Exercise & Nutrition Scientist: The Truth About Exercise On Your Period! Take These 4 Supplements!

a lot of women come with their Partners to see me and say I don't understand we're both doing the same training he's leaning up and getting fitter I'm putting weight on getting slower and that is because we have puberty we have our reproductive years we have pregnancy in there we have per menopause we have post-menopause we have menstrual cycle each one of those is a different hormone profile that can affect the way we eat and the way we train but no one told us this or what we can do until right now Dr Stacy Sims

is an exercise physiologist and nutrition scientist who's best-selling books and over 100 peer reviews studies is revolutionizing how women can optimize their Health Fitness and Longevity by working with their unique physiology we're looking at sports science research everything from training to eating recovery it's based on male data and women have been generalized to that data things like we see men do really well on calorie restriction and fasting but for women doesn't happen that way and we'll talk about that and we also know that during puberty girls hips widen shoulders widen which changes our angle of

need to hit what we call the que angle so they don't feel comfortable running or swimming or jumping and because they're not taught with stuff we see that by the age of 14 girls who previously were sporty over 60% of them drop out of Sport the problem is it's never about how we can Empower women to use their physiology to their advantage so let's change that let's go as it relates to nutrition and exercise how do I need to adapt across the menstrual cycle what's your view on cold plunges and supplements like creatine and what's

the variance between men and women as Rel to sleep and then let's talk about menopause starting with per menopause I'm excited the Diary of a CEO is independent ly fact checked for any studies or science mentioned in this episode please check the show notes this has always blown my mind a little bit 53% of you that listen to the show regularly haven't yet subscribed to the show so could I ask you for a favor before we start if you like the show and you like what we do here and you want to support us the

free simple way that you can do just that is by hitting the Subscribe button and my commitment to you is if you do that then I'll do everything in my power me and my team to make sure that this show is better for you every single week we'll listen to your feedback we'll find the guests that you want me to speak to and we'll continue to do what we do thank you so [Music] much Dr Stacy Sims what is the work that you do and why is it so important that you do it I look

at sex differences and exercise and nutrition because when we think about everything that we know for protocols from training to eating recovery it's based on male data and as a female athlete and working with women across all ages just trying to maximize their potential you have to lean into different data but people aren't aware of it so as I'm looking at what I do and trying to empower women to understand their own bodies realize that there's a lot of research that still needs to be done so if we think about something like caffeine and caffeine

intake right and people are talking about how it either boosts them or not yeah if we look at all the data on performance about caffeine enhancing performance there isn't anything that's been done on women so if we're looking at how does that work for a woman we have to look and say okay how much exercise have you done where are you using the caffeine when are you using it because we fuel differently during exercise so we go through blood sugar quickly caffeine clears blood sugar so a woman is going to have to eat when she

uses caffeine whereas a man doesn't have to you said it's based on male data how can you quantify that like paint the picture for me that proves this is is the case for someone that might not understand the significance of what you just said so if we're looking at sports science research and I'll just bring it down to sports science because that's the exercise to nutrition research if we're looking at who's around the room when we're recruiting for studies for the most part the language around recruitment is geared for getting men because we're using a

lot of aggressive language in sport so it's off-putting to a lot of women the other aspect about Sport Science research is there's Li mited funding so then we're looking at okay how can we get people in that can come in for day after day or week to week most often it's men when we look at what we're doing we might be doing muscle biopsies we might be doing blood draws and if that's not explained in advance it's a little off-putting to people so when we're looking at the major recruitment strategies and the people that will

say yes I'll come and do this study it's 18 to 22 year old College age men and that's just been the norm and when we look at how studies are designed and we're looking again at who's in the room who's designing the studies primarily it's men why because we see that most of the piis on the studies and most of the um I guess scientists that are coming up in Academia are primarily men when did you realize this the first time I realized it from an academic standpoint was when I was a second year at

University and I was a participant in a metabolism lab and I was one of the only women and I standardized properly I did all the things I was supposed to do because I come from a military family I know how to follow rules and at the end of the two weeks of experiments they threw my results out why exactly so I asked why and they're like well your results don't jive with what we thought we were going to see they don't mesh with the results that we got from the men so they're an anomaly so

we're not going to put them in for the the context of talking about how carbohydrate metabolism was going and I thought that was very strange and I was like well I've done everything properly how come mine are the anomaly and those guys aren't the anomaly how do you know that and they didn't have an answer for it so that was like the sticking point for me to understand why would my results be an anomaly when I've done exactly the same thing as what the men had done and it came down to menstrual cycle came down

to understanding that one week I was in a low hormone State and then the next week I wasn't so when I started talking about that this is where the um Professor was in charge of the metabolism lab like well we don't study women because they have a menstrual cycle and we just study men because they're easier and we don't have to worry about hormone fluctuations interfering with our results and at that point I was like excuse me what what are you talking about that was a defining point from an academic standpoint but the seed had

been planted 2 years prior when my dad who was a colonel in the Army was like so what do you want to do when you finish graduate or when you graduate from high school and I said I wanted to be an Army Ranger or Navy SEAL and he said well you can't and I said why can't I and he said because you're a girl I was like what what does that mean and he said well they don't accept women in in the seals or the Rangers it's a special op and they don't accept women and

that was the first time in my life I've ever heard that I was limited because I was a female and I didn't match what the norm was CU my whole life i' been playing with boys competing against boys I mean like was just a normal didn't matter if you were a boy or a girl it just was what you wanted to do and then when my dad said well you can't because you're a girl that was the first seed that had been planted and really made me upset and said well this doesn't make sense and

then when I got to University and that happened that was the definitive seed that just really pushed me into the whole academic and sporting career that I've LED over the past 20 some years give me an overview of that career the sort of significant milestones in the research that you've done that's fed into everything that you know today I've been a competitive athlete most of my life so I would I race bikes professionally I did Iron Man I did extera and I would have teammates who would ask me questions of um you know like how

am I fueling how am I going to perform my best so we take those questions into the lab so we were looking at how do we optimally fuel or how do we optimally uh climatize the heat when we're at a point in our menstrual cycle where we don't have as much heat tolerance so that we see when progesterone comes up after ovulation our core temperature comes up we don't have as much heat tolerance so how do we adjust for that so there are a lot of questions that would come through just by the nature of

being surrounded by competitive athletes and being a competitive athlete so we look at things like we know now that when you want to do um a climatization to the Heat and I bring this up because if I live in New Zealand in the winter time and I'm trying to train for something like Kona that happens in Hawaii and we max out at uh you know 10 degrees celius in the winter but we have to face 40 degrees Cel to race Iron Man and we get into a sauna and we want Toom accommodate for that heat

we know that men can go seven days in a row and be fine to then race in the heat but for women depends on which phase of the menstrual cycle and if you are going in the high hormone phase then we say okay well you don't need a primer you can just go in and do nine days in a row but if you start in the low hormone phase you actually have to go into the sauna for five minutes come back out and then go back in and do that during the low hormone phase for

nine days in a row so there are different nuan is in the way that your body responds to the Heat and is able to accommodate for those heat shifts versus a man can just go in and accommodate for that and be ready for the race so give me your CV oh gosh about the whole thing it's it's pretty varied um what did you study uh exercise physiology metabolism okay and then um got into ultra running when I was doing my masters at Spring field mhm um and then I started getting into more Iron Man distance

stuff um before I started my PhD and you went to Springfield College as well yeah so that was my masters your Masters what did you study in your masters that again was exercise Fizz and metabolism and then you did a PhD yep uh what was your PhD on as well so my PhD was looking at differences between men and women in heat performance okay and and how you climatize to it and how you hydrate for it um as well as looking between menstrual cycle phases and oral contraceptive pill use in women um and again all

of these topics were designed because of questions I had for myself or teammates had and then from PhD I went to Stanford and was working um in the high performance lab and then moved over to do a postto with Marca stefanic who was the pi for the women's health initiative so looking at um hormone replacement therapy in menopausal women but also looking at exercise as a cohort to that and I had another hand in the high performance um research in human biology so I would mesh Human Performance with public health and then that transcend into

a lot of the stuff that I do now looking at what can we do taking some of the ideas from high performance and apply to general population and how does that improve people's longevity well-being but also for those who are trying to be parents who have a high- performing job who want to do well in their age group race whatever it is how can we maximize some of the things we know from high performance with regards to sleep heat cold and apply that to a person who's just trying to get everything done and what small

things they can tweak to improve their own training and performance and you've authored more than 100 peer-reviewed studies on exercise physiology yeah and you're research scientist at University of New Zealand I am a research scientist at aut it's where most of my PhD students are and we have a women's health program and then I also have an adjunct with the lifestyle medicine um at Stanford so that's where a lot of the public health research comes in and when we talk about the the differences between men and women what exactly are those differences is it just

the menstrual cycle that causes these differences or is there other physiological differences that we need to understand in order to understand the subjects we're going to talk about today around exercise nutrition and the variances between men and women there there are sex differences in utero I mean when we look uh what does that mean so the sex differences when the baby's developing okay so we look at stress and the mom under stress we see that there's a higher incidence of a miscarriage if it's a developing boy fetus than a girl fetus and it has to

do with XX versus XY then after birth we see that there's relatively little sex difference that is apparent until the onset of puberty but when we're looking at those sex differences that aren't that apparent there are there we see that there's a sex difference in what we call muscle morphology so that means that men are born with more fast switch fibers so they have more Anor robic capacity as they get older they have more ability to produce power we see that um girls are born with more endurant type fibers so this means they have more

mitochondria for oxygen consumption and oxidative stress and being able to go long and slow then when we get to the onset of puberty we see an expansion of these sex differences with the exposure of the sex hormones so what we're seeing is now the boys are getting leaner they're getting faster they're getting more aggressive but girls bodies completely change because center of gravity drops from the chest down to the lower abdomen area because their hips widen and their hips widen because you know being XX they have to then accommodate for getting pregnant and eventually having

a baby from a biological standpoint hips widen shoulders widen this changes the um angle of the knee to the hip so we then have a yep so for anyone listening this is there's a image I have here which I'll put on the screen and I'll also link below and it's called The Q angle Q angle yes which is like the angle of my meter hip Y and it's showing that women's Q angle basically like the shape of the gap between your leg is is it roughly 15° what is it you know yeah yeah and so

when we're looking at girls whose bodies are changing we see that by the age of 14 girls who previously were sporty over 60% of them drop out of sport because they're not taught that their bodies are changing so they don't feel comfortable running or swimming or jumping or Landing because they have a new um Q angle they become quad dominant their center of gravity is different their shoulders are wider so they don't feel comfortable running because their whole running mechanics change so you know when we're looking at girls who are eight they can keep up

