If you’re a woman in perimenopause or menopause, you’ve likely noticed that what used to work for your body—whether in the gym, in the kitchen, or in recovery—doesn’t work quite the same anymore. That’s because your physiology is changing in ways most fitness and nutrition advice doesn’t account for.
The majority of exercise science is based on young male subjects, leaving women to adapt “male data” to a female body in hormonal transition. Let that sink in: you’ve been listening to “experts” give you advice about how to eat and exercise, but it’s been based on data studying young men.
WHAT??????
Stacy Sim’s Approach
Dr. Stacy Sims has dedicated her career to changing that. She’s one of the few scientists who builds her recommendations from women’s data, not men’s—addressing the specific metabolic, muscular, and hormonal needs of midlife women.
Sim’s gained notoriety for her Ted Talk, “Women are not Small Men.”
I’ve spent countless hours reading, researching, and listening to this information to bring you a curated guide. To help you focus exclusively on Sims’ evidence-based strategies for training, fueling, and recovering in perimenopause and beyond, so you can protect muscle, preserve bone, and boost vitality through this pivotal life stage.
Resistance Training
Resistance Training: ≥3 days; heavy = 6–8 reps to near-failure
Sims recommends three or more resistance sessions weekly, with compound lifts heavy enough that you can do only 6–8 repetitions before failure, or have just 1–2 reps in reserve—ensuring progressive overload and adaptation tailored for estrogen-loss physiology.
▶️ Perimenopause & Resistance Training – Dr. Stacy Sims
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Include active recovery days between these sessions—gentle movement, walking, or mobility work—to support circulation and recovery. This is when it is okay to do Zone 2 training. While Zone 2 training is acceptable on active recovery days, Sims does not recommend it as primary training in peri/post-menopausal women, because overuse can impair lean mass retention and blunt strength gains.
If you don’t have a way to measure which Zone you are in, consider Zone 3 and above would mean that you can’t really talk with ease. You would be out of breath if you tried to talk in Zone 3 and for Zones 4 or higher, you likely couldn’t talk.
Jump training
Jump training (3 × 10 min/week) = Bone health
Implement three 10-minute jump sessions weekly. If you don’t know where to start, try using the OsteoGains protocol: brief, low-amplitude jumps proven to boost bone density by 3–5% in hip and lumbar spine in perimenopausal women. This app has a free portion (which I used exclusively) or a paid portion you can look into if you need more guidance.
Bone health is critical: with estrogen decline, bone loss accelerates—and nearly 50% of women over 50 suffer fractures due to osteoporosis. Sims advises DEXA scans to monitor bone density and notes that degrading bone releases toxins and inflammatory byproducts, making skeletal preservation vital for whole-body health.
▶️ YouTube short: “Can Jumping Really Reverse Osteopenia?” – Dr. Stacy Sims
Can Jumping Really Reverse Osteopenia?
Sprint-Interval Training
Sprint-interval training: examples + target zones
Sims advocates Sprint Interval Training (SIT) 1–2 sessions/week, consisting of 10–30-second maximal efforts, hitting Zone 3 at minimum—and preferably Zones 4–5, followed by 2–4 minutes of recovery to maintain full effort. Examples include:
- Squat thrusts
- Box jumps
- Rowing sprints
- Assault bike bursts
These intense bursts help regulate glucose, support mitochondrial health, and maintain performance without high-volume stress.
▶️ Instagram reel: “Do you have questions about what exactly constitutes Sprint Interval Training?” – Dr. Stacy Sims
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Meal timing and content
Pre-workout:
- 15–30 g of protein before resistance sessions
- If also doing cardio or sprint work: add ~30 g carbohydrates
Post-workout:
- Within ~45 minutes of finishing your workout (this is so hard!): 40–60 g high-quality protein
- Within ~2 hours: ~0.3 g/kg bodyweight carbohydrate, ideally as part of a whole-food meal
These windows counter anabolic resistance in midlife women, because their metabolic reset post-training happens faster than in men. It can be very difficult to meet these guidelines, so be gentle with yourself.
Work your way up to the full amount recommended if needed, but do try to follow this advice. If you push your “re-feeding” window to an hour or more after training, you will have less benefit from the hard work you just put in during training.
What does this mean in regard to all the hype/advice about fasting, intermittent fasting, and time-restricted eating? Well, we naturally fast every day. It’s called sleeping.
Dr. Sims is against any other type of restricting and ads that she recommends all women in this stage of life eat within 30-minutes of waking to stave off the cortisol spike we need to wake up. What if you aren’t hungry?
She recommends adding 15g of protein powder (a clean NSF certified version of protein powder) to your coffee then to get some protein onboard. Then eating a nutrient dense breakfast as soon as possible, maybe after your workout if you are a morning exerciser.
▶️ YouTube short: “What to Eat Before & After Training – Stacy Sims”
What to Eat Before & After Training – Stacy Sims
Temperature exposure: cold vs. sauna
Cold immersion
Sims cautions that standard ice baths are often too cold for women, potentially triggering sympathetic overload without metabolic benefit. She recommends water around ~15–16 °C (55–60 °F) to provoke healthy shivering and metabolic activation. Cold immersion should also be avoided for ~8 hours after strength training, as it impairs hypertrophy adaptations. This is not the same for men. So you have heard other advice, I’m sure. But it’s for men, not for us.
▶️ YouTube short: “Women and cold water immersion – Dr Stacy Sims”
Women and cold water immersion – Dr Stacy Sims
Sauna
Sims endorses sauna use after training, highlighting its benefits for recovery, improved blood flow, activation of heat shock proteins, metabolic support, and potential relief from menopausal symptoms like hot flashes. Heat amplifies training adaptation via cardiovascular and hormonal pathways.
▶️ YouTube short: “Cold vs Hot: Which is Better for Women? – Dr Stacy Sims”
Cold vs Hot: Which is Better for Women? – Dr. Stacy Sims
Weekly guide
- Resistance training: ≥3 heavy sessions/week (6–8 rep range, near-failure with 1–2 reps in reserve)
- Jump training: 3 × 10 min/week (low-impact jumps per OsteoGains)
- Sprint intervals: 1–2 sessions/week; 10–30 sec efforts in Zone 3–5 with 2–4 min recovery
- Active recovery days between strength workouts (gentle movement; Zone 2 is acceptable as recovery only—not a substitute for resistance training)
- Easy movement most other days to support stress reduction and overall recovery
Final thoughts
Dr. Sims offers a targeted, physiology-first framework for women in peri- and post-menopause: heavy resistance, structured jump work, strategic sprint intervals, and nutrient timing, all supported by intentional thermal exposure. This holistic, hormone-aware approach helps preserve strength, bone, and metabolic health through midlife—and beyond. And never forget: women are not small men.
Although Dr. Sims doesn’t focus on it, stress management tools are key to supporting a healthy system. Check out my articles on ways to cope with stress, starting here.