Friday, February 21, 2025

My Story: The Beginning of Perimenopause and How I Dealt With It


If you're like me, maybe you’ve been going through the issues that arise during perimenopause, but didn't recognize that's what was happening. You might not have known the reason you aren't sleeping well at night, having difficulty feeling comfortable in mild to moderate temperature changes, have GI bloating, or a slew of other things that may actually be associated with perimenopause. Or, perhaps you’ve noticed your body's ability to train the way you did last year is just not the same. Yep, another issue related to perimenopause.

Recognizing the Signs of Perimenopause

I didn't recognize the signs, even though I work with women and tell them about this stuff all the time. Can you believe that? Why did this happen? Why did I not know when it was happening to me that it was perimenopause and not just stress related, or as many people say, it's just in your head. Yep, women are given that response so often it's infuriating.

I didn't realize the issues because I was so focused on other things, as so many women are. I didn't have time to really feel into my own needs. And when I did, all I had time for was catching up on sleep, or trying to. Another perimenopause related symptom is difficulty getting to sleep and or staying asleep, I had the latter.

The Dismissal of Women's Symptoms in Healthcare

All this started for me near the end of 2022. It started with irregular periods. Irregular in both amount of time they would last, to amount of blood loss, to the increasing pain getting so bad I was getting migraines, vertigo, and nausea from them. I just figured it was because I wasn't sleeping well. So I ignored it. I did mention to my doctor my lack of sleep issues, and I was just told to take some melatonin. I was NEVER asked about any other symptoms, nor did menopause come into the conversation.

A year later, summer of 2023, I was noticing my body getting smaller. And not in a good way. I've always been lean but muscular. My muscles were getting smaller with the same amount of lifting and training. To top it off, I was having debilitating hot flashes, to the tune of a dozen or more a day, and they were so bad that I would pack extra clothes with me to work to change when I needed. What the hell! This was when I knew something was wrong. Again I went to my doctor, and again I was never asked further questions, nor was I told it might be perimenopause. Keep in mind I was 45 at the time, so well within the range for it to start. Instead this time I was told to take black cohosh (supposedly for the hot flashes) and keep taking melatonin. I never did take melatonin, just too many possible side effects.

Searching for Answers: My Journey to Understanding

At this point it has been over a year of suffering. I had enough of no one caring, and no one with knowledge to help me. At that point I met with a friend of a client. Unbeknownst to me this person just happened to be involved with Midi health. After meeting with her, I filled out one of their intake forms and made an appointment. This was the beginning of some major positive changes and much relief.

At first I was resistant to taking hormones. Not because of any fear of cancer, but instead I feared how much it would cost to go on this, and what if the US took away my ability to access the hormones. I didn't want to have to go backwards. So my goal was to see if doing more conservative things would help me. During the next 10 months, we tried several different protocols to deal with the hot flashes, inability to sleep, brain fog/memory issues, anxiety and muscle loss. It just wasn't working. I also passed the point of no period for 12 straight months and was now considered to be post menopause.

What Are My Options?

I'd had enough and chatted with a new amazing health care professional who understood me and my issues. We did a full blood panel. I'm telling you they took 12 vials of blood. I learned that in addition to my hot flashes, muscle loss, and memory issues, I also had high cholesterol (high on the bad stuff and low on the good stuff), low iron, no estrogen or testosterone, and had huge platelets that were causing my lightheadedness and a couple other things. At this point it was time to make a decision on hormones to help even all those issues out, or take nasty medications that have so many other side effects it makes your head spin.

Hormones, Nutrition, and Strength Training: A New Approach

I've now been on a low dose of estrogen and progesterone for 6 months in addition to daily creatine, BCAA's, no processed food (super hard to do), more protein, Omega3 and Iodine, and have had a complete end to the hot flashes. Yay, no more multi outfit days, unless I'm riding, running and lifting. I've also stopped losing muscle mass, but not yet put any on. My brain fog is nearly gone, and I'm sleeping again.

We will do another blood test in 3 more months to check in on the cholesterol and other issues, but for now I'm feeling back to normal. Or my new normal. I'm still training hard, and in fact am lifting more than I have been in the past, 180 pound deadlifts and 160 pound squats. I'm also putting out more power on my bike and in my runs because of my extra time in the gym.

Advocating for Yourself: Finding the Right Support

If you're like me and are having trouble with not feeling yourself, don't let a doctor tell you you're fine and just take melatonin or whatever they try to pass off on you. Look for someone else, someone with the training and knowledge in peri and post menopause. You wouldn't go get a coach that only coaches soccer to train you as an endurance sport athlete, so why get a doctor who isn't trained in your needs to care for you?



Sunday, January 19, 2025

Diet Culture and Women: How Not To Get Caught up in the Crap

I've been working on a presentation on Women and Diet culture for a few months now, and am nearing the finish. In my final review of the nutrition presentation, I noticed a few key points that kept popping up.

