat your way to more muscle mass, which I actually think people misunderstand because the conversation around protein has become so, I don't know exactly the word, but the conversation around protein is like you need to be having, you need to give up your.

(33:59):
Job in
order to make
sure that you're getting enough protein in a day, and that is going to stimulate muscle protein synthesis.
And therefore, if you get MPS
Than you're golden.
It's like, but MPS is you have to, you have to physically stimulate.
There has to be mechanical
Tension,
you have to demonstrate
there has to be a load that you're moving,

(34:20):
and then
you can supplement the fitness, the mechanical tension, let's say, with the protein.
And it actually doesn't matter what kind of protein.
So that's where I've softened my view on protein.
So I used to have a lot of clients just from Asian backgrounds, Southeast Asian backgrounds.
Like you know, being vegetarian is very, very common.

(34:40):
Like, cows are sacred, right?
They're like, I'm just not, I'm never gonna have a burger.
Like, it's just I can't ethically.
You know, can't get over that.
And I used to be like, well, you're just not going to, when I was a very dumb doctor, it's like, you know, you're just going to have to say, you know.
Like, suck
it up.
Yeah, like, yeah, suck it up, buttercup.
And, and so, so for people who are vegetarian and vegan, like, the great news here.

(35:02):
Is that you can get very close to the results of someone who's consuming whey protein, let's say if you're having soy protein or pea, whatever protein, whatever it is.
You're going to get very close to, and then all the whole foods, like the tem the tof, the ed, all the things.
very close to someone who's consuming animal products every day in terms of muscle mass, which is really important for women,
and strength.

(35:23):
Amazing.
That's great because, again, psychos aspects of women in this era.
Just generally having a low appetite or a strange relationship with meat.
I've had my clients say, I don I just feel weird about eating this much meat.
I know, Aaron, you've explained to me all the great reasons why.
But I just feel weird about it.
Now, I have to take that at face value.
You feel weird about it, then I can't force you to eat meat if it's if it's feeling weird.

(35:48):
So it's good to know that we can say to our clients, Oh, no problem, go have a meatless Monday.
It's fine.
It's absolutely
Completely fine from what we're trying to achieve here.
I also think that appetite is really interesting with women because they have so for probably for a long time been eating under
what they should.

(36:09):
Appetite is often a really good signal for a healthy or not healthy metabolism.
Exactly.
Oh gosh.
Right?
Like you should be ha hungry in the morning.
You've just
you haven't eaten for eight, nine, ten hours, depending on how long you slept in your last meal.
You should like appetite for women often is a little bit of a
It's tricky because they're often not hungry, which is usually a sign of poor metabolic health.

(36:34):
And then, because they have eaten so little for so long, they're used to
Right.
And kind of back to what we were talking about at the top of the hour, like that feminine energy to sort of just want more, like that devouring, like I am insatiable.
I want more.
I want more.
I want more.
That doesn't necessarily like, I think that there's a lot of people who are petrified of that when it comes to appetite.

(36:56):
Like, oh, I'm still hungry.
It's like, yes, you're still
hungry.
Oh my gosh.
See now?
Feed yourself.
Yeah.
Now you open up my can of worms because this is the whole premise behind my women's weight loss program.
But I'm not going to spend time with it.
But the thing is that I hear from women all the time because as I mentioned earlier, I try to get them to have robust meals, and one of them is breakfast.
Breakfast.
I want you
to have a protein-dominant

(37:17):
meal at breakfast, mainly just to get it done, quite frankly, because the day is going to get away from you.
Let's just front-load that protein up in the front part of the day.
And people, women will say to, Well, I'm not really much of a breakfast eater.
I'm not hungry in the morning.
And in my head, I'm like, well, you should be.
You should and I've said verbatim what you said, a healthy appetite's design of a healthy metabolism.
So one of the things I've done is I've

(37:37):
In a manner of speaking, tongue-in-cheek, forbidden my clients from eating yogurt because hear me out.
Because yogurt is
Such a female breakfast.
Do you know what I mean?
It's like, I want
you to have steak eggs.
Do you know what I mean?
It's just small, it's light, it's creamy, it's
It
's not rob.
To
me, it not robust. It

(37:58):
a great side dish, but you need a T-bone. You
need a T
-bone.
You
know,
this is
like a feminine. You
're going to have a big steak for breakfast.
Yeah.
But whenever a woman not whenever, oftentimes when I'm getting women to eat to their full point of satiety, they will say to me with great honesty, I feel fat.
This is the word they use.
I ate that big breakfast, now I feel fat.
It's like, okay, that's fascinating because you didn't get fat since breakfast.

