291. Understanding Perimenopause: What Every Woman Should Know with Becca Chilczenkowski

Feeling off but can't pinpoint why? It might be perimenopause.

In this episode, we sit down with hormone specialist and functional practitioner Becca Chilczenkowski to unpack the misunderstood world of perimenopause. If you're a woman in your late 30s or 40s struggling with weight gain, bloating, fatigue, or mood swings—and not getting real answers from your doctor—this conversation is for you.

We explore the hidden hormonal shifts behind these symptoms, the cost of ignoring them, and the foundational lifestyle changes that actually move the needle. From exercise and nutrition to stress and hormone replacement therapy, Becca shares what she wishes she knew sooner—and how you can avoid the years of confusion and discomfort she endured.

Don’t settle for feeling “off.” Tune in to gain clarity, feel empowered, and take back control of your health!

Resources From The Guest

>> Becca’s Website

>> Becca’s Instagram

>> Becca’s Facebook

>> Becca’s YouTube

>> Becca’s TikTok

>> Becca’s Podcast

Resources From This Episode

>> Insulin Resistance Diet Blueprint - https://www.zivli.com/blueprint?el=podcast

>> Free Low Insulin Food Guide - https://www.zivli.com/ultimatefoodguide?el=podcast

>> Join the Zivli Program Waitlist - https://www.zivli.com/join?el=podcast

>> Test Your Insulin at Home - https://www.zivli.com/testing?el=podcast

Have a question? Email us at: support@zivli.com

Transcript

Morgan Nolte, PT, DPT (00:18)
Hey everyone, welcome back to the Reshape Your Health podcast. I'm your host, Dr. Morgan Nolte, and today's conversation is going to be centered around hormonal shifts in perimenopause, which are the years leading up to menopause. So if you're a woman in mid-life, you're definitely going to resonate with this conversation. Our guest today is Becca Chilsenkowski. She's a board certified functional practitioner and hormone specialist. She is the founder and co-owner of FitMom, a leading functional practice helping women heal from chronic health struggles. She is also a wife, mom of two and recovering exercise and stress addict. So when I read that part of her bio, I'm like, we're going to get along just fine.

Her mission is to help women avoid the struggles that she endured for so long, including hormone imbalances, uncontrolled weight gain, constipation, bloating, and never getting answers or a proper diagnosis from doctors. And she wants to create as many informed consumers and healthy, happy midlife women as possible. Becca, I'm really excited to have you on the show. Thanks for joining us.

Becca (01:36)
Thank you so much for having me. I'm excited too.

Morgan Nolte, PT, DPT (01:38)
Yeah, so start just by sharing your own health journey. think it's always interesting to see somebody that you think, wow, she's so healthy, she's so vibrant, and they don't know the backstory behind like what it took to get there. So I'm really excited to hear more details about your personal health struggles and journey to get to where you are today, because I know that it wasn't always just a smooth ride.

Becca (02:02)
Yeah. And the funny thing is, like when I looked probably the healthiest, I wasn't. So I grew up playing sports always, but I was always also kind of the chubby kid. So I was actually a two sport athlete in college. was an all American in college, but I was still looking back on it. Like I was always bigger than all of my friends. You know, I was working out plenty, eating what everyone else was eating. And I looked like the Michelin man kind of. And so.

Either way, fast forward after college, I found CrossFit and it changed my life for the better in a lot of ways. So I also found the Paleo Diet alongside CrossFit, which anyone that is old school OG CrossFit knows like the Paleo Diet and CrossFit went together in the early days. And so it crossed about two years, I lost 55 pounds and I developed just a love for it, for competing. I mean, I was already an athlete going into it and...

I'm a little hard headed. So I was like, I want to be the best at this. And trained, basically quit my corporate job. I was doing actuarial work at Allstate and was like, I can't do this. I want to do nutrition. I want to do, you know, I want to spend all my day at the gym and train two hours a day. And I looked like I was healthy. I was, you know, 9 % body fat. I was super strong.

I was top 100 in the world of CrossFit at my peak in 2016 before I had my injury. We can talk about, but either way, I looked the part, but I was constipated. I was so moody. My poor husband, I would have a bad day and come home and just, I wouldn't talk to him because I would have had a bad workout and it ruined my entire day. I was bloated and gassy. So the protein shakes that I was drinking, I would get so gassy from.

And so even though I lost my period for three years, so even though I looked the part, I was not healthy. And you know, it's a sport, you do things for a sport that probably aren't the healthiest thing. Sports and health don't always necessarily go hand in hand. But either way, in 2016, I was kind of at my peak and I ruptured my Achilles training for the CrossFit Games.

Morgan Nolte, PT, DPT (03:58)
I was just gonna ask that, yeah.

Becca (04:21)
And at that time, my husband and I were thinking, let's start a family. This is kind of like, let's retire the CrossFit shoes. And I didn't have a period, obviously. And so went the round to IVF and luckily had my first, my little boy, Carson on our first try of IVF, which was great. But after that, I wanted to get into CrossFit again. I was like, I want to get my body back to where it was. I want to compete again, maybe.

And trying to do that, my body spiraled very quickly. So I was training a ton. I was eating healthy, know, tracking my macros, all the things. And I remember very vividly in about a two month span, I put on like 20 pounds and I wasn't doing anything different. wasn't, you know, my training was the same. My diet was the same. And it just wouldn't stop. I couldn't stop it. And

Morgan Nolte, PT, DPT (05:09)
Thank

Becca (05:17)
At the same time, I was running a nutrition program in the gym that I managed, doing macros, six-week challenges, know, like anti-inflammatory diet, very basic. And a lot of the people I was helping, but there was this subset of population of women around like their 40s that just weren't responding how I thought they should be responding to calorie deficits. And at first I'm like, they're not following the plan, you know, it's, they're just not doing what I'm asking them to do.