They are: You are more than your physical appearance. Don’t believe anything that comes out of the research unless it specifically says the research was done only with women, or specifically for women. You absolutely do need to eat MORE. I'm just going to leave those there for you to mull over. Moving on...

Interesting Fact: I was just skimming through some research and found once again that women perform best in a fueled state*. In fact, this recent study on endurance trained females found that in just two weeks of under fueling (in this study was about 1700 calories a day - not too far from most diets) had reduced power output in a 20-minute time trial by 7.8% and time to exhaustion by nearly 19%**. These are some pretty disturbing numbers if you ask me. If women ate what was needed, their ability to work harder, longer and more effectively would begin to go up, but I'll get to that later.

So instead of trying to focus on losing weight this year, I challenge you to Pledge to make 2025 the year you form a healthy relationship with food and fueling. Meaning specifically how you fuel your workouts!

The Crap We are Told
Let's talk about social pressure on women to look a certain way, at the expense of their health. Where did that come from? Men. Yep I know I may have hit a nerve, that's good, truly think about it. Modern medicine was created around the male body and it’s specific physiology. What is physiology? The body's systems and how they work. Ya know the chemical stuff, hormones, cardiovascular systems, nervous system, etc. We all know that men and women have different amounts of each of the hormones that control all bodily systems, so why would we then believe that everything that science says works for men should therefore work for women? 

For those of you who were around in the 80’s, oh man there was crap being slung…low fat diets became all the rage and jazzercise and all those cardio classes were huge. Why, to “help” women become skinny. But did you know that skinny isn’t necessarily healthy either.

What is healthy? Healthy isn’t what we look like on the outside, but what the systems on the inside are doing. You hear talk about diabetes, heart disease, high blood pressure, high cholesterol, right. Well those health markers matter way more than what we look like. I know so many women who on the outside look “skinny” but have terrible health markers and they hare on so many medications to try and help. Oh and by the way most of them don’t exercise, and don't eat healthy. I also have a lot of friends who don’t look skinny but have perfectly healthy health markers and do eat well and exercise regularly.

Myth vs Reality
Women are Not Small Men TedTalk, the research has mostly been done on men...until recently. Have you heard of Dr Stacy Sims? She studied women's physiology at Stanford, and now currently leading researcher on women's physiology. When she was at University studying, her professors would constantly say things like,  "We don’t study women", and "Let’s throw their data out" or "Why do you want to study women? We don’t know enough about men.". It wasn't until her pushback that women really started to get true information on how to train especially through their monthly cycle.

Most “influencers” are using outdated information, or information that was ONLY tested on men for their get thin, or get ripped schemes. I’m not saying don’t follow them, but maybe enjoy their enthusiasm, and realize that what they are selling you either only worked on them or one of their clients and they are trying to apply it to everyone else to make a quick buck. Why do you think so many fitness influencers come and go? Now if you look for the ones that aren’t touting some magic pill, or one way to solve all your problems, then you just might find someone who will share some helpful information.

Just remember that no matter what your goals are, they are yours and will need specific interpretation for you to succeed. Seek help, and ask questions. At the end of this I have listed several places you can get help if you are having trouble.

What is Basal Metabolic Rate (BMR), and why it’s not accurate
Instead work with Energy Availability (EA). “The basal metabolic rate (BMR) is the amount of energy needed while resting in a temperate environment when the digestive system is inactive.” In such a state, energy will be used only to maintain vital organs, which include the heart, brain, kidneys, nervous system, intestines, liver, lungs, sex organs, muscles, and skin. This means that for most people, upwards of ~70% of total energy (calories) burned each day is due to their general body upkeep. Physical activity makes up ~20% of expenditure and ~10% is used for the digestion of food (thermogenesis)***.

In order for BMR to be measured it needs to be done so under very restrictive circumstances while you are awake. This requires that a person's sympathetic nervous system is inactive, which means the person must be completely rested.

The following set of variables are all reasons why BMR is NOT the best way to determine your caloric needs, especially when you like to move.

Muscle Mass – Aerobic exercises, such as running or cycling, have no effect on BMR. However, anaerobic exercises, such as weight-lifting, indirectly lead to a higher BMR because they build muscle mass, increasing resting energy consumption. The more muscle mass in the physical composition of an individual, the higher the BMR required to sustain their body at a certain level.

Age – The more elderly and limber an individual, the lower their BMR, or the lower the minimum caloric intake required to sustain the functioning of their organs at a certain level.

Genetics – Hereditary traits passed down from ancestors influence BMR.

Weather – Cold environments raise BMR because of the energy required to create a homeostatic body temperature. Likewise, too much external heat can raise BMR as the body expends energy to cool off internal organs. BMR increases approximately 7% for every increase of 1.36 degrees Fahrenheit in the body's internal temperature.

Diet – Small, routinely dispersed meals increase BMR. On the other hand, starvation can reduce BMR by as much as 30%. Similar to a phone that goes into power-saving mode during the last 5% of its battery, a human body will make sacrifices such as energy levels, moods, upkeep of bodily physique, and brain functions in order to more efficiently utilize what little caloric energy is being used to sustain it.

