The general guideline is 150 minutes of activity per week. This advice is about 20 years old.
What's important are the ratios of estrogen and progesterone, ratios change as you enter menopause.
Menopause causes a demise in sensitivity of receptors, change in gut microbiome, bone and muscle loss.
How can we do super high intensity work to cause epigenetic changes in the muscles as we become more insulin resistant?
Lifting heavy has a CNS effect. It stimulates muscle protein synthesis. Strength and power. Faster nerve signaling, stronger muscle contraction, in the absence of estrogen.
Raising cortisol is a danger zone. We already have elevated baseline cortisol. Resistance training with 10-12 exercises can just raise cortisol.
Muscle fatigue is caused by the load? or the volume? Women tend to under-load. If you want to gain lean mass, you can just do a volume to fatigue. But if you want to prevent falls, you need the heavier load to engage proprioception. Do 5-7 reps of heavier load rather than 10-12 reps of lighter load. You can do 5 sets of 5 with good mechanics.
Periodization is important for the rest of your life. It doesn't stop at one competitive event. You want cycles of building up and off-season. First 3 months is base building. Then add load.
Sprint-interval training. Not HIIT. Working at 95-110% of VO2max. You can only hold it for <30 seconds. Not more than 1 minute. HIIT is 1-2 minute intervals. In sprint-interval training, you're having longer 2-3 minute recovery periods. It yields more metabolic and CNS adaptations, which are more beneficial to perimenopausal women. More impactful than hormone therapy.
Metabolism, cardiovascular risks, bone density. Improves muscle uptake of glucose. Controls blood pressure.
Protein is super-important! For even sedentary, obese or normal-weight women. 1 gram per pound which is compared to 0.6 grams per pound. Higher protein intake allows reorganization of body composition. If you add strength training, you can do it even faster. Recomposition.
Anabolic resistance happens in perimenopause. Taking in protein every 3-4 hours is important for recomp and protein synthesis. Without taking in protein, you can't recomp your body.
Men age linearly while women have a big change point in the mid-forties. We have some anovulatory cycles. We have estrogen without progesterone. We see significant changes including loss of lean mass, increase in adiposity. We don't have signals to keep lean mass. We are confused and therefore pack on body fat to prepare for hibernation. We lose strength and power.
We have to look at gut diversity. Because our hormones are digested in the gut.
The tendency is that when women start storing fat, they just eat less. Downregulating thyroid, increasing bone catabolism, increasing muscle catabolism. You should not do fasted exercise. You should not be skipping recovery meals. Manipulating body comp is done by fueling training and eating less at night when you're not training.
If you fuel properly, you will have more energy, which will feed forward more quickly, and you will see results. Fasted training can work for men but not women, especially when we're going through menopause. Even for women who are in their reproductive years, fasted training is not good for us. We have a system for using free fatty acids in our mitochondria. We already have estrogen shuttling carbohydrates away from muscles, just by being born female.
The recommendations are 100-150 calories, 15-20g protein preworkout before strength training drops cortisol and allows the body to have access to blood glucose. Pre-workout 15-20g protein with 30g of carbs before cardio training. Which allows us to train harder and recover.
Fasted women end up with more hormone dysfunction. Kisspeptin neurons. Men have more fatty acids available if they train fasted, but this does not work for women. Kisspeptin neurons regulate metabolism (fasting leads to low energy availability). The other Kisspeptin neurons regulate appetite and nutrient density. Keto and/or fasting can be counterproductive.
ROAR was first published in 2016 and updated in 2023. Oral contraceptives and hormone replacement. Different times in the cycle have either great or poor resilience to infection. Track your cycle and heart rate variability. Biohacking can lead to better understanding. Natural vs. synthetic hormones and how they are digested in the gut.
Bleed patterns will change when you approach menopause. If there's ovarian failure, you will have an extended follicular phase. You may get heavier or shorter periods, which is indicative of approaching menopause. When you have perimenopause symptoms, you need to get into sprint-intervals. If you're training 3x per week, do 2x per week sprint-intervals. Even if you're endurance training, do some sprint-intervals for metabolic control.
Even doing a sprint-interval once every 10 days, it's better than not doing any at all. You can go to the gym and do it in a group situation. You might find it hard to get the motivation to sprint. Doing two in one session is better than not doing it at all. Within reality, go for the 80/20 rule. Try to do it all the time and then it's okay to give yourself permission to skip 20% of the workouts.
Two weeks of focused training, then one week of recovery. Do what you love. Undulating periodization. "Focusing" could be heavier load on squats. Focus could be something else in the next 3-week block. As we get into perimenopause, we need more recovery.
Estrogen without progesterone is responsible for how strong myocin bonds to actin. So we don't have as strong of a muscle contraction when progesterone is present. Acetylcholine (muscle depolarizing) is also effected by estrogen. No estrogen, less acetylcholine, less strong muscle contraction. Estrogen helps with strength and power. But progesterone limits strength and power. Progesterone is catabolic. It uses the resources to build endometrial lining. Estrogen is anabolic.
In the women's health initiative study, late post-menopausal, 8 or 10 years beyond menopause, women were studied that were manifesting major symptoms like bone loss, cardiovascular issues, and muscle loss. Adding synthetic hormones at that point had more risks than benefits. But there are lots of other things that can be done that can mitigate these things, other than taking exogenous hormones, for example in early perimenopause.
What supplements would you suggest? Adaptogens like maca, ashwagandha, reishi. SSRIs even can bring back a woman's sex drive, which is opposite of during the reproductive years if women are taking SSRIs for anxiety. Because menopause effects dopamine and serotonin signaling.
Diindolylmethane (DIM) is a natural compound found in cruciferous vegetable family, which includes broccoli, Brussels sprouts, cauliflower, and cabbage. DIM can reduce the severity of hormone swings through the menstrual cycle making it more even throughout the month. Magnesium, zinc and omega-3 fatty acids to counter prostaglandins. Shisandra can address high stress and lack of focus. Holy basil and Rhodiola can specifically be helpful for perimenopause.
Insulin resistance makes us need to be more aware of when we take in carbohydrates. They help with gut microbiome and energy. As long as you are using a wide variety of colorful fruits and veg, you're getting quality carbs. Think more about when you take in carbs. 1g/kg per hour for refueling. 3-5g/kg per hour for moderately heavy training loads. 5-8g/kg per hour for the heaviest training loads.
Creatine 1/2 tsp (3-5 grams per day) women have 70-80% as many creatine stores than men. You will have fatigue if you don't get good sleep. Creatine can address low sleep or depression symptoms. Women tend to eat less of foods that contain creatine. Men tend to go through more creatine because they have more fast twitch muscles. Women tend to eat more endurance-related foods. Get more in and have it available. Creatine helps maintain gut integrity also, by maintaining the mucosal lining of the gut.
Have a 12-h fasted window. Stop eating after dinner. Let your body focus on repair.
"Hit play not pause" group. Have conversations about normal aging. Vocalize to your doctor that you might be going through perimenopause.
The Dr. Gabrielle Lyon show (podcast)
Dr. Sims' TED talk
