Conquer THIS To Completely Transform Your Lifestyle, Self-Talk & Heal Trauma | Insights with Dr. Stephanie Estima

I joined Cynthia Thurlow, NP, to answer your most pressing questions about female hormones, sleep, fertility, contraception, detoxification, autoimmunity and strength training. Below I’ve pulled together the practical, science-forward insights we discussed—written in my voice so you can take action right away.

Quick roadmap

• Breastfeeding and sleep: realistic expectations and practical fixes

• Preconception testing and fertility awareness basics

• Contraceptive options and the importance of informed consent

• Detox strategies for dense/fibrocystic breasts

• Autoimmunity and exercise: stimulate, don’t annihilate

• Nutrition, pre-workout choices, and phase-specific guidance

• Top supplements for midlife women

• Hormesis (cold, heat, sauna) and how to use it safely

Breastfeeding, sleep, and hormones: how to navigate the chaos

If you're breastfeeding and still waking at night (20 months is still young!), know two things: it’s common for menstrual cycles to be delayed while breastfeeding, and uninterrupted overnight sleep might not be realistic right now. That doesn’t mean you’re broken—your body is wired to prioritize your baby.

Practical strategies:

• Adopt a biphasic sleep model: when baby naps, try to sleep too. Use that mid-day nap to recover lost overnight sleep.

• Avoid long late-afternoon naps (post 4:00 PM) that disrupt bedtime; shift late drowsiness toward an earlier bedtime if needed.

• Evaluate why the baby wakes: hunger, developmental regression, habit or self-soothing? Small adjustments pre-bedtime can help.

• Give yourself grace: breastfeeding-mediated amenorrhea can last months to years; lack of menses doesn't automatically mean infertility.

Emotional perspective: lean into the relationship-building aspects of this time. Sleep and hormones will normalize when you and your child naturally transition away from night feeds.

Preconception: low-tech first, then targeted testing

If you’re trying to conceive, start with observation before ordering every lab. Learn your cycle—track basal body temperature (BBT), cervical mucus, and if comfortable, cervical position. That baseline will tell you a lot.

Fertility awareness method (FAM) essentials

• Cervical mucus: as estrogen rises in the follicular phase you’ll see increased wetness. Approaching ovulation it becomes clear, stretchy and “egg-white” in consistency—the last day of that quality is the most fertile.

• Basil body temperature: expect a small temperature rise (≈0.5°F) after ovulation; tracking this daily helps confirm ovulation.

• Cervical position: around ovulation the cervix softens and opens slightly; in infertile phases it is firmer and closed.

If you’ve been trying longer than 6–12 months, get both partners evaluated. Women: check AMH, FSH and sex hormones. Men: semen analysis for count, motility and morphology matters—sperm decline is a documented public-health concern.

Emotionally: enjoy the process. Stress can be counterproductive—connect with your partner and celebrate the journey.

Contraception: choose based on life stage, informed consent is essential

No single contraceptive fits everyone. My starting recommendation for younger women who prefer fewer side effects is FAM—when used well it’s an effective option and reconnects you to your cycle. If you prefer “set-and-forget,” IUDs (hormonal or copper) or long-acting methods are reasonable—but each has tradeoffs.

• FAM: non-hormonal, educates you about your cycle, requires diligence and comfort with mucus/temperature tracking.

• Oral contraceptives: effective for many but can disrupt the hypothalamic–pituitary–ovarian axis; long-term use may delay the return of normal cycles in some women.

• IUDs: hormonal IUDs can be life-changing for some and problematic for others; copper IUDs are hormone-free but may increase cramping/bleeding for some people. Insertion discomfort can be minimized—ask for pain control options.

Bottom line: demand informed consent. Ask your clinician to review risks, benefits and expected timeline for return to fertility when you stop a method.

Detoxification and fibrocystic (dense) breast tissue

Dense or fibrocystic breasts commonly reflect estrogen-dominant pathways and/or impaired estrogen metabolism. The liver is a central organ for hormone metabolism—supporting liver detox pathways and bowel elimination is key.

• Eat cruciferous and leafy greens daily (broccoli, Brussels sprouts, kale, arugula): they provide sulfur-containing phytochemicals (DIM and sulforaphane) that promote safer estrogen metabolism.

• Ensure daily bowel movements: adequate fiber + water softens stool and shortens transit time so estrogen metabolites are excreted rather than reabsorbed.

• Consider targeted testing (e.g., DUTCH dried urine hormone panel) if symptoms persist—this reveals estrogen metabolite patterns and phase I/II detox balance.

• Supplements that may help (work with your clinician): DIM to shift estrogen pathways, calcium-D-glucarate for phase II clearance; consider methylation support if genetically needed.

Screening note: mammogram frequency should be individualized. Newer ultrasonic imaging options are emerging; discuss best screening strategies with a specialist if you have dense breasts or frequent cystic changes.

