How Should Women Train and Eat in Perimenopause?

Nikkiey: What would you say is the ideal weekly training split for someone that's 50 years old?

Stacy: A minimum is two times a week. Minimum. If we're doing total body compound movements, we're really focusing on the strength, and that's great. If we want to start accumulating more lean mass, and that's bone and muscle, then we're looking at three times. That's the minimum. You don't really want to eke it out to going every day, which some people are like, oh, more is better, because we also really need to focus on recovery. You can't build without recovery. People are always like, oh, I can't spend that much time in the gym. I'm like, if you have an hour a week divided into 20-minute segments three times a week, you can get a lot done in 20 minutes in the gym when you're looking at strength training.

Nikkiey: Dr. Stacy Sims. If you don't already know who she is, she's a world-renowned exercise physiologist and nutrition scientist who's flipped the script on the one-size-fits-all approach in fitness and performance, especially when it comes to women. She is the author of ROAR and Next Level, and her mission is grounded in one of the most powerful truths out there: women are not small men. We need to train, we need to fuel, and we need to recover differently, especially the women listening to this right now who are navigating hormonal changes as they go through perimenopause or menopause.

So today, we're diving into how women can build muscle, lose fat, feel strong, and actually understand their bodies. And this episode, guys, is going to be packed with some truth bombs, and I just can't wait to get into Stacy's brain and have her drop all of this knowledge here. Dr. Sims, welcome to The WarriorBabe Show.

Stacy: Thanks for having me. I've been looking forward to this.

Nikkiey: Let's go.

Nikkiey: What actually changes in how women should train once they hit this stage of life, like perimenopause and menopause?

Stacy: Yeah, so I like to bring people back to that conversation around puberty, right? Because we've all been through it, we know that your body changes, and you have all these things that happen, and then you get your menstrual cycle. So we're on the other side of things, where we're starting to see our body unwinding our ovarian function. So what does that mean, really? We're having more and more anovulatory cycles, so we're not dropping an egg.

If we don't drop an egg, then we don't produce progesterone. We're seeing that we're having more flux of estrogen, and our body has been affected by a continuous cycle of estrogen and progesterone for decades. Now every system of the body is starting to be affected. We see it from brain changes, cardiovascular changes. We see it when you go get a blood test, and all of a sudden you have high cholesterol, and you're like, I've never had that before. I don't have a family history. It's primarily because of estrogen and progesterone and how they have an interplay in every system of the body.

When we talk specifically about skeletal muscle, we see that estrogen is really tightly tied to how our muscles respond and how strong our contractions are and how powerful they are. We also have the other side of things, where our body, by aging, is becoming less and less responsive to protein intake and to resistance training. So all these women who up to this point have been, oh yeah, I get 20 grams of protein after training. I've done my HIIT. I've done my CrossFit metcon. I've done my 3x10s or 3x15s. I've gone into fatigue. None of that works now, because our body's like, oh, wait a second. We need more protein to stimulate anabolism, or building muscle.

We also need to find a different stressor that's going to create an adaptive response, because our bodies are really kind of used to not being threatened. So if we are able to create a stress that's going to cause a threat, the body's then like, oh, I've got to build more muscle. I've got to have a powerful contraction. Then it's going to respond in kind.

So when we take that into translation, it's like, okay, what are we doing here? We want to look at that power-based range of lifting. We want people to learn how to lift heavy properly. We want to do compound movements. We want to have adequate rest between our sets, because we want a central nervous system response. If we're having a central nervous system response, it's the nerve saying, hey, wait a second. I need to be able to stimulate all of these muscle fibers for a really strong contraction. How am I going to do that? Okay. I need some more of this neurotransmitter around so I can actually jump and contract these muscle fibers. In these muscle fibers, I also need my myosin and actin to be really on point. So let's stimulate the myosin a bit more so the myosin and actin contract strongly and bond together.

And then by the nature of having to have more lean mass, if we are having a continuous stress from the central nervous system and also the peripheral nervous system, the body's like, okay, I need to be able to build more mass to keep up with what's happening from the brain. So when we're looking at the training scope, it's no wonder that people who are used to doing the HIIT and the higher reps and lower weights are not finding a change. It's not the right kind of stress we need when we're starting to have these changes in our hormones.

Nikkiey: Yeah, that makes total sense. So for the women that are doing those types of activity, you're saying focus on more compound movements, put more stress on the body with the weights. How about the women that are in menopause? Is it the same thing, strength training, compound movements? Is there anything different that would be done during that phase of life?

Stacy: No. What's happening is we're having that wind-down during perimenopause. So we start to put those new patterns into place, and the body's responding, because we see the biggest change in body composition occurring over that menopause transition. So when we're doing the heavier weights and we're actually looking at loading the body properly, not only are we stimulating lean mass development, we're also stimulating bone. And both of those are really important.

So when we get to postmenopause, we have those patterns in play. But if you're listening to this and you're like, oh, I'm well past perimenopause, it's not too late to start. If we start lifting heavier, we're putting stress on the ligaments and the tendons and the muscle. We're also building bone to support that. And when people are like, oh, you know, I'm 62, how can I lift heavy? It's like, well, we don't want you to go in and do a heavy deadlift right now. Let's look at where you are and phase it in a relative way, just like we would with any other person in any other phase of their life.

Nikkiey: So what you're basically saying is lifting is essential. It's not optional really, right?

Stacy: Exactly.

Nikkiey: What would you say is the ideal weekly training split for someone that's 50 years old that wants to build muscle?