And then it got to the point where it was like consistently the same group of women going through perimenopause, dealing with a lot of stress, probably chronically under eating before they came to me. And I saw myself in that place too. was like chronically under eating, overtraining, very stressed, new mom, running a business. And I couldn't help myself and I couldn't help these women. And it was eating me alive inside. And so that's when I found functional because I was going to doctors.

Morgan Nolte, PT, DPT (05:59)
Thank

Becca (06:13)
All my thyroid markers were normal, believe it or not. All of my hormones looked quote unquote normal, right? There was no diagnosis for me. There was no autoimmune. There was no mold toxicity. There weren't those things. I was a weight loss resistance case. And now that I've spent years trying to figure out weight loss resistance cases and how hormones impact all of this, and we can obviously get into that today, but when you are a female,

Our immune system acts differently than males immune systems because of estrogen. And so when you have big ups and downs of estrogen, like coming on and off birth control, pregnancy and postpartum, perimenopause, our immune cells have a lot of estrogen receptors on them and the immune system can get triggered. And if you have a history of chronically under eating, we know that slows down the metabolism, right?

And so that metabolic slowdown isn't just weight that you can't lose. It's food staying in the system longer, which causes oxidative stress buildup, can cause gut imbalances. Obviously, know blood sugars stay higher, driving up that inflammation. And it's just a slow creep that starts to happen. And then for me, it was the postpartum on top of trying to get back into training. It was just this crossover of too many physical and chemical and emotional stressors that launched my body.

Morgan Nolte, PT, DPT (07:31)
Mm-hmm.

Becca (07:33)
into this rapid weight gain and all of these symptoms. And the thing that I find so fascinating for a lot of these cases, and in my case too, is the extreme weight gain a lot of times isn't body fat, like it's swelling. Exactly.

Morgan Nolte, PT, DPT (07:46)
Right, it's like impossible to much

body fat in that amount of time when you're not eating more food.

Becca (07:52)
Yes, exactly.

You're swelling. basically the immune system's causing this storm internally. And for some people that shows up as autoimmunity, right? Because those T and B cells get overactive. They're creating too many antibodies. And for me, it was so validating to finally figure out like, this is why this happened, you know? And it's something that I think a lot of people don't realize is going on.

And perimenopause is such a trigger for so many women because of those estrogen fluctuations. And most women, unfortunately, don't go into perimenopause completely healthy or completely stress-free. And so they might seem okay. They might be, you know, mostly asymptomatic, but I always say like being asymptomatic does not mean you're healthy. And so that is kind of what landed me to what I do now is I couldn't help myself, you know, for so long and I couldn't help this group of women that

Morgan Nolte, PT, DPT (08:24)
Mm-hmm. There you go. Yep.

Becca (08:46)
wanted so badly to feel better and to finally get their mind back, their physical back, their vitality back. And so I have kind of started to specialize and hone in on understanding better hormones and how they impact the body and how to calm down what kind of turns into this big cycle of immunological flares. And so that's where I'm at now is helping that population and

helping to hopefully provide a lot more informed consumers in the market because that population I think is also very gas lit. They're preyed upon because they are desperate, because they feel like they're not themselves anymore. So yeah, that's my story.

Morgan Nolte, PT, DPT (09:30)
That's awesome. I want to backtrack just a smidge in case people are not familiar with that term perimenopause and the changes that estrogen can go through during this time. Can you just give us kind of a bird's eye overview of what is perimenopause? Like when does it normally start for women? How long does it last? What are the major symptoms? And then kind of as you alluded to, what is estrogen doing this time that's different than before perimenopause?

Becca (09:59)
Yeah, all great questions. So perimenopause is basically the time before the complete loss of your cycle, right? And so technically menopause is one day. It's the one day, one year after you have lost your period, right? You've had a period 12 months later, if you still don't have one, technically you're now in menopause because unfortunately there really aren't any valid tests to diagnose menopause. You can do an FSH and LH, but even then those can fluctuate.

Menopause is technically a day. Perimenopause is what most women struggle during. And that is five to 10 plus years prior to that menopausal date. And that is when hormones start basically slowly going offline. And progesterone goes on kind of this linear decline. It just starts going down and just keeps going down. Testosterone and DHEA also go down kind of linearly, but they don't go down as quickly or as much.

Morgan Nolte, PT, DPT (10:52)
Okay.

Becca (10:59)
as progesterone and estrogen. And estrogen basically goes on this roller coaster. And sometimes you can actually end up the highest estrogen you've ever experienced in your life during perimenopause, which turns into most women being estrogen dominant symptomatically during perimenopause. what I see is this starts as early as 35. And I'm seeing it starting earlier and earlier for most women because of stress, because of...

Morgan Nolte, PT, DPT (11:09)
interesting.

Hmm.

Mm.

Becca (11:25)
what we're exposed to on a day-to-day basis now in our world. And it's just, we as women are so much on our plates. There's always the to-do lists. There's so much societal pressure and all of those things kind of burn through your hormones to an extent for lack of a better term. And again, we'll kind of talk about that a little bit deeper, but the perimenopause timeframe is so hard for women because again, so much can be happening that you have no idea why it's happening or what's going on.

And so the ups and downs of estrogen will cause for lot of women, basically heart palpitations, weird injuries. So I'm sure as a PT, you see frozen shoulder, plantar fasciitis actually is really, both of those are very common in perimenopause timeframe. The shortening of the period is really common or irregular periods. So because progesterone starts going down, you shorten that second half of the cycle. So women go from having a normal 28 to 30 day cycle. Now they're having a period every 24 days or shorter.

Right? Or they'll have 24 days, 38 days, 22 days. And it's just very irregular because of that up and down of estrogen. Their periods sometimes get really bad. So they'll start to have like horrible bleeding, breast tenderness, bloating. I always say like the bees of estrogen dominance or bitchiness, bloating, breast tenderness. It is not people's favorite time.