Pregnancy – Ensuring the livelihood of a separate fetus internally increases BMR. This is why pregnant women tend to eat more than usual. Also, menopause can increase or decrease BMR depending on hormonal changes.

Supplements – Certain supplements or drugs raise BMR, mostly to fuel weight loss. Caffeine is a common one.

Energy Availability (EA)
Since BMR isn't good, how do we calculate what we need to eat to be healthy? Have you heard of Energy Availability (EA), Exercise Energy Expenditure (EEE) and Low Energy Availability (LEA)? These factors take into account YOUR current fitness level and the varying amounts of energy you need per day depending upon your exercise program for that day.
The equation…

EA = Dietary Energy Intake (kcal) - Exercise Energy Expenditure (Kcal)
                                              Fat Free Mass (kg)

When we talk about EA, we need to understand its parameters, which are constrained by Low Energy Availability (LEA). Low Energy Availability can creep up after as few as 3 days, and the symptoms are: fatigue, menstrual irregularities, mood changes, frequent illness, injuries, decreased libido, GI issues, poor concentration, decreased bone density, reproductive disfunction. If these are all the issues that occur when we are in LEA, then why are you continuing to eat too little, causing you to have to take meds to assist with mood, libido, bone density? When all you need to do is eat better.

In EA calculations, research shows that for the average sedentary “normal” weight woman, the target is at least 45kcal/kg of FFM per day. I don’t like when they use normal, but that what the scientists have described this as for now.

An example of a 68kg (150lb) woman with 25% body fat (51kg FFM). She would need to eat at minimum 2,295kcal in order to stay out of the LEA category. Anything lower than an intake of 2295 kcal per day (when exercising) puts this person at risk for all the negative side effects of LEA.

Places to Look for Correct Research Based Nutrition & Fitness for Women 
The following list is of the most important people and companies I use to get my information and help direct me to proper studies to read. Leading the way for the new era of information on women is a former teammate of mine, Dr Stacy Sims. She led the charge to have women be recognized as necessary in research and to have our voices head on the field and off when it comes to training and nutrition protocols. Her coauthor of the book ROAR is Selene Yeager, noted columnist since the 80's, who even now talks about the crap she used to spew. Selene is also the host of an amazing podcast in its 5th year, Hit Play Not Pause, and they talk about everything women's sports, health, nutrition, you name it they talk about it. Then there is Midi Health, an online medical system that is covered by most insurance companies, the doctors there are ALL specifically trained in everything female hormone related from puberty, through childbearing years, to perimenopause and post menopause. They know their stuff, and they helped me where my doctors and gynecologist couldn't. 

Most doctors are taught NOTHING about menopause and perimenopause, and only a little bit about women's health when it comes to getting and staying pregnant. Also, your OB/GYN knows NOTHING about peri and post menopause, because like I said earlier they aren’t taught anything because medicine was and still is based around health for men and then just applied to women.

However places like Midi Health, NAMS (North American Menopause Society) now called the Menopause Society are working to break down the barriers to research on women and ALSO bringing up to date information to you through well educated people who really care about women's health.

Last, if you are looking for an app to help you track your cycle, or even if you are post menopause but want daily suggestions of what you should/could be doing, the WildAi app is great. It's owned and run by an amazing group of women who know their stuff. Plus it's not publicly traded so there is no need to fear the period tracking in their app, that information stays with them. 

References
*https://feistymedia.acemlnb.com/lt.php?x=3DZy~GDIVqGdEpF8ywDJgOad23_Wid~ykMY2XnjFVnSf75BAz0y.zuhs1I2njN-~jNYwXnjGIU

**https://feistymedia.acemlnb.com/lt.php?x=3DZy~GDIVqGdEpF8ywDJgOad23_Wid~ykMY2XnjFVnSf75BAz0y.zuhs1I2njN-~jNYwXnjGIk

*** Johnstone AM, Murison SD, Duncan JS, Rance KA, Speakman JR, Factors influencing variation in basal metabolic rate include fat-free mass, fat mass, age, and circulating thyroxine but not sex, circulating leptin, or triiodothyronine1. Am J Clin Nutr 2005; 82: 941-948.”

Additional Places for Amazing Information
Podcast from Hit Play Not pause: January 17, 2024: Weight Loss Drugs and Active Menopausal Women with Jody Dushay

Podcast from Hit Play Not Pause: January 31, 2024: Ditching Diets for Good with Pam Moore


Monday, December 9, 2024

Low Energy Availability (LEA) Isn’t Just a Female issue, it also hurts Men's Performance too!

With all these fad diets like keto, and intermittent fasting just to name a few, being promoted all across the social media stratosphere, there has been an uptick in the low energy availability (LEA) across the entire group of endurance athletes. This is especially seen in my practice with many of my clients/athletes being female. However, I also coach a local tri club with somewhere in the range of 400 plus members, and the number of men being affected by LEA is just as high, they just don’t talk about it like women do. 