with the boys right their bodies haven't quite started changing it by the time they're 10 they're starting to see a discrepancy and I say that cuz my daughter's now 12 and I've seen it over the course of the elementary school years where they used to be on par with the boys playing soccer and rugby and stuff on the field and then you start seeing a morph where the boys are becoming more aggressive and they're kicking the balls faster and running faster and the girls are starting to develop a little bit more getting a little bit

more body fat feeling a little bit more un comfortable running they can't do the monkey bars anymore because their center of gravity is lower so they can't get up and do the monkey part bars as well but no one explains this to them so then we see this discrepancy of being sporty not sporty we see um you know the changes in body composition and all of this is in those early stages of the teen years which is another knock because we also have brain changes where girls become more um self-aware and boys don't they're like

okay you know what you piss me off I'm going to beat you up and we're going to get on with it but girls are very self-aware and they hold things to themselves in a more negative fashion and this creates a lot of mood changes and this also creates a feeling of of of negative body positivity so they don't feel that comfortable with how they look or who they are and Society doesn't help that either so this all perpetuates in a sociocultural as well as a biological change which regards to exercise and as it relates to

we'll talk about the Q angle a little bit more in a second when we talk about exercise but the as it relates to the other changes um fat differences in men and women yeah so if we see essential fat for men is around 4 to 8% so that means what we need for our nerves and just survival yeah for women essential fat is around 12% okay so this is for nerves and and looking around our essential organs to survive we look at body composition itself we see that women tend to sit around 20 % as

a normal healthy individual although the data has changed over the years um and Men sit around 15% and what about the heart how is the heart different in men and women so women have smaller heart and lungs yeah relative to relative body size to men we also have less hemoglobin so that means our oxygen carrying capacity is lower uh because if we are looking at our red cells and we have four different what we call heem molecules in a red cell and each one carries oxygen our red cell count is lower as compared to men

because the red cell count is driven by testosterone so men have around 100% more um aromatized testosterone as compared to women so this increases the carrying capacity of oxygen which means it goes to the muscles can deliver more fuel to the muscles to be able to contract better have more power more strength does that mean women breathe more exercising the same not that they breathe more when we're talking about oxygen carrying capacity this is the amount that you're taking into the lungs how it transfers to the red cells to then be able to go to

the working muscles to give the muscles the available fuel to do a contraction so it's not a respiratory rate it's the ability for you to breathe in and how fast that can be conducted to the muscle so there's going to be an impact on endurance then it's more of a power and speed Factor okay okay okay because the speed in which the oxygen can get to the muscles is what's being impacted and the volume of oxygen that can get to the muscles yep okay fine and then you said the lungs are sort of I read

25 to 30% smaller than a man's lungs typically yeah and what's the impact of that as it relates to exercise so when we're looking at um I guess world World Records right that have been kept and we see there's a gender gap there MH and this is slowly closing in the endurance world but that has to do with muscle morphology with regards to being able to go long and slow we're looking at the Sprint capacity where we have to have a quick transference of oxygen and quick muscle contraction that Gap isn't closing and that is

because we have smaller lungs smaller heart we have less blood volume we have less red cells so the overall capacity for quickly developing power and speed is at a smaller um I guess it's a limited capacity in women versus men and in your book raw and Page four in the opening of the book you talk about how women are 52% as strong as men in their upper bodies and 66% as strong as they are in their lower bodies when women train they can become 70 to 80% as strong as men mhm so we're looking at

resistance training itself we see that women relative to men can accommodate and develop muscle just as well as men in the lower body but upper body not so much okay um we talked about this Q angle thing one of the things that I've I'm really fascinated by is there's been a big conversation recently around ACL injuries and Sport yeah and from reading your work it seems that and just doing some research online it seems that this increase in women getting ACL injuries linked somewhat to this Q angle situation which again is the I don't know

how to explain it for someone that is listening on audio and can't see but I will link it in this description so I highly recommend you look at this picture cuz the minute you see it makes a ton of sense but it's essentially like and this is me probably butchering it as a man because my Hips Don't widen my legs are effectively quite straight yep so from my hip down to my toes it's quite straight which means that I'm going to be more sturdy say if I jump up in the air when I land this

I know this cuz my dad's engineer the center of gravity being straight means that I'm less likely to get injured but if you're is that right right yeah CU your forces are going to be in a more linear fashion so you have more um even distribution of the force through the knee MH but for women as you're going to describe our hips are wider so we have more of an angle to the knee and the forces aren't distributed evenly when we land so we look at that as well as the quad dominance develops for women

because so that means that we use our um front muscles of our legs our quads a lot more than our hamstrings our posterior chain so we don't use our glutes and our hamstrings by default um as well as men do so we're being pulled forward more and we let we put more emphasis on the front of our body um because those tend to take the the quads tend to take the bulk of the muscle work that we're trying to do unless we're really trying to train hamstrings and glutes to fire which isn't the default for

women's bodies because center of gravity again is lower and you tend to lean forward so when we're looking at ACL injury again it comes down to one training stress two mechanics and if we're not taught again how to land how to run how to jump with the new angles it predisposes people to severe ACL injury and how much more likely is a woman to have an ACL injury than a man it is a higher rate but the thing about the research is that there hasn't been a direct comparison because we hear incidentally that women tear

their ACL and so we see a lot of observational studies that women have torn their ACL and we have lots of retrospective studies that are going back to uh where are we in our menstrual cycle when we tore ACL but there hasn't been a definitive comparison between men and women if we were to look at the current research we see a 3 to four to one ratio of ACL tears of women versus men so three to four so either three to one or four to one depending on the research that you look so three women

for every one man or four women for every one man okay so 300% difference yeah okay so interesting I absolutely never knew that and in fact it wasn't until I was looking through your work that I I'd seen um I went and did some research and there's a big conversation online a lot of sort of news coverage around women's football because it's I think it's the fastest growing sport in the world but I read that this the probability that a woman tears her ACL muscle is significantly like hundreds of percent more likely than a man

because of this in part because of this Q angle in professional sport is not as much as when we're looking at recreational sport because when we're getting into professional sport we have specific warm-ups especially for football um um put up a FIFA to prevent ACL tear to make sure that you are actually properly warmed up and engaging the right muscles and learning how to stop pivot because it's a it's a a mechanism in action usually is a twisting angle but if we're looking at more age group or Grassroots Sports because people aren't aware of this

Q angle they aren't aware of the Quad dominance women haven't been taught again how to work with these new mechanics then we're seeing a greater incidence of ACL tear 30 female football players missed Women's World Cup in 2023 due to ACL injuries including in the UK lioness Beth me and Leah Williamson um which is staggering to me yeah it's very high incidence y so is there something that can be done if you're a woman that's exercising that's doing things like jumping and running and sprinting and the fast sort of twitch uh Sports is there something

you can do to avoid having an ACL injury it's all about being strong so if we're looking at how what is the biggest thing for ACL prevention and I'll bring in one of my PhD students that's graduated looked at um ACL rehab after surgery and it comes down to the definitive difference between quad and hamstring strength so if we're looking at improving the um strength capacity of the hamstrings then it offsets some of the default strength that the quads are taking so we able to balance it from being front loaded to being more even loaded

it comes down to you know how we were talking about distribution of forces through the knee with men being more linear and women having an angle well if we're able to take that angle and we can evenly distribute the load between the muscles of the hamstring and the quad so the front and the back yeah then it pulls the forces more centrally okay which reduces the stress of one point of contact so if we're developing the strength through the whole posterior chain we're looking at glutes we're looking at hamstrings we're doing a lot of calf

work and we can develop that whole posterior part it reduces the incidence of being pulled in One Direction and The misalignment of forces the other is the cutting motion where we're looking at at um lateral movement so a lot of times when we're looking at warm-ups and you're observing on like kids sports there's not a lot of lateral development so if we're looking at at um prevent prevention of ACL tear we have to work a lot of the EXP exposive lateral movements as well as jumping and single L single leg jumping and these are things

that aren't really done in Grassroots but as we start to get more into professional sport is becoming more and more apparent that we have to do specific mechanism of injury prevention so they're looking at the sport we're a football player we have a high incidence of ACL potential so we have to really develop our posterior chain we have to work on our power for our lateral movements our step and our jump so this is part of what FIFA's put in for the warm-up because there is such a draw and as you're saying that 33 women

in the world cup for their ACL part of it is loading part of it is a little bit maybe overtrained before they go into the World Cup but a lot of it has to do with um this imbalance between the muscles and now having to address it did science just look at women as a different version of men like sorry did they just look at women as like a smaller version of men is that what how they looked yeah for the most part because I mean a lot of the stuff when I was going through

school and even now textbooks so I was standing in the metro in DC uh a few months ago and there was a young girl who has just gotten into exercise physiology and I overheard a conversation and she was talking about some of the experiments that they were doing but it never she never talked about like we have to make uh you know we're doing women specific we're doing men specific and I asked her I was like has anyone you know talk to you about how women's bodies are different than men's from angles and muscle morphology

she's like no what are you talking about I was like this is the second year in exis now and if you look at the textbooks it's still a representation of men in the textbook with regards to images you have him or they you never have her they might have a very small section in there about the female athlete but usually it's about the female athlete and anemia or relative energy deficiency in sport it's never about how we can Empower women to use their bodies and their physiology to their advantage and it's what almost 2025 now

is there any element of it of people being too scared to talk about differences in physiology amongst men and women I don't think so I mean I always explain it from historical perspective when we're looking at the history and when we started seeing the modernization of medic medicine prior to the modernization of medicine it used to be women who were the caretakers if you're thinking about you get sick you go and someone has an herbal remedy for you but when we started medicalizing and becoming more nuanced in the medical education women were excluded so when

we start looking at at the origins of medicine and who was in the room it was men we start looking at the origins of Science and science development it was men so all the scientific experiments and everything have always been a default to men we look at AI now and they're learning from algorithms based on male data so even now Healthcare is still heavily male oriented so when we start looking at why women haven't been included or why women have been generalized to male data it's just been the nature of how things have developed now

that we're aware of it and now we have more research money coming into to Women's Health we're starting to see a change and part of the two definitive moments in health healthare research that really invoked this change one was when we started seeing a lot of incidences with ambian and the dosage of medicines where women were getting into a lot of accidents car accidents after they takeen ambient because it was still in their system the next morning it's ambient It's a sleep aid okay it's a a prescription strength sleep aid so then people are like

