Why Women Are Not Small Men, with Dr. Stacy Sims

We speak with Dr. Stacy Sims, one of the leading researchers on women’s physiology and training and performance.

why women aren't just small men

In episode 74, we speak with one of the leading researchers on how women’s physiology influences optimal training and performance. There has been a long history of gender-neutralizing sports science. Money in sports science research is tight, and physiologists often assume they don’t have the resources to study male-female differences. We’ll address later in the show why that “added expense” assumption isn’t true, but the more important issue is that most research is conducted on men and then generalized to women.

The problem is that women are not just small men. Now that sports science research is being conducted specifically on women, we are discovering, not surprisingly, that men and women don’t have the same physiology. And what works for men doesn’t always work for women. Dr. Stacy Sims has been leading a surge in research on women athletes. Her book Roar takes a deep dive into female physiology and how it impacts training. There’s a wealth of knowledge in the book – far too much to address in a single episode – but today we’ll focus on a few of its key points, including:

  • Stacy Sim’s background, and how she became a leader in women’s sport’s physiology
  • Why the “shrink it and pink it” approach to women’s sports research doesn’t work – optimal performance means tailoring training to the female physiology
  • How the menstrual cycle affects both training and performance, and why some types of training can be very effective at certain times during the month and relatively ineffective at others
  • Why all female athletes should track their cycle and learn how it impacts their training – there’s a very real physiological explanation why you sometimes get on the bike and just can’t put out the power
  • Why women often need more protein for recovery
  • The impact of birth control pills, and why the very common practice of giving athletes the pill may be misguided
  • Why research has too often ignored these questions, and why that actually presents a big opportunity for coaches and physiologists
  • Finally, Dr. Sims will offer advice specific to both masters and junior female athletes

Our primary guest today is, of course, Dr. Stacy Sims. Many of you know her as the founder of Osmo and one of the founders of Skratch Labs. But her research has always focused on the physiology of female athletes and her book Roar is a must-read. In addition to Stacy, we also talk with Brent Bookwalter, a WorldTour pro with Michelton-Scott. His wife is an ex-professional cyclist and we discuss how their training regimens differ.

Finally, Chris speaks with Ruth Winder, a top pro with Trek-Segefredo and winner of the 2017 Redlands Classic. Ruth had some insights on how the length of women’s races affects race dynamics and, more importantly, as a big fan of Stacy’s book, how understanding the science specific to women has helped her training.

And one final note: We know that the majority of Fast Talk listeners are male. But before you say, “So much for this week’s episode,” we encourage you to listen in. Dr. Sims does a great job of explaining this complex subject. And as she points out later in this episode, just about every one of us has a wife, daughter, sister, or a female training partner. This is a sport that’s about helping one another out and you can’t help if you don’t understand. And with that, let’s make you fast!

Primary Guests Dr. Stacy Sims: Physiologist, nutritionist, and book author
Secondary Guests Ruth Winder: U.S. national road race champion with Trek-Segafredo

Episode Transcript


Welcome to fast off the velonews podcast and everything you need to know to ride letterpress.


Trevor Connor  00:09

Hello and welcome to Fast Talk. I’m your host Trevor Connor along with my jetsetting co host velonews managing editor Chris case. Chris is once again on the road. Sam is on his way to Asheville to race out route, so make sure you cheer him on. There has been a long history of gender neutralizing sports science, money and Sport Science Research is tight and often physiologists feel they don’t have the resources to study male female differences will address later in the show why that added expense assumption isn’t true. But the more important issue is that most research is conducted on men and then generalize to women. Problem is women are not just small men. Now that sports science research has been conducted specifically on women we are discovering not surprisingly, the men and women don’t have the same physiology. And what works for men doesn’t always work for women. Dr. Stacey Sims, our guest today has been leading the research in women’s sports. Her book roar takes a deep dive into female physiology and how it impacts their training. There’s a wealth of knowledge in the book, certainly far more than we can cover in one episode, but today we’ll touch on a few of the key points including Dr. Sims background and how she became a leader in women’s sports physiology. Second, why the shrink and pink approach to women’s sports doesn’t work. optimal performance means tailoring training to the female physiology. Three how the menstrual cycle affects both training and performance and why some types of training can be very effective at certain points during the month, and relatively ineffective and others for by all female athletes to track their cycle and learn how it impacts their training. There’s a very real physiological explanation why you sometimes get on the bike and just can’t put out the power five, why women often need more protein in recovery. Next, the impact of birth control pills and why the very common practice of giving athletes the pill to keep them regular maybe misguided. Seven buy researches to often ignore these questions why that actually presents a big opportunity for coaches and physiologist. Finally, Stacy will offer some advice for both masters and junior female athletes. Our primary guest today is of course Dr. Stacey Sims, many of you know her as the founder of Osmo nutrition and one of the founders of scratch nutrition. But her research has always focused on the physiology of female athletes and her book roars a must read. In addition to stay so we also talked with Brent bookwalter World Tour athlete with mitchelton Scott, his wife is an ex professional cyclist herself and we asked Brent Have you noticed any differences in how she trained Finally, Chris talked with Ruth winder, a top Pro with trek Sega Fredo and winner of the 2017 Redlands classic. Ruth had some insights and how the length of women’s races affect how they actually race. And more importantly, as a big fan of Stacy’s book how getting science specific to women is helped her training. And one final note, we know the majority of Fast Talk listeners are male. But before you say so much for this week’s episode, we encourage you to listen on. Dr. Sims does a great job of explaining this complex subject. As she points out later in this episode, just about every one of us has a wife, daughter, sister or a female training partner. This is a sport that’s about helping one another and you can’t help if you don’t understand. My ex wife was trying to make the 2016 Olympics. I tried to support her. But I can tell you I wish I’d had this knowledge back then because I know I could have supported her a lot better. And with that, let’s make it fast.