Morgan Nolte, PT, DPT (12:34)
Mm-hmm.

Yeah

Becca (12:53)
the stress that women go into that phase with just worsens because when you lose your sex hormones, you kind of lose your backup to your stress system. Like you can't handle things that you used to be able to handle. And so a lot of women, you know, I'm doing the same workouts, I'm eating the same diet, I'm so irritable, I can't handle my husband breathing, I yell at my kids more often. And it's you go through the mental emotional piece of it I think is worse than anything because you just feel like you're not

Morgan Nolte, PT, DPT (13:15)
I'm

Becca (13:23)
you and you can't do anything about it is what most people think you can but they don't know who to turn to because their doctors tell them it's normal or they put them on an antidepressant or anti-anxiety medication and they're left feeling like they're the crazy ones and yes yeah

Morgan Nolte, PT, DPT (13:40)
Yeah, like being gaslit a lot.

Another couple of solutions would be a hysterectomy and birth control. So do you see that a lot for women too? Like I know one of my family members was experiencing all of this and decided to get a hysterectomy because her periods were so bad and she's just like, I'm over it. Like I'm just, I'm done. And if you think about it and the way she described it is I'm losing a quarter of my life.

to these terrible periods? And what is that worth to me to get a quarter of my life's happiness back and joy back? And I was like, hate to see people go through surgeries when there might be a more natural option that's not as drastic for their body. But I mean, I think for her it was an okay outcome, but what do you say to people who are considering...

Becca (14:22)
Yeah.

Morgan Nolte, PT, DPT (14:32)
hysterectomy or whose physicians just want to put them on birth control to normalize their cycle again.

Becca (14:37)
Yeah, so I'll start with hysterectomies, a little bit shorter of an answer. So partial hysterectomies, I don't think are the worst scenario for a lot of women. There are some women that you can do natural routes of trying to lower estrogen levels, of trying to support with progesterone and things just in most cases by supporting detoxification, the gut and hormonal balance, you can get things resolved in most cases.

There are some women that deal with adenomyosis or endometriosis or some of these more severe conditions to where I think quality of life is taken from them because of it. And a partial hysterectomy can be a really great solution in those scenarios. Yes. Yep. Yep. I do not love full hysterectomies. ⁓ in really any cases, even in breast cancer cases, I work with a number of breast cancer patients and

Morgan Nolte, PT, DPT (15:21)
which means we're keeping the ovaries, but we're getting rid of the uterus essentially. Yeah.

Becca (15:35)
it is just so harsh on the body and launching you into full menopause. And I struggle to agree with it in unless very rare situations. And so, you know, there's a lot of like preventative care of full hysterectomies for women that have the BRCA gene now. And it's just, again, kind of this gaslighting situation of people worrying so much about breast cancer that they may not even have.

And so they're getting their breasts removed, their ovaries removed, their uterus removed. And I struggle to get behind that. It's a very extreme choice given our options. So partial hysterectomies, I think sometimes can be a good option for people. When it comes to birth control, birth control, I think is the social experiment on females that we don't fully know what the outcome is yet. I think we're starting to see it.

I we're starting to see the rates of infertility. I think we're starting to see the massive increase in mood disorders, autoimmune cases, because what birth control does, there's a couple of things. One, it includes progestin, right? So progestin is a synthetic form of hormone. And when you are on a birth control, your T and B cells actually get heightened. So T cells are immune cells that kind of gobble up infected cells that are infected by viruses or bacteria. And when they do that, they

create inflammation. B cells create antibodies in response to an immune trigger. What happens with high antibodies, right? Autoimmunity. so birth control increases the activity of both of these cells, immune cells, and it decreases the activity of T regulatory cells, which are anti-inflammatory in the immune system. And so, and we've seen this on research, females have higher CRP levels when on birth control. Their body is in an inflamed state.

Morgan Nolte, PT, DPT (17:30)
And

for people who don't know that I coached someone before about her, like all of her blood work was pretty darn good, but her HSCRP, which is a marker of low grade chronic inflammation that Becca's talking about was like 15 and optimal is less than one. And the first thing I went to is are you on birth control? Because that will absolutely increase your level of inflammation in the body. And we know that that's going to make weight loss harder. And she was, you know, far past

Becca (17:55)
Absolutely.

Morgan Nolte, PT, DPT (17:58)
Childbearing aid, she's like, I don't want any more kids. I don't really even know I'm on this. It was something that she'd just been on and hadn't really had anybody second guess that for her.

Becca (18:08)
Yeah, creates a ton of nutrient deficiencies too because it impacts the gut microbiome. It increases, I saw a recent statistic on a paper, it increases hypothyroidism risk by like 280%. And so there...

Morgan Nolte, PT, DPT (18:12)
leh

Hmm. Like clocks

are not uncommon for people on birth control.

Becca (18:25)
Mm-hmm. Yep. Because again, you're taking especially estrogen based birth controls that have at no estradiol in it. And so the other thing that I see is that when you come off of the birth control, a lot of these females are not detoxing properly. They're not, you know, taking in adequate fiber to help bind to hormones as they come off of the birth control. They're in a chronic dieting phase. And so then your body's already stressed from that. And now you add another stressor in. And so it's it's a catch 22. Right.

It's kind of like Russian roulette coming off of a birth control. You really don't know what's going to happen because most women have been on it for a long period of time. And so there aren't many redeeming qualities of birth control. I get it. I was on it, you know, for a period of time. Most women are on it for at least a portion of their life. But I really beg the question for the person utilizing it is, are you willing to take the risk that it may drive a lot more dysfunction?

Morgan Nolte, PT, DPT (19:00)
Yeah.

Becca (19:24)
right? And, you know, in a lot of situations, it makes things worse. And I see it constantly in our practice.