whoa what's going on here oh the dosage for 180 lb man is the same as 120 lb woman and we also know that there's differences in body comp compos and Metabolism so a 180 lb man can take this dose and be fine in the morning but 120 lb woman can't take that same dose and be fine in the morning and then we have covid and the outcomes of um long covid and the differences between the Sexes with regards to women ended up with more long covid men ended up dying so then in during the covid

time period people were like whoa there's sex differences in the outcomes of this disease we have to really start looking at that so there's slow things that are really impactful on society that now people are starting to step and say wait we have to really look at women as women we have to look at men as men and is there an element of hormones impacting injury at all there's always an in uh an impact of hormones when we're looking at the overlay of hormones and sex hormones and then the protocols that have been developed they

don't take into account estrogen progesterone and to some extent testosterone so if we're looking at injury and the way that estrogen makes more um laxative ligaments so that means that our ligaments become more relaxed when estrogen comes up which is why people assume that around ovulation is when people will have more ACL tears it's not because we also see that progesterone comes in and can have a different effect on the tendons but that isn't accounted for in a lot of of the protocols that are out there for training and prevention of overtraining we see that

when we're looking at male and testosterone there tends to be the more testosterone the better for developing muscle and recovery but that's not necessarily true either so there's nuances in the sociocultural idea around sex hormones that also impact on our actual guidelines and protocols if a man and a woman came to you and said I want to lose weight they said I'm 200b um and I'd like to some weight would you give them different advice on what to do absolutely absolutely would and it comes down to a lot of we see this on social media

all the time calories in calories out right so when we're looking at calories in calories out that idea of that algorithm can work well in men and the reason for that is the hypothalamus so if we're looking at the hypothalamus which is an area in the brain that controls appetite it also controls our endocrine system so for men they don't have as many of what we call our kisspeptin neurons activated so this is uh neurons that are responsible for when we have nutrients coming in they fire they're like yeah okay we got enough nutrition coming

in that we can now accommodate for developing muscle and losing body fat for women we have more areas that are very sensitive sensitive to to nutrient density so when I say this we're talking about uh four grams of carbohydrate that come in and say they're carbohydrate from fruit and veg not from Ultra processed stuff those four grams of carb will affect the bodies differently between being a man and a woman for a man this four grams of carb coming in primarily will go blood sugar and then be stored as liver muscle glycogen for women it's

blood sugar it doesn't get stored because for women in order to store muscle um and liver glycogen you have to have an activation of uh some enzymes from the liver as well as some enzymes within the skeletal muscle itself to say yeah okay we want to store this we don't want to circulate it so then we start looking at how the brain is perceiving that so if the brain is saying yeah we can store this because there's still enough muscle tissue around there's still enough blood glucose that we can keep going and we can survive

the day but for women it sits there the blood glucose sits there and when it starts being used use the hypothalamus is like okay where's the extra food that's coming in so we can keep going and countering the stress that's coming in and the best way from a numbers perspective to look at it is when we are looking at calorie Baseline calorie intake just to exist and not get into any kind of endocrine or hormone dysfunction and appetite dysfunction for men it's 15 calories per kilogram of fat-free mass for women it's 30 so we start

to see men do really well on things like fasted training we see men do really well on calorie restriction because the hypothalamus is not as sensitive to lower calorie intake or to low carb intake or to high protein and um high fat intake but for women because the hypothalamus has more areas that are sensitive to nutrient density what does that mean sorry I'm not even sure what the hypothalamus is so the hypothalamus is is an area in the brain yeah and it's a sensing so you have blood that circulates through the brain it senses temperature

how hot your your blood is like the thermostat or something of the body yeah okay so it's yeah it is a thermostat it's the appetite control center it's how your body responds to Salt how your body responds to protein carbohydrate do I need more do I need less so it's it's like the control center for the most part so for women who come in and they're doing acid training the hypothalamus is like wait a second we don't have any blood sugar we don't have enough carbohydrate to actually do this kind of training so what I'm

going to do is I'm going to create a little bit of dysfunction here and I'm going to start downt turning all the other systems that need the same kind of fuel because I don't have enough just to do these muscle contractions so that means you could end up losing muscle absolutely so if a woman comes to me it's like I want to lose weight and I've been doing fasted training I get up I have a black coffee I go to the gym I do my lifting I do some of my cardio my girlfriend does exactly

that and then I'm not that hungry because I did a hard workout at the gym I might have a protein recovery shake and then I'll hold off eating my first meal until noon I always turn to them and go well why did you go to the gym because all you've effectively done is burn through your lean mess your body needs to have some fuel and the first thing that goes is lean mask because it's a very ACC active component of the body so it would be better for you as a woman to have maybe 15

gram of protein if you're going to do strength or 15 grams of protein with 30 grams of carb which isn't a lot before you go do cardio and strength because this is just enough to raise your blood sugar to circulate to the hypothalamus that yes there's some nutrition coming in I'm able to get that blood sugar working I'm able to get that blood sugar into the muscle I'm able to stimulate the mitochondria in the muscle to actually use some more free fatty acids I'm a able to tell the liver that I can actually get through

this and use these three fatty acids instead of storing them it only takes a little bit of food to then have benefit for what you're doing for a man if he's like comes in I have a black coffee I go to the gym I do my strength I might do a little cardio have my protein afterwards and then I might delay my meal like that's all right because you have a long longer window for Recovery the hypothalamus isn't as sensitive you're not burning through a lean mass you're developing a stress on the body and we

know that it's really good that you had that protein post exercise because that's going to create some muscle protein synthesis and hold you over till you have your meal okay so I'm going to try and explain this to you um like I'm a 10-year-old which is the exact level of IQ I have on this subject matter yeah so you've got this hypothalamus in the brain which is basically this sensor it's trying to figure out make sure everything is in I'm trying to think of that big word that someone taught me homeostasis homeostasis everything is level

right yeah and a woman's hypothalamus is more sensitive so if my partner wakes up goes to the gym has her black coffee goes to the gym does a Big Workout she always does her body her hypothalamus is going to panic a little bit more because it's going to assume that there's stress on the body now and it's going to look around to see if it has sufficient blood glucose levels and it's and it's not going to because she's not had anything for a while she's not going to have the sufficient blood glucose levels so it's

going to start burning her lean muscle mass exactly which means that she's she's essentially gonna it's like one step forward one step back right super simplified for a guy has his black coffee in the morning goes to the gym does the workout the body looks and because the hypothalamus is less sensitive it's less requiring of there to be higher blood sugar levels doesn't care as much so it's going to it can also tap more into our liver and muscle glycogen stores okay so it's going to yeah okay well we have a little bit of blood

glucose we need a little bit more so let's tap into the stores and pull them out so it's less reluctant to go straight for my lean muscle mass exactly it has an alternative fuel source hm that's interesting and what's the evolutionary story of this why why does this make sense when we look tribally like there and I might get hit by some sociologists who like wait this isn't completely true but for the exception there are some tribes that didn't fit into this but for the general idea from a biological evolutionary standpoint when we had times

of low calorie intake so we had to go find the Beast or we had to go out and find calories it was at a disadvantage for the woman to be pregnant or to have a baby an extra mouth to feed so in times of low food intake the reproductive system or the endocrine system of a woman would wind down so she would become a menic or lose her menstrual cycle for a while but it didn't affect men in that same way because they had to lean up and get fitter and faster because they had to

go fight the Beast or they had to go find the calories and bring it back so we're looking from that evolutionary standpoint in times of low calorie intake or low food intake a woman's body will start to conserve and wind down because it thinks that there's a famine coming but for men they're not as sensitive and the body's like oh not a lot of calories coming in that must mean there's a fight that I have to prepare for so I'm going to lean up I'm going to address all of my fuel systems so that I

can tap into all these alternative fuel systems so that I will have the energy to be able to go and fight the Beast to bring the calories back MH so when there's adequate calories available we see that women will lean up they'll become uh more acutely aware cognitive function comes up carbohydrates are really important so we see that there is a development of egg maturation we have better endocrine pulse so that means that our hormones that pulse on a daily basis they actually have the full pulse um and return to Baseline to encourage the body

a really robust endocrine system so that's thyroid that's our menstrual cycle it's all of the things but when we start pulling the calories back all that stuff winds down so what does that say about fasting so this is the big debate right so we look at fasting and where it first came out and it's like okay we see that obese sedentary individuals who had to lose weight rapidly for surgery they're put on a fasting type program to lose weight quickly in order to survive surgery and unfortunately a lot of the times we look at clinical

research and it gets transposed over to health and fitness without actually asking if it's viable so then we look at the lower end of the fitness population people are just learning to move and wanting to move and like I also want to lose more body fat so that I can move better oh I'll start fasting and when we see a lot of the like push on it it comes from male data again so when we start looking at women and a lot of women used to come with their Partners to see me and say I

don't understand we're both doing the same kind of fasted training he's leaning up and getting fitter I'm putting weight on and getting slower I'm like okay well we have to separate it out right if you're a woman you want to fast for all the health reasons that we hear about with regards to telr length improving longevity improving our body's metabolic control then we work with our circadian RH where we stop eating at at dinner so we have dinner we don't eat 2 to three hours before bed we have the overnight fast and then you want

to have food within a half an hour of waking up to blunt that cortisol Peak that's natural upon waking for men you can have variations of fasting you can do intermittent fasting you can do uh Warrior fasting and you can still have benefit but for women when we look at the data and if we were to do a warrior fast which is a 20-hour fast 4-Hour eating window for men we see more parasympathetic drive so they get that more Focus they have better blood glucose control they get uh an acceleration of body fat loss they

become more metabolically flexible meaning their body's able to transfer between carbohydrate and fat utilization for women doesn't happen that way for women who do a warrior fast so that's a 20h hour uh fasting and 4H hour eating window they end up with less blood sugar control we have higher resting blood glucose we have more fat storage we have more sympathetic drive so that means the body is under stress and you're not going to be able to sleep or recover well and we see a downturn of the thyroid within four days of doing this so when

we're looking at the data of fasting again it's pulling from the men and generalizing to the women but when we start really looking and narrowing it down and looking at female specific data thepe typ of fasting that's out there in the health and fitness world is not appropriate for women but you would say that the sort of overnight fast eating dinner at a earlier time at 6 s 6 6 o'cl and then eating breakfast when you wake up at say 8: in the morning or 9: or something six or seven what about the like three-day

