Over 40 and Feeling Sore? How to Make Exercise Hurt Less

I work with women of all ages, but in my over 40 crowd (myself included), I see an increase in post exercise soreness. This happens even when they’re lifting/training properly and under my supervision, yet they end up feeling sore for days afterward. This excess soreness (more than before they hit their 40’s, and for much less work), causes them to never be able to find a routine, because they’re always finding themselves taking too long of a recovery which puts them back at square one.

This doesn’t just happen to my new-to-lifting ladies. It happens to my longtime exercisers who hit or are near the peri/post menopause point in life, and it’s happening to me too. I find myself the day after a hard workout with more delayed onset muscle soreness (DOMS)—the stiff, achy muscle pain that makes it hard to walk down stairs or even sit down to pee—after training than I ever had before. The stiffness is amplified when I have a rest day and do nothing on my rest day instead of gentle mobility exercises. 

Once women reach the menopause transition (which generally happens in the mid 40’s, but can happen anytime from the late 30s onward), they can struggle to recover as quickly from workouts because their bodies have a harder time repairing exercise damage with fluctuating hormones due to perimenopause, and less to no estrogen due to postmenopause.

Because estrogen has anti-inflammatory properties, it’s also common for women to experience more musculoskeletal pain in general during this time. I found out through following the Feisty Menopause group that there is even a name for it: the musculoskeletal syndrome of menopause. The good news is you can do something about it. 

Top 3 Things You Can Do to Hurt Less

Warm Up/Cool Down

Let me start with a few things most of us skipped when we were younger; getting proper warm ups, cool downs, and taking rest/recovery days. A rest day now isn’t going to cut it by sitting on the couch and doing nothing now. You are going to have to move, gently, carefully, with focus, attention to detail and be cautious of your intensity. I use my recovery day as a day to really dial in my mobility practice. Feel into what needs attention and work on it. If you are unsure where to start, I practice Functional Range Conditioning principles, FRC for short. This teaches you how to move your joints in a systematic way to not only improve joint function, but also decrease overall aches and pains, AND improve strength. See one of my videos here.

Prioritize your sleep 

This is when your body does its best recovery. During sleep your body releases growth hormones that stimulate muscle repair and growth and help to regenerate cells. Getting the proper amount of sleep has many more benefits like, helps improve immune system function, stress reduction, memory consolidation, energy conservation and storage, hormone regulation, and improved mood and cognitive function. 

FUEL

And, last but certainly not least, fuel yourself before and after exercise, so your body has the building blocks it needs to restock your energy stores and repair your muscles. Fueling and protein, you’re probably tired of hearing about protein. But, the hard truth is that we need more of this macronutrient along with BCAA’s (especially Leucine) and Creatine (helps to counteract the menopause-related decline in muscle, bone, and strength by reducing inflammation, oxidative stress, and serum markers of bone resorption to stimulate muscle protein synthesis). Research papers on protein and DOMS are lacking for midlife women. However, the big takeaway is that post exercise protein is really working for so many women. To make the most of it, you’ll need to aim for 30 grams of protein at each meal and eat protein rich snacks after hard workouts. So, why not give it a try.

Other Things To Keep In Mind

Eating an anti-inflammatory diet, rich in anti-inflammatory foods such as fruits and vegetables and omega-3 rich foods has been shown to help reduce exercise induced muscle damage and perceived soreness. Stay hydrated. There’s some evidence that dehydration can worsen DOMS, so stay on top of your fluid intake. According to the Mayo Clinic, the recommended daily amount for women is 2.7 liters or 11.5 cups a day, and more when you’re active.

Creatine: The generally recommended dose of 3 to 5 grams a day of creatine monohydrate to help reduce the post-exercise inflammatory response and reduce muscle damage and soreness in the days following hard exercise. 

Cold Plunge/Therapy is on many people's minds. You hear about them popping up in your local gym, or at a specific hot/cold therapy center. Research has been showing that cold water immersion may have a positive effect on recovery after cardiovascular exercise by reducing inflammation (helpful for menopause) and soreness, and has even been shown to improve nervous system function. However it has also shown negative effects on post strength training sessions in that it blunts the body's ability to build muscle, not a great thing for postmenopausal women. 

