BITESIZE | What You Need To Know About Strength, Menopause & Healthy Ageing | Dr Stacy Sims #673

Jul 9, 2026 Episode Page ↗
Overview

Dr. Stacy Sims, an exercise physiologist and nutritional scientist, explains why conventional fitness advice often fails women in midlife. She details how physiological changes in perimenopause necessitate specific resistance and high-intensity interval training for optimal health, vitality, and resilience.

At a Glance
9 Insights
29m 36s Duration
11 Topics
6 Concepts

Deep Dive Analysis

Common Fitness Mistakes for Midlife Women

Physiological Differences Between Men and Women

Why Walking Alone is Insufficient for Aging Well

Impact of Estrogen Decline on Body Systems

Importance of Resistance Training in Perimenopause

Role of HIIT in Metabolic Control and Fat Reduction

Structuring Workouts for Time-Pressed Women

Home-Based Strength Training Options

Benefits of Strength Training for Longevity

Urgency and Empowerment in Starting Early

Finding Support and Community for Training

Vascular Compliance

This refers to the ability of blood vessels to constrict and dilate in response to stimuli like hot and cold, which affects blood pressure. Estrogen decline in perimenopause reduces this flexibility, leading to stiffening blood vessels.

Insulin Resistance

A condition where the body's cells don't respond well to insulin, leading to higher resting blood glucose levels. This tends to increase in women during perimenopause due to hormonal changes.

Myokines

These are hormones released from skeletal muscle during exercise that circulate and influence other body systems. High-intensity interval training (HIIT) stimulates myokines that help the body use free fatty acids as fuel rather than storing them as visceral fat.

Anabolic Resistance

As people age, their bodies (both men and women) become less responsive to exercise and protein in terms of building muscle and bone. Strength training helps counter this resistance and promotes muscle and bone growth.

Neuroplasticity

This is the brain's ability to change and adapt throughout life. Heavy resistance training stimulates neuroplasticity, which is important for maintaining cognition and preventing cognitive decline.

Obesogenic Phyla

A type of gut bacteria (e.g., firmacruities) that, when dominant, encourages the body to hold onto body fat. This can increase in women during perimenopause due to changes in gut microbiome diversity.

?
Is walking 60 minutes a day enough for a 45-year-old woman to age well?

No, walking primarily provides cardiovascular work but does not optimize vascular compliance, metabolic control, bone density, or the strength and power needed to age well, especially with declining sex hormones.

?
Why do women in perimenopause experience a loss of strength and an increase in body fat?

Initial strength loss is due to estrogen affecting muscle contraction proteins; later, a significant loss of lean mass and increase in body fat occur, partly due to changes in the gut microbiome favoring obesogenic bacteria.

?
How does heavy resistance training help women in perimenopause?

It creates adaptations that strengthen muscle contraction, stimulates muscle and bone building, and improves neuroplasticity, helping maintain strength, power, lean mass, and cognitive function.

?
How does high-intensity interval training (HIIT) benefit women in perimenopause?

HIIT improves metabolic control by allowing muscles to pull in carbohydrates without insulin and stimulates myokines that encourage the body to use free fatty acids as fuel, reducing visceral fat.

?
Can women strength train effectively at home without a gym?

Yes, women can start with bodyweight exercises and gradually add external load using items like loaded backpacks, sandbags, kettlebells, or weighted vests, with many apps available for guidance.

?
Is it ever too late for women to start strength training?

No, it's never too late; examples like Joan, who started in her mid-60s and achieved significant strength gains, demonstrate that the benefits are accessible at any age.

1. Prioritize Heavy Resistance Training

Women in perimenopause and beyond should lift heavy loads to maintain strength, power, lean mass, and stimulate muscle stem cells, countering the effects of declining estrogen on muscle contraction and bone density.

2. Incorporate High-Intensity Interval Training

Implement true polarized HIIT (80-110% of max effort with significant recovery) to improve metabolic control, enhance metabolic flexibility, and reduce dangerous visceral fat accumulation.

3. Rethink ‘Move More, Eat Less’

Traditional diet culture advice is ineffective for women 40+; instead, focus on more high-intensity exercise and potentially eating more to shift body composition.

4. Adapt Walks into HIIT Sessions

Even during regular walks, incorporate short bursts of high-intensity effort (e.g., picking up pace for a minute or two, then recovering) to integrate HIIT without needing dedicated sessions.

5. Start Strength Training at Home

For those who dislike gyms, begin with bodyweight exercises, then gradually add external load using items like loaded backpacks, sandbags, kettlebells, or weighted vests.

6. Seek Community for Training

Find a friend or join online communities (e.g., Betty Rocker, Haley Happens Fitness, Loretta Loves Lifting) for support, adherence, and progression in your strength training journey.

7. Address Physiological Differences in Training

Recognize that women and men are physiologically different, and training advice should be tailored to female physiology, especially during perimenopause and postmenopause, rather than relying on male-centric data.

8. Focus on Muscle-Centricity for Longevity

To age well, prioritize being muscle-centric and strong, as observed in studies showing better viability and quality of life for older women with more lean mass and strength training.

9. Integrate Mobility Work Before Training

Dedicate time to mobility work before resistance training to open joint capsules, create more range of motion, and prevent injuries.

Women are not small men.

Dr. Stacy Sims

If we're looking at what optimizes a woman's body as she's going through perimenopause and into postmenopause... There are things that you can optimize from an external load to really create a stress resilient, strong frame, both mental and physical frame to carry you through to your late years of life.

Dr. Stacy Sims

Be the oldest person in the gym, not the youngest person in the nursing home.

Dr. Stacy Sims

It's not that one is more complicated than the other. It's just, we're different. And we respond differently.

Dr. Stacy Sims

One-Hour Weekly Workout for Time-Pressed Women

Dr. Stacy Sims
  1. Mobility Work (20 minutes): Focus on opening joint capsules, increasing range of motion, proprioception, and loosening tendons/ligaments to stay injury-free.
  2. Compound Heavy Resistance Training (20 minutes): Perform exercises that involve multiple joints and muscle groups, lifting heavy loads.
  3. Sprint Interval Work (20 minutes): Do 2-3 rounds of 30 seconds of 110% effort, followed by 2-3 minutes of full recovery (e.g., on a salt bike or kettlebell swings).
40 plus or 45 plus
Age range for perimenopause According to Dr. Stacy Sims
55 kilos
Bench press weight for Joan A 72-73 year old woman who started lifting in her mid-60s
100 kilos
Deadlift weight for Joan A 72-73 year old woman who started lifting in her mid-60s
Mid-60s or late 60s
Age Joan started strength training Example of someone starting later in life