Morgan Nolte, PT, DPT (19:30)
And I think people just from personal experience, it's almost like a part of it. It's like a part of them. And sometimes they forget, oh, I don't have to take this. Like I had, um, like any teenage girls, I was a moody, you know, I was like 14, 15, 16. And actually my high school volleyball coach, um, suggested I go on birth control to help stabilize my mood. Did I need birth control? Absolutely not. I did not need birth control. And I stayed on it until my freshman year.

college when I still didn't did not need birth control. And my breasts were so enlarged. And I'm like, considering a breast reduction surgery. And I was numb, like emotionally, I felt numb. I felt like I was staying in a relationship that was kind of like blah. But I was like, well, not a big deal. And I just I wanted to like, feel my emotions again. You know, I'm like, I don't care if I'm mad, sad, happy, I just don't want to be numb anymore.

Becca (20:25)
Yeah.

Morgan Nolte, PT, DPT (20:30)
And so that was my experience with birth control was it really numbed me out emotionally. then secondly, it really enlarged my breasts to the point where I was considering a breast reduction surgery. I'm like, why am I taking this? I don't need to be taking this. Stopped it. My, lost like five or 10 pounds right away. Like you said, from the swelling, my emotions, you know, kind of came back to me and it was great. like, why did, why was I on this for so long? What the heck was I doing? But you know, you just don't think about it sometimes. So I think.

conversations like this are helpful to just get the juices flowing. Like, do I need to be on this birth control? Is there a more natural option for me? So yeah, it's important. Okay, those are all really good things. I wanted to talk about some triggers for perimenopausal symptoms, because you said that a lot of women, first off, you're seeing perimenopause start earlier. I think part of that is the metabolic dysfunction that we have.

Becca (21:09)
Yeah, absolutely.

Morgan Nolte, PT, DPT (21:27)
running rampant in our country. know like 80 % of adults have some degree of insulin resistance, which is a form of metabolic stress. Weight is a huge issue for people. I was thinking like alcohol might be a huge trigger for some perimenopause symptoms, but what can we do to kind of reduce or mitigate or like gently ease into midlife versus kind of feeling like we're on a

like a bronco that's just kind of like, we're just along for the ride, know, and husband, know, cross your fingers and say a prayer that you're going to get a nice version of us today.

Becca (22:00)
Thanks.

The highest rate of divorce is during peri-menopause. And it's again, because women just completely feel like they go crazy. So great question. Couple things. This is where I kind of talk a little bit about the hormonal hierarchy and sex hormones are important and they can make you feel all kinds of ways, but they are, they're bottom of the totem pole when it comes to what you want to change or influence. You have to look upstream and the very top you will

fully agree with me is insulin. So as you go into perimenopause, the one thing that I explained to lot of women is that you may not be changing in terms of your habits or your routines, but your body is physiologically changing. And so you need to in turn change your habits and your routines. You cannot live your life the same way that you have lived when you were 22 years old and you could drink a gallon of gasoline and get three hours of sleep and be fine. Like you just, can't. And so

Morgan Nolte, PT, DPT (22:37)
Mm-hmm.

Yes.

Becca (23:03)
I think it's kind of this softening and rebirth that happens at that time. And things that I look at, one, our type of exercise, because a lot of women in this age range are doing the F45, the HIIT classes, the CrossFit, the Orange Theories, and they are systemically stressful. And so you are running your body into the ground. A lot of them are doing it five to six days a week without rest. And we know exercise is an inflammatory trigger.

It's a good trigger if your body can adapt to that stress, but in most cases, you're not giving it enough time to adapt to the stress. So you are just chronically inflamed from it. And so I look to switch that to more walking and more strength training, like get into a bodybuilding gym with some machines, hire a trainer, find someone because then you are more so isolating stress to the muscle group versus the systemic stress that hit classes and all of those.

running, like all of those things are very stressful on the body. And so if you have all these other stressors going on, exercise is the easiest one you can manipulate in my opinion. Food, right? So a lot of women, fun fact, starting around the age of 13, on average, females diet twice a year until they're about 60 years old. Yeah.

Morgan Nolte, PT, DPT (24:06)
Mm-hmm.

That's miserable.

Becca (24:20)
And I think personally that by the time you're 30 or 35, most women are no longer dieting and coming out of it. They're just chronically under eating and they're inconsistently eating. And so they'll skip meals. They'll, you know, say they're fasting, but they just like binge at night. And so they're not nourished. And in turn, they're ending up with gut issues, bloating, liver burden, all of these things going on, not detoxing hormones, because they're not getting enough fiber, antioxidants and all the nourishing foods that the body needs.

Morgan Nolte, PT, DPT (24:28)
Yeah.

Becca (24:50)
And as we know, with all of the cortisol raging through their body because they're super stressed at that time, insulin's going kind of up. And now your body's blood sugar is not staying as regulated. The cells are inflamed. They're kind of closing off. They're like, hey, I can't handle all this. I'm not taking in nutrients. I'm not taking in blood sugar. And now you're chronically inflamed. And so a lot of women, I try to go more towards the not straight keto right away, but like, let's spend some time eating really good sources of fats.

Morgan Nolte, PT, DPT (24:56)
Mm-hmm.

Becca (25:20)
some high fiber carbs, know, fruits, vegetables, maybe some potatoes here or there, and then adequate protein. And that nourishes the adrenals. We know fats are necessary for adrenal function, for hormone production, and for cellular health. They're filling. They don't spike insulin as much. And so I have a lot of women try and adjust their diet a little bit and eat adequately, but change the proportions of carbs, proteins, and fats at that time, just because most women start to become more insulin resistant during perimenopause.

Morgan Nolte, PT, DPT (25:34)
Mm-hmm.

Mm-hmm.