(38:20):
That just biologically didn't happen.
What you're feeling is satiety.
And you've probably not felt that since you were maybe a toddler.
I don't know, a child?
When was the last time women
ate to society?
And my rally cry is
Ad women are the only creatures on planet Earth that don't eat to satiety when they're hungry. Everybody
else does. Your dog
does, your toddler does, your husband does. Just us.

(38:42):
We're just
not allowed to. We never have done
it. So we're
really it's really unpracticed for us to feel
that.
Yeah, there's a couple things that I was thinking about when you were saying that.
First, I think that as a woman, especially in midlife,
You are in a race against time to preserve your muscle, your bone, tendons, ligaments, brain, organs, all the things.

(39:05):
And time will steal that from you if you are not smart and strategic about it.
And there's still, like, there's still like a certain level of inevitable decline.
Like, you can do all the things right, and you're still not going to be as jacked when you're 85 as you are maybe now when you're 45.
So.
The first thing that I would invite any woman who feels like she wants to have a little bird breakfast with seeds and yogurt, let's say

(39:31):
is consider that you have been sleep like you are now in a post catabolic state because you have been sleeping, right? So eight hours,
your body has worked through whatever the last meal is that you had.
And in order to survive, your body will break down your muscles to derive the amino acid reservoir.

(39:54):
for your brain.
And so you really have to think about the first meal of your day, which is should be in the morning.
Yes.
to break that catabolic state so that you actually move from catabolism to anabolism, right?
So you're moving from breakdown to growth.
So you're giving your body I know everybody talks about 30 grams of protein.

(40:16):
I would say minimum of 50.
That's sort of my number.
I like 50 grams of protein in the morning.
Like, you know, I was like, eggs.
I can't wait to make my clients listen to this.
Yeah, yeah, yeah.
So, eggs and, you know, all the things, right?
So, whatever that looks like, it could be.
Eggs, you know, you could have.
I love to have eggs and bacon and
avocado.
That's sort of
like my favorite, and a big piece of sourdough toast.

(40:38):
You really need to think about breaking that cat.
Because right at when you're and even if you're someone who loves to fast, you can still fast, but you can change the fasting window.
Like you should be breaking your fast.
First thing in the morning.
I'm not a huge fan of fasting for women in midlife, but if you are and you love it, that's fine.
Think about moving, like having a phasic shift of your fasting
to eating

(40:58):
earlier in the day and stopping, you know, two, three, four hours before you go to sleep.
That's fine.
But it's that first meal of the day.
And the earlier you can have it, the better you are.
So you're not sacrific. Like
if you're going to the gym and then you're fasting until 12, like, girl, what are you doing?
You
're
wasting your time.
You know, it's like two steps forward, you know, one step forward, two steps back.

(41:21):
Eat in the morning.
And the other thing I'll say with food is, now I like to train in the morning.
I typically train earlier in the morning.
And not always, like depending on the day, because my kids have soccer, practice early some days, you know, so depending on the day.
I don't always get to eat prior to my training, but I will have like a protein shake or something like that that I'm sipping intra work.

(41:47):
The weekend, I always have a bit more flexibility.
So I always make sure that I'm fed before I train.
And I can tell you with 100% certainty that those work
are categorically different
in terms
of my endurance, my performance in the gym, my ability to push myself further to a PR or personal record or personal best.

(42:09):
than the ones that I do during the week.
Now, I still work as close as I can to failure and do all
the sort
of working on tempo and technique and all that stuff.
However, my performance in the gym is noticeably
augmented
when I'm fed.
So I would also say that if you're someone who's like, Yeah, I really want to make sure that the time that I'm spending in the gym

(42:31):
Is worthwhile.
Like, you have to feed yourself.
You have to feed yourself.
Yes.
This idea of like circadian rhythms is something that I really geek out on, and sort of shifting the feeding to what I call the awake.
Half of the day.
There's awake stuff and there's asleep stuff, and the food stuff should happen more in the awake time of day.
This is literally how I simplify the language for my clients.