Stacy: We see that a minimum is two times a week, minimum. And this is total body movements. If you are looking to actually build on top of the strength, so if we're doing total body compound movements, we're really focusing on the strength, and that's great. If we want to start accumulating more lean mass, and that's bone and muscle, then we're looking at three times. That's the minimum. You don't really want to eke it out to going every day, which some people are like, oh, more is better, because we also really need to focus on recovery. You can't build without recovery. People are always like, oh, I can't spend that much time in the gym. If you have an hour a week divided into 20-minute segments three times a week, you can get a lot done in 20 minutes in the gym when you're looking at strength training.

Nikkiey: Heck yeah. And so many women...

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Nikkiey: I think they're more about moving the body more. They've come from the age of I need to eat less and I need to train more. And now the narrative is less is more, right?

Stacy: Yeah.

Nikkiey: What would you tell somebody? Because we see women that want to train six days a week, and they're having a hard time even breaking that type of habit and understanding, hey, less is more. Two, three times a week is all you really need. How would you navigate a situation like that with someone and say, hey, we need to pull it back, and why?

Stacy: I feel like that's a conversation I have every day, many times a day.

Nikkiey: I bet. Same. I should just say, go to this podcast and listen to it, and the answer is right there.

Stacy: Yeah. I mean, again, coming from the endurance background, a lot of my friends are still in that, and I have friends who are coaches and that kind of stuff, and so they're still locked in that mentality. And then the general everyday person is like, oh, I need to get X amount of steps per day and go to the gym and do this and that. I'm like, well, actually what we want to do is polarize. If you work out every day, can you hit a max intensity on one of those days? And they're like, what do you mean? Can you do sprint interval training on one of those days? Can you do 30 seconds full on, as hard as you can, and repeat that a few times? And most people are like, well, yeah. And then they go try it and they're like, no, I'm always too tired.

That's the thing. You're always in this kind of moderate intensity. If you're exercising every day at the same intensity and trying to do the same thing with the idea of burning calories to lose weight and change body composition, you're not. You're just creating this cascade of sympathetic drive and stress that's not going to allow your body to understand exercise stress. From a mental standpoint, sure, maybe we do want to go outside every day, but it doesn't mean doing the same intensity every day.

If we pull it back and go, we want three key training days in a week, and these are the intensities that we want. And when you go to lift, and we're only lifting, it's hard. You leave feeling like you've done some work. It's not about supersetting to try to get the burn. It's about actually putting in that hard work, because that's how the body responds. So when we start putting in these little teasers, tests of how hard can you go and how well can you recover, people start to get it. It takes some time, but it's all about seeing how you can polarize it.

Here we have a hill that everyone likes to walk up. I'm like, how long does it take you to walk up the mountain? And people are like, oh, I don't know. I go up and down a couple of times. Like, let's go up once and try to get up there in 12 minutes. And most people are like, no, I can't do it. I was like, if you're rested and recovered, you can do it. So then people try it and they're like, oh my God, that was so hard, but I feel so good. It's like, yeah, but don't do that every day.

Nikkiey: Let's shift gears to nutrition, because that's where I feel like a lot of women are stuck. I feel like every conversation I have with someone on the nutrition topic, it's like they're looking at it like a deer in headlights. Women are eating 1,100, 1,200 calories, thinking that it's going to help them drop fat, it's going to help them drop weight. But they're not seeing the progress that they want to see. In fact, they're gaining weight, they're losing muscle, or they're feeling constantly exhausted. And they think that something's wrong with them. That's a narrative that I hate to hear. And I want anyone listening to know, one, that's not the case. You're not broken. And I want this conversation to help them see, one, it's not their fault, and two, they just need the right strategy for where their body is at now.

So with all that being said, many women, like I said, are eating 1,100, 1,200 calories and wondering why they aren't seeing the progress that they want or losing fat. Can you speak to the danger of that, especially for women that are in the phase of menopause and going through that journey? The danger of just eating 1,100 and 1,200 calories?

Stacy: Yeah, it's not enough. We've been caught in this narrative, probably from the 100 years of cardio stuff, where it's calories in, calories out, eat less, burn more. And we have to remember that inherently we are biological beings that require food. If we are not eating enough to support just general health, the body perceives it as a threat. And the body is like, wait, I want to stay alive. So I'm going to start conserving every possible high metabolic cost that I can.

So if you're only eating 1,100 to 1,200 calories a day, that's not really even enough to touch a resting metabolic rate. We see on average a resting metabolic rate is around that 1,100 to 1,200 calorie point. So that's lying in bed and not even blinking, right? This is just the basic amount that your body needs to survive, for all its breathing and heart rate and blood circulating and brain and everything. But as soon as you get up to pee, you need more calories. Your body needs food to do all of these energetics. And if you're not eating, your body's like, I'm bringing it all down. I'm only going to allow the essentials to work well. So I need to preserve the brain, and I'm going to keep trying to fuel the brain.

I don't have enough blood sugar, so I'm going to start using some free fatty acids or ketones and amino acids. Where does that come from? It comes from your lean mass. Your lean mass is very metabolically active, and that's one of the first things the body is going to go after and say, hey, you're too metabolically active. I can't conserve you. So I'm going to break you down and use you for the sum of the parts.