Massage your muscles. There is some evidence that massage and self massage tools like the massage stick or massage guns, and foam rollers can help prevent or reduce DOMS. 

Consider hormone therapy, but talk to a specialist not your GP or OBGYN. Their knowledge is NOT in peri/menopause related issues. There’s some evidence (clients testimonials and my own experience) that menopausal hormone therapy can help with symptoms of the musculoskeletal syndrome of menopause, particularly joint pain, and pain caused by inflammation.

Check your thyroid. Finally, you’re more likely to experience DOMS if you have low thyroid levels. Underactive thyroid is somewhat common in midlife women going through menopause, so if pain persists, it’s worth a check up.

*Other Reading:

Anti Inflammatory Diet

Mayo Clinic Water Paper

Feisty Menopause Article on Leucine and Protein

Low Thyroid Causing Joint Pain

Cold Plunge/Therapy

Hormone Therapy Specialists 1: Midi Health

Hormone Therapy Specialists 2: Elizabeth Greenfield Functional Wellness

Items You Can Purchase:

Massage stick

Massage guns

Foam Roller

Training Zones: Why, When and How

Imagine this, you decide to enter in your first triathlon, and you sign up with a coach. Once your coach has on-boarded you with their system, you look at your training peaks and the fist thing on your plan is…Zone 2 easy run for 40 minutes with 3 x 60 seconds at Zone 4. What the heck is a Zone 2 run, and what the heck is Zone 4?

When I talk about zones, it is the difference between intensity of exercise that determines these zones. In most cases, we use heart rate to determine the zones. These Zones are numbered 1 through 5, or sometimes given names like, Recovery, Endurance, Tempo, Threshold, SuperThreshold, and Maximum output for example. While training for sport, all the different zones are necessary for performance improvement, Zone 2 training is by far the most important part of the endurance training program. The purpose of each training zone is to elicit specific physiological and metabolic adaptations in order to improve performance, and it's important to know what physiological and metabolic adaptations occur while in each zone and how they can be improved in training.

To understand this, first we need to have an understanding of basic physiology and muscle metabolism. Through our 3 main energy systems we can train for all types of activity. Let’s break it down.

Energy Systems

Three energy systems contribute different amounts towards re-synthesizing the compound Adenosine Triphosphate (ATP), the "energy currency" of our body. With the help of our mitochondria which processes ATP, our muscles make the contractions for movement. The main energy system we utilize depends on the intensity, type and duration of the exercise being performed, as well as the fuel sources available and the fitness levels of the individual. These systems are also dependent on whether we use oxygen (aerobic) or not (anaerobic). They are:

1. The ATP-CP System (Anaerobic): lasts up to about 10 seconds of very high intensity efforts. An example of this would be doing an explosive Olympic lift, or a 100 meter sprint. The ATP-CP system uses a stored molecule in the muscle called creatine phosphate (CP) to resynthesize ATP. It is the breakdown of this molecule that releases the energy needed to rejoin the ADP and free phosphate to form ATP. This system is anaerobic as it works without oxygen, and does not produce any waste products. This is Zone 5 & 5+

2. The Lactate System (Anaerobic): is the active system used from 30 seconds to 3 minutes of high intensity efforts. An example of this would be doing a set of HIITS, and anything up to about an 800 meter sprint. The Lactate system uses glucose to help create ATP. It breaks down the glucose molecule into pyruvic acid through anaerobic glycolysis (the splitting of sugars). Through this anaerobic glycolysis system chemical energy is released and used to synthesize two ATP molecules for every glucose molecule used. This is Zone 4.

3. The Aerobic System: this is the active system our body uses to sustain long duration low intensity efforts. Duration wise, think 5k, 10k and up. This system needs oxygen to be present for the creation of ATP and will use one of three processes to create it, Aerobic glycolysis, Krebs cycle or Electron transport chain (feel free to look those up if you are curious I’m not going to get that deep into the science). It's a slow process and thus is used for lower intensity demands but can continue for long periods of time. This is Zone 1, 2 and 3.






**Found this chart on a Google search, not my own. It gives a good visual of what I was talking about as far as how long each energy system lasts, and that there is some overlap between them.**


Physiological and Metabolic Adaptations of Zone 2 Training

Performing most of your training in Zone 2 will help you build endurance, durability and strength. In addition, these easy training sessions help you...