Trevor Connor  03:54

This episode of the Fast Talk podcast is sponsored by OH group. What is a group? Well, it’s not a cycling tour. It’s more than a road race. It’s a multi day granfondo style event where everyone starts together each morning and you can ride with friends all day. You can indulge your competitive side on time segments if you feel like it and explore iconic cycling destinations around the world. Over take service to the next level of pro tour style support on the bike and rider focus amenities offered. Choose from a dozen events in 2019 in France, Italy, Norway, Oman, Mexico and China. In the United States, there’s still entries available for ote route San Francisco and September. It’s a little late for ote route Asheville. But follow my co host Chris cases weekend as he races the event. Try something new in 2019 try over.


Chris Case  04:49

This episode of fast Talk is brought to you by whoop. Now, Trevor, having worked with you, you you being my coach, I know what you like and that is logical munication between your athletes and yourself, you won’t even lay out that plan in a weekly form. Because things need adjusting. Sometimes you never know how somebody is going to feel you never know what stresses they might have in their life or if their sleep is bad, or if something just comes up at work and interrupts their training. So, with a tool like whoop, it really helps understand what’s going on in an athlete inside their body and helps with that planning of really robust training.


Trevor Connor  05:29

Yeah, I can tell you as a coach, and one thing I’m not a big fan of is the six week training block with every day mapped out because I can map out the perfect plan. But we just don’t know how you’re gonna feel five Wednesdays from now. And I think you always need to be adjusting to how your body’s feeling where it’s at, and his recovery state. And you’ve heard me say time and time again, you need to be as committed to your recovery as you are of your training. And we’re really good on the training side, athletes are really good at tearing themselves apart. We’re not great on that recovery side. And so I think that day to day ability to adjust is really where the magic of the training is. And that’s one of the things I love about the whoop strap. This isn’t another tool of how can you go out and destroy yourself? How can you go and hit a climb harder, this is a tool to say, you’ve done good training, or you haven’t done enough training or your recoveries really good. There’s a ton of research out there showing that heart rate variability is a great tool for measuring recovery levels. And this is a tool that’s going to give you that day to day, you’re ready to go out and do what’s on the plan are no you need to back down and you’re tired.


Chris Case  06:32

It really makes it custom to you. Right? whoop is the performance tool that is changing the way people track their fitness and optimize their training, who provides a wrist worn heartrate monitor that pairs the app that provides analytics and insights on recovery, strain and sleep. Know your body is recovered or when it needs rest. By getting to know your nervous system through heart rate variability, and quality of sleep. Automatically track workouts and get strain scores that let you know how strenuous training was on your body and see even more data like average heart rate max heart rate and calories burned. Get optimal sleep times based on how strenuous your day was on track sleep performance with insight into your sleep cycles and stages of sleep, sleep quality, and sleep consistency with monitors heart rate 100 times per second 24 seven to give you full insight into your day. So you can optimize the way you train. Whoop is provided an offer for Fast Talk listeners to get 15% off their purchase with the code. Fast talk that’s f a s t, capital T A lk Just go to whoop.com that’s w h o p.com. And use the code Fast Talk at checkout to save 15% and optimize the way you train.


Trevor Connor  07:50

Dr. Sims, I’ve interviewed you in the past, we’ve worked a little bit together when I was the manager of team Rio Grande and your sponsor the team. And I’ve always known you as a hydration specialist. So you’re the brains behind skratch nutrition, you’re the brains behind Osmo nutrition, I believe you’ve worked with some other companies on the nutrition side or the hydration side. So I was actually quite surprised to find out that your PhD was not in hydration, but you are actually focusing on the difference between male and female athletes.



Well, kind of a combination. My PhD was in hyper hydration and hydration, and the differences between men and women and and menstrual cycle phases. So everything that I’ve ever done in my whole academic career has been sex differences. But focusing on hydration aspect is what a lot of people know me for of course, but you look at all of my work, it’s all been on sex differences, and really trying to figure out why things are different for women than men and why it’s not out there. And that’s why I also had the women’s only line because there is a lot of data to support the fact that women or men are different. When you’re trying to create a new niche in sport nutrition. It’s hard enough trying to explain what that new thing is, let alone trying to explain that there are sex differences involved in that new thing.


Trevor Connor  09:10

And I remember with Osmo, you had commented on the fact that there are other sports drinks that have a women’s version, but it’s really just they put a little less of everything in it where yours was actually a different formulation.



Yeah, so the industry is notorious for shrink and pink. Let’s make it smaller. Let’s doll it up, put some colors on it and call it a woman’s product. And it’s not just cycling industry and even things in the medical industry. Things like hip replacements, right. So you hear about a lot of cyclists have revision and like the Birmingham resurfacing, it’s fantastic and men but the outcomes and women there’s five times higher risk of failure. And people don’t talk about it. But it’s endemic, like there’s so much research has been done specifically on men, and then just generalize to women, be it biomedical research, sports science stuff, just everything. And so like I said, My whole academic career over 20 years has been I’m trying to pull it apart. And and because I’m a sport scientists pull apart in the sports industry.


Trevor Connor  10:05

You start your book with you said one of the lines that you love to use, which is women are not just small men.



Yeah. Because and that comes from more of a tagline. When you’re looking at writing grants for NIH and stuff, some of the reviews I’ve gotten back, it’s like, well, women are just small men. And I’m like, well, women are not small men, or why do you want to study women? We don’t know enough about men, you can generalize from the male data over to the women’s like, Well, no, actually. So it’s just kind of in that that kind of catch phrase that people can really resonate with. That’s kind of been with me for decades.