Autoimmunity, fibromyalgia and exercise: the “stimulate, don’t annihilate” principle

If you have an autoimmune condition (Hashimoto’s, lupus, MS, etc.) or fibromyalgia, your nervous and immune systems are often sensitized. That means training needs to be carefully dosed.

• Intensity guideline: aim for an RPE (rate of perceived exertion) around 5–6/10—enough to stimulate muscle adaptation, but not so hard that you’re wiped out for days.

• Frequency and format: favor full-body, moderate sessions with adequate recovery days rather than constant high-volume single-muscle annihilation.

• Recovery is critical: prioritize sleep, controlled stress, cold/heat protocols as tolerated, and nutrition. If antibodies or symptoms flare after training, back off.

• Know your personal tell: if you consistently need a nap after a workout, that’s a cue to reduce intensity or increase recovery.

Autoimmunity often has a trauma or chronic stress component—addressing nervous system regulation (therapy, vagal-tone practices, restorative recovery) is as important as the gym plan.

Phase-aware training and nutrition

Your menstrual cycle affects appetite, recovery and performance. Track it, and align training and nutrition:

• Luteal phase (after ovulation): metabolism rises and hunger increases. Increase calories modestly (about +10% as a starting point), emphasize protein plus some extra carbs to support recovery.

• Avoid long fasts during the luteal week—shortened overnight fasts (12 hours) are fine, but heavy 16–20 hour fasts can impair performance and mood in this phase.

• Pre-workout: coffee is a simple, effective stimulant for many. If lifting, a small mixed meal (protein + complex carbs, e.g., protein + oatmeal) 45–60 minutes prior may improve strength performance vs. fasted training. For cardio, many prefer fasted sessions if tolerated.

Evidence-backed supplements for midlife women

My practical, minimalist supplement list for muscle, brain and sleep:

• Whey protein: helps hit protein targets and supports muscle preservation and growth.

• Creatine monohydrate: 5 g/day supports muscle, cognition and metabolic resilience.

• Omega-3 fatty acids: 1–3 g/day total omega-3s with at least ~1 g DHA for brain health and inflammation control.

• Vitamin D: a baseline of ~4,000 IU/day is reasonable for many (adjust by labs and sun exposure).

• Magnesium: glycinate (for calm) and L‑threonate (for cognition/sleep) are useful; baseline ~400 mg/day, increase modestly in luteal phase if needed (watch stool tolerance).

Work with your clinician on doses and testing (25-OH vitamin D, omega-3 index if available) and minimize pill overload—choose what meets your specific needs.

Hormesis: how to use cold, heat and intermittent stressors safely

Hormetic stressors like cold plunges, saunas, and short fasts can provide big benefits—but dose them smartly, especially in midlife or with autoimmunity.

• General rules: stimulate, don’t annihilate. Short, repeated exposures are preferable to long extremes.

• Order matters: if you plan intense resistance training and cold exposure, avoid plunging immediately after training—cold within ~4 hours post-resistance can blunt muscle protein synthesis. If you want both, do cold first or allow a buffer after training.

• Timing: cold in the morning can be stimulating and support resilience; heat (sauna) in the evening can help with sleep due to the post-sauna core-temperature drop.

• Build tolerance progressively: start with tolerable durations/temperatures and work up over weeks. You’re training a physiological tolerance like any other skill.

Practical takeaways: a checklist to bring with you

1. If breastfeeding, accept biphasic sleep and nap when the baby naps. Expect delayed return of menses while lactating.

2. Track cycles: cervical mucus, BBT, and optional cervical checks to understand ovulation before jumping to advanced testing.

3. Evaluate both partners for fertility if conception takes longer than expected (AMH/FSH for her; semen analysis for him).

4. Choose contraception intentionally: weigh FAM, hormonal methods, and IUDs against your goals and understand likely timelines for return of cycles.

5. Support liver detox and estrogen metabolism with cruciferous greens, fiber, hydration and daily bowel regularity; consider targeted testing if breast changes persist.

6. With autoimmunity, favor moderate-intensity full-body training (RPE 5–6/10) and prioritize recovery—sleep, stress reduction and pacing matter more than maximal workouts.

7. Eat a bit more in the luteal phase, especially protein and some extra carbs; avoid prolonged fasting in the week before menses.

8. Use targeted supplements (protein, creatine, omega-3, vitamin D, magnesium) in line with testing and symptoms.

9. Apply hormesis progressively: short cold exposure in the morning, sauna in the evening, and avoid extreme or prolonged exposures that outpace recovery.

For more information, watch this youtube video:

Resources and next steps:

For deeper dives on cycle-aware training, sleep, hormones and lifestyle, look for the Better with Dr. Stephanie podcast and my book The Betty Body (focus: cyclical living and aligning training/nutrition with the menstrual cycle). Cynthia Thurlow’s show is an excellent place to hear the full conversation and additional listener Q&A.