Becca (25:50)
And then I look to kind of the other stressors that we can control, right? You're staying hydrated. Are you getting good sleep or time in bed? If you're not getting good sleep, okay, that's another, you we can talk about options for that. But like, are you at least making sure you're in bed for about seven and a half to eight hours? Are you emotionally and mentally in a good spot? Do we need to consider, you know, talk therapy or?

more gratitude and meditation and walking in nature and all of the things that help fill more of the parasympathetic because the parasympathetic side is where your sex drive happens and anabolic things happen like muscle growth and the repair of the body happens. And most people, if you look at their, you know, I say like their coin bucket, they have all of their coins in the sympathetic. They have all of their coins in the stress state. And so yes, you're going to be catabolic. You're going to break down muscle. You're going to build more fat.

You're gonna have zero sex drive. You're gonna have zero motivation. And you're gonna feel like your hair's on fire when it's probably falling out. And so there's all of these things, but you have to start with the foundations because again, if you don't have healthy blood sugars, it doesn't matter what hormone balancing hacks you do. Like you can throw progesterone at a body that's insulin resistant. It's gonna make it worse. You're not gonna see improvement. And so I love HRT. I love improving sex hormones, but...

you have to look at the hierarchy of what's more important and what's upstream affecting downstream. Because if you put HRT into a body that's inflamed, that's not metabolically healthy, you're going to either not even get the benefit from it because your cells are going to be so insensitive to it, or it's going to make things worse.

Morgan Nolte, PT, DPT (27:25)
Yeah, I love all of that description. I took some notes here. was just kind of curious. So if you're kind of discovering all of this at your CrossFit gym and then you're like telling women not to do CrossFit anymore, do they get mad at you? Yeah.

Becca (27:40)
of figured it out after the fact. Luckily COVID

was probably one of the best things that happened to me with CrossFit because I was in an employer-employee relationship that was not healthy. There was a lot of verbal abuse going on from my boss and he was a very hard person to work for and he's since changed and all that.

COVID allowed me to leave the gym completely because I was also waking up at 4 a.m. to coach 515 classes. would like, I don't care. mean, unless you're going to bed at eight, even then it's not natural for your body to get up at that time. So I was so stressed, so many different ways. And when COVID hit, I went all online with our now our functional practice. And it was probably the best thing that ever.

Morgan Nolte, PT, DPT (28:10)
Mm-hmm.

Becca (28:33)
could have happened. And so I had to leave CrossFit. I've tried to go back to it a few times and every time I do, it's like an abusive relationship for me. just, get super inflamed right away. I, you know, I cannot do CrossFit for fun. I can only do it competitively. So now I just don't do it because so yeah.

Morgan Nolte, PT, DPT (28:47)
Yeah, just mentally.

I was wondering too, like I've really enjoyed longer distance running in my life. Like I've done several half marathons. I don't really care to do a full, but this last time I tried, obviously it's harder after children and aging and I like, we live in a hundred year old farmhouse. So my training was going very well. And then I decided to rip up the carpet on the main floors and completely refinish the floors, which took like three months and all of my training time.

So I went into this race totally untrained, but I was kind of curious, like, is it possible for me to get back into distance running down the road in a way that doesn't totally stress my body out? And if so, what would you suggest?

Becca (29:28)
Yeah, it's a great question. So this is where I kind of talk a little bit about this triangle hierarchy. And the three tips of the triangle, you have performance at one tip, you have longevity at one tip, and you have body composition at one tip. You cannot have all three. And so you can't even have two at the same time. And you can have some of each, but when you are training for something like a race or a cross-dict competition or whatever it might be, you're gonna give up a little bit.

the longevity health piece and a little bit of the body composition piece, because again, your goal is performance, right? And when we go for performance, we have to feed up to fuel performance, right? We realize that the performance is probably more stress than the body maybe would prefer to have, right?

Morgan Nolte, PT, DPT (30:12)
Yeah, it's not really

normal to just go out and run 13 miles or to even train for that. Like your body's like, what are you doing? Why are we doing this?

Becca (30:17)
Yeah. Yes, exactly.

And as a female, unfortunately, mean, in males too, and whenever I have runners, because we work with some runners, almost all of them have digestive issues. Because when you spend that long running, if you think about that versus lifting, right, you go and lift for a set for 45 to 60 seconds, then you take a rest, right? 30 seconds, take a rest. When you're running, it's constant.

Morgan Nolte, PT, DPT (30:30)
Interesting.

Mm-hmm. Yeah.

Becca (30:43)
And that is a constant blood flow away from the digestive system and more of the vital organs and to your extremities to keep your body moving. And so we see a lot more stress on the digestive system and inflammation around the digestive system. And so what I typically recommend is if you can try to keep to like two-ish days, maybe like one longer day and one interval day, and then lifting one or two days to keep strength of the joints and cartilage and then fuel.

around your workout. like the days that you're running should be higher carbohydrate intake to help basically with recovery with fueling and you can put it around the workout to help with insulin sensitivity. So yeah, we typically it's definitely different eating and managing stress and you would probably look to like where can I pull stressors back?

Morgan Nolte, PT, DPT (31:33)
Exactly. Yeah. And that's so important. It's like there's a season, right? Like, I'm, you know, I'm about to have a baby and this is not the season to be training for a Happy New Year's on when you're sleep deprived. Like that's just not, it's dumb. But I remember like back in high school, my best friend and I would run like five, six miles every day. And then we might do like one long run a week. It's like, that doesn't work anymore. And that was so clear to me this last time that I was trying to train. I wanted to pick your brain too.

on your own exercise program. You kind of, you know, toiled with CrossFit and it's like love hate relationship there. And so I kind of wanted to know like, how do you eat? How do you exercise? I always love digging into this with my guests.

Becca (32:14)
Yeah, absolutely. It has definitely evolved. So I have used a little bit of genetics with this too. I'm fascinated by genetics and it's become a huge love of mine to kind of see predispositions because there's a lot that genetics can tell you about recovery ability, muscle and joint and cartilage health, inflammatory predisposition. So like how easily your immune system gets triggered by stress and inflammation and then causes inflammation.

