27: Fourth Trimester x Mornings with Megan: Postpartum Recovery After 38

The Fourth Trimester Podcast Episode: Postpartum Recovery After 38: What Changes Metabolically and What To Do About It Guest: Megan Pfiffner, MS, CNS

INTRODUCTION AND CONTEXT

Sarah Trott (00:01) Hi, this is Sarah Trott and welcome back to the Fourth Trimester Podcast. Today we’re going to be honing in on postpartum recovery after age 38, why that can be different, and what to do about it. We’ll discuss strategies for being proactive and intentional in your recovery process.

According to the CDC, women are having babies later in life. We saw an increase for older mothers having their first births by 12.6% for those aged 30 to 34, and a 25% increase for mothers age 35 and above. So this really does mean that more mothers might be experiencing symptoms of perimenopause during their postpartum recovery. We have touched on this topic before, quite a bit actually, in an episode with Dr. Shosh. We will link to that episode, which really talks about when perimenopause and postpartum overlap, so have a listen to that as well.

Today’s focus is a deeper dive into the physiological differences older, relatively older moms may experience, and strategies for smarter ways to heal. That’s going to include what changes metabolically after 38, the testing gaps in the six to 24 month postpartum window, the insulin resistance piece that sometimes people miss, and practical nutrition and lifestyle adjustments that really protect your long-term health. This is going to be a very rich conversation.

Today I’m joined by Megan Pfiffner, perimenopause nutrition expert and creator of the Perimenopause Matrix, which is a data-driven framework designed to help women reclaim their energy, focus, and hormonal stability. Welcome, Megan.

Megan Pfiffner (01:57) Thank you so much for having me. I’ve been looking forward to our conversation, Sarah.

INTRODUCTIONS

Sarah Trott (02:01) Megan, you have your own podcast called Mornings with Megan, so we’re going to put links to your program down below. Everyone, go click, follow, subscribe to all the things with Megan. Megan, can you please take a moment to introduce yourself in your own words?

Megan Pfiffner (02:11) Sure, thank you so much. My name is Megan. I work with women in perimenopause and the goal is for them to start feeling like themselves again, because this is a transition in life when sometimes we lose ourselves or start feeling a little bit off. I help them get back on track with diet and lifestyle changes they can make themselves, support themselves, and get back to feeling the way they want to again.

Sarah Trott (02:45) I love that so much. And why perimenopause? Why this topic for you?

Megan Pfiffner (02:51) For me, it’s very personal. I spent decades working in the fashion industry and got very sick. Throughout that process of getting healthy again, I got a master’s degree, went back to school, and started working as a nutritionist focused in the women’s health space. I then underwent my own fertility journey, which I’m still in.

That journey crossed over into perimenopause because of my age. I’m 43. Those two together are a tricky combination because not a lot of people are treating both or working with both. It’s either you live in the pregnancy and fertility space or you live in the perimenopause space. It was very challenging to get support for both of those things simultaneously. I felt more compelled to help women in this transition, this second life phase, because there is a lot of fertility support out there: doctors, people who are taking care of that. But I think there is less support, less research, and less conversation about this second transition. We are hearing a lot about it now, especially with the changes in laws and regulations that are happening, and it seems to be a topic people are much more comfortable broaching now than they were 20 years ago.

WHAT CHANGES METABOLICALLY AFTER 38

Sarah Trott (04:06) Yes, 100%. I do hear that conversation happening more and more, certainly in the news media. Let’s set the foundation. When we talk about postpartum recovery after 38, what is biologically different compared to recovering 10 years younger, say at 28?

Megan Pfiffner (04:28) The really big difference is that as we age, women become more insulin resistant, and that change depends on their hormonal shift versus their actual biological age. Each woman is going to have a different journey as she transitions through perimenopause.

When we’re in our peak fertile years, we are high in estrogen, high in progesterone, feeling great. A lot of those hormones are contributing to our metabolic health. They’re keeping our insulin in check, keeping our moods in check, helping us sleep, helping us naturally regulate. As we step into perimenopause, our hormones start to decline and even get a little erratic. We don’t have this consistent release and cycle that we had in our younger fertile years.