So when we see women who aren't eating enough, we see this, right? They put on belly fat. They put on a lot of extra subcutaneous fat. They look a little bit puffy. They're losing lean mass. They're not responding to training. And then they can't sleep well, right? Because they're in a sympathetic drive, where their body's in this really highly stressed state of, there's no nutrition coming in. I'm getting ready to fight or flight is that continuous feeling.

When we get into the menopause transition, unfortunately, we see a big shift in body composition with this change in the hormones, because the body is under a sympathetic drive. That's why we're always feeling tired but wired. We're having these shifts, and the body's under a little bit of normal stress from these shifts because it's starting to find a new biological set point. So we start seeing conversations between the liver and the free fatty acids that are floating in the blood, where now the liver is like, I need to store you around the organs in case I need to be able to access you, which is why we get visceral fat. We also see that we have less ability for insulin to pull sugar into the muscle. We have more insulin resistance. And it's because the body's like, I need to conserve blood sugar. I need it for the brain.

So there are all these things going on because we're under a bit of stress. So if we say, let's feed the body and let's train appropriately, we start to see better conversations across the organs, which allow us to not store visceral fat, but to take fatty acids and put them into the skeletal muscle to be used at rest, and to increase our body's ability to pull glucose into the skeletal muscle and the liver without insulin. So we start to see better metabolic health. If we're not feeding it, we don't even start to have an impetus on that.

Nikkiey: I feel like everybody needs to rewind that whole last bit and just listen to it over and over and over again. I have chills and I'm screaming yes in my head because of all that you just said. I'm so glad you said that. And the way that you broke it down makes it so understandable as to what is actually going on. Because it's not like a lot of women know, hey, this is what's happening around my liver, visceral fat equals this. The brain doesn't compute like that for women that don't have the knowledge that you have or aren't in the bubble that we're in, where we eat, sleep and breathe this kind of stuff. So I just thank you. That's the exact message I want to continue hammering home, so women can understand how important it is to eat food and eat the right amount of food.

Nikkiey: Today, guys, I have Alicia here with me. She's also known as the Midlife Maven, and I know this is going to resonate so hard. At 51, Alicia completely transformed her entire health and fitness journey, proving that midlife is just the beginning. After a 13-year career as a portrait photographer, she's now on a mission to empower other women in their prime to embrace their strength and vitality through strength training and nutrition. And everybody listening, once you start following her, wait till you see how ripped and incredible she looks. I'm so excited. Let's go. I'm so excited to have you on here, Alicia. Thanks for being here.

Alicia: Oh my gosh. Thank you for having me. This is so fun.

Nikkiey: Can't wait. Your vibe is so great. Your energy is so great. We're going to have so much fun today. And something I see that you do on social media, which has inspired me because I'm only at 2,000 steps today, don't yell at me, is getting out there and getting my 10K steps in.

Alicia: Yeah. Walking, too. Yes. Huge. Walking is my new absolute favorite thing to do. I do not run anymore. I walk and I hike. I live in Washington State, so we have a million hikes here. We hike all summer long. We're snowshoeing this winter. It's just my favorite. It feels so good.

Nikkiey: That's amazing.

Alicia: And my body loves it.

Nikkiey: When you stopped CrossFit and went into what you just said you do, did you have to lose weight? Were you skinny fat? Were you overweight?

Alicia: I wanted to lose 10-ish pounds, 10 to 15. I just had a little extra layer going on. So I went into a caloric deficit at first, and I did that for about three to four months. And from there, it took a minute for me to start losing weight, because my body was adjusting to the protein. I had not really tracked my protein like that before. And I was like, whoa, hold on a second. So it took a minute for things to start happening. And then once they did, it was really kind of quick. My body started to respond. And from that point, I was like, okay, I'm happy with what I'm weighing. I just want to recomp from here. I just want to stick with what I'm doing, stay at maintenance, and push hard in the gym and recomp. And that was crazy, too, watching what happened over the next year.

Nikkiey: You just said maintenance. Because I say maintenance is where the magic happens, sometimes.

Alicia: Oh, yeah.

Nikkiey: Although people can go into a cut, some people shouldn't go into a calorie deficit or a cut. So you mentioned maintenance there. You just lifted heavier inside the gym. That's what you did.

Alicia: Yeah. And when you see the pictures of me at the end of my cut and then a year later, it's insane. I wish I would have done a DEXA at the beginning of my maintenance, because I know that I put on so much muscle. I completely changed my body composition. It was crazy. Insane. And what women don't realize is, so you're in maintenance, and then as you're putting on more muscle, your maintenance calories actually go up, because muscle is so efficient and muscle just burns through your food. So you get to eat more food. It's freaking awesome.

Nikkiey: It is freaking awesome. I just wish more women understood that, which is why I love you doing what you're doing and coming on and sharing this message. Whenever I hear people saying the same thing that I'm saying, it feels good, because it's like, oh, Nikkiey says this, but she's saying this too. So it actually might mean something, and it gets more believability behind it.

Alicia: Totally. And I think especially with my generation, Gen X, we've just been taught something completely different. So it's very hard to get this through.

Nikkiey: Yeah, 100%. So you did all of this around 51, right?

Alicia: Yeah, as I was turning 50.

Nikkiey: Were you experiencing any signs of perimenopause, or are you going through it?

Alicia: Oh, yeah. Definitely. I felt like as I was going into my mid-40s, perimenopause was for sure coming on. And I definitely noticed that with the activities that I was doing and also with alcohol. I decided to cut out alcohol after a 25-plus-year relationship with alcohol. I was like, this just is not doing it anymore. My body is just like, we are done. We are not handling this like we used to. We need to be done. It was just making me feel like crud. And also, I had goals. I had things I wanted to do, and it was just getting in my way. So I completely cut that. You just notice that your body responds differently to things as you're coming into peri. It's like, this isn't doing it anymore.

