1 hr 6 minHow to Navigate Menopause: Protein, Carbs, HRT and Lifting
With Esther Blum
Guest on the show
Esther Blum
Esther Blum is an integrative dietitian and holistic nutritionist with almost three decades in practice, and the author of See You Later, Ovulator, Cave Women Don't Get Fat and Eat, Drink, and Be Gorgeous.
Episodes with Esther Blum
1 hr 6 minWhat Esther talks about
Ep. 130: How to Navigate Menopause: Protein, Carbs, HRT and Lifting
If your body stopped responding to what used to work somewhere in your 40s, this conversation explains why. Integrative dietitian Esther Blum joins Nikkiey Stott to walk through what changes in perimenopause and menopause, and why, in her words, you can no longer write checks your body cannot cash. Her starting point is food: at least 100 grams of protein a day (working toward 120 to 150), 30 to 40 grams per meal, more protein than net carbs, and whole-food carbs at dinner to help calm nighttime cortisol and protect sleep.
From there, Esther covers the perimenopause symptoms most women never hear about, from second-half-of-cycle insomnia and meno rage to heavy periods and a shift from pear to apple shape. She explains why alcohol hits harder now, shares her view on hormone replacement therapy and the Women's Health Initiative study, and lays out the blood, DUTCH and GI-MAP testing she runs before anyone in her practice starts hormones. These are her clinical views, so take them to a hormone-literate provider.
The episode closes on the basics: daily walking, including 10 minutes after meals, strength training at least twice a week with progressive resistance, an honest look at intermittent fasting, and advocating for yourself at the doctor's office. Nothing here is complicated. It is the foundations, done consistently.
- Esther starts women at a minimum of 100 grams of protein a day and works toward 120 to 150 grams, since most come to her eating only 60 to 70 grams.
- Aim for 30 to 40 grams of protein at each meal, roughly four to five ounces, which Esther calls the minimum threshold for enough leucine to support muscle growth.
- Flip your ratios so protein outweighs net carbs, for example 120 grams of protein to 100 grams of net carbs.
- Eat whole-food carbs like sweet potatoes, rice or potatoes at dinner, paired with protein and fiber, which Esther says helps counter nighttime cortisol and improve sleep.
- If you lift first thing in the morning and can't eat much, have half a protein smoothie, half your breakfast, or a couple spoons of honey with salt.
In Esther's words
Questions Esther helps answer
Ask Nikkiey →
Menopause & Perimenopause Weight Loss
What are the first signs of perimenopause?
According to guests on The WarriorBabe Show, the first signs usually aren't hot flashes or missed periods. Dr. Jolene Brighten says falling progesterone shows up first as worsening PMS, irritability, breast tenderness and waking at night before your period, sometimes from 35. Hatty McCafferty adds sleep disruption, skin changes, digestive shifts and fatigue.
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Menopause & Perimenopause Weight Loss
How much protein do women in menopause need?
Nikkiey's recommendation is about one gram of protein per pound of body weight, so a 150-pound woman aims for roughly 150 grams a day, and that target stays the same through menopause. Guests on The WarriorBabe Show land in a similar range, and several say most women are eating far too little.
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Menopause & Perimenopause Weight Loss
Should I do intermittent fasting during menopause?
Maybe, but it's individual. On Ep. 130, dietitian Esther Blum says menopausal women in her practice tolerate fasting best, though it may not suit women with hypothyroidism, cortisol or adrenal issues, chronic illness, or disordered eating history. On Ep. 117, Dr. Stephen Cabral warns fasting can become one more stressor on hormones. If you try it, start with 12 hours.
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Strength Training for Women
How often should women in menopause lift weights?
Two to four sessions a week, depending on who you ask on The WarriorBabe Show. Esther Blum and Dr. Stacy Sims put the minimum at two full-body sessions, with three to build more muscle and bone. Nikkiey suggests about four, or three, up to an hour each. Everyone agrees: not every day, because recovery builds muscle.
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Women's Health & Aging
What should I do if my doctor dismisses my symptoms?
Don't accept "it's just aging" or "it's stress" without data. Nikkiey says to push back politely and firmly, arrive with a weekly symptom log and a list of questions and tests, and remember you can get a second opinion or change doctors if yours won't engage.
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Common questions
How much protein do women in menopause need?
Esther aims for 120 to 150 grams of protein a day, starting with at least 100 grams because higher targets feel intimidating at first. She recommends 30 to 40 grams per meal, roughly four to five ounces of protein.
Should I eat carbs at night during menopause?
Esther recommends whole-food carbs at dinner, paired with protein and fiber. She explains that a small insulin bump counters the nighttime rise in cortisol many menopausal women experience, raises serotonin and dopamine, and helps with sleep, and her clients still lose weight this way.
What are the signs of perimenopause?
Esther lists a second half of the cycle that feels radically different, insomnia, hot flashes, vaginal dryness, extreme irritability or sadness, sore breasts, very heavy clotting periods, joint aches, brain fog, a shift from pear to apple shape, and intolerance to HIIT or long cardio. She notes perimenopause can begin 10 to 15 years before menopause.
Should I do intermittent fasting in menopause?
Esther says it is individual: in her practice, menopausal women tolerate fasting best, but it may not suit women with hypothyroidism, cortisol or adrenal issues, chronic illness, or a history of disordered eating. If you try it, she suggests starting with a 12-hour window and stopping if you feel fatigued, irritable or shaky.
How often should women in menopause lift weights?
Esther says a minimum of twice a week will still get results, with more recovery time between sessions. She notes you can do three or more sessions if you feel great, but the science shows little clinical difference between two and three days a week.
How do I find a doctor who understands hormone therapy?
Esther suggests calling a compounding pharmacy in your state or zip code and asking which hormone-literate doctors run prescriptions through them, or searching ifm.org, the Institute for Functional Medicine. She recommends confirming the office prescribes bioidentical hormones.