Chris Case  10:40

How much of this research that you’ve done is driven by pure curiosity? How much is driven by frustration? How much is driven by other factors?



Well, all of it really stems from being an athlete and wanting answers for myself that I couldn’t find anywhere. So just having the luxury to go into a lab or be in the academic setting and ask those questions, and then find out who else might be doing the research in a in the research world and making those connections? And so it’s been a curiosity for the most part, driven by some of the frustration of the answers I got were not not appropriate, or they weren’t fulfilling enough. Yeah, there’s always some kind of passion behind research that’s being driven for years and years and years. And mine is now trying to make sure that the upcoming younger athletes and you know, youth development, that kind of stuff can have as much as they need to perform well, just small things like girls and boys going through puberty, like completely different, that no one really talks about it right, and things that they need for development and hydration and fueling and stuff to help support growth as well as athletic endeavors completely different, but no one talks about it. It’s ongoing, ongoing, not only battle, but an ongoing passion and drive.


Trevor Connor  11:58

I have to ask you, so how did that take you down to New Zealand? Oh,



okay. How did


Trevor Connor  12:04

Chris and I were trying to figure this out? Well, the podcast, we were wondering, based solely based solely on that reaction, I


Chris Case  12:10

think we’re in for a pretty good story, maybe an edited version. I don’t know, let’s let’s hear it.



When I was very young and carefree. I was 25 single, no attachments living in San Francisco. And I hosted some pro triathletes from New Zealand. And they’re like, wow, San Francisco looks just like New Zealand. And it coincided with a job that came up in Wellington. And at the time, I was like, yeah, I’m in my 20s. I’m single, no attachments, might as well try it and had an offer within three weeks to move down to New Zealand. I was like sweet going. So I moved down here, 90 into 97, beginning of 98. Ish for job. And after two weeks, they made me redundant because they decided to close a clinic and bring the physiologist from that clinic into town. So I was like, What do I do now. So started really investigating the sports scene and what was happening in New Zealand and leverage that information to get a position as a system professor at Massey University in Wellington. And the push when you get into academia is to do your PhD. So at that time, I was very interested in altitude and sex differences in altitude altitude training, and I moved to the bottom of the world and uneaten which is a city very close to Antarctica to do environmental research. And then along the way, ended up racing in Kona, and getting very perplexed about why some of us got hyponatremia. And some of us didn’t, so came back, and changed to looking at exercise performance in the heat and how to support that. So did my PhD, Indonesian and then my PhD supervisor, his best friend was introduced to me, and he ended up becoming my husband. So I married a small town that I met a boy. And after my PhD, got recruited to work at Stanford. So two weeks after we got married, I moved back to California, he stayed here for a bit. And then he came over, and we were over there for almost 10 years. And then when I opted to close Osmo, and there’s a job that came up back here to start a research program in environmental physiology and nutrition. So I took it, and about two and a half years ago, we moved back, and it’s about 45 minutes away from hobbiton where my husband grew up. It was right on the beach in a beach town. It’s a good place to have your kid grow up. So all right, I guess. Yeah, if I didn’t travel, I’d go crazy, because it’s a very small town, but it’s pretty good, especially with everything that’s going on in the world. We’re kind of heading down here.


Trevor Connor  14:41

We should mention your book rar which Chris and I have both been reading through the last few days and so this might be the only valuable contribution I make to this whole podcast so bear with me for a minute. One of the things I really appreciated about it and almost to me sounded it felt refreshing was it was very purely a, I’m just going to address the physiology. This, this is not evaluative, this is not better or worse, I’m just going to look at what is the physiological difference between men and women, and what is unique about women’s physiology that we need to address. I’ve coached a lot of female athletes. And this is a conversation I’ve had with almost all of them. And you actually used a very similar analogy in your book. But the analogy I was gave was from something I learned in my anatomy class, we talked about throwing like a girl. In anatomy, we learned that actually, the muscle structure how your muscles are attached at the shoulder, are different between men and women. So the way we’ve been taught to throw is based around the way a man’s arm naturally throws, or its natural movement, which is why girls can’t throw when they try to throw the same way, like a man because that’s not how their anatomy works, it’s not a better or worse thing. And as I remember, from my anatomy class, if women actually throw more, and this is audio, I can’t really demonstrate this, but more kind of a sidearm throw, that works with their anatomy, and then they can throw very well. And I always use that analogy to say, if you’re always just trying to throw like a man, they’re always gonna say you throw like a girl, because you’re fighting your own anatomy, you have to figure out how to work with your own anatomy, you have to work, learn how to work with your physiology. And it seems to me, that’s really the the big point of your book, it’s saying, look, in some ways we won the genetic lottery in some ways we lost. But that’s not really important. The what’s important here is understanding the female physiology, so you can work with it and perform at your best.



Exactly. And it comes from understanding inherently things women get more gi distress, or like right before their period comes, they might have a lot of bloating and stuff. And, and it has to do with the way hormones and stuff affect so many different systems of the body. So it’s not saying, Well, if you would just Buck up and ignore it, and we get better, or try this or try that or do some kind of weird standard in your head kind of thing that some people recommend. It’s all just like, this is the basic science, this is what happens. This is our born. This is what happens when you’re an x x versus an X, Y, because it’s all about biology. And so we know these things happen. And then there’s some things that you can use from tools in your toolbox to maximize it and and then there are things that you can do to minimize the negative effects. But that’s just how it is.


Chris Case  17:29

I don’t know what the what the percentage of our listeners are male, but I’m sure it’s way more than 50% velonews as a whole our audiences is male dominated. I want to know what we can address here that males will say, oh, man, I I’m glad I listened to that whole episode. Beyond the interest factor beyond the you know, the the fascination, the some of the social issues we’ve we’ve touched on all of that stuff is very interesting. But is there something that we can also bring into the episode where where the men out there are, are benefiting in some way beyond just the interest factor?