Nikkiey: I love watching your stories. I think it was last night you were pouring your seltzer into a wine glass.

Alicia: Oh, yeah. I drink it out of a goblet. A little goblet, or a chalice, I call it.

Nikkiey: Dancing to rap music at the time.

Alicia: Yeah. Because I'm just like, you know what? I'm more fun sober than I was before. I'm more fun now. My energy has skyrocketed.

Nikkiey: Hell yeah. What motivated you to fully take out alcohol and take out processed sugar?

Alicia: Well, I will say I am a woman of faith. So I definitely felt something in my spirit. And I've heard somebody else say this before: it just wasn't aligning with me, spiritually, mentally, physically, in every aspect of my life. It was just not matching up. And I'm the kind of person, as you can see, who goes all in with what I do. I understand that some people are like, hey, I just need to moderate. It's too much for me to completely cut it. Hey, if moderation works for you, that's great. And moderation is zero to two glasses a week. That's moderation. And what I used to consider a glass was probably more like three glasses. So if that works for you, that's great. But I knew what I needed to do for me. Every person has their own decision that they need to make, and they don't need to compare with anybody else when it comes to alcohol. You need to do what you know is best for you. And I just knew in the depths of my soul that it needed to be completely gone, because it was too habit-forming for me. It was four, five, six days a week. And I could do anywhere from a glass to a bottle. Easy. Or even more on the weekends. I'm like, I can't do this anymore. I need to completely be done.

Nikkiey: That's amazing, first of all. Kudos to you. That's really hard for people to do. I love that you said you listen to your faith, whether it's spiritual, the universe, God.

Alicia: Yeah.

Nikkiey: You had the voice inside of you and you followed it. And that is amazing. At that point, where was this in the mix of your transition from CrossFit?

Alicia: I was in the middle of CrossFit.

Nikkiey: And when you stopped drinking, did you see results come quicker?

Alicia: Well, they call it the sober glow, too. And I definitely saw it in my eyes and my skin. I took selfies every day for months, and it continued over the months. Everything became so much more vibrant, so much more alive, so much more glowy. At the end of the day, you're putting a toxin in your body. So to me, this was a game changer. I just felt like a new woman. New woman.

Nikkiey: Kudos to you. I hope you're inspiring anybody that's listening to this right now to take that first step. And it's just incredible that at 51 you transformed your entire body and you did the basics. I just want to drill that back in: macros, protein, strength.

Alicia: Yeah.

Nikkiey: The majority of women that listen to this podcast are 45 to 65 years old. For any woman in midlife who might feel hesitant about starting strength training, what advice would you give her to help her take that first step?

Alicia: Well, I know that it can be overwhelming to think about going into the gym. Where do I even start? Am I going to get bulky? I know women think about getting bulky, but do I look bulky to you? Your nutrition is going to dictate how bulky you're going to get. So I would just say, get out of your own way with your mindset. Get out of your own way with whatever preconceived notions you have. Look at these women who are transforming. There are so many women online. Look at what they're doing and listen to what they're saying. There's absolutely no reason why anybody couldn't do this. We're just doing the thing. We're just being consistent.

And another thing I think our generation has been taught is that this is going to happen so quickly. Well, it's going to take months, if not years, to build the body that you want. That's where you have to fall in love with the process, the whole process of what happens, because it's going to take time. You don't need to set a time limit on things. Just start doing the thing and start chipping away, and fall in love with it as you're doing it, because it's going to take time.

Nikkiey: Amen to that. I actually want to dive in a little further with you on that. Everyone listening, if you follow Alicia on Instagram, you can see that her consistency shows in the results she has with her body. And you're speaking to the generation of women that grew up with Jenny Craig and Weight Watchers. I always say they expect to put their body into a microwave and out comes a toned body. And I say, if you can just accept that your journey is going to take anywhere from 8 months to 12 months to 18 months to 2 years, you stop looking at and chasing the outcome and you start getting addicted to the journey. You start falling in love with the journey. You can start to be happy now, rather than waiting for a result to happen and then finally being happy.

I also say people follow macros, people do strength training workouts, but that's the tip of the iceberg. What people don't see is the bottom of the iceberg: what you put in on a daily basis, your consistency, showing up, your willpower, your persistence, your patience. Can you talk to the audience about what that means to you and why you show up and keep the promises to yourself every day?

Alicia: Well, who doesn't want to wake up feeling like a million bucks? You wake up feeling like you have confidence. You feel good. You have high energy. You walk around just owning your womanhood and feeling amazing. Who doesn't want to wake up feeling like that? You prove to yourself that you're a badass and that you can do hard things. Your confidence skyrockets, and you feel so freaking good. It takes work. And I will say it takes a lot of mindset work, too. I think that's not touched on enough: where your mindset is at and how you speak to yourself, and really getting your mind right for this, because I think that's where people get a little stuck.

Nikkiey: Yeah. I totally agree with you on that. They're stuck in the old stories, limiting beliefs.

Alicia: Big time.

Nikkiey: Even the patterns of seeing their mom on diet after diet, so they think they have to do the exact same thing. And then that carries on into their habits, and then it's really hard to change the behaviors. And like we mentioned earlier, you've got to get out of your own way. I always like to say, if you're doing the same thing over and over and over again and expecting different results, that's the definition of insanity.