fast you hear about to get into like autophagy or whatever is exercise is a stronger stimulus for autophagy than fasting because if we look at exercise in itself is a fasting State what happens during exercise you start exercising your body is trying to provide fuel so it's breaking down fat it's breaking down glucose it's breaking down amino acids it's also creating in a recovery standpoint a boost of growth hormone a boost of testosterone in both men and women that creates the cell cleanup which is theophagy right so if we're looking at the difference between fasting

and exercise exercise is a stronger strength stress all the things that we hear about fasting and Longevity exercise does the same it's a stronger stimulus for it but the problem is we've become a lazy society and people think exercise is too hard as an exercise physiologist it breaks my heart to see people who are struggling to walk down the street because we are so used to being conditioned to a certain temperature in a room to having a car automatic opener or Uber com so we don't have to walk down the road and I bring up

that movie Wall-E from the early 2000s with the little robot who's like wandering around society and you see all these people on these floating beds watching a screen and one of the guys gets kicked off by Wall-E accidentally falls down he can't get up and he's looking around going what why can't I get up what what's going on I like that's today's society where people are are not able to actually pull their own body weight around for a significant amount of time because feels too difficult whereas we look at all the stuff that comes out

with nutrition and all the trends that come out with nutrition from fasting to carnivorous diet to you know the oldfashioned Paleo all of these things that people are trying to do we turn to exercise and we Chang the modalities of exercise are we doing intense exercise are we doing low intensity are we doing resistance training are we doing cardio what are we doing all of these things in exercise are significantly stronger stress on the body that create more more adaptive changes than all these crazy diets but people find exercise too hard or they don't have

time so if I in that example where a man and woman come to you you would you wouldn't recommend the woman to fast in the same way that you'd recommend a man to fast is there any differences that you'd recommend in training if they were if their goal was to lose weight yep absolutely so when we're looking at regardless of age for women because we see that women don't age in a linear fashion like men so we had definitive points we have puberty we have our reproductive years we not have pregnancy in there we have

per menopause we have postmenopause each one of those is a different hormone profile that can affect the way we train for men you know you just kind of go and we start to see a decline of testosterone we get into our late 50s so when we're talking about women and training if someone is coming in and they're in their mid-30s and they're like I want to lose weight okay resistance training if someone comes in and they're in their mid-40s and Par menopause resistance trining doesn't matter resistance trining is key for mobilizing abdominal fat and for

creating more lean mass and also increasing the amount of cross top between their skeletal muscle and are stored fat through little things called myokines which are hormone signals that are released during exercise and released from the skeletal muscle so if we say okay let's do resistance training to really recomp the body we also want to increase our protein intake because we see if you're doing a resistance training with a higher protein intake then we have complete recomp over the course of 12 weeks and it's a very powerful motivating tool for women because for the most

part women have been excommunicated from the strength World until recently it wasn't Kosher for women to have a lot of muscles we see like I grew up in the '90s with the supermodels that were super skinny right it wasn't Kosher for women to be in the gym lifting weights but we're see this Evolution change and so we're starting to see more research come out in women in resistance training and it's so imperative for body composition change to invoke that resistance training what about a zenek a zimp yeah so I find it interesting because of all

the impact it's having on society and it is a very powerful tool the problem with it is no one is being NE necessarily taught how to come off it so if we look at o impc and how powerful the GPL 1 is we see it does invoke an appetite switch where it mutes the appetite it dampens Cravings so we see it's rapid weight loss but the rapid weight loss is lean mass so that comes back to the Wall-E picture where you can't get up because you don't have lean mass I fear for society who doesn't

have the opportunity to learn how to come off it through proper strength training exercise modalities and nutrition to support the weight loss that comes with as impus it's absolutely brilliant tool it's absolutely a brilliant tool but we're falling on the behavior change if we were to really teach people how to create that behavior change while they're using the tool then they can come off it and not be afraid of putting weight back on okay so would you recommend it for your for people that come to see you or ask you for advice no because most

of the people that come to see me have those 10 vanity pounds they want to lose I call them vanity pounds because they're the ones that creep up and you can instigate little changes within the daily life to actually lose them and keep them off for people who are struggling who have severe obesity they're pre-diabetic they have other medical conditions and exercise is definitely in the to hard basket because they get breathless just getting up out of their chair we need to lose some weight first so that we can then Implement some of the Adaptive

changes of exercise and do you think women should be eating immediately after they exercise and Men or is it does it is there a variance there at all there is a variance because when we look at um what we call metabolism coming back down to Baseline so that's your overall body coming back down to its resting state for women it happens within 30 to 40 minutes after exercise for men it's 2 to 18 hours depending on the intensity so in that we see that if we want to maximize our body's resistance training muscle building capacity

we need to give it some food we need to give it some really good hit of protein for women who are in their reproductive years we see 35 grams of protein post exercise within 45 minutes will tip the muscle into muscle protein synthesis for men it's 20 grams and it can be two four whatever hours later when we're looking at returning our our muscle glycogen back to normal we don't need as much carbohydrate post exercise as a woman as men need more because they tap more enter their stores so the window of opportunity for women

post exercise is around that 45 minute mark But for men it's open a lot wider what about the keto diet for women I am kind of anti- Keto for both sexes and I say this because when we look at the gut microbiome that is so important we see a decrease in diversity as we become more and more I guess City dwelling and we are having less and less of uh Variety in our food chain we have to take care of the gut microbiome if we look at the ketogenic diet and the high fat intake that

comes with it it significantly decreases that gut microbiome diversity which reduces the body's ability to synthesize vitamins to produce serotonin to have this conversation between the gut and the Brain and for women we're already metabolically flexible by the nature of being born with more of those endurant fibers that there's no reason to try to do a ketogenic diet could I not take a Prebiotic or something or just eat more fruits and veggies and stuff so if you're eating a lot of fruit and veggies sorry not fruit veggies no if you're eating a lot of fibrous

fruit and veg then that's how we increase the diversity taking a probiotic pill just affects the upper intestine but even that is a little bit suspect because there's only two to three companies that are making all the probiotics that are B2B so that means business to business and we don't really know the long-term outcome and we can have the overgrowth of some probiotics that again can cause some disbiosis could I be on the keto diet and still protect my microbiome I don't think so not from what I've seen because I thought the gut microbiome was

predominantly about like plants it is but you also need some protein that comes from a wide variety of different sources and the amount of fat that is taken in through a true ketogenic diet is 70 to 80% of your total intake coming from fat and then that will cause the overgrowth of the bacteria that relies primarily on fatty acids which downregulates all the good bacteria that relies on our fibrous fruit and veg because you're not going to be able to consume as much fiber as you need on a ketogenic diet to really invoke this diversity

if we're thinking about invoking diversity you want 30 different plants across the week and on a ketogenic diet you're just not capable of being able to eat as much to create that diversity and the reason why it's really important for women to have that diversity is because we have some gut bugs that are responsible for our sex hormone metabolism so we think about estrogen progesterone people think oh yeah well it's released from the ovaries and the adrenals and it goes and it hits our Target tissues but we have this thing called the second pass where

our sex hormones will be taken up by the liver Bound by sex hormone binding globulin shot into the intestines through bile unconjugated or unpacked by these little gut bugs and then shot back out in circulation to work if we have a lower diversity of the gut microbiome we don't have those bugs that will help with our sex hormone um I guess reactivation and the ability for the sex hormones to work optimally what about things like saas and cold plunges yeah is there a difference a variance there between menim wom in absolutely so if we're looking

at Cold plunge and it's all the rage right so we're saying let's get into ice water it's going to invoke this massive Paras parasympathetic response I'm going to have lots of cognition and focus it's going to create a hormonal response that improves my blood glucose is going to invoke a lot of autophagy and all the things that we see with fasting as well and it gives me this incredible sense of being in control male data we look at women who were in ice bath it's too cold to invoke those responses and the reason for that

is we have differences in um our skin sensation between men and women in with regards to Thermo regulation so women have more um subcutaneous fat so more fat Under the Skin and we into Vaso constrict and vasod dilate first so that means that um blood vessels will constrict tightly and then we'll start to have some internal changes or if we're too hot we'll vasod dilate first and then we'll have internal changes to create sweating so we look at a cold plunge there's too much constriction and it becomes too much of a threat to women and

their bodies don't have the same response to ice water we see that 15 to 16° C or around 5 5 degre fah is optimal temperature for women to experience the same effect that men have with ice so there's a sex difference in the temperature to invoke the same response between cold water um immersion responses in the sauna everyone responds and we see that the adaptation for sauna is different again for men and women because for women with the difference of the vasod dilation in the heat before they start sweating it takes a longer time for

core temperature to come up so women can spend more time in the heat before they start to get changes in their hormone responses and blood volume adaptations for men they can go in and I kind of laugh my husband will come in with me in the sauna and I'll sit there for like 10 minutes I'm not sweating yet and he's like pouring he's like I got to get out and it takes me like 20 or 30 minutes in order to get the same response so when we look at the the actual research and data that

looks at acclimatization and looks at sauna invoking changes we see again that women need more time both long long longer time for an acute bout and longer time across the weeks in order to get the same cardiovascular adaptations as men interesting I didn't realize that a typical ice bath is what temperature it's What minus one or something or is it I think it's 0 to 4° C oh okay 0 to four okay so you saying that a woman should be nearer 15 mhm for the same benefits mhm yep at my company flight Studio which is

part of my bigger company flight group we're constantly looking for ways to build deeper connections with our audiences whether that's a new show a product or a project it's why I launched the conversation cards I've relied on Shopify before who's a sponsor of today's podcast and I'll be using them again for the next big launch which we'll hear about soon and I use them because of how easy it is to set up an online store that reaches all of you no matter where you are in the world with Shopify the usual pain points of launching

products online Disappear Completely no matter the size of your business Shopify has everything you need to make your business go to the next level and better connect with your customers all over the world to say thank you to all of you for listening to my show we're giving you a trial which is just $1 a month you can sign up by going to shopify.com Bartlet that's shopify.com Bartlet or find the link in the description below one of the um conversations I had with my partner last year at New Year's Eve was about creatine yeah um

