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The New Science of Women’s Health: Strength, Metabolism & Menopause with Dr Stacy Sims #578

Sep 16, 2025 2h 18m 32 insights
As we get older, have you ever wondered why the exercise advice we’ve been given doesn’t seem to work as well as it once did? As we move into our 40s and beyond, our physiology changes in ways that can often feel confusing and frustrating. But what if we could harness those changes to feel stronger, healthier and more resilient than ever before? My guest this week is exercise physiologist and nutritional scientist, Dr Stacy Sims. Stacy is dedicated to helping active women – and the people who support them – take back control of their bodies, health and lives through science-based knowledge and practical tools. She is the author of two books, including ‘ROAR: How to Match Your Food and Fitness to Your Unique Female Physiology for Optimum Performance, Great Health, and a Strong, Lean Body for Life’ and the creator of her signature course, Women Are Not Small Men, after recognising the lack of research specifically done on women in exercise, nutrition and medicine. In this conversation, we discuss: Why conventional fitness advice often fails women in midlife, and how we can move beyond outdated recommendations How hormonal changes during perimenopause affect everything from metabolism and muscle strength to mood and sleep The crucial role of resistance training in maintaining bone density, muscle mass and cognitive function as we get older Why high-intensity interval training can boost our metabolism, balance blood sugar and reduce harmful belly fat How the language around “muscle toning” can be unhelpful, and why lifting heavier weights is so important for building real strength and protecting our long-term health Practical ways to start strength training safely, even if you don’t enjoy the gym, and simple strategies for fitting effective movement into a busy week with minimal time How building strength now supports our independence, resilience and vitality, helping us stay active, prevent injuries and feel confident as we age This conversation is an invitation for all of us to rethink what’s possible as we grow older. Stacy’s insights remind us that with the right information and support, we can build strength, confidence and better health at any stage of life. And if you find this episode helpful, why not share it with the women in your life – friends, family or colleagues – so they can feel empowered and informed about their bodies, too. I hope you enjoy listening.   Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com.   Thanks to our
Actionable Insights

1. Prioritize Strength & HIIT

For women in their 40s and beyond, prioritize resistance training and high-intensity interval training (HIIT) as essential forms of movement. These are crucial for aging well, countering hormonal changes, and maintaining strength, power, and metabolic health.

2. Rethink ‘Eat Less, Move More’

Challenge the cultural belief that women need to ’eat less and move more’ for health or weight loss. Instead, nourish your body with high-quality food and appropriate movement, which often means consuming more calories than typically perceived as suitable.

3. Sleep is Foundational

Prioritize getting really good sleep as the first step in any health journey. You cannot effectively implement or sustain other lifestyle changes, like exercise or nutrition, without adequate rest.

4. Lift Heavy for Longevity

Engage in heavy resistance training (0-7 reps per set) to build and maintain strength, power, and bone density, especially for women in perimenopause and postmenopause. This directly counters muscle weakness and lean mass loss associated with declining estrogen.

5. Implement True HIIT/SIT

Incorporate true polarized High-Intensity Interval Training (HIIT) or Sprint Interval Training (SIT) into your routine. This involves short bursts of maximum effort (e.g., 30 seconds all-out with 2-3 minutes full recovery) to significantly improve metabolic control, reduce visceral fat, and enhance vascular compliance.

6. Eat More Quality Food

To change body composition and lose fat, focus on consuming more high-quality, nutrient-dense food, including sufficient protein, rather than restricting calories. This approach supports your gut microbiome, muscles, and hypothalamus, aiding in fat loss and overall hormonal balance.

7. Avoid Undereating for Fat Loss

Do not reduce calorie intake to lose fat, as undereating can disrupt appetite hormones and lead to increased fat storage. Instead, eat consciously and in alignment with your circadian rhythm to support proper hormonal function and positive body composition changes.

8. Time-Efficient Workout Plan

If time-constrained (e.g., 1 hour/week), structure your session with 20 minutes of mobility, 20 minutes of compound heavy resistance training, and 2-3 sprint intervals. This bare minimum approach maximizes gains for body composition and brain health.

9. Walking Alone is Insufficient

For women in perimenopause and beyond, walking alone does not provide the necessary stimulus for building strength, power, bone density, or optimizing vascular compliance. These are critical adaptations needed to age well and mitigate hormonal changes.

10. The Importance of Heavy Lifting

For women, heavy lifting is critical for aging well, maintaining independence, and being ‘muscle-centric’ and strong throughout perimenopause and postmenopause. This directly stimulates muscle stem cells and strengthens muscle contractions.

11. Distinguish ‘Toning’ from Strength

Understand that ‘muscle toning’ (higher reps, lower loads, Pilates) provides metabolic stress but not the nervous system stimulus for true strength and power gains. For longevity and robust physical changes, heavy lifting is required.