Alicia: Albert Einstein. Big time.

Nikkiey: Yeah. Mindset is something that needs to be addressed at the beginning of the journey, at least subtly, to bring self-awareness to it. Because if that isn't right, and people think that they can't do it, then they're not going to be able to do it. If they think they can do it and they change the narrative, then they're going to see themselves excel.

Alicia: And that's exactly what I was telling myself when I started this whole thing. I was like, you can do this. You are absolutely able to do this. And I was also telling myself, you know what? I love you like this, too. I appreciate you, body, for everything you've brought me through, for everything you've done up to this point. Thank you for getting me to where I am today and for providing everything that you have. You can still love yourself and love your body but want more. That's okay. And still believe that you can do and accomplish more. I think that's a sweet spot that a lot of us have a hard time finding. I honestly feel like I worked for years to accomplish that with my mindset: loving and accepting me where I am and still saying, you know what? We can do more. We can go even further. Let's go.

Nikkiey: Unstoppable, baby. That's some resilience right there. Let's go. I love it.

Nikkiey: Quick break. If you're finding this episode helpful so far, it would mean a lot if you could hit pause for just a second, leave a quick rating or review, or share it with someone who could benefit from it. Your support helps more women discover these tools to build muscle, lose fat and feel confident. Thank you so much for being a part of this journey with me.

Nikkiey: Today I have an internationally renowned hormone expert, a nutrition scientist and the founder of Dr. Brighten Essentials. She is a board-certified naturopathic endocrinologist, a certified menopause specialist and a sex counselor. I mean, what has she not done? She's also the best-selling author of Beyond the Pill and Is This Normal? Dr. Brighten is here today, everyone. She is on a mission to help women uncover the root causes of hormonal imbalances and reclaim their vitality through informed, science-backed choices. Today we're diving into all of the things: perimenopause, hormonal shifts, mood, libido, energy, and what it truly means to take control of your health through every phase of womanhood. I'm really excited for this conversation. Dr. Brighten, welcome.

Jolene: Thanks so much for having me. I'm very excited to jump in and talk.

Nikkiey: Everybody, she sent over some of the best questions.

Jolene: So I'm going to tell you right now that you're going to want to share this with your friends, because we are going to bust so many myths. And I'm going to give you everything that your doctor should have given you in every single visit you've ever had but hasn't yet.

Nikkiey: Amen to that, lady. I'm super stoked. So let's first start off in the bucket of hormonal imbalance. For many women, perimenopause feels like it just sneaks up on them. I've learned that it can start as early as your mid-30s, right? So what are the earliest signs of hormonal changes that women experience? What should we be paying attention to?

Jolene: Yes. What every woman needs to know about perimenopause is that hot flashes are not the first sign. Irregular periods are not the first sign. The very first hormone to decline in perimenopause is progesterone. Progesterone is only made after ovulation. The onset of perimenopause is when our savings account of eggs is running out. When you're out of eggs, you enter into menopause, which is 12 consecutive months of no period. The next day, you're postmenopausal. So you get a birthday of no periods. Yay, menopause. Next day, postmenopause.

But before that, what we see is that progesterone begins its decline. What do those symptoms look like? Worsening PMS. So you're more irritable. Your partner chews their food loudly, and you're like, I'm getting a divorce. I'm out of here. I can't be with this person anymore. I'm so irritable. Because what progesterone does is stimulate the GABA receptor in your brain. So you make progesterone, or you take oral micronized progesterone, and your body converts that into allopregnanolone. That hits the brain. GABA lights up. GABA says, chill. You love this person. They're not that annoying. And we're going to get really good sleep. We're going to go to sleep and we're going to stay asleep throughout the night.

So if you're someone 35 or older, and two, three, maybe even five days before your period you're having night waking or you're waking up much earlier, so instead of waking up at six like you usually do, now you're waking up at four or five, that can be pointing toward a progesterone issue. The good news is that in the early perimenopause phase, there's still a lot we can do naturally to get the ovaries to work for you and help mitigate these symptoms.

Nikkiey: How? What can we do?

Jolene: Okay. We'll go right into it.

Nikkiey: Give it to us now.

Jolene: Okay. So if you are experiencing increased PMS, you're having breast tenderness before your period, you're irritable, you're having insomnia or sleep issues, there are several things that can help. Number one is increasing our vitamin C, whether that's coming through diet or through supplements, and vitamin B6. With vitamin B6, we're going to be looking at 20 to 25 milligrams coming in a day. Those are going to support the corpus luteum, the temporary endocrine structure that's left behind post-ovulation to produce progesterone. There's an herb known as chaste tree berry, or vitex. We typically use that at 200 milligrams. That can also help with supporting ovarian production of hormones, and it can help during the luteal phase.

Now, the other thing we've got to look at is stress. Stress is absolutely the number one thing that will rob you of a really easy period. The reason is that when the brain perceives stress, your body, wanting to survive no matter what, says make stress hormones, survival hormones. Don't make reproductive hormones, the expensive, potentially-gets-us-pregnant-in-a-scary-environment hormones. We need to survive. So your body, being really wise, is going to shift in that way. The problem is the modern woman is living under chronic stress day by day by day. And evolutionarily speaking, the way you developed your entire hormonal system does not match what is happening in your environment.