(42:54):
You mentioned it's like race against time on the loss of lean body mass.
And I actually referred to it as like walking up a down escalator.
Like you basically have to
just
stay in the same
spot, right?
Just keep walking up.
You're not going to maybe make gains per se.
Although I have big goals, I'm going to be the next train with Joan.
You just wait.
When I'm
80, I
'm going to be.

(43:15):
I can see it now.
But it is this idea.
Like to some extent, I sarcop that apparently this starts after our 30th birthday. We start
losing our lean body mass after age 30 and it just kind of falls off a cliff. So we
are kind of just working to preserve it, but it's it's work.
The way I've re it for my misguided, starved youth, is this is actually way more fun work than the work of starving and doing cardio and eating salads with dressing on the side and rice cakes and Diet Coke. This is way more

(43:41):
fun to be nourished robustly and feel good. But
It just is a paradigm shift that female clients of, I think, of our era will have a hard time with.
And so the health coach can help them.
This is such an opportunity for health coaches because what are we?
We help people execute the behavior changes that they're hearing about on podcasts or hearing from their doctor.
to support their body through menopause and all the stages of life.

(44:03):
And our role as health coaches is to help them execute the bare minimums that they can manage successfully in their lives and get them into the
The realm of executing these things with some consistency.
So, this is great for us to talk about.
Really great.
Yep.
And the simpler it is, the more likely they'll be able to stick with it long term.
So if you're a coach, don't make it too, don't make it too complicated.

(44:25):
It's like squat and repeat.
Exactly.
It like just yeah, yeah.
I'm working on a strength training program for my clients because they asked me to and I don't want to build one because I a nutritionist.
I'm a personal trainer as well, but I don't necessarily play in that space.
But it's like, okay, I'm going to give you two exercises every day, like two completely unrelated.
A deadlift and an overhead press, like a squat and a, I don know, a row.

(44:50):
Two random things.
Just go in and do those as heavy as you can.
I actually do want to talk about that because you touched on that earlier.
There's the narrative around women lifting heavy.
I'm hearing so like there's some now arguing, there's just so much arguing on the internet, isn't there?
Women should lift heavy, women, especially menopause, should lift heavy.
And then your perspective, and I think this is really important, is
Unless they don't have the tissue tolerance or the body awareness or the mind muscle connection to lift heavy, then they probably shouldn't.

(45:14):
So your perspective is we can play with resistance in terms of tempo, range of motion.
Rep scheme, that kind of thing.
But
do you believe
all women should lift heavy?
Well, heavy is a relative term.
Right.
So for me, I would say this is how I would define heavy.
First and foremost.
Your body weight can be heavy.
Your technique is king.

(45:36):
Like there's nothing more important than your technique.

You must be able to execute whatever movement pattern you're doing (45:39):
squat, lunge, overhead, press, push up, pull up, whatever.
Whatever it the technique must be dialed in.
And if that means that it's not heavy.
It doesn't feel heavy right now, but you have problems with your ankle mobility, let's say, or your hip mobility, or thoracic extent, whatever the issue is.

(46:04):
Work on that first because I promise you, I've, you know, I used to, my practice used to be right beside a CrossFit and no hate to CrossFit, but it was very good for business, right?
Because it's like they always want to know like how many you can do.
the w like how many you can do in a minute, right?
It's like so they sacrifice technique for reps.
I mean, I'm sure that I don know if they've changed I don't know if they've changed their philosophy now, but I was like, I

(46:26):
Don't even, I couldn't even predict how brilliant I was opening up right next to how dress in. There
's like always people coming in. It
's like, oh, I was doing this wad yesterday. Okay,
anyway. So prioritize
your technique.
Master the technique.
And once you do, you will know that if, especially if you are a gym girly, if you're going to the gym, most people in the gym are not doing that.

(46:48):
They're prioritizing weights, their ego lifting, and it is a surefire way if you don't have the tissue tolerance that you will injure yourself.
And especially, like.
Muscle injuries are annoying, right?
So sprains are su super annoying. Strains
are super annoying. But if you damage
the holding elements, the ligaments and the tendons, like those take

(47:09):
Even if you're 25, they take forever to heal because the blood flow supply is different, et cetera.
So I would say master the technique first.
And then overlay on top of that, because that is a form of progressive overlay.
If you are able to improve your ankle mobility so that you are able to squat properly.
That is a wonderful way to progress.