I had it had some with me on the counter in our in our home and we were away from home and I said to her I said oh you should take some and her response was no that's not for women and she went on to explain that she felt it was for effectively like bodybuilders yeah and that it would like put on weight and I was like I don't think that's true I said some people on my podcast have told me that that everyone should be taking it yeah and so we sat there Googled it

and after Googling it for a couple of um minutes she was like scooping it into her drink as fast as she possibly could but there is a prevailing narrative here actually before you came I asked AI a couple of questions about women's perceptions on Creatine and the number one thing was women thought that it would in gain muscle and gain weight and they thought it was um for bodybuilders yep that is the prevailing myths around creatine and what's the expression people will use the dose or the poisons in the dose mhm right so that's part

of the creatine so if we're looking at the bodybuilding set and how it increases muscle capacity and training status so we're using a lot of creatine the dosing for bodybuilding is five grams four times a day with one gram of carbohydrate and we see that creatine helps store water within the muscle with glycogen and we want that for muscle performance because the idea of being able to train harder with creatine is to enhance the amount of of enzymes that are available for muscle contraction and creatine is part of the buffering system of that if we're

looking at creatine for health and for women the dose is 3 to five grams only once a day without carbohydrate and the reason for that is women have around 70% of the stores that men have by the nature for the most part don't eat as much creatine food as men and we see that we use it for a lot of our fast energetics so like for our gut health for our brain health um and then also for muscle performance so if we're having women take three to five grams once a day it does not have

the same side effects as the bodybuilding set of taking five grams four times a day yeah because it on the label it tells me to take it a few times a day yeah you don't have to and it says about loading so this is all the bodybuilding stuff right so if you want to load we see a loading protocols over the course of two weeks and you're starting to really saturate the body with those five grams four times a day but for women we see that 3 to five grams will fully saturate the body over

the course of three weeks so that means that all of our fast energetics like I said our gut um the intestines and we're looking at the Integrity of the intestinal cells and the mucosal lining and we see that there is a greater incidence of GI distress in women I think it's something like a 5 to1 r itio of women to men having GI distress running and it has to do with estrogen but also has to do with what we call the mucosal lining of the intestines so we want to maintain the Integrity of the mucosal

lining and creatine is really important for that so if we're looking at saturating the body over three weeks with 3 to five grams we improve that Integrity so we have less GI distress we also see that there have been randomized control trials looking at uh mood and with specifically with regards to depression and anxiety and women who are taking 3 to five grams of creatine will come out of a depressive episode more so than women who are just using an SSRI so it's really important for brain metabolism and when we're looking at that whole loading

strategy for men that's all about muscle performance it's not about gut health it's not about brain health it's about muscle performance just looking at some studies creatine supplication creatine supplementation for both men and women enhances muscle strength increas lean muscle mass improves high intensity exercise performance yep improves recovery has potential cognitive benefits and supports in neurodegenerative diseases yes so Abby Smith Ryan is a colleague out of UNCC and she's done a lot of work in creatine for women um and yes we see that there is an improvement in muscle capacity because you're increasing the amount

of buffer that's available for muscle contractions but it doesn't have to be the same loading dose as men if you are looking for performance enhancement because you want to improve a training block or you're in physique building or you're going to do something like high rocks and you need to have greater muscle capacity you might want to try the loading strategy yes you will gain water weight because you're also storing more within the muscle but for the general woman who's looking for health and performance benefits you don't have to do a loading strategy you just

have to do that three to five grams a day that loading strategy for anyone that doesn't know is basically some of the creatin boxes will tell you the labels will say for the first week or two weeks whatever have a huge dosage of it and then thereafter you can kind of ease down the dosage but I think that's kind of been debunked as something that we all need to do in all cases yeah are there any other supplements that you recommend women to take based on the way that we live our lives and the food

that we eat vitamin D okay um and why and what does that do so if we're looking at Vitamin D especially vitamin D3 the difference so you have vitamin D2 and vitamin D3 vitamin D2 is more of a storage form it's not converted to being a functional form so if you take D3 it's already a functional form so it means your body is going to take it in and use it as it should be so we're looking at a vitamin D3 supplement then we are able to boost circulating levels of vitamin D3 or vitamin D

that's usable and it's used for every system in the body and it's really important now especially I'm coming from the southern hemisphere just out of winter you're in the upper parts of the northern hemisphere in the middle of winter and we don't get enough sun and when we're looking at now all the worries for skin cancer people are Slip slap slop you know sunscreen hat clothes and we don't get enough and then if we're looking at our food supply there's not a lot of proper vitamin D rich foods you're looking at mushrooms or fortified dairy

products and those 10 not to be consumed a lot nowadays so if we're improving the amount of vitamin D3 that we're taking in and the amount of vitamin D that's circulating we have better recovery we have better muscle function we have better brain health we have pretty much every system is affected in a positive way omega-3 yep Omega-3s are good especially as we get into Perry and post-menopause we want to look at uh how inflammation affects the cells so we look at using a really good vitamin or sorry really good omega3 um and Omega uh

I guess we're looking at the types of Omega-3s that are in there then we're enhancing cellular Integrity that our estrogen used to help with anti-inflammatory properties it's not something that everyone needs to take it's something that we have to consider when we start getting into our late 30s early 40s maybe get a blood test for it see how your omega-3 levels are and then consider dosing with a really good fish oil what about iron levels because I've had a friend of mine who is a woman um tell me that their ion levels were low this

is common and we see that there's the incidence of a change in the Norms when we're looking at the reference ranges and I find it really interesting that the reference ranges that we have for all of our blood markers are shifting to a sicker population what does that mean so if we're looking at the bell curve and we're taking po ation data overall our society has become sicker so now we're seeing that the norms for iron used to be a fertin of 50 or lower was considered low fertin now it's 26 for women we look

at testosterone lower testosterone now for men is normal and it is because that is just what a sedentary population now presents but if someone is active and comes to me and says you know I had my iron test tested and it's sitting at 26 they say that it's normal but I feel awful it's like that is not normal if you were part of my high performance athletic crew we want to see minimum 50 preferably 100 so we have to supplement you to bring it up and it's a really specific area of how we supplement it's

supplementing every other day with a very high bioavailable iron and when we start looking at how we are supplementing every other day with either a carbonal or glycinate then we're really able to boost that fertin and people start to feel better what does ion do and how does someone who's iron deficient feel so iron is responsible for that those heem groups that I was talking about with oxygen carrying capacity hemoglobin the blood thing the blood cells yeah they blood cells so iron is responsible for allowing those heem groups to carry oxygen if we have low

iron then we don't have enough oxygen circulating throughout the body or being used by the body so you feel very flat very tired you start to get really dark circles under your eyes um it's a mission to do anything so it's like a deadend fatigue and people are like this this isn't stress oriented fatigue or jetl oriented fatigue this is fatigue where I can't even walk up the stairs without getting winded what foods have iron in them or iron rich so primarily red meat is where a lot of people turn to but if you are

more plant-based then we look at leafy greens we look at nuts and seeds but using a lot of vitamin C with that prly adding um a little bit of olive oil on our salads uh maybe cooking in an iron skillet to improve the amount of iron that comes into the food and we also know that we have to time it with what we call heidin or heepen depending on where you come from in the world it's an enzyme that decreases the body's availability of iron absorption it increases with inflammation so it's higher after training for

about 5 hours in men and in reproductive women and it can be elevated for up to 24 hours in late Perry and early postmenopausal women so basically how do I supplement supplement before training or at night away from training when you think about men's and women's diets is there anything to be aware of when we're thinking about because you know me and my partner will sit down for dinner and we share the food yeah so we the food comes out we even when we go to a restaurant sometimes we'll order the exact same thing and

we'll both finish it yeah is that okay is it is it working for you guys I think part of the reason I ask is when I did some um blood glucose tests yeah I think I I think if I recall this correctly my partner was more sense glucose sensitive than me and I recall them telling me that women are have a greater blood sugar sensitivity than men so this is the interesting part so when we're looking at blood glucose and insulin sensitivity it changes across the menstrual cycle so it depends on is she in the

high hormone phase or not if she's in the high hormone phase which is after ovulation uh we have more insulin resistance and the reason for that is when progesterone comes up it's trying to take in everything as a building block for the uterine lining insulin resistance what does that mean so insulin is the hormone that that is a signal for your muscles to uptake glucose to store it okay so it sends a signal to grab the glucose out my blood store it which brings my glucose levels down exactly okay exactly when progesterone's in the picture

insulin doesn't do its job very well okay because Pro progesterone wants to have more carbohydrate available to be able to then send it to the developing uterine lining the endometriosis because the endometriosis becomes a really thick layer of tissue that is really rich in glycogen so progesterone increases lean mass break down or you increase your protein intake to have more circulating amino acids it also makes your body less apt to store glucose because it wants both amino acids and glucose to build this Lush uterine lining when we get into par menopause we have more insulin

resistance because there's confusion across all systems of the body and the body is like I don't know if I'm going to need this glucose or not so I'm not going to store it and there's a misstep in the liver and a misstep in the mitochondria which is responsible for tapping into using free fatty acids with carbohydrate so the body is having a higher level of blood glucose because the body doesn't know if should store it or not so when your partner gets tested depends on how old she is and what phase of the menstrual cycle

or if she's well beyond that so the part of the menal cycle where her progesterone is highest is when she's going to be most sensitive to Sugar exactly and that is typically between day 19 and 23 if she has a normal cycle a regular cycle whatever well the caveat there is ovulation is she OV ating or not okay and unfortunately we're seeing in the modern fertility literature that women are having more and more an ulatory Cycles but you won't necessarily know that because you'll still have a bleed what's an anovulatory cycle you don't ovulate why

they're looking at a lot of the stress that's coming on today's society the food system a lot of the um I guess trendy diets that are out there a lot of women aren't eating enough to support their im or their menstrual cycle function to allow the egg to actually develop to then instigate ovulation and it's not just an active women it's across the board so as it relates to this menstrual cycle yeah 28 days I'm going to put on the screen for anyone that doesn't understand it um or doesn't know what I'm referencing right now

but I'll also link it below in the comments in the description sorry um 28 days long there's the early follicular stage the late follicular stage the mid Lulu L that's exactly what I said Y and the late Lal phas yeah yeah yeah as it relates to nutrition and exercise yeah how do I need to adapt across these 28 days and why do I need to adapt so again it comes down to the ovulation right so if we're looking at the low hormone phase so that's your follicular phase day one to six roughly yep and even

up to ovulation which is where so around a 12 or 13 on 20 8 day cycle so right at that Peak to 13 yeah yeah there so this is where um the immune system is really robust and we're really resilient to stress and we can have a lot of carbohydrate and protein intake and we're not going to be that affected we're more sens sensitive to glucose it's going to be pulled into places it needs to be if we ovulate after ovulation like I said progesterone comes up it's only produced if we ovulate because progesterone is