And then also the inflammatory predisposition can give you insight and around like style of diet that you could benefit from. And I've experimented a ton with my diet, which is also a big piece that has helped me get to where I am now. And it's still an experiment, right? Stress hits, you're like constant.

Morgan Nolte, PT, DPT (32:54)
It always is. It's like your hormones

are always changing. So I feel like our strategy always has to change with those hormones.

Becca (33:00)
Completely.

So exercise wise, I am now strictly bodybuilding. So I have a coach that I hired to help me unlearn a lot of my CrossFit tendencies because CrossFit is do as much as you can as fast as you can. There's, know, yes, you move pretty well, but like you're compensating with certain muscle groups and all the things of, you know, not that you don't do in bodybuilding that that's and my goal was I had spent so long competing and my body was

muscular and fit, but it was also like, was, I was like big, you know, like I, I big in terms of like fat, but I was, had a ton of muscle and it wasn't the most feminine look for me. and I'm five, nine, I was 165 pounds when I competed, like I was, I was dense. And I was like, you know, I spent a really long time being an athlete. Like I want to have like a smaller physique again, or, know, for the first time in my life and like have

hold muscle tissue, but not be this like super dense, no curves type physique. And so my goal has been more body composition and basically managing the stress in my life with using my diet to help manipulate that. So I have gone in the past year, multiple years actually through learning about fasting and how to utilize fasting in certain strategic ways. So now I use that a little bit here and there. Sometimes I'll go into deeper fasts occasionally, but

The one thing I always tell people when I mentioned fasting, fasting is not about eating less, it's about eating less often. And so in my feasting window, I would still be eating adequate calories. I've also experimented a little bit with ketosis because having a history of overtraining tons of protein and carbs, right, to fuel my workouts, I actually had become a little bit metabolically resistant. So even though I looked pretty healthy, my blood sugars were in like the little high 90s, low 100s consistently.

Morgan Nolte, PT, DPT (34:36)
Mm-hmm.

Okay.

Becca (34:57)
And yes, it's not pre-diabetic, but like you're inflamed and you're not optimal. And so I had to use a lot of things to help basically resensitize my blood sugars. I went through a low protein period where I was eating like less than 20 grams of protein a day. And now I would say that I I try to keep both a carb protein balance and a high fat balance kind of in rotation. So.

There's different options for this. could cycle sync and do like lower carb during your follicular, higher carb leading in the luteal phase, second half of your cycle. You could do two weeks high carb, two weeks low carb. Like diet variation is where I live is what I say. And for training, I work out three days a week. And I lift for about an hour on those days and I lift heavy. I still push, but I do lots of walking now. And all of that has helped me keep the best physique and the healthiest, most stable energy.

I've ever had in my life. And it is all things that if you would have asked me three years ago about fasting and keto, I would have been like, they're horrible for you, don't do them.

Morgan Nolte, PT, DPT (35:58)
It's so funny how our brains think that way too. And I think anybody listening and who knows me and who knows my approach to nutrition and I call it the low insulin and inflammation lifestyle, like spot on, know, there's no like one way to do this. There's a lot of ways to help lower your insulin and inflammation, but the principles remain the same. You know, it's like we have to control stress and eat in a way that keeps insulin low. And I'm kind of curious. So when you're talking about walking,

Are you walking on the days that you're lifting two or are you walking on the other days?

Becca (36:32)
Well, you know, with small children, you're always walking. But on days that I rest, I try to do some cold therapy, some sauna. I'm actually even experimenting with training for one week and resting for one week right now because of how like insane my inflammatory response is when I get stressed. And I've been very stressed with work lately. And so we're continuing to experiment to try and like see how I can maintain good muscle. Cause we also know when you're constantly stressed, you're breaking down muscle.

Morgan Nolte, PT, DPT (36:35)
I chasing.

interesting.

Becca (37:01)
Like it doesn't matter how much you're lifting. And so we think that it might be a little bit of a key for me to like take actually more rest to maintain the dense muscle tissue I'm searching for. But I try to shoot for at least 10,000 steps a day. I have a walking pad, which is the best thing in the world in Chicago. thing ever. Most days I probably get 12 to 15,000 steps. And on the weekends is even more, which I like, I don't strive for, but my children make it inevitable. And so my coach usually yells at me on Monday. He's like, you need to rest.

Morgan Nolte, PT, DPT (37:16)
great, isn't it? ⁓ my gosh, I love.

Becca (37:31)
stop walking so much.

Morgan Nolte, PT, DPT (37:34)
But for real, the walking pad is huge. And so many people work from home now. I have loved my desk. I have a flexi spot desk. And then my team got me like a walking pad and especially being pregnant. It's like, it's the, it's the easiest way I'm walking like four miles a day and you don't even think about it. You're like, I've been walking 20 minutes already. And it's so easy. I think if we want to really incorporate physical activity into our lifestyle, we have to set up our environment to facilitate that.

So anybody listening who's been thinking about, oh, should I get a walk? Yes, you should. You know, sometimes I'll drag it into the living room and walk while we watch a basketball game or a football game. yeah, my family thinks I'm a little crazy, but I'm like, if you were to ever wear a continuous glucose monitor, you might want to walk. It's so good for insulin sensitivity, glucose regulation, all the things. Okay. Thank you for being generous and sharing kind of your dietary and

Becca (38:19)
Mm-hmm.

Morgan Nolte, PT, DPT (38:30)
exercise routines and just being open about how they do change and that is okay. It's okay to experiment. It's okay to mix it up. I wanted to talk a little bit more with our time left about hormone replacement therapy and your approach to that and how you kind of identify a good candidate for that. What if you're taking any hormones right now, what does that look like? So if you have someone who comes to you, you obviously have this hierarchy.