We all hear LEA in reference to women in sport, and especially in younger women when it used to be called the female athlete triad. Regardless of age, it has debilitating negative effects for all. The damage it causes in women is, dangerously low bone mineral density, reproduction dysfunction, hypotension, hypoglycemia, and suppressed immune system just to name a few (1). However did you know that for men the negative effects are just as bad. Decreased hormone levels (both decreased testosterone production but also estrogen, and yes men have estrogen too), decreased bone mineral density (it’s not just a women’s issue), muscle loss, psychological issues (irritability, depression, decreased concentration), and performance decline (2). 


The one thing I tell every one of them, women AND men, when it comes to avoiding LEA, is that it starts with eating enough.


What is LEA? How is it defined?


Low energy availability (LEA) represents a state in which the body does not have enough energy left to support all the physiological functions needed to maintain optimal health. LEA may result from altered dietary behaviors that are caused by body dissatisfaction, the belief that a lower body weight will result in greater performance, or social pressure to look a certain way. Pressure can also be experienced from the coach, teammates, and in this day and age through social media platforms.


Knowing what your body composition is, is the first step to understanding how to avoid LEA. 

If you know your body composition, you can start with using the following equation (3) for determining your energy availability, EA for short. Dietary energy intake (kcal) minus your exercise energy expenditure (kcal) divided by your fat free mass (FFM) in kilograms (kg). 


EA = (Daily intake(kcal) - Exercise Energy Expenditure (kcal)) / Fat Free mass (kg)


You want the final number (EA) to be over 45 calories per kilogram of FFM; 50 calories per kilogram FFM is a good number to aim for if you train regularly. Anything less than 30 calories per kg is defined as LEA, and at that point you start experiencing health risks after only 5 days of low EA (4). These numbers are the same for both women and men regardless of age or hormonal season in life (5). 


Recommendations for avoiding LEA


First and foremost, fuel for the work required! This means providing enough carbohydrate relative to your upcoming session, but finishing that session not fully depleted and eating as soon after exercise as possible. Thanks to the amazing work by Dr Stacy Sims and Selene Yeager for their work on Road and Next Level, not only has there been research on this, there are guidelines specifically for women in all phases of life.


The recommendations on carbohydrates and protein intake based on intensity for peri and postmenopausal athletes….these are slightly higher than the requirements that most people see from research, that is because most research is done on young college age men, and does NOT apply to women.


Carbohydrates: 

Moderate to high intensity training days, lasting 60-120 minutes: You need 3 to 3.5 grams of carbohydrates per kilogram. 

Light or active recovery days: aim for 2.5 grams per kilogram. 

For short intense days (think HIIT, CrossFit): aim for 2.5 to 3 grams of carbs per kilogram. 

Endurance Training 2-5 hours of intense training per day (distance swim/bike/run): Aim for 5 to6 grams of carbohydrates per kilogram.

Extreme intense training of 5 or more hours a day (Ironwoman/man type events): Aim for 6 to 8 grams of carbohydrates per kilogram


Protein:

Strength & Power phases of training: You need 2.0 to 2.2 grams per kilogram.

Endurance phases of training: You need 1.8 to 2.0 grams per kilogram.

For recovery days: You need 1.8 grams per kilogram.

For optimal recovery try to get 30 to 40 grams of protein within 30 minutes post event/training.

To stimulate maximal muscle protein synthesis aim for a per-meal amount of 0.5 to 0.6 grams per kilogram of protein.


A note on protein, especially for women. If you don’t eat any protein, your body will not use carbohydrates for refueling muscle and liver glycogen, as it is supposed to; instead the carbs you eat will assist in repairing your muscles.Meaning when you go to exercise next time your energy stores will be low due to the carbs being used for muscle repair instead of glycogen storage for fueling exercise.  Protein is also necessary to facilitate fat loss, as it keeps the muscles repairing and rebuilding, a process that allows carbohydrates to refuel the muscles and liver - thus allowing fat stores to stay empty (6).


These numbers are a little lower for men when it comes to protein as their hormones naturally are building their muscles at all times. Women on the other hand have a hormone that builds and a hormone that breaks down, thus why it is so much more important for women to eat the proper amount and not go into LEA. 


Nutrition is a nuanced field, we all need to figure out what exactly works for us. Both for Women and Men by aiming to fuel appropriately from breakfast to dinner, then stopping eating about 2 hours before bed, you are on the right track for optimal training adaptations, recovery, and health. So stay fueled, avoid LEA, and crush your next event. 





  1. https://pmc.ncbi.nlm.nih.gov/articles/PMC9724109/#:~:text=The%20health%20concerns%20associated%20with,the%20risk%20of%20injury%20or

  2. https://journals.humankinetics.com/view/journals/ijsnem/28/4/article-p385.xml#:~:text=The%20reviewed%20literature%20indicates%20that%20a%20prolonged,when%20approaching%20the%20lower%20limits%20of%20BF.