produced from the breakdown of the housing of the egg progesterone like I said earlier will hold everything in the blood it will it will tell the body we need more blood glucose and we need that glucose to come to the endometrial lining we also need more amino acids so we're going to break down lean mass or I'm going to make this person crave more protein oriented Foods so that I can have amino acids to come in so if we're looking at adapting right the only real thing that we need to be aware of is after

ovulation if we're going to do a high-intensity workout we need to make sure that we have some more carbohydrate so we're actually eating before and after having some good carbohydrate that comes in which is from day 14 onwards yep so from day 14 onwards if we are going to do a lot of high intensity workout or High um a big workout yeah then we need to just make sure we're having more cobs yeah and then we have around a 12% increase in our protein needs because we have a higher amount of amino acids that are

needed one because we're developing tissue but two we also have skeletal muscle turn over that we need to keep up with interesting so is there any day in the cycle where we shouldn't be working out hard that's individual so it used to be early days when menstrual cycle research was coming out we saw on a molecular level that the low hormone phase was where we could really push it and we could really get really good adaptations because our body was really responsive to stress then after ovulation we see a fuel shift like I said progesterone

is is really conserving or pulling glucose away estrogen's also sparing it and saying you know you need to go to the uterine lining so with the change of hormones we have a change our fueling system we also have a change in our core temperature where it goes up by about five or0 5° celi or around 1° Fahrenheits or our heat tolerance isn't as great but because we're seeing more and more an ovulatory Cycles we have to rely on the woman to track her own cycle which is hard well it doesn't have to be as hard

as what people think okay it's the Nuance of how do I feel today so I tell women instead of really dialing it in and saying oh well I think I ovulated today so that means I should back it down when you go to the gym use what we call sessional rating of perceived exertion so I tell people most of the time you're going to go in you're going to have a physical and a mental right physical how are you on a 1 to 10 mental how are you on a 1 to 10 if physically you're

an eight and mentally you're a two warm up really well and see if that mental capacity comes back up if not then we're not going to push too hard we're not going to work on technique because mentally you're just not there physically maybe you are if you go in and you're low on both of them then it's going to be a technique in recovery day you're not wasting time at the gym you're going to make it work for you by really working slow under the bar nailing technique not getting the heart rate up so much

and as we're going through and tracking how we feel we're going to start to see patterns across our cycle and we can anticipate those patterns and say okay well I know on day 21 I always feel flat so I'm not going to schedule a high-intensity workout that day I'm going to sleep in maybe do some Mobility recover and really know that I'm not going to nail it that day so I'm not going to go push myself because I don't want to beat myself up mentally because women do this they're like I suck I don't know

why but it comes down to that physiological variability and for a woman to track her own cycle understand her own nuances if you're really onto it and you know when you ovulate then you can take those molecular structures into play where you know you can hit your PR and you can really push it in the low hormone phase after ovulation you're going to switch it to more endurance maybe not so high intensity but more Tempo type work and then about the four or five days before your period starts where your immune system is more compromised

you just kind of want to dial it down use it as D Lo so we can take the strength and conditioning ideas of building up macro micro cycles and D Lo across the menstrual cycle so where in this cycle am I going to be strongest if I'm a woman so if we're looking from a cognitive and a physicality aspect it's right around where that estrogen starts to come up so around day six day six to about day 13 day 13 okay and where am I going to be least strong theoretically from about day 23 yeah

yeah yep as those hormones start to come down yeah to 28 oh okay to the very end okay the very end and the variation of those hormones coming down is what instigates a total inflammatory response so if we're looking at inflammation which drives the menstrual cycle to start the bleeding phase we have a change in our immune system bleeding happens at 28 around day 28 so we say bleeding is day one in a cycle is day 28 of course yeah day one to day six typically okay fine yeah what question should I be asking about

the menstrual cycle well you know the questions that are never asked is like what is a typical menstrual cycle yes we have a textbook like Yeah from 1 to 28 that's very very rare most women have a cycle that might be 21 to 40 days the bleed cycle is something that's never talked about what does a bleed cycle look like is it really six days no every woman has a different one and if you're tracking what that bleed is maybe you have two heavy days a light day and another couple of days of spotting and

then a heavy day that's your Norm when you start having changes in the norm that's when you want to look and say am I getting into low energy availability am I not recovering well enough or am I my late 30s early 40s and I started getting into per menopause the bleed pattern is so important for people to understand because that's how we have a true inherent identification of stress so we see changes in the bleed pattern as well as the length of the menstrual cycle itself when the body is not adapting to stress and stress

isn't just our daily life stress it's exercise stress and that disruption could also be just not having a bleed yes because a lot of women talk about that they talk about having a regular period or just the period didn't come this month is that often an indicator of the body being under stress yes and that stress can be not just a bad emails at work but it could be you're working out too much or something yeah working out too much not eating enough is the big one we've done some really interesting research looking at recreational

female athletes so people who go to the gym three or four times a week right they're not training specifically for anything but life MH and they tend to fall into some of these trendy diets like FD training or maybe they're eating too low carbohydrate because they're on a low carb high fat or high protein diet and they're missing on the carbs and again that interrupts the hypothalamus so we call it low energy availability when someone isn't eating enough for the hypothalamus to say yeah all of our systems can work and we can adapt to exercise

so we see on the upwards of 55% of recreational female athletes in a low energy state or subclinical low energy site and it comes out as changes in the bleed cycle or a missed period That's why I tell women look if you're tracking you can do sessional RP but really track that bleed pattern and the length of the cycle because if you start to see changes in the length and changes in the bleed pattern or just changes in the bleed pattern it's an opportunity for you to take a pause say what what have I done

from a training perspective or a sleep perspective or somehow increase my stress that my body's adapting well because if we do that first then we don't get into a clinical position of aena which is no menstrual cycle and poor bone health and psychological issues and things that all come with endocrine dysfunction why is bone health so important for women in particular when we see bone it is driven by estrogen progesterone and an interplay between estrogen and progesterone we see a peak velocity or Che bone mass hitting around the time we're 20ish and then we'll start

to degrade it if we're not creating multi-directional stress on the bone through jumping through resistance training and if we start to Lo lose bone density and we become osteopenic or osteop partic meaning we have very thin bones they break easily and it's really really difficult for someone who is in their reproductive years to to be able to do all the things they want to do if they don't have a really strong robust skeletal system and this is why vitamin D is also so important yes okay and men and women have different bone density y men

have thicker bones and tend to not have as much degreg of the bone because they don't have estrogen progesterone perturbations that are changing the signaling to increasing bone density or stopping the growth of bone right so women have this perturbation throughout their menstrual cycle that will change how their bones are responding and then when we don't have a menstrual cycle or we get put on an oral contraceptive pill we have changes in that signaling which changes our bone density and you mentioned sleep a second ago yeah how is sleep relevant and what's the variance between

men and women as it relates to sleep sleep's really important because that's where we have our parasympathetic drive and our ability to recover so the whole I shouldn't say the whole reason because nobody really knows why we need to sleep other than the fact this is where our physical and our mental capacities become solidified so that means that our body fully repairs while we're sleeping our memories get solidified our brain becomes a little bit relaxed and can repair itself while we're sleeping for women we see changes across the menstrual cycle in our sleep phases so

when we are slow sleep phases meaning our deep sleep versus our late sleep versus our Dream sleep and we need to get in that really super deep sleep in order to have optimal reparation when we are getting close to the bleed phase then we see more interruption in the sleep and it's really really apparent for women who have really bad PMS or uh other conditions that happen to affect estrogen progesterone we have an increase in our core temperature from progesterone we have changes in melatonin pulse because of of estrogen so when women are talking about

having really poor sleep right before their menstrual cycle it is because we have these sex hormones that are interfering with our sleep phases for men they don't have that perturbation for men we see that um chronologically they tend to have a melatonin Peak that's later than women so they tend to want to stay up later and they can sleep in but they can also have shorter sleeps so there's a chronobiology aspect that comes to it with regards to how our body actually falls asleep and wakes up and there's a sex difference in that chronobiology theal

women suffer more with jet lag women suffer more with jet lag and if so why why is that because if we're looking at our circadian rhythms and how long they are like I said melatonin Peaks earlier for women than men and we have a slightly different what does that mean sorry melatonin so melatonin is what allows our body to actually get into sleep and our wind down for that is melatonin production so a lot of people will start to feel really sleepy at like 4 in the afternoon noon right it's just a natural occurrence our

core temperature comes up we start to have melatonin production and for women a melatonin Peak for sleep to for Sleep onset hits around 900 p.m. on average for men it's about 10 or 11 p.m. because our circadian rhythms are different so women are on a shorter side than men so we're talking about jet lag for women going east it's a little bit easier because it's a shorter for women going west it's a little bit harder because it's longer so there's the difference men will do better going west and worse going east women go better East

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artificial are often a sign of foods to avoid have you ever noticed a health claim on fresh fruit you probably get my point understandably there's loads of distrust out there who should you turn to for accurate information I use Zoe which is backed by one of the world's largest microbiome databases and most scientifically Advanced atome gut health tests Zoe gives you proven science whenever you need it as a Zoe member you'll get an atome test kit and personalized nutrition program to help you make smarter food choices that support your gut to sign up visit Zo

and use my code Steven 10 for 10% off your membership that's zoe.com code step1 trust your gut trust Zoe use this term chronobiology mhm I have no idea what that word means but that's the biology of our cron Cadian Rhythm yeah okay yeah yeah and is there anything else that men and women should understand about our chronobiology that's pertinent to making sure that we're High performing and healthy yeah so this comes down to our hormone and pulses throughout the day so we see that cortisol which everyone talks about as being a bad thing it's not

a bad thing we have a peak about a half an hour after wake up and for women we need to eat in order to dampen that Peak for men it just naturally dampens so you don't need the food to instigate dampening of that Peak we see a luteinizing hormone pulse in both men and women but the um amplitude of that pulse is greater in women because it's responsible for how our body responds to developing an egg so that it can be fertilized we also see estrogen pulses again to pulse throughout the day and then throughout

the week before we can come to one of those estrogen Peaks so our body is is aligned for these pulses and we have a 20ish 24ish hour clock and within that we have cellular clocks so we have a cellular clock that's telling us to pulse mizing hormone every so often we have a internal cellular clock that's telling estrogen to pulse every so often and we can change that through differences in sleep change that through our light wake time and through food intake how important is it to time our meals and be intentional about when we