Sometimes those two phases can butt up against each other, because just because we are fluctuating doesn’t mean that we are fertile, and doesn’t mean that we can’t have a baby. When those two overlap, we can get into a place where we are more metabolically vulnerable because our insulin becomes less regulated and tends to drift up as our progesterone and estrogen start to step down. Those two play a role in our metabolism and our insulin resistance, so keeping blood sugar stable becomes more challenging.

We also have to think about cortisol. When we talk about self-regulation and our ability to bring cortisol back down naturally, that becomes more difficult when our hormones are fluctuating. The natural progesterone that we usually have, which is higher in our cycling years and helps us feel good, calm, and regulated, is often the first hormone to drop. When that goes, it’s much more difficult for us to self-regulate.

When we think about a brand new mom, she’s not sleeping, she has a baby that she’s taking care of, and the amount of responsibility has grown exponentially. When you’re older, that’s often when your career is peaking, you may have aging parents, you may already have children in the house. There are a lot more responsibilities. When you were 28, it was much easier for your body biologically to pull everything back in and physically regulate. That capacity has diminished with age, and your life stage has changed as well, which compounds both of those things. It really is a lot, and no one is prepared for it. It’s not like someone sends you a nice little notice in the mail saying, hey, pay attention to these things in your early 30s so it’s easy to slide into your 40s.

Sarah Trott (06:52) I mean, that’s a lot of change.

Yeah, so true. And some of the phrasing that gets put on documents for women over 35, it’s like “advanced maternal age.”

Megan Pfiffner (07:16) Geriatric pregnancy. So offensive.

Sarah Trott (07:18) Right? Yeah, women, you also deserve some kind of label like: you’re doing it, you’re powerful, you’ve got this.

Megan Pfiffner (07:28) You should get a crown and a label. However you want to look at it. Surprise, we’re doing this. Here you go.

IS THIS BEING TALKED ABOUT?

Sarah Trott (07:35) Because it is. And these challenges, are they getting talked about? Do people know?

Megan Pfiffner (07:41) I think there’s a conversation happening in the perimenopause space about some of these challenges, but I don’t think enough of it is happening in the maternity space. People still have this very hard line where it’s either you are fertile and having babies, or you are unable to reproduce. But there are women going through IVF into their late 40s. I work with women who are 46 or 47, going through that fertility journey and giving birth at a late stage. At that point, they are only two or three years away from the average age of menopause, which is when we completely stop cycling for 12 consecutive months. That average age is 51 and a half. So if you’re getting pregnant at 47 and giving birth at 48, you’re pretty close to that timeframe.

We have amazing technology and a lot of new things emerging that are helping women do that, but the conversation around postpartum care for these women is lacking. So many people don’t separate the two, and they’re combined for a lot of women, especially when we’re talking about a second or third pregnancy. If you start having babies at 32 and have your third child at 38, you’re 39 when you’re in postpartum, which is right in the window when your hormones might start stepping down. That postpartum space, where you might have low mood, low energy, and brain fog, which is to be expected with such a dramatic drop in hormones after pregnancy, may be exacerbated by your biological step down in hormones through perimenopause.

Sarah Trott (09:17) Yeah. I was just reminded, hearing you talk, about Janet Jackson, who had a baby at 50.

Megan Pfiffner (09:24) If anyone’s gonna do it, she’s crushing it, right?

Sarah Trott (09:26) Absolutely. The symptoms are so similar. We talked about some of this beforehand, off camera. The symptoms of postpartum recovery can feel a lot like the symptoms of perimenopause: fatigue and other things. So how can someone really tell if what they’re experiencing is typical postpartum recovery versus something metabolically shifting?

HOW TO TELL THE DIFFERENCE

Megan Pfiffner (09:57) The big thing to remember here is that the actual cause of those feelings is the same in both spaces. It’s just the reason why. When you recover postpartum, there is a dramatic drop in all of your hormones, which is why you feel that way. That’s the same thing happening in perimenopause.

The big differentiator is whether you were having those symptoms beforehand. So if pre-pregnancy you were having challenges with brain fog, your sleep was off, you were feeling a little short, feeling sometimes very irritated the week before your period in a way that’s not normal to you, feeling that stresses were pushing into overwhelm rather than something you could handle with a few breaths and some perspective, those are a lot of the early perimenopause signs. That’s when progesterone starts tipping down.