1. Increase the number and density of your mitochondria - as you know from reading earlier the mitochondria is where the muscle gets its energy to create muscle contractions.

2. Increased capillary pathways - means more oxygen carrying capacity, and more ability to keep going.

3. Increase Stroke volume - amount of blood pumped out of your heart per beat; more blood means more oxygen and longer duration exercise.

4. Increased Fat burning capability - your body can more easily access the fat and use it for energy.

5. Increased lactate clearance - the mitochondria has the ability to break down the lactate and reuse it.

6. Increased blood plasma - the liquid part of the blood that carries cells and proteins.

7. Allows you to increase your training volume without beating up your body.


How Do You Find You Zone 2

This is based on heart rate, and there are a couple ways to calculate it. If you do not have a heart rate monitor or prefer not to use one, using nasal breathing can help keep you in zone 2 in the beginning of your training. But, as you become more fit, your body will adapt and it really is helpful to use and track your heart rate. The best way to track heart rate is with the use of a chest strap.

One of the best ways to get started with heart rate training is to calculate your heart rate reserve (HRR). First start with gathering the following numbers:

1. Max Heart Rate: 220 - your age = MHR

2. Find your Resting Heart rate (RHR), this is taken immediately when you wake up, before sitting up.

3. Find your Heart Rate Reserve (HRR): Subtracting your Resting Heart Rate from your Max Heart Rate.

4. Multiply HRR by the Zone percentage you want to calculate, Zone 2 = 65-75% of MHR

5. Add back in your RHR to each of the calculated numbers in #4 to get your range for Zone 2.

For the other zones, the ranges are: Zone 3 multiply by 75-85%; Zone 4 multiply by 85-95%; Zone 5 multiply by 95-100%; Zone 5+ anything higher than Zone 5.

Here is an example: Let's say you are 40 years old, with a resting heart rate of 50 beats per minute.
MHR - RHR = HRR
(HRR x 65%) + RHR = Lower end Zone 2
(HRR x 75%) + RHR = Higher end Zone 2
220 - 40 = 180 MHR
180 - 50 = 130 HRR
130 x 65% = 84.5
130 x 75% = 97.5
88.4 + 50 = 138.4, Zone 2 low end
97.5 + 50 = 147.5, Zone 2 high end

According to this method this person's Zone 2 Heart Rate is 134 to 146 beats. This means in order for this person to train at a Zone 2 training threshold they would need to keep their heart rate in that range. Now this isn't the most accurate way to get your zones, but it's the best way for someone new to heart rate training, or just new to training in general. If you are interested in the more advanced method of attaining your actual Zone 2 threshold please feel free to ask me for help.

What About Zone 3?

You may have noticed I did not mention Zone 3 in the energy systems above. The reason is that Zone 3 is this grey area in performance training. Your body uses a mix of Lactate and Aerobic systems, with no specific ratio of either. So when you hang out in the Zone 3 "Grey Zone" your body isn't getting the best adaptations it can due to the mixing of the systems. In this zone you aren't going fast enough to improve speed or power, and you aren't going slow enough to improve the cardiovascular benefits mentioned earlier, plus the recovery time from Zone 3 comes at a high price.

When to Train the Zones

If you are training for an event, you’re going to want to start with building your base of fitness, Zone 2. This should be started as soon as you begin your training plan, and will last throughout your entire training up to your event. Let’s say you’ve got a 4 month training plan. You will want to get into some Zone 4 and 5 training intervals in that second month of training for short periods of time with significant recovery. Then in months 3 and 4 you’re going to start building up the number of intervals, or the length of time of the intervals in that zone 4-5 range. This is obviously just a basic starting point. A coach would be able to help you determine when these changes need to be made.

Wrap Up

Knowing what your heart rate training zones are will benefit you in many ways. It's not just for endurance athletes, but also those trying to keep a general health and fitness routine. So the next time you head out for your workout, make sure you know what the purpose of your training session is, and know what zone or zones you should be working out in.

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?

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

Dr Stacy Sims

Selene Yeager/Hit Play Not Pause/Feisty Media

Coach Jamii North/ Newsletter

WildAi

Midi Health

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

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.

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