  3. https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-020-00275-6

  4. https://asbmr.onlinelibrary.wiley.com/doi/full/10.1359/JBMR.040410

  5. https://thesportjournal.org/article/low-energy-availability-lea-in-male-athletes-a-review-of-the-literature/

  6. Next Level: Your Guide to Kicking Ass, Feeling Great, and Crushing Goals Through Menopause and Beyond

Tuesday, November 12, 2024

Building Endurance: How Menopausal Women Can Train Smarter



We all know that in order to build a strong aerobic body, we need to do lots and lots and lots and lots of zone2 training. But as women age, especially in peri and post menopause their ability to recover from these bouts of exercise takes longer. However, we are also built for this. If you have been paying attention to the endurance sports world of late, you will have noticed that women have been making the news. A lot. And even a few have taken an Overall win, such as Fiona Kolbinger in the Transcontinental bike race, an Ultra endurance event. This is due to our ability to prefer fat use over carbohydrate, and our bodies ability to store more fat, and retrieve it easier than our male counterparts.

With that in mind though, we do need to be careful with the long endurance training as we age, and be mindful to mix it up, but also listen to our bodies and give them a rest when they ask for it. And they do ask for it. When I say mix it up, I’m talking about not only the mode of which you are participating, be it, run, bike, swim, hike, or other. I’m also talking about the intensity in which you are doing it. There isn’t just one way to build that cardiovascular system, so why do we see some people only train one way. Now I get it some people just don’t like anything but that one form of movement they choose, or maybe they cannot, for whatever reason, use another form of cardiovascular training. Let’s get creative then. Let’s find you at least one other form of cardiovascular movement that you can do even just once a week to break things up.

Now that you have found that other form of cardiovascular fun, now I’m going to tell you to ALSO do 2 more things. What??? You are probably saying. This is all part of making sure you are well rounded and a complete and durable athlete/human, and not one that is going to be held back by annoying little niggles, as we like to call them. In addition to your Zone 2 training, I’m going to challenge you to do at least once a week of HIIT’s/SIT’s and at least once a week, preferably twice, of strength training, AND short bouts of mobility right before your endurance workouts. Why, oh Why do I forsake you like this??? Because as we age, our bodies do not like the repetitive activities, it breaks them down much faster than when we were younger, and we need more time between bouts to recover. So instead of taking a full day off, I know you would rather keep moving, do it in a different way.

Let’s say you are an Ultra Runner, and you are training to do a 50 mile run, be it a race or you just want to complete it. If you go out and run zone2 for 5-6 workouts a week, yes you will get better, but at some point your body is going to say it’s had enough. And training that way will only build your zone2 base of fitness, and remember there are many more aspects of fitness. Instead let me break down a week I’ve given to my athletes who have already been training for several years, and they are going into their offseason. Huh, sound about right for this time of year?


Monday: gentle mobility and lots of stretching and foam rolling and even a massage if needed.

Tuesday: Morning - Strength & Plyometrics. Evening - Pre-run Mobility, then Track intervals, for top end speed and run form.

Wednesday: Pre-run Mobility, Recovery Run All Zone2, post run mobility.

Thursday: Morning Strength & Plyometrics. Evening Cross Train Day: either bike or swim for 60-90 minutes of mostly zone2 with a few short Zone4 bursts.

Friday: Pre-run Mobility, Tempo/Fartlek Run (this is an undulation between Zone 2-4 efforts).

Saturday: Cross Train - Long bike/hike/swim (several hours if possible) etc. Afternoon Core strength & Mobility.

Sunday: Pre-run mobility, Long Run (several hours depending on where they are in their training) mostly Zone2 with some short efforts into Zone3/4 on hills.


Doing something more like this example week versus Zone2 for 5 to 6 days a week, will not only produce results sooner, but your body won't always feel beat up and run down. Keep it fresh and change it up often. Don’t skip your strength and mobility, and please please please don’t just do Zone2.

The reason we ALSO need strength training isn’t just to make us overall stronger, it’s to help build our bones. Again as we age that osteoporosis nightmare likes to pop its evil head up for some of us. But, you can decrease its effects by lifting consistently, twice a week, and lifting HEAVY-for-you weights. When I say heavy I’m talking about something you can ONLY lift for 4-6 reps, and doing that for 4-6 sets. Now what are you waiting for? Get out there and get moving. Switch things up, lift heavy stuff, run fast, faster, fastest. And by all means HAVE FUN doing it.

Monday, September 30, 2024

The Impact of Sleep on Performance for Menopausal Triathletes


Sleep disturbances are prevalent during the stages of perimenopause and even into menopause, and their impact extends beyond nighttime restlessness. Poor sleep quality and insufficient sleep can contribute to multitudes of health conditions in women, including cardiovascular disease, cognitive impairments and mental health issues.


Not getting enough sleep can affect all areas of your life. Lack of sleep can make you feel even more irritable or depressed, might cause you to be more forgetful, and can even lead to falls. Research now suggests that waking from sleep may trigger hot flashes, rather than a hot flash waking you from your sleep.