Once we get into postpartum, we’re not ovulating, so that progesterone you normally get when you’re cycling, which comes from your corpus luteum after your egg releases, that’s not happening during postpartum, just as it’s diminished in perimenopause. So if you were having these symptoms earlier, that’s something to be talking to your OB or GYN about.

And if you feel like you had these symptoms before and your current OB is not able to address them, it might be time to have a conversation with someone who prescribes MHT. There are lots of resources now, lots of companies doing that. But there’s no single biological marker that definitively tells us. We can’t give you a test that says, yes, you are in perimenopause. We can track and say, okay, your FSH has gone up into double digits. It’s usually under 10 when we’re in our reproductive years. Once it starts tipping into double digits, we say we’re stepping toward that menopause space, but that’s still not a hard and fast rule.

Even with the way ACOG sets everything up and has guidelines for what perimenopause stage you’re in, they’re based on cycling. And there are lots of women who are still cycling but having hot flashes and night sweats, which muddies the water. So it’s more of a self check-in: where did you feel like you were pre-pregnancy, and now that we’re past that three or four month hump, do I still have those symptoms? Is this something my OB feels is normal? And should I be having a conversation with someone who specializes in MHT? Because your OB and the MHT provider are probably not going to be the same person.

MHT EXPLAINED

Sarah Trott (12:32) Okay, why don’t you break down MHT for people who might be hearing this for the first time?

Megan Pfiffner (12:38) MHT is menopause hormone therapy. We used to call it hormone replacement therapy, and we’re stepping away from “replacement” because in the United States, our guidelines do not advocate for replacing physiological doses. We’re aiming toward symptom management. What that means is using the lowest amount of hormones, which could be estrogen, progesterone, or testosterone, to help manage the symptoms you’re experiencing.

That’s very different from trying to get a woman who had peak estrogen in her most fertile years back to those same levels in her 40s. There are some doctors who work in that space, and choosing the right practitioner depends on where your interests lie. If you’re thinking about extending fertility years and potentially pursuing another pregnancy or IVF, that’s a different conversation than simply wanting to manage symptoms, not have hot flashes, reduce brain fog, and address joint pain.

Sarah Trott (13:42) So someone wouldn’t want to withhold information about their intentions. If they are trying for a baby, doing IVF, or are still breastfeeding, that’s really important information to share with the medical provider if they’re talking about MHT.

Megan Pfiffner (14:02) Absolutely. When you are in that space, testosterone is completely off the table if you’re still trying to get pregnant. There are ways to work with progesterone and estrogen, but they need to be managed by a practitioner who understands these things, including the breastfeeding piece. We’re normally not using MHT when someone is breastfeeding because what you consume or put into your body gets transferred to the baby. That’s an area that needs practitioner oversight.

And it’s important to share that information proactively because a lot of practitioners aren’t thinking that this fertile woman who just gave birth might need MHT. I personally fall into that category: if my IVF is successful, I will be someone who was on MHT before the IVF cycle, will stop it during the retrieval and transfer, and then will have to wait after postpartum to get to a place where I can start again. That’s a conversation I have to remind and continuously revisit with my doctors so they’re aware that it’s a factor in my specific scenario.

Sarah Trott (15:13) Yeah, absolutely. And hopefully they would be screening and asking these questions, but be proactive and advocate, right?

THE TESTING GAP: SIX TO 24 MONTHS POSTPARTUM

Sarah Trott (15:13) You mentioned something about a testing gap, six to 24 months postpartum. Let’s move into the postpartum period, post-baby. What metabolic markers are commonly missed during that recovery period after 38?

Megan Pfiffner (15:35) One of the things that gets missed across the board is fasting insulin. As we get into that perimenopause space, we become more insulin resistant, as we talked about earlier. The first marker that’s going to move is fasting insulin, and that’s not a common marker for many practitioners. It’s a cheap test, you can get it done at Quest, and it’s letting you know how well your body is responding to glucose.

You can have a normal fasting glucose, but behind the scenes, your insulin might have to work really, really hard to keep that in check and bring it down anytime you have a large bolus of carbohydrates. So you have a bunch of sweet potatoes for dinner, your blood sugar shoots right up, and your insulin is still working well enough to tamp it back down. But you need a lot of insulin to get back to your normal fasting sugar range. And fasting insulin shows up as elevated up to 10 years before your fasting glucose starts to move.