We need to control insulin and stress and modify your diet and your exercise plan and your sleep and those mental and emotional factors. That doesn't change. That has to get done regardless of if we do HRT and HRT is going to be effective, far more effective if we have that healthy baseline. But now that we've discussed that, let's dig a little bit deeper into HRT.

Becca (39:25)
Yeah, absolutely. I always tell people HRT is not a weight loss pill. It is not a sleeping pill. It is to help support what your body is naturally losing. And so also in that token, do not be afraid or ashamed to take HRT. It is going to help with your long-term health, cardiovascularly, cognitively, insulin-wise, like blood sugar-wise, metabolically. It is going to help you be happier. A lot of times I tell people like, do you want your mind back?

Morgan Nolte, PT, DPT (39:43)
Okay.

Becca (39:54)
Do you want your energy back? Do you want your relationships back? Like that is how powerful it can be when it's done properly. And so when I have worked with a client, we typically do not visit it until a few months in because I want to make sure that their baseline health is in as good of a place as possible because sometimes you don't need to put it in as high of doses or right away or at all in certain, you know, hormone situations if you get the baseline health in a really good spot. And so.

Morgan Nolte, PT, DPT (40:20)
Great.

Becca (40:21)
Like we talked about working blood sugar, sleep habits, stress habits, metabolic function, all of that comes first. And then for females, what research shows is that the earlier you get it in, the more effective and the better the outcomes. So most people, I do not recommend waiting until you lose a period to put HRT in, especially progesterone, because we lose progesterone far earlier and progesterone helps to calm the immune system. It helps level out your periods. It helps level out your mood. It helps with sleep. So progesterone can be really, really helpful.

And there's a number of ways and routes you can go. And we'll talk about that, but progesterone always comes first for me. And I never add more than one at a time. And I might add them consecutively, like take one for a few weeks, see how you handle it, and then put in another. But after progesterone, either testosterone or estrogen. At some point, estrogen comes in, but sometimes people, you know, they're still having regular cycles. They just want to level out their cycles a little bit. They want to, you know, we look at hormones and their testosterone is completely bottomed out.

And you can do a lot of natural stuff for testosterone, but in my experience, not much moves the needle if you are stressed and your stress isn't going anywhere. If you have a history of overtraining, chronic dieting, all of those things, testosterone can take a while and a lot of effort to come back online and even a little bit. And I don't find the natural supplements help as much. so testosterone, a lot of women benefit a ton from testosterone and they feel so much better on it.

The one thing that have to be careful about with testosterone is that we know it aromatizes into estrogen. And so you don't want to be on too much. Why I don't like pellets and estrogen levels you want to start with as low as possible. So all hormones start with as low as possible because it's a lot easier to walk doses up than it is to go in too high and have to walk yourself down and detox. So progesterone, I always start with first, then either testosterone or estrogen, depending on their symptoms.

Morgan Nolte, PT, DPT (42:07)
Thank you.

Becca (42:16)
And then, if you want to round it out with, maybe you'd go progesterone, estrogen, and you want to round out with testosterone, some women just do progesterone and estrogen and that is fine. So forms of HRT, progesterone, oral, in most cases, sometimes trochies for women. I don't do a ton of creams, mainly because one, absorability. So it varies with people depending on how coarse their skin is, how old we are, the clicks, all of those things. And I'm not saying they are,

Morgan Nolte, PT, DPT (42:42)
you

Becca (42:45)
valid or fine to use. I just don't use them as much with clients. So progesterone, I try to start as low as possible. I usually start clients at 50 milligrams, but that is through a compounding pharmacy. If you go to your OB, Prometrium is the brand name of progesterone. And so that's bioidentical. The lowest that starts at 100 milligrams, which is also a fine dose. Like most people, that should be fine.

Morgan Nolte, PT, DPT (42:57)
Great.

Becca (43:10)
but I try not to go above 200 milligrams with progesterone. I just don't think it's necessary in most cases, and I think it can cause bigger issues. So progesterone, I usually go oral or a troche, which is like a dissolvable tablet. Estrogen. Estrogen patches are my favorite to start with because they are a very low dose. They are prescribed by your doctor in most cases. They are covered by insurance, and most women tolerate them very well. Estrogen creams are not systemic. And so if someone is concerned about the breast cancer risk,

Morgan Nolte, PT, DPT (43:21)
Okay.

Becca (43:40)
If someone wants something a little bit more low entry, like they're nervous about going on estrogen, estrogen creams can be a great option. You can also do them vaginally for vaginal dryness or atrophy, tenderness in the labia. All of those can be great with estrogen cream. so creams for estrogen, I'm a little bit more prone to do in those cases. But I do like patches.

I try not to do oral estrogen. Some people have differing views on this and opinions, but it does have to bypass the liver then, and it can kind of burden the liver a little bit. It tends to turn into the more potent form of estrogen within the body in terms of how it detoxes and the mutating pathway that can go down when it detoxes and metabolizes. So I try not to do oral estrogen. We sometimes will do estrogen injections, but I find those to be the most potent and the most side effects. So those are kind of, you know.

Morgan Nolte, PT, DPT (44:29)
Okay.

Becca (44:30)
Either patch or cream is my go-to. And then testosterone injections are my favorite. But you can do a troche as well, a dissolvable troche for testosterone. I typically don't do testosterone creams. The other thing with creams is you can rub off onto pets, family members, things like that. So I try to avoid that if I can. I do not do pellets. Some people, they swear by them. They say they're life-changing. I have seen way too many clinical experiences of people coming in

Morgan Nolte, PT, DPT (44:46)
Hmm.

Okay.

Becca (44:59)
Their testosterone is not only through the roof, but now their cardiovascular impacts are there. So their hemoglobin is high, their hematocrit is high, their red blood cells are high. We're seeing inflammation arterially. And it gives people a very false sense of amazing feelings that just are not sustainable physiologically in myopyridin. So it's supposed to be slow release. But again, you're playing Russian roulette because some people do not respond to HRT great.