(47:31):
And then you can put the 2.
5 pound or whatever, whatever you're putting, like just a little bit more next week,
and a little bit
more next week, and a little bit more next week.
So I would say, yes.
As heavy as you can in a range of motion that you can own that is full and pain
-free.
Yes.
That's the other thing is like you're any exercise, you should never feel pain in the joints.

(47:54):
Never, never, never.
There's not one weightlifting exercise where you should feel it in your joints.
There's none.
Right.
If you're feeling it in your joints.
You need to change your technique.
You need someone to watch you.
You need to film yourself.
You need to get somebody to critique you to help you.
You need to figure out where the imbalances are in the kinetic chain because there's a break somewhere.
And you need to figure that
out.
So,
yeah, you should only ever feel it on the muscle.

(48:16):
If you feel achy, like sometimes, like some like a chest press, like sometimes people find
like a wide grip pull-up.
Some people get like a little their shoulder gets a little bit weird.
Or, you know, if you have a camera bar chest press bar, sometimes
like there's too
much of a big stretch on the should, that kind of thing. Then
you have to modify the
exercise.
Pain
is just a request for something different.

(48:39):
So if you feel pain, honor the request that your body's giving you to change the way you're doing
it.
That's very good advice for all the fitness trainers listening.
I think about one exercise I think I see women doing a lot in the gym that I wish they would do better.
In air quotes, is overhead press.
I women will kind of do these partial range overhead press, and if you, you know, maybe ask them, you know.

(49:04):
to help or whatever.
In this particular case, I'm teaching the class, so I'm allowed to go up to them and say, Hey, can we do this a little better?
Otherwise, I would never approach somebody and try to
critique their technique and super seated.
Standing
and they're just struggling to kind of get full extension over, and they'll say, Well, I can't because it bothers my shoulders. And in
my head, I'm thinking, I think your shoulders are bothered because you've not

(49:24):
you know, executed a full over press. But that
's, you know, there's it's a delicate balance there. Do
you have any thoughts on something like that? Women
who have sort of a decreased range of motion maybe from not having tapped the range of motion and how to, if or how to move them past
that?
I would say find ways to add stability.
So that's why I clarified whether it's a seated or standing.
So when you're standing, there is less stability, right?

(49:47):
So now they have to engage their core.
They have to make sure there's no rib flare.
And they have to be able to brace in order to lift it up overhead.
And then you have to look at their grip, et cetera, right?
So the grip might be too tight, might be too wide.
So I would say that if there is something that is causing you pain, find a way to add stability to it.
Because when you, the more unstable a movement is,

(50:10):
the higher well, I'll say the less you're less able to actually recruit muscle fibers
because your body
will always prioritize stability because your body doesn't want you to fall, right?
So, find stability.
You'll be able to recruit more of the muscle fibers, and you may also find that you're going to be able to increase your range of motion.
And then the other thing is, drop the weight.
Like, leave the ego at the door of the gym.

(50:31):
Like, if it is too heavy for you to do a full range of motion, just do a lighter weight until you can add on.
I mean, that's always an option, right?
Full range of motion is very important for women.
At the shoulder joint, I would say, especially, I'd also say at the hip.
Those
are the two joints
where I would see the most problems with women.
So we.
Maybe many women have heard of like frozen shoulder.

(50:53):
Certainly, I would see that a ton.
I would also see a lot of hip bursitis and very, very poor external rotation and internal rotation of the
hip.
So these are like things like fire hydrants, that kind of thing.
Like if you're on all fours, let's say you're lifting the leg out to the side, the knee's bent at about a 90 degree angle.
So I would say always find
Like more stable position.

(51:14):
So maybe instead of on all fours, maybe you get on your side and you do a clam, right?
So now you're still working external rotation of the hip, or maybe it's a bent.
You can put a band around it if you want a bit more resistance.
but now you're not relying also on the core to provide that stability.
That's an example.
The standing versus the seated overhead.
Press might be an option, and then it's always like you can always drop the weight until it feels really great and you have that full ROM, and then you can add on weight.

(51:41):
And I think the seated version would take out a bit of the central nervous system piece too, which I think is the big is taxed quite often.
One thing on the hips, though, I was hearing that one of the other
sort of dysfunctions of of of hip mobility is hip flexion.
We we lose the ability to hip f actual hip
sorry,
sorry, hip extension, my bad, hip extension.
Well, both, but yes,
tell me about extension,

(52:02):
then I'll color it in for you.
I hip
extension is if we lose the ability to extend our leg behind us, now we're kind of in this anterior sort of lean of sorts.
And this is sort of the falling risk.
And being able to take a big step to catch yourself when you're falling.
So I've got a trainer that I work with who's working on my sort of longevity pain-free movement, and they're getting me to do mostly like knees over toes split squats.