The second thing is watching your lipids. A lot of women come to see me, either for IVF prep or postpartum. Some have had babies for a while and are just showing up because they didn’t go back to the doctor after their final postpartum checkup. Their doctor said they were great. Their husband was going every couple of years getting his lipids checked and feeling fine. Then three or four years later, they show up and say, I went to my primary care doctor for a physical and now she wants me on a statin, on blood pressure medication, on all of these things, and I have no idea what happened. What happened is they started tipping into perimenopause. One of the first signs of that shift is an increase in fasting insulin, and then an increase in lipids.

Triglycerides specifically are a flag for how well we’re tolerating carbohydrate. If your triglycerides suddenly shoot through the roof, that’s a sign of metabolic dysfunction happening. You need to work with a practitioner or look at your diet and how you’re reacting to carbohydrates. Your body in your 20s could manhandle almost anything. Black coffee and a croissant for breakfast, a bagel a couple of hours later, totally fine. Then you get into your 40s and it’s like, I had a piece of sweet potato and my blood sugar is through the roof. I’m crashing, I’m craving, everything is happening. There’s a big gap that opens up when we start transitioning and those hormones step down.

Sarah Trott (18:04) That’s so interesting about the insulin piece, because it is really common to get the gestational diabetes test during pregnancy, but it sounds like that’s not enough.

Megan Pfiffner (18:17) In pregnancy it’s appropriate, but postpartum, you can still get a glucose tolerance test. That’s possible and many practitioners use it. There are some people who don’t react well to that, myself included. I’ve had challenges with Candida for years, so that’s something I won’t participate in. Instead, I use a continuous glucose monitor to look at how I’m reacting to glucose. That’s something women can do during or after pregnancy to see how their body tolerates different foods. It gives you very concrete data: this is how you react to grapes, this is how you react to rice. Some carbohydrates are going to be a problem for some people and not for others, and that’s the key, because it’s about how your body is reacting and recovering to those foods in a postpartum and perimenopausal state, as opposed to how it did when you were in your 20s.

Sarah Trott (19:15) So the practical takeaway here is: sometime in the postpartum recovery, six to 24 months afterwards maybe, ask for an additional insulin test, the fasting insulin?

Megan Pfiffner (19:26) Fasting insulin, with your lipid panel and your fasting glucose, which you’ll get at your normal practitioner checkup.

MANAGING LIPIDS AND CORTISOL

Sarah Trott (19:36) And what’s going to happen if your lipids aren’t looking normal?

Megan Pfiffner (19:39) There are several ways to manage it. The triglyceride piece is definitely carbohydrate-dependent. From an LDL perspective, I’d recommend looking at your overall diet. That’s something that can also be affected by movement: whether you’re getting walking in, whether you’re resistance training. All of those things help with your LDL. This is when you hear people talk about high intensity interval training, sprint interval training. These are tools you can use to modulate your LDL. There’s a certain point where biologically you can’t go further and some people will need medication. That’s a genetic situation your cardiologist or primary care doctor will discuss with you.

Then think about your diet and lifestyle: how much processed and added sugars are you getting? That plays a large role. And as we age, we’re not able to tolerate alcohol and caffeine quite the same way. There’s a metabolic pathway that gets a little bit bogged down at that age. Some women get up and say, I used to have coffee every day and now I have heart palpitations. That’s another part of this process.

Sleep is crucial, and I know that’s harder with a brand new baby. So when you have a newborn, think about other ways to restore and regulate. Part of the sleep piece is cortisol regulation. If you can’t sleep through the night and have a baby waking you up, what are things you can do to give yourself 10 minutes of calm? Meditation, breath work, journaling, anything that’s going to help you rest your body so we can get that cortisol back down, because cortisol plays a role in this insulin picture.

If we have high cortisol and high stress, we have high blood sugar. Those two are besties and they travel together. You can’t have a cortisol spike without a blood sugar spike, because if your cortisol is going up, that’s your body saying, hey, there’s an emergency. There might be a bear outside. We need to run away fast. And if you need to run away fast, you need a quick burst of energy, so your body releases a big bump of blood sugar. But right now in our modern world, there’s probably not a bear in the next room. There might be emails, family members, news feeds. All of those things are happening. We don’t want little cortisol hits all day giving us blood sugar spikes that affect our long-term metabolic health. Anything we can do to get you back to a regulated state is going to help bring that cortisol down and help your metabolic markers.