So what can we do with that? We have to look at where we can mitigate stress and where we can cut out stress. You cannot control all stress, but you can control your response. I have several articles on drbrighten.com, and one I would recommend people check out is on vagus nerve stimulation. I also have a podcast episode going through ways that you can stimulate your vagus nerve. There are certain breathing exercises. There are massage exercises. The vagus nerve runs from your brain, it innervates your heart and it innervates your gut. And this is a way that we can access the rest-and-digest aspect of our nervous system. We can hum. We can sing out loud. We can do deep breathing. That will shift us to more resilience against stress.

And then I ask people in my practice, can you do a stress inventory? I just want you to brain dump all of the things that are causing you stress. And then I want you to look at what you're unnecessarily putting on your plate, because we do that. We think, oh, I'm the only one who can do this best. Does it really have to be you? Do you really have to sign up for that PTA thing again? Do you really have to volunteer for this extra thing? Where can you offload stuff? And then look at what is perceived stress and what's actual stress. Because sometimes when we write something down as a source of stress and we look at it, we're like, actually, I'm making that up in my head. That's not real stress. I need to let that go.

And then there's my favorite one. Everybody talks about a detox diet. I'm like, detox the people in your life who are toxic. So take a look at that. If there are people in your life who, when you spend time with them, leave you feeling more exhausted and drained, and you go home and think about the interactions and hate on yourself about things, those people have got to go, especially if you're in a healing phase of life. That doesn't make them bad people. It makes them not the right people for you and your hormones.

Nikkiey: Wow. Such good advice already this far into the episode. I want to ask you, what are the most common myths and misconceptions that you hear from your patients about perimenopause and hormone health?

Jolene: Actually, I hear this one from other providers: that perimenopause and menopause are just natural, so if you're having symptoms, you just need to ride it out. And you know what I find really funny, as somebody who has been prescribing hormone replacement therapy, or menopause hormone therapy, for over a dozen years? This is part of my core training and my background in medicine. It's how many of these doctors, primarily gynecologists, have been out here telling women to just raw dog their way through menopause. Suck it up, get through it. It's natural. Don't use these hormones, they'll cause cancer. Some of them were sending me nasty messages, like, what are you trying to do, kill this patient, giving them HRT? I'm like, no, I'm trying to give them back their life, let them not lose their mind and actually enjoy a fully lived life.

Nikkiey: Or not feel like a stranger in their body.

Jolene: Yeah. And now these people are like, oh my God, sign me up. I want this HRT, and I'm also going to be an expert in it. And I'm like, could you just for a minute recognize the fact... I mean, there are a few gynecologists out there in the menopause space who I think are doing a great job, and they do talk about how they had no background, no training, and they did a disservice to their patients. We have to have that dialogue to build trust with patients, because the people you denied hormones to absolutely remember you.

So I think that is one big myth in that space: that it's natural, so you should just deal with it. You don't have to just deal with it. And you don't have to use hormones if you don't want to. That's one option. There are a lot of natural therapies that we can use. And nutrition and lifestyle go so far. And I will be the one to tell you, HRT is not enough. I don't care about these people singing it like it's the gospel that's going to save your life. It is not enough. You have to be looking at nutrition and lifestyle as well. The way you show up every day to live your life has such a tremendous impact on your outcomes.

And I think anytime we put up this paywall, telling people that if you want optimal health, you have to see a provider and get a prescription, it's very disempowering, because there's a lot that you can do now, with or without hormones. And there are also other medication options we can use if you're like, I don't want to go the hormonal route, I'd rather try something else. So you shouldn't just suffer through it. There are lots of options, lots of things we can do.

The other myth is that perimenopause is a new phenomenon, that it wasn't even a thing until this generation of millennial women started talking about it. When really, it's been documented for hundreds of years. Perimenopause has always existed. And then there's the concept that our ancestors didn't have this, therefore you don't need hormones. I hate to tell you this, but our ancestors died in childbirth a lot. A lot. And they also didn't make it past their fifties. Our life expectancy has been extended. And so with that, we have to pivot and look at how to support women much better.

The other myth is that if you take hormones, you're going to get cancer. That's a big one. There was a study called the Women's Health Initiative. They used much older women than we initiate HRT with these days, and those women already had the onset of certain disease processes. Hormones aren't going to reverse those. But the concept that these hormones cause cancer, we have to really peel that back. As the new research comes out, what we're seeing is that progestin, which you find in hormonal birth control, tends to be the one that is more associated with cancer than the bioidenticals that we use today. Premarin, which comes from the urine of pregnant horses that we extracted estrogen from, is also not great. But using your own biological hormones doesn't show the same risk as we saw with the synthetic hormones that we were using.

I just released a podcast episode, and I have several, where we talk about estrogen and breast cancer. The latest one is with Dr. Felice Gersh, and it's great because she talks in so much detail about how estradiol, the form that we use in hormone replacement therapy, actually helps glue the cells together so that you don't get metastasis, which is what kills us in breast cancer. I know there are going to be people commenting, yes, it does cause cancer, and you're going to kill people, because this myth has been so perpetuated by the media. But medicine got it wrong, and science got it wrong, to make that blanket statement. And I want women to understand that smoking, drinking alcohol and binge eating ultra-processed food are higher risk factors for breast cancer than using a very small dose of estrogen hormone replacement therapy with progesterone. They've got to be balanced out. And that's when it's done right, because when it's done right, we're using the lowest dose to support your body. We are not trying to get your period back or get your levels back to what they were when you were still menstruating.