Oh, you know, I always think about it as most men kind of described like, I talked to this conference two weekends ago, and I was like, stand up if you have a period. Stand up if you have a wife, or daughter or sister who has a period. And then I go, how many of you talk about it, sit down, if you talk about it, how many of you are aware of it sit down if you’re aware of it. And at the end of the day, there’s one person standing, and he was the keynote of this conference, and he came up to me laters like, Oh, my wife dealt with all that stuff. I was completely unaware. I’m sure there would be someone else standing up. So it’s more of like making them aware and asking that question. So do you have a partner or daughter or sister or coach or whatever, that is a woman then this is applicable, and you can talk to them about it and say, Hey, you need some more protein. Or maybe you should increase your carbohydrate intake when you’re writing your high hormone phase so that you cannot spread money. But I mean, that’s really basically the concept or the connection other than having to go off on a completely different tangent and talk about things like why low fat, high carb, or high carb, low fat, all that kind of stuff is better for men and women, which would be a completely different episode.


Trevor Connor  19:29

I interviewed Brent bookwalter a pro with mitchelton Scott just a couple days after we recorded this podcast with Stacey. Knowing his wife was also a professional cyclist or now a retired professional cyclist. But unfortunately not home at the time I asked him if he noticed any differences in how they train. Well, he does say he can’t speak to the physiology. He points out that one place where there is no difference is in the dedication and willingness to train hard. Your wife is a was a professional cyclist as well right



Yeah, she was Yeah, she raised professionally, she raced to the pro level on the mountain bike for a few years and then dabbled in road racing a little bit, did a little bit of racing over here in Europe with the national team raced with the colavito women’s team. And yes, still is no slouch on the bike I was riding out in the mountain bike today with they’re trying to do recovery, right. And she was, she was tweaking me up all the little short climbs we were doing.


Trevor Connor  20:23

So we just did a podcast with Dr. Stacey Sims. And really, she talked about how the the physiology of women is different. And they do need to train differently. So what’s your feeling on this? Or the things that you notice that are different about the way your wife trains versus you? Or is Do you find that the training is pretty much the same?



When Jamie was racing, and she and she had a coach and she was training, you know, training hard and meticulously, she was definitely training different than me. But, you know, she was also in a much different place in her progression as a cyclist than I was she, she came to the sport much later than I did, she was a runner in college, a solid division, one runner at University of Tennessee and Chattanooga, and then found the bike through running injuries, so came to it pretty late, which I guess isn’t abnormal for women. You see, there’s a lot of strong women, professional writers who sort of start a little later. And I think that was maybe the biggest difference I saw, if I compared the types of training I was doing to what she was doing was I think she was just earlier in that progression. So she was it was even more just fundamental base, it was a little more like technical and technique based. And then from what I could also observe the the demands from the races were a little different to you know, I think the the distances that she was racing were a little shorter. So, you know, the weekly hours weren’t quite as high as mine were. But you know, from what I could see her and her teammates and her peers, you know, the racing is just as hard fought and the training is just as focused and the lifestyle commitment and contribution is just as equal the commitment that I observed through her and her peers when she was doing it and even living in Drona. Now and still being friends with some of the other women pro cyclists here, I’m not as honed in on the the physiology is I’m sure Stacy was would be interested to listen to this podcast and see the commentary she had on that. But um, the real physiological differences, I guess,


Trevor Connor  22:18

do cheat period is pretty much the same, particularly over the course of a month, or Were there any differences there and that might be getting too deep into the weeds.



Yeah, that part was pretty similar. It’s still bike racing. And it’s still road races are still whether they’re women’s or men’s, they’re unfolding sort of in the same way that to, to hilly climbing race, you got to be able to accumulate a large load of climbing hour after hour and do a great peak effort, you know, towards the end of the race to make those key selections. So as far as that it was, it was quite similar. I guess on that note to another interesting, I don’t know if you there’s a little bit of news coverage. But this winter when I did one of the training camps with my current team at Sheldon Scott, we had enemy fen Luton, who’s the current reigning Women’s World Time Trial champion. She came along with us. And this camp that we were doing was a pretty massive volume overload camp was really cool camp we trained from started in southern Portugal and we wrote across, you know, the whole country of Spain, Portugal, taking the most indirect mountainous route we could find. So we’re doing you know, essentially what amounted out to be I think it was like 10 or 11 days of riding and we’re doing six, seven even more hours every day. And she was with us for the entire thing. We are all just so impressed that she was even coming off an injury I think in the road race at Worlds last year she had a pretty gnarly injuries coming into the season a little she felt like underprepared and undercooked she opened her eyes for sure to what the level is that these pro pro women are doing and and what it takes to be the best She’s literally out there doing the same thing we were


Trevor Connor  23:53

let’s get back to the show and dive into the physiology.


Chris Case  23:56

So let’s jump into that Stacy and and get into the complexities of the male female differences. And I know that one of the most critical is the complexities added by the menstrual cycle. So perhaps you could give us an overview of of why that is.