REGULATION AND RESILIENCE

Sarah Trott (22:37) I really liked that point. I recently had a conversation with someone about the topic of resilient parenting. Her point was, if you talk about self-care or resilience building as just another thing on your to-do list, you’re never going to get to it. The trick, especially if you’re a sleep-deprived early-stage parent, is to find ways to build techniques into your routine naturally without it becoming an additional task. Some of the specifics she talked about included box breathing to help calm and regulate the nervous system, or doing a simple meditation around a favorite place and going there in your mind where you feel calm and relaxed, bringing that energy back to lower cortisol.

Megan Pfiffner (23:42) I love both of those. Another one, if you have kids who are a little bit older, is Gratefuls. Taking a moment at dinner or breakfast for each person to share something they’re grateful for. Just the act of doing that helps to lower cortisol levels, and it’s also teaching your kids another way to be resilient and to regulate themselves.

Sarah Trott (24:02) Of course. Our children are borrowing their nervous system regulation from us.

Megan Pfiffner (24:08) They sure are, which makes it challenging if you’re in perimenopause. If you’re not regulated and you’re trying to regulate yourself and your kids, that’s a lot of extra regulation that your body and brain have to manage and sort out. That’s just another piece of the puzzle when you cross into perimenopause while you’re in postpartum.

PRACTICAL INTERVENTIONS: NUTRITION AND LIFESTYLE

Sarah Trott (24:28) Yes, acknowledging the change and lowering expectations around productivity are huge themes that come up a lot on this program. Okay, let’s get to some of the practical intervention stuff. If someone is listening and wants to be proactive, what recommendations do you have for nutrition shifts, lifestyle shifts, smarter ways to heal?

Megan Pfiffner (25:02) Start where you can. I’m going to give you a few options, but this is your postpartum and your perimenopause. What I say is most important may not be most important for you. So take what fits best into your life.

The first thing I’d talk about is recovering from a food perspective. When you think about growing a baby during pregnancy, your baby can’t go to Whole Foods, so you are Whole Foods. And now, after delivery, you are Sunday night at Whole Foods when all the shelves have been cleared out and everyone has done their weekly shopping. That is where you end up after you have your baby. We want to restore you to that Friday morning, fully stocked stage. To do that, the most efficient way is through nutrient-dense foods. Think about everything you buy on the edge of the grocery store: fish, meat, eggs, vegetables, produce, legumes, beans, nuts, seeds, all the things that don’t come in a package.

I know that sounds challenging because you’re tired, you don’t necessarily have time to prep. This is when a food service can be useful to fill in, or pre-made options like Kevin’s at Trader Joe’s or Whole Foods, so you can have nourishing food that will fill you up. A lot of what I see is moms who are recovering, trying to breastfeed, getting ready to go back to work, taking care of older kids, and forgetting to eat. Not only is that depleting them, it’s giving them blood sugar dysregulation and mood problems. From a pure recovery perspective, your body needs resources. It cannot repair when it doesn’t have those resources. So your number one goal is recovery so you can take care of this adorable little baby. You need to be at your peak, make sure your resources are replete, and then you can care for them. Because if you crash and burn, who’s going to take care of anyone else in your life?

The next piece is sleep. If you are a brand new parent, this may not fully apply yet, but once your kids get a little older, prioritize sleep and set a bedtime for yourself. Your day needs an end point. You cannot stress-chore until you pass out. You have to say, my bedtime is 10 o’clock, and whatever is not done on my to-do list is not done. I need to go to sleep because I have to restore and recover. My brain needs to regulate. If you do not sleep, your brain is not able to regulate. Think about a day when you’ve had four hours of sleep: how reactive you are, how hungry and irritable you get, how much you crave things, how making a decision about dinner becomes a cry-worthy moment when you’re running on four hours and working all day. Sleep is a big piece of this.

The next piece is moving your body. Right after having a baby there is a recovery window, but even just walking. Walking with your baby, getting outside, getting sunlight. Getting into an exercise routine once you’ve recovered is important from a long-term metabolic and perimenopause perspective, but from a regulation standpoint, movement helps your body know it needs to start replenishing those resources and generating energy again. We need to let your body know you’re going to continue to use it and use it well. Because if you’re giving your body sedentary signals, it says, okay, I know how to be sedentary, I’m going to down-regulate my metabolism, put things on pause, start storing fat. You don’t want that. You want your body to know that movement is part of the picture and we want to keep moving forward.