Morgan Nolte, PT, DPT (45:18)
and

Becca (45:28)
at high doses. And now you throw something in the body that's going to be there for three months. That is a ton of hormone, which can cause a lot of cellular insensitivity because it's too loud for the cells. It's too much hormone. So, you know, I see a rare population that does well on them long-term. Some people do great on them for a year or two, and then it starts to downslide. So I don't recommend them. That's my personal opinion. Again.

Everyone needs to get their own opinions and their own information. But just from what I've seen, having so many women utilize HRT under our care, I just, don't see great results and outcomes long-term.

Morgan Nolte, PT, DPT (46:06)
the pellets. Well, thank you for breaking that down. I'm such a linear learner. And so I love how you're like, there's progesterone, there's estrogen, there's testosterone, these are the different forms. I love that. Now you mentioned offline that you're on progesterone. And I wanted to ask like what dosage, how long have you been on? How often do you test your levels or modify that dosage, that kind of stuff?

Becca (46:19)
soon.

Yeah, absolutely. So these are the tips I have around HRT. So I'm on progesterone. Funny story, I actually went on it because my husband and I had a 10 year wedding anniversary trip and I was supposed to get my period on the trip. And I talked to my medical team. I was like, hey, can I take some progesterone and like extend my period a little bit? And so we did and I did and it worked out great. so, but I was also having really short cycles at the time. So I was starting to turn into like 25, 24 day cycles, which if you're a female and you get your cycle every 25 days, it's awful. Cause it's like every two and a half weeks.

So I went on 50 milligrams of progesterone orally and I only take it in the second half of my cycle. So I only take it in my luteal phase. So I'm cycling it because one of the benefits of cycling of hormones. So when you are premenopausal and estrogen is high in the first half of your cycle and progesterone is higher in the second half, it's cancer protective, it's tumor protective. And so I'm not saying that you need to constantly cycle hormones, but

I don't love people going on really high doses chronically. And so I do just the second half of my cycle. It keeps my cycle nice and healthy around that 28 to 29 days. I don't experience as much PMS. I don't experience as much unstable mood. I still get some cramping, a little bit of bloating and water retention like anyone will. But I've been on it since September and I plan to stay on it now. I also am planning to go on testosterone in low doses just because

One, although I am a recovering stress addict, I still have high stress and I've learned to manage it a lot of ways. But since I have been getting blood work consistently for the past few years, my testosterone is always low. And having the motivation, the energy, the sex drive that I would love to have, I'm gonna use testosterone in really low doses for probably foreseeable future. So those are the two that I'm taking. I do not plan to take estrogen anytime soon. I'm still very young. Some people, you can put it in.

I just, don't feel the need to at this time. And so that's what I currently use and have experienced great results with it. I feel great with it. Very low, progesterone is very low risk. Like there's really no downsides of progesterone at moderate doses. So it's what, again, why I always start with it.

Morgan Nolte, PT, DPT (48:34)
Yeah.

Yeah, I've really enjoyed this conversation. I know I've learned a lot. I took a lot of notes. I think it's a perfect season for me to start thinking about this, especially kind of after this baby and then coming out of that and managing my stress and then just always in the back pocket. Like, okay, is it time for some HRT? You know, if so, what's like the best maybe beginner dosage and that kind of stuff. So this was such a great conversation.

Is there anything else that you wanted to share before you let our listeners know where they can learn more about you?

Becca (49:16)
Yeah, one is progesterone is a great option postpartum because it can help with postpartum depression. So just a little, little tidbit.

Morgan Nolte, PT, DPT (49:24)
Hey, it's no, might talk to my provider

about that because I've never, I don't know if it's my postpartum seasons have been very unique because after my oldest was born, I started my business and he was four months without childcare. then Leah was born during COVID, which also you're trying to run a business without childcare. It's just very stressful seasons.

I'd say postpartum stress and anxiety, but maybe not depression, but it's still something to consider because I don't think you ever really know how it's going to hit you. I think every time is going to be different. Thank you. Thank you. Yeah.

Becca (49:53)
Mm-hmm. Yeah. Yeah. It can help just kind of stabilize things a little bit, handle the stress a little bit better, I say.

But for anyone listening, I always tell women, like, you and your symptoms and what you're feeling matter, and they are valid. And if you do not have someone that's listening to what you're experiencing or writing it off to being normal or you're just depressed or whatever it might be, find someone that will listen and that will care because your body is changing in this phase of life.

and it does not need to be a downfall. It can be a rebirth. It can be a phoenix rising, right? If you find the right support and if you are open and willing to change the things that maybe are no longer serving you in that state. So I just want to let women know like you matter and what your feeling matters because I think a lot of people feel unheard in that time of life. And you can find me, I am on Instagram at the Hormone Queen, super simple.

And then our company is FitMom. So our website is fitmomlife.com. And we do consultations, we do all of that good stuff, work with people privately. And yeah, it's a big passion project for me.

Morgan Nolte, PT, DPT (51:04)
Well, can tell you, I mean, you definitely walk the talk. I've interviewed so many people. And I just wanted to thank you for your journey and sharing that and going through that messiness for yourself. I always like to say, you know, God gives us a mess and then we kind of become the messenger in some capacity. So I really see that in you and just wanted to let you know, I respect you so much. think so highly of your work and you're clearly an expert in this and thank you for teaching me some new stuff today. I appreciate it.

Becca (51:33)
Thank you so

much for having me. This was super fun.

Morgan Nolte, PT, DPT (51:35)
Yeah. All right. We'll cut it off. And that was great. Okay. Thank you. That was I really out of his a great conversation. I'm going to look into the progesterone. I'm 35. I didn't want to hear him. I didn't want to ask how old you were. But I am.

Becca (51:41)
Thank you so much. That was awesome conversation.

No, I'm 36.