I always start with the basic explanation of what the menstrual cycle is and how it works primarily because a lot of people are just have a general idea of of what happens okay, a week before women bleed, it happens every so often. Bla bla bla bla but if we think about as a textbook case, it’s primarily 28 days and the first day is the first day of bleeding. So we say that’s day one. And they want about day seven, you have very low estrogen progesterone, and then estrogen starts to rise and has a big peak right at oscillation around day 14. Then estrogen dips down and progesterone starts to come up and then estrogen starts to come up again and around five days before the period starts again estrogen and progesterone are elevated relatively I don’t know, depends on on the women’s sensitivity and the ratio is but could be five to six times that base of follicular phase. And then right before the onset of bleeding, there’s a stimulus for those to drop the uterine lining sheds, it’s an inflammation response, and then they start bleeding. So the aspect of this hormone perturbation that happens across a woman’s lifespan with low estrogen progesterone, most of what we know regarding thermoregulation metabolism, recovery is fairly similar, except for some muscle enzyme activity that’s different that has no regard for the hormone fluctuation. But when estrogen starts to rise, if a woman is estrogen sensitive, she’ll feel really flat and bloated right around ovulation. But if she’s not estrogen sensitive, then she feels invincible. And at this point, and she can go out and she can hit prs, you can really use it to a training advantage. And the fact that if you feel strong, you push harder, you get really good, strong workout that day, then it’s about that adaptation. And then about five to seven days before your period starts when estrogen progesterone are at its highest. This is where women are the least like men because estrogen progesterone cross the blood brain barrier, they affect metabolism, estrogen, spares and carbohydrate by reducing the body’s ability to access storage store glycogen, so it increases free fatty utilization. progesterone is very thermogenic. So your core temperature is at point five degrees C, it also competes with the receptor side that aldosterone attaches to. So you have increased total body sodium excretion. Estrogen has an interplay with melatonin, so you have poor sleep, the few days more period starts. And again, both of them invoke this huge inflammation response. So this is why a lot of women feel bloated, and puffy and just really lethargic before their period starts. And when we think about it from like a performance metric, a lot of women will feel really flat, they’re time to fatigue is shorter because of the elevation and core temperature. So muscle temperatures elevated as well. And because they can’t access the carbohydrate, so well, then they can’t hit those high intensities.


Trevor Connor  27:18

Looking at this, as you said, from a performance standpoint, there there is a reduced training and effect, there’s a reduced performance effect. And also your ability to to handle extremes of the environment. So hot and cold are also reduced during this period of time.



Yep. And things like going to altitude from sea level wind have an increased heart rate and respiratory drive because of the effects of progesterone on the sympathetic system. So when women first go to altitude, if they’re in their high hormone phase, they might have a really difficult time might trigger asthma, if they’ve never had it before. Even simple things like HRV, it’s not a very, very good measure for women, because it fluctuate so much across the cycle. Unless you have a really good baseline and understanding what happens over the course of three cycles, just all of a sudden launching in and trying to measure HRV is not going to not going to give you very much information. So these are some of the small tools that are endemic in coaching, right, and they’re not really appropriate metrics for women.


Trevor Connor  28:19

And they could potentially lead the coach astray, like the coach is going to see these numbers and thinks that they mean something that they don’t.



Right. And I mean, one of the other things that is very central to cycling, is doing an FTP, or 20 minute power test or something. And we had to design is some really interesting study just to be able to get the FTP numbers between the phases, but I didn’t want anyone to know that’s what it’s doing. So I was doing like this double blind crossover, quote, hydration study, but really, I was just looking at power. And there’s an eight to 10% decrease in power in the high Orman phase, the five days before women’s period starts. So if you do an FTP test, and they’re right in that high hormone phase, the numbers are going to be off. So you can either under train or overtrain. So it’s just knowing like where a woman is in her cycle when to do appropriate testing. And if you’re doing FTP and in the low hormone phase, knowing that when they get the high hormone phase, you’re going to have to do a little bit of adjustment because the body just can’t push the same power due to the fact they cannot access the carbohydrate. There’s a neuromuscular change as well, the fibers don’t fires quickly. There’s increased central nervous system fatigue, which causes some this neuromuscular, I guess attenuation. So understanding that and I mean, it sounds complex, but the best thing to do is have a woman track or cycle. And even though you can’t necessarily do a comparison from one woman to another because everybody’s cycle is different for the most part. They’ll get a really good understanding of how they are on particular days of their cycle and they can use that to talk to their coach where the coach can see that and then they can make fine adjustments to maximize what they’re doing in training and maximises adaptations. Because the reason we go training is to break our bodies down and then recover from it to get fitter. But if you’re going to doing a hard stage session, when physiologically you, you’re not really at your best to do that hard session, then it’s kind of a washout. So I


Trevor Connor  30:15

remember learning the registerone is catabolic. So if you’re doing time in the weight room, and you’re looking to put on some strength, you’re looking to put on a bit of muscle mass, you should really be doing that during the the low hormone phase, and I’m not gonna say useless, but you get a far less value being in the weight room during that high hormone phase. Is that correct?



Yeah. So there have been some recent studies in will strung out of Sweden did a series of studies looking at the typical strength training model of three hard days in a row, or five hard days in a row, and mixing it up between high hormone low hormone OCP. And the outcomes across the board were when women did the high intensity, hard strength training work in a very low hormone phase. So the follicular phase, and those women who are not estrogen sensitive, maximize that surge around ovulation to hit prs in the gym. So they increase their lean mass and strength decrease their body fat, as opposed to those women who maintain the same three days a week program so endemic or doing the same kind of work in the high hormone phase. So when you’re looking again, at physiology, and you’re planning it out, and becomes a little bit complex when you’re working with the team, but if you’re working with individual athletes, again, planning things out against the menstrual cycle, can give that your female athlete just that little bit of extra that she’s looking for, without too much extra, I guess work is the best way to put it. Because when you start working with your body, instead of fighting and all the time, you get better adaptations at a faster rate.


Trevor Connor  31:53

I actually underlined this in your book, because when you think about getting a good hit of protein after a workout, that’s, you know, if there’s anything I just go, that is a male stereotype of you know, I was in the gym, and now I’m going to take my giant protein shake the reading your book, it’s actually in many ways more important for women to make sure they’re getting substantial protein as part of the recovery.