The fourth thing is regulation. Learning box breathing, doing a gratitude journal, trying a four-seven-eight breath. If you feel like your monkey brain won’t settle, get a Calm app or Headspace, something guided. And the one thing to remember about meditation is: the goal is not a calm mind. Everyone has a monkey brain. The point is the consistency, putting yourself in the chair, committing to that two minutes, three minutes, five minutes every day, because that is building the resilience we’ve been talking about. If we do that every day, we are making ourselves more resilient, working on our brain power, working on regulation, and also working on immunity. All of those things together give you a more resilient mama bear who can take care of her family and move into perimenopause with a better foundation.

PROTEIN TARGETS

Sarah Trott (30:25) Megan, what a wonderful, practical set of guidelines. When you were talking about food and shopping around the edges, you were implicitly talking about protein. Are there realistic targets for postpartum women in this age group around protein?

Megan Pfiffner (30:45) It depends on the person and where she is from a muscle-centric perspective, but most women can aim for 30 grams of protein three times a day. That’s on the lower end if you are someone who lifts, but 30 grams three times a day gets you to at least 90 grams. Most people are operating lower than that with the old dietary guidelines. We’ve got new dietary guidelines now, and that’s still being debated, but I always work from a metabolic health perspective with a higher protein content.

Protein is satiating. It fills us up. And it’s the material our body uses to repair. When you have a baby, your body has done a beautiful thing to create a new life, but there’s a lot of tissue to repair. That damage is repaired by amino acids, which come from protein. If you’re not eating that protein, your body doesn’t have those little amino acid legos to slot into spaces to repair itself. That’s a really important piece of this.

The other part is from a craving and blood sugar balance perspective. When you use protein as a base at breakfast, getting 30 grams in the morning, you are much less likely to ride a blood sugar roller coaster all day with mood swings, crashes, and that 3pm crash where everyone wants to crawl under their desk and take a nap. We can manage that using protein. Thirty grams is a really good starting point. See how it works in your body. I personally hit closer to 120 grams, but other women I work with who are less active do better closer to 90. Start at 30, see how your body feels, and adjust from there.

Sarah Trott (32:45) So what would that look like for breakfast, lunch, and dinner? How much or what kinds of food?

Megan Pfiffner (32:52) For breakfast, I personally have a black bean brownie, which is a protein brownie made with a bunch of eggs, so I get about 20 grams of protein from that. Then I have a cup of coffee with collagen in it, about 18 grams of protein. Combined, that’s over 30 grams. If you’re an egg person, three eggs with a cup of black beans is a great combination. Add a little avocado for fun. That’s another really good way to do it.

For lunch and dinner, use your hand as a measuring utensil. A palm of fish, chicken, or meat will get you about 30 grams of protein. If it’s ground meat, think about a fist size. When you’re rounding out your plate, you also want to make sure you’re getting fiber to keep you full throughout the day. Think about two fists of vegetables, a palm of protein, and a thumb of fat to build out a nutrient-dense plate while you’re in that recovery space.

STRENGTH TRAINING

Sarah Trott (34:04) Great. What about people who are strength training? That comes up a lot for women in the late 30s to 40s age range.

Megan Pfiffner (34:14) Strength training is one of my favorite ways to build metabolic resilience. If you think about muscle, it is your most metabolically active organ. If you want to invest in your longevity and your health, muscle is the number one way to do that. It is the best longevity drug we have. Muscle helps to balance your blood sugar. It’s a big glucose sink. If you’re a woman who’s lifting and doing your weight training sessions, you have a bunch of muscle in your body, you are able to metabolize and tolerate a lot more carbohydrate than someone who is not doing those things. From an investment perspective, that’s really important.

When we think about maintaining that muscle, protein is necessary. There are people who can lift weights and eat a lower amount of protein, but we’re not necessarily building muscle that way. If the goal is to build more muscle, you need to fuel it. In that space, I’d say think about one gram of protein per pound of ideal body weight. So if before you had your baby you were comfortable at 120 pounds, aim for 120 grams of protein as you’re fueling your recovery and your training.