(52:27):
Because I need to get that extension.
Like you've got to preserve hip extension.
That's one of the things that is sort of being implicated in falls, is that loss of extension.
Yeah.
So one of the things so extension, when we're thinking about hip extension, we are thinking about glute activation.
which is for most of us, we are often sitting on our butts, on our assets, right?

(52:48):
So we are sitting on our glutes and then they become sort of long and weak.
So I think glute training is super important for women.
There's also direct as your glutes are, let's say the stronger your glutes are, there's also a direct connection with your cognition.
And leg I would say legs in general.
But at fall risk, yeah.

(53:09):
Yeah.
So if you have if you've so our glutes actually they are they do so much in the body.
I mean, this is an entirely separate podcast, but they literally connect the upper
I am in love with glutes, I just have to say.
So they're such, I mean, I would always, as a chiropractor, I anyone that came into my practice with back pain, I would test their glutes.
Because more often than not, it was either bilateral glutes or unilateral glute weakness.

(53:33):
So there's a orthoped test called Trend. Like you just basically
get someone to stand on one foot is elevated and you're looking for a hip drop.
which is usually an indication of like nerve weakness, like insufficient nerve act it's not getting to the glute to activate it properly, the nerve.
So glutes are super important.
Fall risk is actually hip flexion.

(53:55):
So it's both of them.
So when you're thinking about falling, especially falling forward, if you think about an elderly woman, maybe she trips on.
stairs or a corner of a carpet or f icy patch on the ro whatever.
She has to be able to have the speed.
Yeah.
In
her pso,
in her
hip flexors to catch her, right? So

(54:18):
to prevent falls, one of the things that we want to think about for women as we're aging is hip flexor speed and power.
So we want to think about core.
That's super important.
And that includes the pelvic floor, ladies.
And actually, if I can, just talk for a moment about this.
This is like a I had a Dr.
Sarah Rudin on my podcast.

(54:38):
She's a pelvic floor physical therapist.
And we were talking about, you know, we've been talking about osteoporos and, you know, sarcop on this. You know,
we've been talking about bone health and muscle health, you and I, on this show.
What often doesn't get talked about is urinary incontinence.

And this is the number one reason why women are admitted to a nursing home (54:52):
they are no longer, they are either urging cont, stressing cont.
and that progresses to fec incontinence. And
no one wants to talk about this because it's like cloaked in shame. Like
no one wants to, Yeah, when I jump, I'm peeing myself.
But your core, which what I was saying, and I sort of went on this tangent with the pelvic floor, your core also, like the top of it, obviously, is the diaphragm.

(55:17):
We have anteriorly the rectus abdominis, and then
Pose like caud, so at the bottom we have the sling, which is the which is the pelvic floor. So
the core is super important for longevity, hip flexor speed.
Is also super important.
And then your back extensors, right?
So these are like the extensors up, you know, those that's the back of the core, let's say.
And that's the only thing that you kind of have really supporting the spine as well.

(55:41):
So if you think about
The rib cage sort of locks the thoracic spine in place, like it kind of stabilizes.
We don't often get a lot of thoracic, like mid-back injuries, we get a lot of low back injuries, right?
And that's because there's a weakened core.
The glutes are part of that.
So I just wanted to just wanted to clarify that because I think for women, when we're thinking about how can we help them age powerfully, part of that is hip flexor speed and strength.

(56:06):
Because you want to be able to get your foot in front of you because your center of mass is moving forward as you're
falling.
You need to get your foot forward ahead of you before you fall and to
be able to
break that fall because you don't want to break a hip because there's a whole
You know, get into that as well.
Yeah, depressing stats with hip fractures, cognitive decline, death, all the

(56:27):
things.
Incredible.
We've covered a lot of ground.
I actually do have one more question for you, just a quick one, I think.
Probably not, though, because I do want to make sure we circle back to this.
Yes.
Women
coming through the menop trans, which we both are, and many are. Here we
are. We're
doing it. We're
doing the thing. We're
figuring it out for the generations after us. Don't
worry. We got you.
Gen X.