eat it's pretty important if we're looking about how our clock is aligned yeah and how we are repairing while we're sleeping cuz if we're eating late and we've shifted everything late because people eat late they go to bed they wake up they're not hungry they don't dampen that cortisol peak for women and then they don't sleep very well because if you are eating right before bed your body is using parasympathetic response to digest instead of invoke really good sleep so we see a lot of this circadium misalignment that's occurring we see it a lot in

shift workers we see it a lot in our Global Society of staying up late and working and having screens and the impact on metabolism is that it changes appetite hormones for women where it will increase the craving for carbohydrates and the desire to eat more and they don't ever feel full for men it's just a craving aspect and so they'll eat according to Cravings it's called hedonistic eating rather than a true change in appetite hormones so people who are having difficulty sleeping and difficulty changing body composition for overall health we shift it we're like okay

we want to shift to be able to eat during the day and to have regular food at regular intervals so that our body has fuel to do what it needs during the day we stop eating at dinner time which is around 6 or seven have a good two to three hours before we go to bed so that when we do go to bed all our parasympathetic responses can go into getting really good sleep architecture so that means that we get really good um phas of sleep for optimal physical mental recovery because if we have that

then we have better blood glucose control so better insulin responses we're able to have more energy during the day and all of our systems work better I I had noticed something intriguing about me which is when I wake up early to go to the airport so say I have to wake up at like 4:00 a.m. to go to the airport I am so hungry yeah and I've never understood why because if I wake up at say 9:00 a.m. MH I wake up is hungry yep why your brain is perceiving a stress and this is that

hedonistic where you're like oh my brain is like I'm under stress and I need fuel I need glucose so things like a line has woken me up yeah [ __ ] hell that makes so much sense honestly it's so it's so it's always confused me because sometimes I have to wake up super early so 2 3 a.m. to go get a plane or something and when I get to the airport I'm so hungry but like a day today what time is it it's 1:00 p.m. mhm and I have haven't eaten yet I know you're mad

at me no but I haven't eaten yet because I don't want to eat before I do a podcast because then it's going to like it like messes with my articulation so I can't get the words out my mouth okay that's maybe that's [ __ ] I'm saying this to someone that knows what they're talking about but maybe there's something else I could eat but I just find that if I eat something heavy or if generally if I eat the way that I've always rationalized it is all the Oxygen's like going to my digestive system is

that nonsense that's nonsense is it actually yeah so can I eat before I do a podcast yes you can and it won't impact my ability to articulate myself if you're really worried then you can have like a protein shake or protein water you could sit protein water while you're having a podcast so then you're getting amino acid circulating your hypothalamus is like sweet okay we're all good to go but I hear you because I don't like to have a lot of food in my stomach when I'm going to be concentrating a lot or trying to

articulate so I eat things that are high in protein but easy to digest try that so like protein water protein shake would be a good idea before or hardboiled eggs hardboiled eggs okay okay let's talk about menopause then yeah starting with Perry menopause yeah you got a smile on your face ah it's something that I'm really excited is coming into conversations now because three years ago no one would say the word I knew we had made it as women in society when the Nightly News was talking about menopause so let's go I'm excited one thing

I saw which is quite an interesting observation is in the UK this year on Apple the most shared podcast episode in the whole country of all podcasts was a conversation I had about menopause nice and congratulations that's awesome it gets even better and in the US the most shared podcast episode of all podcasts in the US on Apple was the same guest on Mel Robins podcast talking about menopause I go that's that's incredible and also crazy that in both countries the number one most shared podcast episode was the same guest talking about the same topic

yep that doesn't surprise you nope why well I know this guest and she's very good at articulating but also we have seen this upsurge of women like myself my age group put myself out there we all grew up on the understanding that we were women we were a little bit different from men but no one told us about menopause and now all of a sudden there are these extreme changes that are going on and people are like what's going on and if I were to take a typical case scenario of a woman who's in her

40s and goes to a doctor and goes you know what I can't sleep I am trying to exercise but I'm so tired I can't do it my body is changing and I just don't know what's going on the general response to her 3 years ago would have been well look you're a woman in her 40s who's highly stressed you have kids on one side you have older parents on another you're trying to you're right in the middle of your career you have a really busy life here's an SSRI for anxiety and depression is going to

help you sleep but now with all the conversations that have been going on a woman in her 40s will go to a GP and for the most part will be told well you're in your 40s it might be per menopause and this is such a relief to so many women because they're not being gaslit anymore they're not being told that what they're feeling isn't true it's just something to do with stress now they're being told you know what all your systems in your body are being affected because your sex hormones are changing so remember puberty

when everything was changing and no one wants to live through puberty anymore you're on the other side of that you're in Reverse puberty where all of your hormones are starting to downregulate so every system in your body is being affected let's un packet let's see what's going on so when Mary CLA comes on and talks about menopause as an MD and talks about all the things that she's seeing in her Clinic women are like that's me now I understand I'm not alone and that's the power that's coming through all of these conversations and all these

groups like Naomi watt swell group right they're talking about menopause so now women are listening and keying in and going wait a second there actually are things that are occurring to me me and I can get information which is why these podcasts are taking off because now women are like I'm not just crazy there are actually things happening to me and people understand that now what can I do to help myself because it isn't being taught in med school a lot of the doctors that are out there are getting information because they are seeking it

out themselves and looking to people like Mary Claire and other like Louise Nome in the UK who are actually talking about it and saying these are the things that are happening and these are the things that we know that we can do gosh it's a shame isn't it it's a shame that they must have been so many women over the years that went to their doctor and got really bad advice yeah and were given anti-depressant medications and stuff like that and well the other side is women who are in their reproductive years who have something

like PCOS or endometriosis or they're having irregular periods and they're put on an oral contraceptive bill because the doctors don't understand that there are other things that are going on that will cause a misstep in menstrual cycle so I get frustrated when teenage girls go to a doctor with irregular cycles and they're handed OC's like Skittles it's like that's not appropriate either we have to actually understand what's going on we know that there's irregularity in a menstrual cycle until people are around 3 years post the onset of their first menstrual cycle It's Not Unusual and

OC is not the answer if someone's still having irregularity we have to look at lifestyle and say hey what's going on they're having really heavy menstrual bleeding it's not about using an OC to control it let's look and see why is that happening maybe we use an IUD or maybe we'll use some other medication to help but there's a lot of things that are not taught in med school that women are having to find out for themselves and so when we listen to podcasts and we're hearing information from medical doctors who now have a like

a vocal aspect of being able to touch so many people it resonates so now doctors are trying to find that information if they have the time but we know the healthare systems in most countries doctors are so pressed for time they don't have that opportunity so let's talk about per menopause yeah what do I need to be thinking about what what age group typically is per menopause um I guess it can be a wide spectrum but when does that typically start and how do I need to be thinking about my nutrition and exercise in that

phase so around age 35 up to I think they say now the average age of menopause is 52 years old okay so what's happening in that 15 to 177e span is you're having such a change in the ratio of estrogen and progesterone early days a lot of it appears as I'm not adapting to my training it's not working well I'm putting on more body fat I'm becoming squishy I'm not sleeping well I'm having lots of mood changes it must be this is why a lot of doctors say oh it's cuz you're busy and stressed out

here's a serotonin reuptake inhibitor but no it's changes in the ratios how can we dial it in we look at menstrual cycles and is it becoming shorter or longer what's our bleed phase we get into our mid to late 40s it's very apparent because there are a lot of different changes that are occurring we're seeing a change in our blood lipids there's an increase in our low density lipoprotein which is the quote bad cholesterol even if a woman's never had an issue with it now all of a sudden she's having issues with her cholesterol we

see a 1 C coming up which is a marker for diabetes pre-diabetes without any real change in what they're doing other than the fact that their exercise isn't working their sleep is a little bit disrupted and their body composition is completely changing and when we're Lo looking at what's happening we see that decrease in gut microbiome diversity because we don't have as many sex hormones so that impacts serotonin that impacts vitamin production that impacts parasympathetic drug dve and we're also seeing a misstep in the way liver is reading fat and fat circulation so we're seeing

free fatty acids that are coming around and because we don't have as much estrogen we don't have as much anti-inflammatory responses so we can't pull as many free fatty acids into the mitochondria and the skeletal muscle to be used as fuel so they circulate and the liver has a signal that goes we're going to change that free fatty acid into what we call esterified fatty acid which then gets stored as visceral fat and visceral fat is that dangerous fat that gets stored around the organs which is why women start to get like a minnow poot

or develop a lot of abdominal osity so people will start seeing this and going I don't understand what's going on over the past six months I put on 10 pounds or or I put on four stone right what's going on my training is not working become very despondent and if they don't know they're in par menopause then they don't know that that's what's happening and how can they find out if they are well it's really symptomatic because we can't use blood tests there isn't a definitive blood test to say hey you're a par menopausal you

have to have a a history of everything of getting blood tests like every week and no one does that so we have to go on symptomology really using the sociocultural aspect of how a woman is experiencing life with her symptoms and really listen and say okay well here are the things that are going on and we try to instigate non hormonal options there's exercise there's lifestyle and then if all else is really going to [ __ ] then we can look at using some menopause hormone therapy just like we were talking about o impact being

a tool so hormone therapy can also be a tool does it matter my pre-existing Health when I approach menopause if I'm if I've got more weight on my body is that going to impact the amount of symptoms that I experience of menopause it can y it can we see that there is a greater incidence of vasomotor symptoms or hot flashes for women who have a greater amount of body fat um we also see that if you have more lean mass then you're going to have less of an incidence of insulin um resistance so body composition

has a huge play in symptomology and then you also have to look at what your mom went through because if your mom had a really really horrible time with lots of so vasomotor symptoms and body composition change there's a genetic link doesn't necessarily mean that you're going to experience the same thing but you have a greater predisposition to having more severe symptomology how should I be thinking about exercise as I'm going through my menopause chiny so we look as I said earlier exercises are really good stress for adaptive change so when we start getting into

all these ratio shifts of estrogen progesterone we can't rely on our hormones to create those adaptive changes and so what I mean by that it's like estrogen's responsible for muscle protein synthesis and and strength and power for women progesterone and estrogen responsible for bone bone growth bone density we can't rely on our hormones for that anymore we have to look for an external stress so this is where exercise comes in so we're looking specifically at how to invoke a stress to change our insulin sensitivity in in other words improve our blood gluc Co control we

need to do proper high-intensity work so that Sprint interval or it's true high-intensity work to create a stress that's high enough to have the brain say hey this is a really really really strong stress I need to invoke changes within the skeletal muscle to be able to store more glucose I also need to invoke more changes in the mitochondria so that it can use and store more free fatty acids and I'm going to have more myokine released from the the skeletal muscle to tell the liver don't Esty those fatty acids I want to use them