Nikkiey: Today I am really excited, because I am joined by a powerhouse entrepreneur, a certified health coach and a wellness advocate with over two decades of experience building and scaling successful businesses. She is the founder of... and I'm going to say it, Alexandrea, right? Is that how you pronounce it?

Alexandrea: Yeah.

Nikkiey: The most beautiful name I've ever heard, by the way, the combination of the two. She is the founder of Alexandrea Simple Pursuit, a wellness brand that focuses on simplifying holistic health. And she's also the creator of the Pursuit of Health documentary series, where she explores the intersection of nutrition, movement, mindfulness and overall wellbeing. As we were chatting beforehand, she noted that we have a lot of similarities when it comes to the fitness space and a lot of viewpoints that align. So I'm really excited for her to be here, to share her story and to be on the show. Alexandrea, welcome.

Alexandrea: Thank you so much for having me, Nikkiey. It's a pleasure to be here.

Nikkiey: Let's dive into it. You've built your career around holistic health and self-care. What inspired you to take this path?

Alexandrea: Well, it's a little longer of an answer than...

Nikkiey: Go for it. That's why I love podcasting.

Alexandrea: Sure. I've always been curious about health since I was a child. Before I decided to become a business major, I was a bio major, because I thought I wanted to be a doctor. My father was a doctor, and he urged me not to go into medicine, because he knew that my goal with it was to help people be healthy. And he said, well, don't be a doctor. It has nothing to do with health.

Nikkiey: Wow.

Alexandrea: Yeah. So I had a different perspective on the healthcare world from a really young age. Instead of following that path, I ended up being a business major and going the route of being in business. I was in commercial real estate out of college. Then I worked for two high-powered CEOs in New York for a long time, who taught me quite a bit. Then I opened my own hospitality company and scaled that, and at one point I had six locations of hospitality concepts between two different states and over 50 employees. During that time, I was trying to take care of myself, but I was also raising two young girls, who are now seven and 11, and hustling. I got married. So a lot of the things I knew about health, I just couldn't focus on as much as I wanted to.

Then, fast forward to a couple of years ago, when I couldn't ignore my body anymore. Some of the issues I'd had with my gut that I really couldn't figure out for so long finally came to a head. I was diagnosed with ulcerative colitis. I knew something was wrong; we could just never figure it out. And at that point, I decided it was really time to focus 100% on this lifelong dream, which was to be in the health and wellness space, to heal myself, and through that process, hopefully help others.

Nikkiey: I want to pivot to something a lot of people think about: self-care. They think about it in terms of taking days off or booking spa treatments, but on your social media, in the things you talk about and what you stand behind, you take it way deeper than that. How do you define self-care in a way that supports long-term health?

Alexandrea: Like most things, for whatever reason, my personality likes to learn the hard way. My body had been telling me to slow down for a really long time, and I didn't listen because of my determination. You used this word discipline. I am a very disciplined person, type A, very goal oriented. So I didn't want to slow down, because to me that meant I was not achieving as much as I could.

Nikkiey: Right.

Alexandrea: But it turns out that, first of all, when I came out of the hospital, I didn't have a choice. I had to slow down, and I had to completely shift a lot of the habits I had every day. So what does that look like for me? I used to think workouts had to be five days a week, super hard in the gym, HIIT, hours a day.

Nikkiey: Yeah. All of that.

Alexandrea: Well, I couldn't even do that. All I could do was walk. And I think you talk about walking in one of your quick episodes. Walking is super powerful. To me, walking in and of itself is self-care. It's a habit that you can have now and for the rest of your life. It's good for your brain. It's good for your metabolic rate, everything.

So part of what I do every day is, I've had to learn to slow down, literally slow down the pace of my life, and grow patience around that. And then also be mindful of everything I'm thinking and doing. Am I shoving food down my throat quickly, or am I eating slowly and mindfully? Am I paying attention to how my body responds after I eat certain things? It really is a mindfulness practice every single day. I find that sometimes I'll slip, just like any human, and I have to bring it back. And every time I do, I find myself growing the foundation that I need to feel good every day.

People like to throw out blanket terms, like mindfulness and mindful eating and all of that. And really, all that means at the end of the day is paying attention: to what you're eating, how you're moving, how you feel. That's all it means. A lot of us, myself included for 42 years of my life, are like, oh, I'll deal with that later. I'm just going to go, go, go and push, push, push. That was always what I did before. I physically can't do that now. But what I will say is that I have never felt stronger. I've never felt healthier overall, in my physical body and my mental stability. All of these things have shifted because I had to slow down. And to me, slowing down is self-care in and of itself.

It doesn't mean rushing to a spa appointment so you can get there, relax for an hour and then rush home. People ask me a lot, well, what do you do? What's your practice? Do you meditate 10 minutes a day? And I'm like, meditation is great, and all that's great. But honestly, if you just take the viewpoint of slowing down through your whole day, taking one thing at a time and paying more attention to your body, it becomes a layer and a habit, and you don't have to stop one thing to do another. Everything can be a form of self-care in a way.

Nikkiey: That's so powerful, that whole statement, because it's the flip of how people think they need to operate in society, where they need to go, go, go. The minute they wake up, they're stressed out because they have to get to work or they're late, and then it trickles into the rest of their day. The way I'm hearing what you're saying is, be more in flow, move with more ease through your day. That's a pillar of self-care, and then walking and food and all these other aspects can layer into how you show up with a little bit more flow instead of rushing around.

