Menopause affects around 50% of the Earth’s population, and science has a lot of catching up to do. There are still many open questions - and plenty of conflicting information about how to treat menopause symptoms and maintain a healthy weight during the transition. As a Women's Health Coach and PT a lot of clients are going through the menopause transition, (including myself). The knowledge I have gained from this course is going to be so beneficial to help them and myself be where we want to be and feel great about ourselves.
Hey there, amazing women! Whether you’re in your 20s building a strong foundation, navigating the unpredictable waves of perimenopause in your 30s or 40s, or embracing menopause and beyond, fitness isn’t just about looking good-it’s about feeling empowered, resilient, and full of energy. Dr. Stacy Sims, a renowned exercise physiologist and nutrition scientist, has dedicated her career to helping women understand how our bodies change and how to adapt our training and fueling strategies accordingly. Drawing from her insights shared in podcasts like the Huberman Lab and ZOE Science & Nutrition, plus her latest 2025 updates, this blog post distills practical, science-backed advice to help you get fitter, no matter your age or starting point. Remember, it’s never too late to start-small, consistent steps can lead to transformative results.
Understanding Menopause and Its Impact on the Body
Perimenopause, which can sneak up as early as your mid-30s (or even 32-35 for some), is that transitional phase before menopause where hormones like estrogen start fluctuating wildly. Symptoms might include weight gain around the middle, sleep issues, brain fog, or feeling “tired but wired.” Menopause officially kicks in after 12 months without a period, often in your late 40s or 50s, bringing challenges like bone density loss (up to one-third) and muscle decline due to dropping estrogen. But here’s the inspiring part: These changes aren’t inevitable roadblocks-they’re opportunities to adapt and thrive.
The Role of Hormones
As you enter perimenopause - the time leading up to your final period - levels of estrogen and progesterone fall out of their regular cycles. Because these hormones affect every part of your body, fluctuations in their levels lead to a wide range of symptoms, including hot flashes, sleep disturbances, mood changes, and weight gain. These changes can even impact the diversity of your gut microbiome, as we found in the ZOE menopause study. Shifting levels also affect how well your muscles work - estrogen is vital for maintaining strong muscles.
Dr. Sims emphasizes that tailoring your fitness routine during perimenopause can prevent many unwanted shifts in metabolism and body composition. Even if you’re younger or postmenopausal, these principles build lifelong strength and vitality. Instinctively I had always known that we needed a paradigm shift in all aspects of our thinking about this demographic, particularly with the way we have been coaching female athletes.
Read also: Jen Stacy's inspiring story of recovery
Perimenopause vs. Menopause: Key Differences
When we talk about menopause it is actually one day on the calendar. And it's the one day that marks 12 months of no periods. The time after that, the day after that, is postmenopause. And you have early and late postmenopause. And the time before that is perimenopause. And this is where we see all the symptomology and body composition changes and all the things that people typically say, Oh, it's menopause.
Perimenopause is the most interesting, I guess, time point of differentiation between how a man ages and how a woman ages, because we see a lot of the aging and longevity literatures based on this linear trajectory of age. When we're looking at perimenopause, women age very differently during this time period because it depends on how the ratios of estrogen and progesterone start to shift.
When we get into perimenopause, we start to have more and more anovulatory cycles. So if we're not ovulating, we don't produce progesterone. We're still producing estrogen, but because we don't have progesterone, the ratios of those two hormones are shifting. And these hormones are more than just reproductive hormones. They affect every system of the body.
The Impact on Muscle and Metabolism
Estrogen is really responsible for stimulating muscle protein synthesis along with insulin. So when we have this change in hormones, we're also having a change in how our body responds to blood sugar. And we also have a change in our metabolism. So when we look at all of these things together, and people are trying to unfortunately exercise more, or they're eating less, or they're trying all these fad diets, it's not going to work. Because it's not about metabolism per se. It's not about the strength of your contraction. It's about how these hormones are affecting the basic cell of the muscle fiber. How your body's responding to glucose, how insulin's responding. So we have to really look, take a pause and say, you know what? I need to find an external stress, primarily through exercise, that is going to cause the body to respond in the way these hormones used to allow the body to respond.
Cardio Reimagined: Smarter, Not Harder
Cardio doesn’t have to mean endless hours on the treadmill. Dr. Sims advocates for smarter, more efficient approaches that respect your body’s hormonal shifts, reducing stress while boosting health.