12. Overcome Fear of Bulkiness

Do not let the fear of ‘getting bulky’ deter you from heavy strength training. It is extremely difficult for women to bulk up without specific genetic predispositions; instead, you will gain strength, improve cognitive function, and build strong bones.

13. Lift Heavy Enough

To ensure effective strength training, select a weight that allows you to perform only 0-7 repetitions before reaching fatigue. Most women underestimate their strength, so challenge yourself to lift heavier than you think you can.

14. Integrate Sprints into Walks

Add high-intensity intervals to your regular walks by picking up the pace for 1-2 minutes, followed by a minute of recovery. This simple modification can turn a leisurely walk into a beneficial HIIT session.

15. Proper HIIT Duration

Limit true HIIT sessions to no more than 30 minutes (including warm-up and cool-down) to maintain proper intensity. Longer sessions often result in moderate intensity (‘gray zone’) which can elevate cortisol without the beneficial post-exercise hormonal drop.

16. HIIT Improves Sleep

Engage in true high-intensity interval training to improve your sleep quality. Better sleep is a foundational element that positively impacts all other aspects of your health and well-being.

17. Zone 2 as ‘Soul Food’

For women, Zone 2 training (low intensity, long duration) offers fewer unique benefits for mitochondrial health and metabolic flexibility compared to men. While not harmful, if time-pressed, prioritize HIIT and strength training for maximum gains, reserving Zone 2 for ‘soul food’ or mental well-being.

18. Menopause Hormone Therapy Context

View Menopause Hormone Therapy (MHT) as a tool to manage symptoms like hot flashes and support bone health, rather than a ‘replacement’ for declining hormones. It does not stop all age-related changes, and lifestyle interventions remain crucial for overall health.

19. Consider CBT for Hot Flashes

For mild hot flashes, Cognitive Behavioral Therapy (CBT) has been shown to be more effective than Menopause Hormone Therapy (MHT). Explore this alternative for symptom management.

20. Find a Fitness Community

Seek out a friend or join an online fitness community (e.g., through apps) to support your exercise journey. Community provides encouragement, accountability, and a valuable resource for questions and motivation.

21. Reteach Movement for Girls

For girls entering puberty, focus on reteaching fundamental movements (running, throwing, landing, jumping) to help them adapt to rapid biomechanical changes. This improves coordination and confidence, potentially reducing dropout rates from sports.

22. Functional Strength for Young Girls

Encourage strength training in young girls and teenagers with functional movements and light loads, rather than heavy weights. The goal is to develop proper movement mechanics under load, not to build maximal strength, to prevent poor motor patterns.

23. Home-Based Strength Training

Strength train at home using items like loaded backpacks, sandbags, kettlebells, or fitness apps for guidance. This allows for adding external load and progression without needing a gym.

24. Strength Training Programming (5x5)

For heavy lifting, consider a ‘five by five’ program: five sets of five repetitions with 2-3 minutes of rest between each set. Aim for a weight that causes fatigue by the final set.

25. Prioritize Exercise by Need

Tailor your exercise focus based on your most pressing health needs; lean into HIIT/SIT for metabolic control or strength training for bone density and lean mass.

26. Understand HIIT Umbrella Term

Recognize that High-Intensity Interval Training (HIIT) is an umbrella term, with Sprint Interval Training (SIT) as a subset, and other forms involving 1-4 minutes of work at 80-90% max effort with 1-2 minutes recovery.

27. Strength Training for All Ages

Engage in strength training as you age, regardless of gender, to counteract anabolic resistance to exercise and protein. This helps your body continue to build and maintain muscle and bone mass.

28. Structured Bike Workout

For endurance-focused women on an exercise bike, incorporate 30-second all-out sprints after a 10-minute warm-up, followed by 4.5 minutes of low-intensity recovery. Repeat sprints while maintaining wattage, then cruise.

29. Understand Perimenopausal Changes

Recognize that perimenopause can begin as early as 37-38 with anovulatory cycles, leading to shifts in estrogen and progesterone ratios. These hormonal changes impact every body system, including bone density, metabolism, and stress response.

30. Avoid Body Comp Missteps

If not seeing desired body composition changes despite good lifestyle, avoid increasing walking, eating less, or doing fasted exercise. These traditional approaches are often missteps for longevity.

31. Speak Up to Trainers

Take control of your training sessions by communicating your needs to personal trainers or class instructors. Advocate for workouts that align with your body’s requirements during different life phases, such as shorter heavy lifting sessions or longer warm-ups.

32. Strength Training Benefits

Strength training improves power, balance, brain health, gut microbiome, bone density, vascular compliance, blood pressure, metabolic control, and glucose regulation. These benefits collectively mitigate many negative effects of aging and hormonal changes.