at rest so we don't get bserial fat gain so hit workouts yeah ply metrics yeah which is what jumping stuff resistance training absolutely weights right yeah but specific to the type of Weights that you're doing what about frequency of training and how long I train for we want to think about less volume and more quality okay so we're not going to the gym for an hour and a half every day we're looking at doing short sharp high-intensity cardio or we're looking at doing power-based resistance training three times a week and the cardio can be uh

two to four times a week why why shorter durations of training we're looking at intensity so if we're doing long slow stuff or we're doing moderate intensity zone two stuff that's not really going to create the kind of stress that we need to invoke change what about um saers and stuff like that yeah absolutely we see that women who go into the sauna um get better control over things like hot flashes because it's all about temperature and temperature control so if the blood going through the brain is really hot it understands hey this is what

hot is and can then have subsequent peripheral changes for controlling heat and understanding heat as well as Central changes to understand heat and what about food through menopause is there a specific diet that I should be thinking about for menopause we want a higher protein intake of course because as we get older we become more anabolically resistant to protein so that means our body isn't responding as much to the amino acid so we need a higher dose to invoke muscle protein synthesis and Bone regeneration nerve regeneration also knowing that the recommended daily allowance that's out

there for protein especially for women is based on sedentary older men so it's not really adequate for what looking for uh so we want higher incidents of protein at regular intervals across the day and again taking care of that gut microbiome so we want a lot of colorful fruit and veg that also helps with uh blood glucose control as well as creating that diversity so that we are able to reduce the amount of of bacteria that is responsible for storing body fat we want have that great amount of diversity of gut microbiome to or great

diversity of the gut microbiome to have more of the bacteria that says hey you know what we want more lean mass we want to have less body fat I noticed earlier on when you talked about hormone therapy you referred to it as menopausal hormone therapy as opposed to hor hormone replacement therapy yeah most people say HRT right right why do you say something different yeah I got a lot of my chops and menopause work through the Women's Health Initiative and I'm not going to apologize for that cohort because this study was designed to look at

older women going through per menopause or going through menopause and does it work so there's a whole issue around Whi and other things but when we look at specifically women who are going through menopause or per menopause into menopause we're not looking to replace hormones we're looking at a therapy to attenuate change if we're looking at hormone replacement that could be thyroid that could be uh premature ovarian failure that we need to have some um estrogen progesterone we're looking at menopause and Par menopause in itself we're looking at using a hormone dose that is a

very low physiologic um level so that we don't have symptomology so the body is not going to have vasomotor symptoms and is not going to have mood changes and is not going to really have an incredible amount of body composition change if we're replacing hormones people have the idea that it's going to be the same physiologic level as when we were in our reproductive years and that's not the case is there also bit bit of an underlying notion that women are using these hormones to as a way to stay young and when you say replace

you're kind of implying that they're fighting against something yep that we are replacing our hormones to stay young and be in our reproductive years so if we look at Western society and I like to use um the cast of Friends as an example from you know 90s to now right and we see that the cast of Friends women all have a certain look that they've had to maintain in order to be viable on Hollywood which means that they're thin they have good body composition they are don't have any wrinkles they have really good lustrious hair

and that's the image that women have now of how they're supposed to age where men not so much we see the images of men who are aging becoming more uh demure I guess so they have gray hair they have some wrinkles they're very distinguished and that's the image we have of men aging there's a huge disconnect in society so when women start to experience per menopause it's a definitive point of aging and people are afraid to age everyone's afraid to age for the most part the idea of aging gracefully or embracing it hasn't quite gotten

to the mainstream so when someone's like here's some hormones to replace so you can stay young people are like great but we look at the research and it's not about staying young it's about slowing the rate of change that's so severe that creates quality of life distress and we also see that the research isn't there for maintaining brain Integrity to prevent dementia which is the other thing that's floating around it's not there there's no evidence to show that taking hormone therapy is going to stop dementia so there's lots of things out there that's a a

disconnect and trying to say it's menopause hormone therapy is one way of getting people to understand that it's not an anti-aging agent it's something to help with this phase of life and to help get through so that we don't have severe changes to our daily life and who we are as a person is there anything else that we need to talk about as it relates to menopause just want to make sure we've covered it all covered it all it gets better on the other side I think that's something people don't talk about is Perry menopause

is such the conversation now with all the the conversations around hormone therapy exercise lifestyle but no one talks about the other side once you've gotten through per menopause do my joints stop hurting do I stop having all these sleep interruptions do I stop having to worry about my bones and if you're putting in the right lifestyle changes to maintain bone health yes on the other side everything becomes a new normal without the pain and dysfunction because it's the shift in hormones that's creating so many different issues with every system of the body so if we

get through this with really good um interventions for preventing or attenuating the changes that are happening the other side is much better and for women with PCOS or endometriosis is there anything that they need to be thinking about as it relates to exercise or nutrition yeah so there's I guess a huge misstep in the understanding that endometriosis uh is an inflammatory um response yes and no there's some more emerging evidence that it could be a bacterial or or a viral um cause but with regards to endometriosis we see that if you're able to use some

cold water uh therapy for the most part so a cold water plunge around the time that you think about ovulation where after ovulation you have endometrial growth it reduces the total inflammatory response so that the endometrial lining doesn't grow as much so you don't have as much growth of endometrial tissue outside of the uterus okay so we're looking at how do we stop that extra growth we can use environmental cues to help with that so that's that cold therapy if we look at PCOS it's all about um a higher Androgen count and then we have

more insulin resistance and how we're training for exercise is all about how do we control that insulin resistance so we look at high intensity we look at using resistance training so women who have pcus they have regular Cycles so we can't use the menstrual cycle as an indication of stress so we have to look at things like heart rate variability we have to look at properly putting in intensity and resistance training to work with blood glucose levels to again attenuate some of the symptomology that comes with PCOS what is the most important thing we haven't

talked about that we should have talked about that this conversation isn't just for women I'm very grateful that you're very excited about the menstrual cycle but um I think a lot of people kind of tune out when we start to hear conversations about women and conversations about sex differences but it's for everybody because if we're going to push forward and understand how we need to do research to improve the health of women and men then it's a combination in the conversation so I yeah I'm very appreciative to Men Who come into the conversation and men

who are in the room and very appreciative of you for having these conversations because then it pushes it out and makes it normal across the board yeah and the reason I I have these conversations is because it's a lot of my conversations at home with my partner we spend so long talk about her menstrual cycle and about uh when she's ovulating and she talks to me a lot about how she's feeling because of that and uh certain things we should be doing even when we're thinking about like how to spend the weekend it's often decided

through the context of like her cycle and then obviously we're trying to we're in the phase of life where we're going to try and have kids now so we're thinking a lot about it there but then just more broadly you know if something is having such a significant impact on a woman's life um which I think it does I think it does have significant impact things like menopause in the menstrual cycle generally then I'm going to interface with women my whole life if I have a daughter I have sister I have a mom I have

a partner so if I can better understand um them because I understand how their body is working then we're going to have more successful relationships and frankly a year ago I didn't even know what menopause was yeah so yay to be fair I didn't even know what a menstrual cycle really was a year ago I knew that women had periods but I could have tell can have told you with great confidence that different things happen throughout the cycle in that it was 28 days long I really had no idea and I'm like 32 years old

and I don't really care about admitting that people like but I don't really care because I know there's a lot of people out there that feel the same way and and we're like not allowed to admit that because then you get people attack you or whatever but who cares I had a PhD student who came up to me and he's like my partner has something to tell you and it's going to come through me I was like okay what is it he said she said to tell you that I know more about the menstrual cycle

than she does yeah I like awesome cuz he was looking at women in the Heat versus men in the heat so we had to understand the menstrual cycle and how all of that came and then that upskilled her so it came in the opposite instead of her trying to upskill him he upskilled her we don't really learn about this stuff in school no nobody ever told me about it in school do women learn about it in school not anymore it's been cut all the health programs and everything been cut so um yeah it's really like

I give talks and the rooms get full of parents who want to know what's happening like I give talks for young kids who are you know surf life saving or whatever just explaining it all and then I'll get questions from women well what about per menopause what about menopause what about IUD what about this what about that because it's not taught and it's it's um yeah it's really scary all of the subjects we've discussed today are in these two excellent books well there's even more in the books but all the subjects that I touched on

pretty much all of them are in either of these two books next level which is your guide to kicking ass feeling great and crushing goals through menopause and Beyond and your book raw which is match your food and fitness to your unique female physiology for Optimal Performance cre health and a strong Body for Life I would not have been able to read that if I had eaten today I would not maybe if you had had a protein shake you would have been able to read it even better maybe we have a closing tradition on this

podcast where the last guest leaves a question for the next guest not knowing who they're going to believing it for mhm and the question that's been left for you is if you have children what is the most important message you would pass on to them if you don't then what is the most important message you would have passed yourself as a child I have a daughter MH and the most important messaging that I keep giving to her is to be empowered to ask questions and to be empowered and she'll often say well what does that

mean mom I'm like you have a question you ask it don't be afraid to ask it because if you don't know you don't know so society's is very changing I want you to be empowered and be educated to and have the confidence to ask questions Stacy thank you so much for the work that you do it's incredibly important and it's so wonderful that people are shining a light on some of these differences between men and women um because yeah like me and my partners trained together we work out we it's a big part of our

relationship in life and now having studied your work which was absolutely fascinating to me because it was again it was a first for me to understand that there was any differences and these sort of things that have been pushed on us in ter in culture in terms of exercise nutrition cold plunges fasting Etc absolutely fascinating but it's been a huge conversation now between me and her we were talking before I came on air um about this and it's really turned the lights on and it's actually made a lot of things make sense excellent a lot

of things make sense that we were pondering so thank you so much for the work that you do and I highly recommend everybody goes and checks you out thanks so much I appreciate it are you g to make her eat before you go training now well I don't know I actually did send her a screenshot of that I of that particular part um because we have the same routine especially on like the weekends when we're together we get up we have the coffee then we go to the gym yeah we train and then we go

and try and find something to eat after MH so coffee yeah maybe that's a good idea maybe I'll leave it up to her I listen I'm never going to tell her what to do so I just sent her the research okay encourage yeah I was like look at this you'll find this interesting so we'll see awesome thank you so much [Music] [ __ ] do you know that 80% of New Year's resolutions fail by February it's because we focused too much on the end goal and we forget the small daily actions that actually move us

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