Read also: Training adaptations for women, according to Stacy Sims
Ditch Prolonged Moderate-Intensity Sessions
Skip long, steady-state jogs or spins that spike cortisol without much payoff. Instead, they can worsen symptoms like fat gain or poor sleep.
Embrace High-Intensity Interval Training (HIIT)
Limit to 1-2 sessions per week, keeping them short (30 minutes total, including warm-up and cool-down). Go for 80-90% of your max effort in bursts (e.g., 30 seconds sprinting, 2-3 minutes recovery). This promotes glucose uptake, fights inflammation, and supports fat loss without over-stressing your system.
Beginners:
Start with walking intervals-power walk for 30 seconds, then stroll.
Add Sprint Interval Training (SIT)
Incorporate short, intense sprints (1-4 minutes at 80% effort) as part of your routine to build bone and muscle strength, countering estrogen decline.
Go Polarized
Mix low-intensity “Zone 2” cardio (like brisk walking or easy cycling) with high-intensity bursts. Aim for about 5 hours of moderate-to-vigorous activity per week (around 1850 MET minutes-think brisk walks adding up).
Read also: Sims 4 Well-being Tips
These methods aren’t about grinding it out-they’re about working with your body for real results, like better energy and a stronger heart.
Strength Training: The Cornerstone of Women’s Fitness
Strength training is the “big rock” of women’s fitness, according to Dr. Sims-it’s non-negotiable for combating muscle and bone loss, especially as estrogen dips. But don’t worry if you’re a beginner; the focus is on quality over quantity, and it’s adaptable for any level.
Heavy Resistance Training
Focus on compound moves like squats, deadlifts, push-ups, and rows. Do 5-10 reps per set, leaving 2-3 reps “in the tank” to keep form sharp. Lift heavy enough to challenge yourself-this stimulates your nervous system and builds muscle to offset losses.
Incorporate Jumps and Plyometrics
Add box jumps or stiff-leg landings to boost bone density and power. Start low if you’re at risk for fractures-even simple hops can help.
Start Gradually
Beginners, spend 2 weeks to 4 months mastering form to avoid injuries like frozen shoulder, which are more common in perimenopause due to hormonal changes. Use bodyweight or light weights first.
If time is tight, combine strength with HIIT in a 30-minute session.
Nutrition: Fueling for Strength and Recovery
Nutrition isn’t one-size-fits-all, especially with hormonal shifts making your body less responsive to building muscle. Dr. Sims stresses fueling properly to avoid stress spikes and support recovery.
Protein Power
Aim for 2-2.3 grams per kilogram of body weight daily (e.g., about 140-160g for a 70kg woman), spread across meals every 3-4 hours. Post-workout, get 40-60g of leucine-rich protein (like whey or eggs) within 45-60 minutes.
Pre-Workout Fuel
Have 15g protein plus 30g carbs (e.g., a protein-coffee shake) before sessions to stabilize blood sugar and curb cortisol.
Avoid Fasted Workouts
Skip training on an empty stomach or long fasts-they amp up stress, especially when cortisol is already high.
Carbs and Fats the Right Way
Source carbs from colorful veggies, fruits, and whole grains for gut health and hormone balance. Add healthy fats from nuts, avocados, and olive oil.
Supplements to Consider
- Creatine: 3-5g daily (build up over 3-4 weeks) for muscle, brain, and heart health-great for brain fog.
- Vitamin D3-K2: Take in the morning for overall and bone health, especially if sunlight is limited.
- Adaptogens: Like ashwagandha or holy basil to manage cortisol and stress.
- Magnesium Glycinate: For better sleep and relaxation.
- Omega-3s: From fish or algae sources for inflammation control.
Additional Insights from Dr. Stacy Sims
The Importance of Hydration
Hydration is Power. Dr. Sims returns to discuss the crucial aspects of recovery, hydration, and the unique considerations for women, particularly those in perimenopause.
Challenging Misconceptions
Overall, Stacy wants to move us past the pervasive stereotype that men do weights and women do cardio. Women need to be in the weights room, too.
The Gender Data Gap
Stacy Sims: Perimenopause into postmenopause, there's a significant gender gap in data. Up until about four or five years ago, there wasn't really insight on what causes a hot flash. And it's just so important to break that sociocultural idea that women shouldn't be in the weight room because they're delicate flowers.