Health, Longevity & Biohacking

Dr Stephanie Estima says Kegels can worsen symptoms with tight pelvic floors

Name: Dr Stephanie Estima says Kegels can worsen symptoms with tight pelvic floors
Uploaded: 2026-07-20T12:17:00+00:00
Description: Dr Stephanie Estima says Kegel exercises can help when the pelvic floor is weak but may be counterproductive for people who have a tight pelvic floor and struggle to relax the muscles. She recommends seeing a pelvic-floor physiotherapist for diagnosis and tailored guidance.

Diary of a CEO · Women’s Fitness Expert: What You NEED To Know About Dieting & Exercise | Dr. Stephanie Estima · July 20, 2026

Diary of a CEO

Women’s Fitness Expert: What You NEED To Know About Dieting & Exercise | Dr. Stephanie Estima

"Weak pelvic floors, Kegels are great. They can actually if you have if you have a tight pelvic floor where you actually have trouble relaxing, Kegels can actually make things a little bit worse for you."

Dr Stephanie Estima says Kegel exercises can help when the pelvic floor is weak but may be counterproductive for people who have a tight pelvic floor and struggle to relax the muscles. She recommends seeing a pelvic-floor physiotherapist for diagnosis and tailored guidance.

About this episode

Dr Stephanie Estima, a chiropractor and women’s fitness educator, tells Steven Bartlett she wants to shift women away from pursuing weight loss at “all costs” and towards strength, muscle gain and bone health. She describes her own experience competing in a figure contest, saying she reached 11% body fat, lost her period for months beforehand, later developed hormonal issues and regained the weight, despite receiving praise for her appearance.

Estima outlines four “archetypes” she sees in practice — including “overwhelmed Olivia” and “skinny fat Sophia” — and argues that many women under-eat and avoid heavy resistance training due to fear of bulking. She challenges long-standing gym myths, including spot fat reduction and the idea of a narrow post-workout “anabolic window”.

On diet, she says low-carb or ketogenic approaches may be useful temporarily for certain populations such as people with type 2 diabetes or PCOS, but warns against staying very low-carb long-term, linking it to symptoms she associates with thyroid dysfunction. She also argues that very long fasts can be problematic for women, claiming they can signal “famine conditions” and disrupt menstrual cycling.

Estima discusses sex differences in pelvic anatomy and the implications for squatting mechanics and ACL injury risk, emphasising hip stability. She argues sprinting and jumping should be maintained with age, citing research she says shows sizeable improvements in VO2 max among women in their late 50s. The episode ends with a brief discussion of faith and family legacy.

Key takeaways

Estima says she wants women to prioritise gaining muscle and bone density rather than continually trying to “lose”.
She recounts competing at 11% body fat and says she lost her period for months and later had hormonal issues.
She argues women’s wider pelvis and larger Q-angle can change knee mechanics and may increase ACL injury risk if hip stabilisers are weak.
She claims prolonged low-carb dieting can contribute to thyroid-related symptoms in some women, and argues women need carbohydrates for mood, sleep and performance.
She says very long fasts (20–72 hours) may make it difficult for women to meet energy needs and could disrupt menstrual cycling.
She cites studies she says show sprint training can rapidly improve VO2 max in women around age 58, with large mitochondrial efficiency gains.
She cautions that Kegels can worsen symptoms for people with tight pelvic floors and suggests pelvic-floor physiotherapy for assessment.