In addition to the above mentioned issues, the physiological issues that arise from lack of sleep during menopause can be:

  • Insufficient sleep can contribute to cardiovascular disease, cognitive impairments, and mental health issues.

  • Sleep loss can increase appetite and can lead to weight gain. 

  • Sleep loss can affect metabolic health, including energy expenditure, body adiposity, and eating behaviors.

  • Sleep loss is prevalent in postmenopausal women and is 2 to 3 times more likely than in younger women.

  • Menstrual cycle disruption. Sleep loss affects the hormone leptin, which is produced in lower quantities when women don't get enough sleep and in turn it affects ovulation.


All of those will significantly affect your ability to train, and maintain your fitness in whatever sport you are trying to participate in. Instead of suffering, there are things you can do. The following is a list of easy to control things that may help you sleep better and thus be able to maintain your fitness.

  • Create a sleep schedule: Try to go to bed and wake up at the same time each day. 

  • Avoid napping: Napping in the late afternoon or evening can make it harder to sleep at night. 

  • Avoid heavy meals and caffeine: like coffee, tea, and chocolate, close to bedtime. 

  • Avoid alcohol: Even small amounts of alcohol can make it harder to fall asleep and stay asleep. 

  • Create a bedtime routine: Try reading, listening to music, or taking a warm bath before bed. 

  • Keep your bedroom comfortable: Make sure your bedroom is a comfortable temperature and as quiet as possible. You can also try using 100% cotton or bamboo sheets to feel cooler. 

  • Avoid screen time: The light from devices like TVs, computers, and phones can make it harder to fall asleep. 

  • Exercise regularly: Regular exercise can help improve sleep, but avoid exercising right before bed. For some this causes a rise in metabolic rate for hours 

  • Try relaxation techniques: Relaxation techniques can help stimulate the body's parasympathetic nervous system, which helps you slow down and prepare for sleep. 

  • Consider hormone replacement therapy: Hormone Therapy (HT) can help with hot flashes and other menopause symptoms, which can lead to more restful sleep. 


For me I’ve changed a few of the above suggestions with much benefit, such as avoiding big meals, caffeine and alcohol close to bedtime. I’ve stopped all screens about an hour before bed, and just recently started hormones, and so far my hot flashes have nearly gone away (I was having a couple dozen a day, plus a couple changes of clothes throughout the day), and I can sleep again!


If you are still having trouble sleeping it may be time to talk to your doctor. If your doctor isn't listening or just saying to take melatonin or get a white noise machine, it’s time for a new doctor. That new doctor can be found through NAMS, North American Menopause Society, or reach out to Midi Health. Both of these places are where you will find doctors who have been trained in everything menopause, and that’s their wheelhouse. They care about treating you and listening to your very individual issues and needs. One thing most people don’t realize is that doctors, including ObGyn's, don't get much, if any, menopause training. So stop seeing someone who isn’t trained in your needs.


There are plenty of communities out there to join and share your stories, and hear others. My favorite is the Feisty Media Menopause group on Instagram and Facebook, which I am a part of. I enjoy reading about others journeys and sharing mine. It's a group of women 40+ who are experiencing the plethora of peri and postmenopausal symptoms. Who knows, you may resonate with one that leads you to getting the health care direction you need. Just know you are not alone, so stop suffering alone. In fact stop suffering. Get the help you deserve.



Further reading here

Sleep and Sleep Disorders in the Menopause Transition: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092036/

Why your sleep can really suck during menopause: https://www.feistymenopause.com/blog/why-your-sleep-can-really-suck-during-menopause#:~:text=Common%20Causes%20of%20Fragmented%20Sleep%20in%20Menopause&text=Avoid%20eating%20a%20big%20meal,earplugs%20and%20an%20eye%20mask.Hot Flashes: https://www.nia.nih.gov/health/menopause/sleep-problems-and-menopause-what-can-i-do#:~:text=Hot%20flashes%2C%20especially%20night%20sweats,sleep%20aids%20such%20as%20melatonin

Thursday, September 12, 2024

Mobility IS for Endurance Athletes, AND those in Peri & Post Menopause

 

Many of you know that participation in endurance sports requires many hours of training per week both in your sport, in strength sessions, and maybe even visits to the massage therapist, physical therapist or chiropractor. Wouldn’t it be nice to not need to see the physical therapist or massage therapist or chiropractor? But instead to go see one of them because you want to, not need to?


How often do you focus on mobility? Do you know what mobility is, and how it can help you stay out of the PT and massage therapists office? 

Adding a great mobility plan to your endurance sport training is good for…

Injury prevention: Triathletes subject their bodies to significant repetitive, high impact movements, increasing their risk for overuse injuries. Many have several overuse injuries. Mobility workouts address muscle imbalances, reduce stiffness, and enhance joint stability, and nervous system regulation, ultimately lowering their potential for injuries.