(56:47):
We
got you. Millennials.
So, if a health coach is working with somebody who's coming into their menopause transition or thinking about preparing for hormone therapy, that kind of thing, do you have any quick sort of advocacy advice that a health coach should give their client?
When the client says, I need to look into hormone therapy, what should I do?
My OBG doesn't seem open to giving me estrogen or testosterone. What can

(57:10):
it do? Like any
quick advice in terms of client advocacy for hormone therapy?
Oh gosh.
I mean, the one thing that sort of popped in my head is like, find another doctor.
But yeah, you at least as a woman
Have the I mean, you may or may not be a candidate for hormone therapy.
There are contraindications to it for sure, but you at least should be granted.

(57:33):
the civility of having the conversation.
Yeah.
So depending on the country that you're in, I think the States is a little bit easier in terms of
Getting a second opinion.
I think if you are someone in the UK or in Canada where there's more of a national health program, doctors are overworked and underpaid and full of patients, so it becomes harder.

(57:53):
So I would be looking into more telehealth options maybe for countries where there's more of a national health program and your doctor is ref like I hear all the time from my European women who listen to my podcast are like
Like, we are not talking about this in Portugal.
You know, it's like, we are not talking about this in my country.
Like, there's like the doctors are not even willing.

(58:14):
So I would say where there's like cultural resistance and or it's difficult because
of the system
that you're in, I would be seeking out like telehealth options as
well.
Yeah, I think that's good advice.
So for the health coach, it's sort of you the conversation we can have with our client is, tell me about your relationship with your doctor.
Are they listening to you?
Do you want me to help you find another doctor?
We can do that.

(58:34):
We can Google a doctor in your city or we can find a telehealth option.
We know our opportunity is to have is again, it's in the advocacy space.
We're not telling our clients what to do.
We're not ordering blood tests or urine tests.
We're not doing Dutch tests, health
coaches.
Sure.
But helping the client advocate, having the conversation and seeking out those resources is really in our purview.

(58:55):
And even if that client even if your client just feels supported by having you say that too, because it's
I think for women, we tend to be higher in a personality trait called agreeableness,
right?
So
if you have a doctor that's like, no, you don't need that.
You know, it's more difficult for a woman to be like, really?
Why do
you think that?
You know, versus like,
oh, okay, thank you so much.
Thank you for your time.
Sorry to bother you.

(59:16):
You know?
So I think even just
Feeling giving your client the feeling like you've got her.
You know, it's like, no, that's not okay.
Like,
let me help
you.
Like, that doesn't seem right.
I think that that will also embolden her a little bit and help her advocate for herself.
Because at the end of the day, she does have to advocate for herself, but it's going to feel better knowing that she has someone in her corner that's helping her find resources, et cetera.

(59:40):
Incredible.
Really great.
Oh my goodness.
Well, this was such a wonderful conversation.
I really appreciate you lending your perspective on everything we covered, which was a lot.
Tons of useful stuff for health and use use and useful stuff
for health coaches to use.
That was
a great
Freud slip. Yeah That
was
pretty.
So, Dr.
Sud you're all over the map. You

(01:00:01):
're everywhere. You
're online. You
're in person. Where
can people follow you and just lean into more of your stuff?
Sure.
I'd love to invite you to listen to my podcast, Better with Doctor Stephanie.
Just if you're a podcast listener here, you could just pop on over to my podcast.
We have weekly episodes for from scientists and like top world thinkers on what it means to live a well lived life as a woman.

(01:00:22):
And probably the main pla the main place other than that is my website, so dr. And you'll find like the Instagram,
we've
got newsletters, we've got all fun, like, you know, all the fun things.
Where you can interact with me for free.
And of course, there's books and all that stuff there.
So dr.
Amazing. Thank you
so much for
your time and all your
wisdom. It was a true joy.
It was a pleasure.

(01:00:42):
The pleasure was all mine.
Thank you so much for having me.
This podcast was brought to you by Primal Health Coach Institute.
To learn more about how to become a successful health coach, get in touch with us by visiting primalhealthco. forward
slash call.
Or if you're already a successful health coach, practitioner, influencer, or thought leader with a thriving business and an interesting story, we'd love to hear from you.

(01:01:05):
Connect with us at hello at prim. and let us know why we
need to interview you for Health Coach Radio. Thanks for listening.