Exactly. And I had this guy post all this stuff from I think it was Sterling’s worth and like master who do a lot of the protein research in Canada. And they did this one looking at taking protein right after exercise and showing that there wasn’t an increase in muscle protein synthesis. And if you ate right before, then it wasn’t going to help. And I was like, well, when you look at it, it’s all been done on resistance trained men. And when you look at women who have been cycling or endurance sport for two to three hours, they’re nutritionally depleted. And they have this elevation in cortisol. And they also had this elevation in progesterone, which were catabolic. So when you put the protein in right after exercise stops, look at tabble ism, and then they build the mess. So I pulled up articles to show that and it just goes, you know, like when you read something, and it’s just at the forefront of your brain. But then you forget actually what’s happening from a physiological standpoint in the different sex, you start having these conversations and arguments. So again, it’s like someone’s doing something putting research out but ignoring the fact that there’s this other half. So when we again, look at physiology and say, Alright, so we know that with elevated progesterone and elevated cortisol that comes with training and exercise, very catabolic, first thing you want to do is bring that protein in to stop that metabolism so that the body can relax, repair itself build lean mass, right?


Trevor Connor  33:52

That was fascinating that because as you pointed out, that’s very much something that that’s ingrained in the male mind and less than female athletes and it should almost be flipped around.



And the older you get, the more important is in both sexes, but in particular, that Peri and postmenopausal were the uprising of the Masters female athlete becoming really sensitive to carbohydrate and then losing the anabolic stimulus that estrogen gives for developing lean mass. First thing that they should be doing is throwing more protein in their entire diet and doing plyometric and power base training to maintain that lean mass and maintain that synthesis for muscle purging. Development.


Trevor Connor  34:40

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Chris Case  35:56

One of the things that I’ve been thinking about as you’ve been describing all of these differences and the effects within each cycle that have for women, is how these are affected if they are on some form of birth control, the pill, an IUD, things like that, I would imagine that that does that sort of blunt the changes that are seen within women and so that it it can also influence the adaptation process as well what what kind of impact does does that have?



So we’re looking at an oral contraceptive pill itself. So having exogenous estrogen progesterone ingested and usually it’s three weeks on a placebo pill, those three weeks now more and more are monophasic pill, so is three weeks of the same steady course hormone and then one week completely off. And then one week completely off is not a low hormone week, because the body rebounds and produces enough estrogen to mimic the first trimester of pregnancy. And when you look at this elevation of hormone all the time, you have a significant blunting of anaerobic capacity, vo to peak, your metabolism changes, core temperatures elevated. And then there’s the side effects that women have often are an indication that the higher elevation of the hormone is just not sitting right with their body. And there’s been some studies out of all as recently Nia, Shawn has done quite a few looking at the effects of sprint capacity and recovery on women who are using the pill versus not. And there’s an 11% difference in that ability to hit that high intensity and recover. So I often say, you know, if you’re on the pill, and you’re looking to hit that top end power, you’re leaving between eight and 11% of your performance potential on the table just by taking this pill. And we know sort of the long term effects from a health aspect. But we don’t understand the long term effects on performance. Because women in sport is such a very small niche area. And there’s not a lot of money in Sport Science funding to begin with, let alone money for Sport Science specific to women. So it would be very interesting to see the long term effects of power generation performance and that kind of stuff of a woman on a pill and then taking them off. And then when we think about the marina IUD, it can that one’s the hormonal one. So it’s just a localized dose of progesterone. And it has the least effect on performance, because it is just a localized dose to change the texture and the ability of the uterine lining to be implanted. But you still have your own natural hormone flux. So you’ll still have estrogen and progesterone naturally being produced, but it’s not gonna cause a period, it might cause some brake, breakthrough bleeding, but it isn’t cause a period per se. And from a performance perspective, you’ll still have the same fluctuations as a normal menstrual cycle, and track your mood over training, you’ll be able to see the patterning without having to get blood tests.


Trevor Connor  38:53

My job almost hit the floor in the middle of part of what you were saying. just realizing there are so many women who are on birth control. Women’s Sports is huge women Olympic sports. That’s that’s an enormous industry. And you’re telling me this research has never been done, that they haven’t looked at the effects of contraceptive medication on performance. That that just that floors me.



I know, it’s crazy, isn’t it. And most of it stems from, there’s this misconception that you shouldn’t be on your period when you’re when you are training or racing at a high level. And women want to control it or they don’t want to be on it. So one of the automatic responses is I’m going to go on the pill. The other thing that’s very concerning, and this is an area that I’m into now that is the relative energy deficiency in sport. So we often talk about like the female athlete triad where a woman loses her period gets poor bone mass and often said, Oh, it’s because you’re too skinny. And that’s just one component of it. But women when they start having regular periods or their period stuff, one of the initial responses to from their GP or Their ob gyn is will put you on estrogen will put you on the pill, that way, you’ll get your cycles back and protect your bones, which is the exact opposite thing they should be doing, especially for female athlete one from the performance aspect. But to when you start having issues with your period, that means there’s something wrong, like the first thing to go when you’re in an energy deficient state or a perturbation and energy. And maybe you’re overtraining or you’re not recovering well, your endocrine system, your endocrine system just bottoms out. And so when you start having fluctuations in your period that’s irregular for you. That’s a very first warning sign that something’s not right in what you are doing so you do have time to correct it before you get into this longer term problem, which most people associate with being overtired. adrenal fatigue or overtrained. So it’s that first step, after four days of being in low energy availability, the thyroid starts to downturn resting metabolic rate goes down. And these are conservation mode. So when your body starts to get in that conservation mode, it’s not going to let you reproduce. So then you start having endocrine dysfunction and menstrual cycle stops. So when I hear physicians say, Oh, well, we’re gonna put you on the pill because you’re in an area come I go, Wait a second. Now, let’s not do that. So we have a working group here in New Zealand called WISPA, it’s women in health and sport, the performance advantage, and on it are physiologists like me, sociologists, there’s some fertility specialists, ob gyn performance nutritionists, so transdisciplinary type group, and finally getting some of the fertility Doc’s to understand like when you stand up and say, the first thing that goes when a woman is in a misstep for her training is your period. And you guys say, well, let’s put you on a pill, we need to talk about this. So now there’s a big push in New Zealand to get female athletes off the pill, so that we can see what their menstrual cycle is like, if they’re carded athletes are the equivalent of Olympic athletes, I keep track of it. And people more and more coaches are tracking their females menstrual cycle as a sign of wellness and health, as well as being able to tweak their performance in their coaching metrics to improve the performance of the female athlete. But when you start talking, in general, most people have no idea about it, right? They’re like, Oh, I’m on the pill, because I need it for XYZ or I don’t want to get my period or my doctor said I needed it for my bones.


