Perimenopause is a hot topic right now. There is so much in the media about perimenopause and, while it’s amazing that people are speaking out and more women are educating themselves about it, there is a lot of noise and misinformation out there as well. I recently completed an online course on menopause, created by Dr. Sims, one of the leading experts on women’s health; here are just a few takeaways. This is not just for women – guys, you should read this too!
Perimenopause can start as early as 35 years of age (not after 40, like we’ve long been told). Most women spend years experiencing symptoms they don’t understand and wondering what’s wrong with them. Women have estrogen receptors in every system in the body. This is why the list of possible symptoms is 35+ (most women know up to 5). In perimenopause, estrogen doesn’t simply decline, it fluctuates wildly; spiking one cycle then crashing the next. This creates unpredictable and confusing symptom patterns and commonly leads to women being misdiagnosed with anxiety and/or depression. If you are feeling “off” in any way, talk with your medical provider and advocate for yourself.
Intensity and heavy lifting are key. The advice to dial back workout intensity during perimenopause was based on research done on men, not women. Read that again… High intensity drives the hormonal responses needed to improve body composition, metabolic health, insulin sensitivity, and brain function – all things that estrogen used to support. High intensity interval training (including sprint interval training) creates powerful adaptations in muscle, mitochondria, blood vessels, and fat metabolism that traditional moderate-intensity exercise does not. This does not mean that endurance training and HYROX are “bad,” but this shouldn’t be the only way you train. You need to add short, intense workouts and do heavy lifting and resistance training (hello, CrossFit!). Resistance training is critical for maintaining strength, bone density, and metabolic health. Heavy lifting also supports joint mobility, glucose control, and body composition.
Most women are under-fueling. We’ve long been told to “move more and eat less” if we want to lose weight and improve body composition. In perimenopause, this actually works against us. As said above, we need to train smarter not harder, and we need to properly fuel our training and recovery. For women in perimenopause, the pre-workout recommendation from Dr. Sims is 15g of protein and about 30g of carbohydrate. Training puts stress on the body but, if we have properly fueled for that stress, our bodies have a better ability to repair, adapt, and become stronger. Over time, we can then adapt to even greater stresses, which is what becoming fit is all about. It’s equally important to fuel after training. For women in perimenopause, the post-workout recommendation from Dr. Sims is 30-40 grams of protein and a little bit of carbohydrate within 45 minutes. (The window for protein intake to initiate protein muscle synthesis post-workout is shorter for women; men can still get that benefit by fueling up to 4 hours post-workout). When we’re not fueling after training and staying in that post-exercise depleted state, our bodies go into a catabolic state, or a breakdown state; this removes the body’s ability to adapt to training. Post-exercise fuel gets us out of that breakdown state and gives the body the ability to repair, recover, and adapt.
This is only a surface-level scratch into a huge topic. If you’re interested in learning more and going into detail about training and nutrition through peri and post menopause, keep an eye out for a small group coaching program coming in 2027!
-Coach Liz