I want to bring up something you posted on your Instagram that I loved. It was a graphic, and it connects to what you were saying earlier about paying attention, being more mindful and more in tune after you were diagnosed and you were eating. You mentioned in the graphic that food is information. Can you unpack that? What does that mean to you, and how does it correlate with your journey of listening and being more attuned to what you're eating on a daily basis?

Alexandrea: I think we're all trained to look at food in a certain way. We look at it as fuel and calories, or fat and protein and carbohydrates. And all of that is true, but there's more to it. When I'm eating something, I think about the texture of the food and the fiber in the food. What nourishing aspects does this food have for me? Is this a calming food? Is this an energetic food? I actually had to really pay attention to that because of my digestive issues.

For instance, if I'm feeling sluggish and I'm also feeling like my digestive tract needs a break, what information do I need to give it? I need to give it something that's a little easier to digest, a little more gentle on the gut. So a lot of times I'll steam veggies and keep it really simple. Literally steamed carrots with some olive oil on top, or a soup, because I know that the information I need to give my body isn't just about fats and carbohydrates and all those things. I need to give it something that's soothing. It's the same if I feel like I could use a little more flushing in my body; I'll do more juices or things of that nature. Is it a cooling thing? Is it a warming thing? Do I want to be comforted? Do I want energy? If you really get curious about food, all of those things are really fun.

Without being neurotic about it, because I think we like to become too neurotic. Most anyone listening to this podcast, I'm sure, knows we have an issue with pesticides and things that are in even whole foods. We know that. But we can't hyper-focus on all of those things either. You have to trust that you're giving your body enough of what it needs to be able to process those toxins, and that you're moving your body, you're sweating, you're doing other things. And then you can really find joy in a different way of looking at food, as a form of self-care and nourishment. I think we get scared of food. Food is really interesting, it's what we need to survive and it's beautiful, but it can cause a lot of stress.

Nikkiey: Yeah. And I'm sure you've heard this from the people you've worked with, too, but so many women don't eat enough. It's the epidemic of the wellness space. They go throughout the day, and by the end of the day maybe they've had a thousand calories, but they don't know what they don't know. I always hear that from our babes. It's like, well, I grew up this way and I saw my mom eat this way, and I just thought I had to eat less in order to lose weight. And then when they get into our ecosystem, and I'm sure you also do this with your clients, we give them more food and they start getting the results they want. They feel more energized. And it's also teaching them the mindfulness you're talking about, which makes them more aware of how food positively impacts all these different pillars of their life.

Alexandrea: A hundred percent.

Nikkiey: How do you help your people see that self-care is so essential and shift their mindset?

Alexandrea: Well, first of all, I want to know what their morning looks like. I'm not going to tell somebody to completely change everything at once, or to wake up an hour earlier if they're already exhausted. What I will say is, okay, if you're getting up and immediately drinking coffee, I'm going to suggest swapping that for hot water and lemon. I'm going to ask you to take one minute to just breathe. I'm going to ask you to take two minutes to stretch. Little things. And what happens is, if you get positive feedback from that, instead of it feeling like just another task, just another chore, it starts to become integrated. Like anything else you do, a habit is first discipline and then integration. And then it doesn't feel like anything other than your normal day, how you normally move through the day.

I think integration is key. That's why diets are really hard, or crazy cleanses. That's not lasting. It can't be integrated throughout your life. So all these habits have to start as micro habits that become second nature. You can't do it all at once. It's one step at a time. I think our challenge here is that we're so programmed to think, now it's time to relax, now it's time to meditate, now it's time to... right? But in other cultures, it's very integrated. My brother lives in Spain. They walk a lot. The market's right there, so they get fresh food on their way home, and it's small amounts because they're walking. They take a long lunch. These are things that are integrated. The challenge for us is real. The challenge is to figure out how to take the world we live in and the days we have to face and make them feel more integrated with these practices, which may feel counterintuitive at first. That's the challenge. And I have to teach myself this over and over with certain things. Other things are now so integrated that I feel weird not doing them.

Nikkiey: I love those points. If you want something different, or you want to experience something different, you have to change what you're doing in order to get new results. And the way you're going to do that is by integrating new habits into your day-to-day. And I know we align on starting small, even just the minute of breathing and the two minutes of stretching. That'll give you some good ROI in your feedback on how you're feeling.

Alexandrea: Yeah. And then from there, you want to do it more, and it just becomes a part of your day-to-day. If you do that for four weeks, then the next day you're like, oh, I need to do this. It just starts to click.

Nikkiey: Yeah.

Alexandrea: You want the positive feedback, and you want the joy, and you want to feel good.

Nikkiey: Yeah. That's what we're all trying to do. Your approach to wellness is very refreshing. It's a reminder that it's not just about how we eat or how we move. It's also about how we listen to our bodies, how we live on a daily basis and how we can create balance in our lives. So thank you. And anybody who's listened to this, just remember that small, consistent habits on a daily basis can make the biggest impact on your whole life. Even just the minute of breathing when you wake up and the two minutes of stretching, and then see all that positive feedback. Alexandrea, thank you so much for being here. I appreciate you and your time.

Alexandrea: Oh, thank you so much for having me. This has been really fun.

Nikkiey: Real quick. If this episode resonated with you or gave you the push that you needed, I'd love for you to pay it forward. Drop a quick rating and review, share the podcast with someone who might need it and help me keep spreading the word. Your feedback not only helps the show grow, but it might just be the nudge someone else needs to kickstart their transformation. Thank you so, so, so much for your support.