Trevor Connor  42:20

I actually witnessed this firsthand, my ex wife, she was trying to go to the Olympics and pole vaulting. And her coach and her doctor told her well for performance, you need to be on the pill. And for the two years leading up to the Olympic trial, she was on the pill. And then I was reading through your book, and it was saying that elevates progesterone and progesterone prevents it’s catabolic. So once your ability to build muscle tissue, and I was sitting there going, that’s the worst recommendation they ever could have given her. Why did they do that?



Yeah, because it’s so endemic. It’s so widespread in the medical industry to just put women on the pill. Even as young as 15. Like girls coming in, you know, puberty in their, their cycles are regular, heavy, which is normal on puberty. But irregular periods are now thought of we need to control it with a with a pill. And most of us are like,


Trevor Connor  43:12

Whoa, no, let’s not do that. They told her mean when she came home and told me she was getting on the pill. She said what they had told her was that she’s she’s going to start training very hard. And that meant that her cycle was going to get very irregular. And they wanted to have her on the pill to keep her regular because that was going to help her her training. That’s exactly what they told her.



Yeah. And we see that and hear that all the time. So my colleague here at Waikato, Holly Thorpe, she does all the female athlete extreme sports and looks at the socio cultural aspect, like what women what drives women? What are the nuances in the culture of our sport? What things do their coaches say, and this comes out so often in high performing athletes or the coach expects them to have an irregular cycle? Or it is known that if your period stops, this is a good thing, it means you’re training hard enough. So we’re like, wait, no, we need to educate people. And let them understand that that is not normal. Yes, when your training increases, what happens is your appetite is blunted, so you actually don’t eat enough to support health and training. But being able to understand that that’s happening, and that you need to eat more, so that you get leaner, and fitter and faster and maintain your cycle is an education standpoint that needs to be pushed out there. It’s slowly getting out there from like grassroot level, but it’s still not reaching the top level where when you’re thinking about money and metals on the line, something people should be paying attention to.


Chris Case  44:41

Could you put a I know this is maybe a silly question, but can you put a number on the performance loss that’s being left on the table by either the ignorance sort of the just lack of knowledge here about this, obviously, in Women’s Elite athletics,



I probably couldn’t put a number on it because it’s so complex. I mean, it would really be sports specific to. So for example, in sports require a lot of strength. Olympic lifting, could even be pole vaulting track and field. So a lot of strength and power movements. From self selective standpoint, as a woman is going through training and making it higher and higher in the ranks. There’s a very high percentage of women who have PCs, so polycystic ovarian syndrome, and they have a higher level of testosterone and a lower level of estrogen progesterone, and that helps self SELECT INTO better performance. And they may or may not have the side effects of PCs, they might not know they have it. But then when they get put on a pill, they still have this elevation of testosterone that helps them. So in there, then that case, is it better to be on a pill? So it moderates the estrogen progesterone so that they end up not having symptoms of PCs? Or is it better for them to be offered and try to control the PCs factors through nutrition and training? So those are the questions that also need to be asked. So it’s looking at the self selection and within the sport itself, going okay, well, here’s this wide Qadri and these are the people that have the greatest potential, but what is their physiology? Why are they Why do they have the greatest potential? It’s not just genetics, genetics does have a little bit of play, but also what’s going on there. The surgery is really complex. And we get into these really interesting conversations. And I mean, can even get into the transgendered conversation about what are the rules and regulations about that, because from a biological standpoint, we all understand one thing, but from a social standpoint, it’s completely different. So there’s so many layers and complexities they can’t just say, Well, this is the number of on the table that we’re we’re losing from a performance standpoint.


Trevor Connor  46:49

Chris recently interviewed Ruth winder professional with trek segafredo, and asked her about the differences between men’s and women’s racing, as she feels she needs to train differently.


Chris Case  46:59

This is sort of a broad question regarding the differences between women and men when it comes to training in sport board science. Do you think that there is any general training advice that doesn’t apply to women at all?



Not necessarily. I think once you get super high in the super top levels, the guys just need to do so many more hours than the girls just like so much more volume, because their race is so long. But especially like if you’re just a beginner cyclist, or you’re just trying to get in getting fit and riding a bike, like everybody needs to work on kind of every different range that there is to work on from sprinting to endurance, whether you’re male or female, and depending on your goals, I think that there’s just so many variabilities to that question. But I think not until you get to the pro pro level where I’m at, you know, comparatively to the guys that are at the same level that I am just because they do races that a near 300 kilometers long sometimes like my longest race will be 150 160 just kind of a volume thing. I think at the end of the day,


Chris Case  48:00

how does that impact the racing itself? What are the differences between men’s and women’s racing, I assume a lot of that does have to do with the length in that changing of dynamics because of the increased length. But what else is there?



