The Female Athlete: How to Stay Lean and Maximize Performance Through Menopause

I recently attended an Online Masters Athlete Symposium in which Dr. Stacy Sims was a speaker…..I polled our followers asking if they wanted me to share what I’d learned and many answered with a resounding YES! So here are a few takeaways from the brief 1 hr presentation:

• There are 3 distinct phases: perimenopause, menopause and postmenopause
• Perimenopause is actually where many female athletes start noticing that despite the same diet and exercise routine, they’re starting to put on weight (especially around the middle section or abdomen). Generally begins between 36-45 years of age. It can last up to 10 years but usually 4-5 years before periods stop. Estrogen goes up relative to progesterone (estrogen dominance).
• Menopause: The average age is 51 years old and is technically after 12 months of no menstruation. Premature or early pemopause starts between 40-45 years old.
• Post Menopause: Menopause is complete and menstrual cycle has completely stopped. Some women experience hot flashes for 20+ years (adipose aka fat tissue related ie. the more body fat you have, the more likely you’ll experience these hot flashes)

Since I’ll be turning 44 years old in December 2020, I paid extra attention to the peri-menopausal portion of the presentation. It’s a bit sobering when you look at what starts to happen with the hormonal fluctuations:

1. Reduced sensitivity to anabolic stimuli (exercise, protein)
2. Decreased muscle synthesis
3. More subcutaneous (especially visceral i.e. fat around the organs or belly fat) and intramuscular fat
4. Decreased bone density
5. Decreased Insulin sensitivity (means you need more insulin to lower blood sugar levels and a harder time metabolizing glucose/sugar)
6. More muscle catabolism (breakdown of muscle)
7. Increased protein needs

By this point of the lecture, I was getting a bit depressed! But then she offered some solutions:

• HIIT (High Intensity Training) and Strength Training are CRITICAL
• She says to put away the bands and the 2 lb dumbbells and lift heavy sh*t
• She presented a study on sprint interval training on the Body composition (fat vs lean mass) of postmenopausal women
• For Strength and Power: focus on plyometrics, crossfit style workouts, low reps with HEAVY resistance
• For Endurance: Focus on intensity (% of VO2max), HIIT for insulin sensitivity and LESS focus on long slow distance (LSD)
• She recommends doing a 2 weeks ON (build), 1 week OFF (recover) training plan as opposed to the generic 3-4 weeks on, 1 week off that many coaches prescribe.

Interestingly, there were a lot of parallels for Master’s athletes in general from the other speakers in the symposium. Master’s athletes are athletes over 40 years old. You can still be very competitive and in fact, many of the top Ironman athletes are in the 40-49 age bracket! I’ll write another blog about Master’s athletes in general another time.

What’s cool is that I’ve instinctively done some of the things she recommends (I’ve also read her book Roar which I highly recommend) and some of her advice confirms my bias for sure! I like lifting heavy and definitely see a improvement in my body fat during the winter months when it’s triathlon off season: I do less cardio and instead focus on the big compound movements or lifts: deadlift, squats, pullups, etc.

I personally also feel that while bands, 2 lb dumbbells and pilates/barre/yoga classes have their place, they are certainly NOT the best way to build or preserve bone or muscle mass as we get older. I’ve got a group of over 70 year olds (it’s a small group class we call the IronFit Crew) that all lift kettlebells for strength and do pilates for mobility, core and balance. We regularly do squats, deadlifts and pushups (modified to an elevated surface as opposed to knees). They put some of my 30-40 year old patients to shame! Here’s a pre-covid video:

I also teach an advanced kettlebell class that I’ll be changing a bit to incorporate more plyometrics based on the information from this symposium. Especially since many of them are also runners! The great thing about kettlebell training is that if you train properly, you will build power and it’s easy to make it HIIT. Ever do 100 kettlebell swings, a kettlebell complex or a snatch ladder? It’s power and high intensity training wrapped up into 1 workout. Here’s a slow motion video on how to perform the Kettlebell swing properly:

Wanna learn how to train with kettlebells but don’t know where to start? Check out my Beginner Kettlebell Foundations Video Guide: https://www.ironhorsept.com/For-Patients/Kettlebell-Training/a~9486–c~399476/article.html

I hope this article helps some female athletes who want to continue training at a high level while preventing bone and muscle loss as we age. Feel free to share with a friend who could benefit from this information and/or subscribe to our Youtube channel for more tips and even some sample kettlebell and pilates classes! Contact our San Ramon physical therapy expert today.