Enhanced Performance: Imagine a swim long, powerful stroke that moves through the water effortlessly propelling you further than you are going right now. Or how about a pedal stroke on the bike in your deepest aero position that feels powerful and efficient as it does when you are upright. What about your run gait that is long, balanced and little vertical oscillation? Incorporating mobility exercises into your routine can improve not just your joint range of motion, but your strength in that new range, increasing power output along with better biomechanics and efficiency across all your disciplines.

Smoother Recovery: Endurance sports are demanding, physically, mentally and emotionally. When you have a solid mobility routine, this can aid in faster recovery through reducing muscle and joint stiffness, and continuing to maintain full ranges of motion that don’t limit your movement. With more fluid movement you'll be more willing to hit that hard workout once your planned recovery period is over, and not have to wait long for your next hard set.

The 40+ Woman

Perimenopause is where your hormones are on a crazy unpredictable roller coaster ride. Some days they are up, some down, and some days you’ll get extremes of both. This is what causes the symptoms, such as hot flashes or night sweats. They are also responsible for brain fog, irritability and decreased sleep. Wait, there's more. Don't forget about tight joints, and decreased muscle and bone mass to name a few. These things can sometimes go away after menopause, but some may still linger. Regardless of which of these periods of your life you are in, wouldn't it be nice to have control over even just one of those issues? Tight joints perhaps? You’ll benefit from doing focussed mobility training along with your triathlon training which will make your journey to the finish line more enjoyable.

You may have noticed that it takes you longer to warm up. There may also be joint aches and pains sometimes for no apparent reason. Before your traditional warm up, an additional mobility specific warm up may be helpful. This mobility work focuses on slowly moving your joints to warm them and the nervous system up. While doing them you will also increase your heart rate. The nice thing about mobility work is that it is a GREAT post-exercise cool down too. Doing them post workout will help bring your heart rate down while calming your central nervous system.

Functional Range Conditioning Mobility

When I talk about mobility, many people think of typical stretching and dynamic warm ups. But that is not it. I’m talking about specific, joint movement patterns that focus on your available range of motion. These movements will also help you improve your range of motion and strength, in a controlled systematic way. This practice is called Functional Range Conditioning, FRC for short. In short it is to “increase one's active, usable ranges of motion by simultaneously improving articular mobility, strength/resilience, and neurological control”. All things that start to deteriorate when we hit perimenopause. See how they define mobility work here.

When I first start with my athletes or clients, they always get a mobility screen. With this I learn where their limiters are, and it gives us a place to start building them up to be more durable. These limiters are worked on by starting each session, be it their swim/bike/run or strength sessions with the specific mobility exercises to address their needs. Then this allows us to shorten their warm up and get right into the heart of the workout.

 

Here is a quick video (sped up x10) on how I prep my ankles and hips before I run. It has helped me tremendously with getting rid of ankle, hip and back stiffness at the beginning of my runs. I feel better, so I run better, longer, and recover quicker as a result.




Above is a video for those swimmers looking to improve their shoulder mobility and strength to have a more powerful swim stroke. This mobility exercise focuses on shoulder external rotation both in increasing your range of motion, but improving nervous system function/control of that range of motion, AND building strength in the new range of motion…turn the volume up, I was having microphone issues.

The Long Haul

Are you looking to stay in your sport as long as YOU want to? If yes, then you’ve got to focus on more than swim, bike and run fitness. I’ve seen some amazing older athletes. At Nationals, this year, the oldest female competitor (and oldest competitor) was 84. This doesn't just happen. Go beyond SBR and work on your strength and especially your mobility.

Thursday, August 8, 2024

Back-to-Back Race Planning: Triathlons/Events

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Whether you’re looking to use a race as a means of focus to get fit and healthy, or the races you really want to do just happen to be a few weeks up to a month apart, training for this will require some special attention. It can be done, but you need to set yourself up with a plan well ahead of time to make sure to give yourself enough time to peak, and also rest and recover from the training necessary to make this possible.

Quite a few years ago, my first year of racing triathlons actually, I got signed up for a Full Iron Distance (140.6 miles) Triathlon, but had never even participated in a triathlon before. I knew it was going to be a lot to get ready for a 2.4 mile swim, 112 mile bike and a full marathon. So I decided to sign up for all the triathlon distances in that year (Sprint, Olympic, 70.3 and 140.6) in order to get ready for the big one. I’d been coaching athletes mostly in cycling events, road racing, criterium, and time trial, and I had a new athlete who was doing triathlons. She's the reason I signed up for the race! Luckily I had 7 months to prepare for it. With the triathlon season starting in April and my big race in July, there was the potential for multiple races happening within a short period of each other.

I look back now and can reflect, and objectively recognize and understand learning points that I gained from that experience. The amount of work I put in that year was incredible, and NOT what I would be able to do now as a masters athlete. My recovery between hard bouts was poor, and my nutrition questionable. It made me start thinking, “How do endurance athletes race events successfully back to back?” Well I learned a lot, and have been using that experience to help my athletes plan for seasons where you may have several races clumped up close to one another.