And when we’re recovering, remember that restriction is not the way. When you’re recovering, you want to make sure your body has enough resources so it’s not having to make choices. We don’t want it to have to partition and say, we have enough to weaken and repair your heart, but we don’t have enough for your hair. Your body will obviously pick heart over hair. But we don’t want your body to have to make that choice at all.

Sarah Trott (36:00) Absolutely. And working with your physicians to make sure you’re cleared for exercise and know when and how it’s safe is important too.

Megan Pfiffner (36:10) Yes, we don’t want to go back too soon. We don’t want to deal with pelvic floor problems or prolapse. Making sure your body is safe and cleared before lifting any weights is essential.

Sarah Trott (36:20) Exercise as a topic has been discussed in depth on this program, and a number of perinatal professionals have talked about the importance of not doing too much too soon because it can ultimately prolong the overall postpartum recovery period and even potentially re-injure. So it really is important.

Megan Pfiffner (36:38) Absolutely. We do not want to prolong that postpartum recovery period, especially once you get older, because it’s already longer in general. You really don’t want to injure yourself and extend it further.

SMALL DAILY HABITS FOR BIG METABOLIC IMPACT

Sarah Trott (36:54) Any other small daily habit stuff you want to talk about that could create the biggest metabolic impact?

Megan Pfiffner (37:04) Between food, movement, and sleep, those are going to move the dial the most. But some small things that slot in nicely would be sunlight in the morning. That’s playing into our circadian rhythm and our Regulate pillar. Getting that morning sunlight lets your body know what time of day it is, which then helps you at night when your body is getting ready to sleep, because cortisol and melatonin are on a seesaw, opposing each other. In the morning, we want cortisol high. We want that to get us up and out of bed. Sunlight lets your body and your brain know it is time to be up and awake. That also sets the clock for when melatonin should start rising in the evening.

You can also get sunset light, which does something similar. It’s not quite the same because you’re not getting that morning cortisol rise, but you are letting your body biologically know what time of day it is. And we don’t get that through a window. If I’m sitting here looking outside, that sun I can see is not giving my eyes the same information as being directly exposed to sunlight. So that’s another piece of that regulation picture.

The other piece is taking time for yourself. This is something I get the most pushback on from my perimenopausal clients, and I imagine your community would also push back if you said, I need you to take 10 minutes for yourself. They say they don’t have time. But that 10 minutes alone, so you can regulate, shut down, and say: okay, I am fine, I can reset, I can get myself regulated and then go back out and face the world, really matters. And 10 minutes is less time than we spend on social media or watching Netflix. Find that time, carve it out, and protect it. You matter. You deserve that time to recover. You deserve that time to regulate. It’s going to not only help you, it’s going to help everyone else in your life.

Sarah Trott (39:14) Yes, connecting the goal, wanting to build resilience, wanting to heal in a smart way, being proactive and intentional about your nervous system, connecting those goals and committing to that 10 minutes every morning or whenever you can find it, it doesn’t have to be perfect or the same time every day, that can really help.

Megan Pfiffner (39:40) And motivation matters too. For some women it’s really hard to do things for themselves. If you’re struggling with that, think about the reverberations: if I do this for me, I’m taking care of my children. If I do this for me, I’m taking care of my partner. If I do this for me, I’m taking care of my boss, my family, my relationships. You’re doing this to take care of yourself so that you can show up in a way that takes care of the people you love.

CLOSING THOUGHTS

Sarah Trott (40:06) Brilliant. Megan, what final thoughts do you have for our listeners?

Megan Pfiffner (40:22) You can’t let it slide. If you don’t take care of yourself in postpartum and this just keeps going, then when you start going into perimenopause, you’re going to be behind the ball. It’s going to be more challenging because you didn’t lay the foundation. Get those labs, take care of yourself, get that food. Remember, we want to restore you to that fully stocked Friday morning Whole Foods space. And remember to give yourself a little kindness and a little compassion, because you are doing great.

Sarah Trott (40:49) Thank you. Megan, where can we find out more about you?

Megan Pfiffner (40:53) At my website, meganpfiffnernutrition.com. I’ll spell that out because it’s a little challenging: M-E-G-A-N-P-F-I-F-F-N-E-R, nutrition.com. Thank you for having me, Sarah.

Sarah Trott (41:05) Wonderful, and we’ll link to that in our show notes. Thank you so much for being a wonderful guest on the program today.