Plan Well Ahead of Time

Before you even start training for your events, you must plan out your season to build up for a big event or events. Identify which event(s) are most important to you, and which are more of just the experience event. This may be Nationals, an Ironman sanctioned event, a world championship or the local event you want to win or PR in.

Once you’ve decided, then you can address how you want to treat all your events throughout the season. Do I want to be competitive in that distance? Do I want to finish in a certain time? Are there qualification requirements to get into the race(s)? Has your nutrition and hydration been a pain point for you? Etc.

To help you organize your races/events there is this wonderful labeling system for this sort of thing. They are labeled as “A,” “B” or “C” events based on how important they are to you. You can have more than one “A” race in a year, but you have to really be sure there is enough time between them to prepare for each one adequately. More importantly, after one of these “A” races, you’ll need to recover, rebuild and then re-peak.

Lastly you need to make sure that mentally and emotionally you have committed to these race labels, not just on paper. I’ve seen athletes say that an event is only a “C,” but then their nemesis shows up at the event and they go all out, throwing their hard work and recovery plans out the door. It’s best to keep to your plan as best you can for the best possible outcome.

Manage your Load

I use the Annual Training Plan (ATP) on Training Peaks to help build a season, and it’s the perfect management system. The ATP will allow you to plan out when your build, transition, peak and recovery times will be. It will also allow you to track your amount of weekly stress and compare it to how you feel you are recovering. With that information it will allow you to figure out how much training is needed to peak for your “A” race, and any other races that may be close to it, and also how much recovery you will need to make the peak the strongest possible.

When building your ATP it is helpful if you have some prior training. This allows you to see how much training you were capable of and how long it took you to recover from it. Even if you don’t have prior info, you can still plan out your training, you will just need to be patient as it may take some time to figure out your capabilities.

Many of my long course athletes like doing an ultramarathon or marathon event during the winter or early season to help boost their running fitness. As a coach I can argue both ways if it is beneficial or not, but if it is not your main race, why shy away from doing a long bike ride the day before to simulate racing? Equally, remember that each triathlon distance or endurance event brings with it different physiological stresses that have to be trained for. What you have to be good at for long distance triathlon racing is very different from the sprint or standard distance races.

Recover Right

When you race, you are pushing your body to the limit. Things like carbohydrate storages will be low and cortisol will be higher than they would normally be. If you don’t recover properly, you could end up ill, injured, fatigued or lose interest all together. Racing is exhausting both physically and mentally, and a recovery phase can bring you back to form and feeling stronger than before.This is how we allow our bodies to adapt to the training we just put it through. Think of it this way, Build, Peak, Race, Recover, Build from a higher level of fitness, Peak higher, Race better, Recover, Repeat.

The truth is, no matter how much pre-planning you have made, you can never fully estimate how you will fare after the event, especially if the event in question is long distance. When you are racing back-to-back events, don’t have unrealistic expectations of “smashing” each race. Treat the race with the priority it deserves based on your goals. Then the recovery process becomes much easier. Most importantly, listen to your body, not your ego. Your body may need more recovery than the plan gives, you’ll need to let your coach know and adapt the program as necessary.

Equally, if you have decided to train straight through one race to your next event, do exactly that, put in the big overload sessions as planned. Don’t shy away from them because you are tired. You had planned to be! Stick to your annual plan.

Often doing some familiar workout loops can help you compare yourself using time, speed, power or RPE. Your local loop lets you know how well you are feeling and performing so you can gauge your fatigue and overall performance level better.

Pay Attention to Signs of Over-Fatigue or Injury

I can’t say this enough, listen to your body. If you feel a niggle, address it, talk to your coach, don’t just follow the plan blindly. All aches and pains are information, and this information is useful. If you keep on struggling to hit targets, you may be going too hard too soon, or it may be time for a recovery week. Maybe you are more tired than you anticipated being at this point in the year, maybe your nutrition is in need of a check in. Make sure you bring this up with your coach, don’t just keep following the plan without saying something.

When you're training for these goals, you’re putting stress on your body, and it needs to be given time to recover. This will allow you to look at what you were doing, see if it was enough or not enough, and you can learn something new about yourself in the process.

Going back to my first year of racing and all the events I did within a 2 month span - I recall even now the comment of a teammate that I obviously heard but for whatever reason chose to ignore - probably because I was 35 and invincible - ,“Are you eating enough and getting enough recovery?”

Summary

At the end of the day, if you have plenty of time between events, you will want to reset and rebuild into the second event. However, if you only have a few weeks between your big events, you’ll most likely need to favor one over the other, and that would be something you went over with your coach in your annual training planning meeting.

The period in between two back-to-back races can literally make or break your season, so you’ll have to pay attention to both your training data and your body's overall energy or fatigue then make your decision based on both of them. This is where a coach can really help you through giving an objective perspective to help you keep on track for your “A” race(s).