I think for women we just have because we’re raced three to four hours, it’s just there’s a lot less time for us to kind of ride into the race, or I think sometimes one of the guys like, Okay, this is the break that’s gonna go in, it’ll be the break that’s gone for the majority of the race. And maybe occasionally we’ll mess up but we won’t catch the break room is supposed to catch the break. And the break will you know, when and it’s a super exciting stage. But for the most part, like there’s a little bit of a rhythm that goes to the race. And I just think but yeah, it’s not that like that. That never happens in women’s cycling, because it does for show but really infrequently. And normally, it’s like you’ve stopped and it’s just immediate, you’re racing straightaway, it was actually really funny because just working on new to trek segafredo women’s team this year. And as we work with some of the people from the men’s side, and they’re like, Oh, we never send just one yard to the start line to take jackets, because we always send us one yard to the start line to take jackets right away from the from the good. Like if we stood on the start line, we’re getting really cold. Now we’ll just keep them on until like three minutes before the start and passing to us Juanjo. But the men’s one is we’re saying they never ever, ever do that. Because the guys kind of, generally speaking, have this relaxed introduction to the bike race where they have time to just send someone back to the call with everybody’s jackets. But the girls races stop immediately. Like we don’t have, we don’t have a little bit of time to like move up and then send someone back because generally if you’re sending someone back to the car race, they’re gonna have a really hard time getting back on, you know, and obviously that’s not every single race, but it was just kind of funny hearing that difference from from that side of things even


Chris Case  49:43

going back to sort of my original question about general training advice that doesn’t apply to women. What are some of the things that you do as a female that you know are different based whether it’s has to do with pure Physiology or if it has to do With the menstrual cycle, we talked a lot about that with Stacey Sims and how that affects so many things from obviously hormones. And there are good times and bad times to work in your training and there’s more recovery needs at certain times. How have you adapted to that? Is that something that you think is commonly done? Or is that only starting to be done in the women’s field?



Yeah, I think that Stacy’s doing some really cool work, a big fan of Stacey Sims, for sure. And I think that only now just more science is being done specifically on women and trying to kind of keep up with that and figuring out what is specific to women’s and specific to men’s. And I think so much of the science right now is just down off of men. So it’s kind of like, we’re just assuming a lot of the same things. And we’re still figuring out a lot of the different things in that. And I think, yeah, with the menstrual cycle, just it’s really important. And I think like we can really fluctuate and all hormones and taking that into account has been great. And I’ve actually just reread Stacy’s book really recently for the second time and just kind of understanding going through and being like, Okay, this is why I feel this way this this day, instead of being down on myself about something. And it’s like you just kind of have more knowledge you have about why you might be feeling one way and then you can kind of move forward and eventually, not saying boys don’t ever have bad days on the bike, obviously.


Trevor Connor  51:16

Let’s get back to the show where admittedly, I get myself into a little trouble with the male lens. But more importantly, we discuss how the lack of research actually offers a tremendous opportunity to both physiologists and coaches.


Chris Case  51:28

I believe you mentioned that a lot of this knowledge has really yet to reach the the top levels of the sport. So I guess for instance, in cycling, if you take the Women’s World Tour, is it simply a matter of it being a male dominated at that level? Still, even when it comes to women’s teams, that the managers, the coaches are males? Is that why this information isn’t reaching that level? Or is there more complex answer there as well.



So part of it is management and the maleness factor. But the other thing is, everything in cycling is viewed through the male lens, right. So everything from coaching, nutrition, nutritional products, sponsorship, team makeup, who’s directing, everything that has to do with it is still viewed through the male lens. And I say that not as being like a feminist or anything, but I’m just saying that most of society views things through the male lens. So it doesn’t even occur to them to think differently. When the education comes up, and they start thinking about it, and they might want to apply it, they’re still surrounded by people who haven’t thought about it. So it’s a cultural aspect, as well as an education aspect. But then also trying to break people away from viewing everything through the male lens is something that’s going to take years to do. So there’s small pockets of people who are like, Okay, well, I was reading this article in The Guardian, and I posted it on my Facebook page talking about all the data that’s coming out from like protective vests for police, women are designed for men, and they’re told to wear it, but it doesn’t protect them well. So it leaves them in gaps, things like hip replacements, all this kind of stuff. So all the data that’s out there still is still through this Nolan’s. So it’s that cultural aspect we have to break through and then bring the education and then allow the coaches and the management not to be afraid to implement, because money is tight. And it’s very secretive and very siloed. teams don’t know what other teams are doing. Because of the competitive aspect. No one’s going to breach those conversations and break the confidence in in that arena, really to spread the conversation and spread the word.


Trevor Connor  53:34

The one thing I will I’ll add to this is you are adding a level of complexity. Just talking right now as a coach trying to map out an athlete’s season figuring out what type of training they’re going to do when so that we can have them on peak form for a particular race is very hard to do, it’s very complex. When you add another level onto that have you have this cycle that you have to deal with which we can’t control, and could very well be right at the wrong point, when you hit that target race. It’s a level of added complexity that this is not an excuse that some people just aren’t prepared to, they’re just going to go on, I’m having a hard enough time wrapping my head around periodization I don’t want this extra level. Likewise, you you look at research. And it’s hard enough to if you’re doing a study on cyclists, to find eight cyclists who can come to your lab four times in a month to do your experiment to add to that now you have to be at this particular phase in your cycle. Sometimes it’s hard to get the funding sometimes it’s hard to find the people for that again, it’s it’s not an excuse, it’s more kind of a laziness of I’ve already got enough to deal with I don’t even want to think about this extra factor.



So I kind of wish that we had like had visual because you would see my face and kind of laughing it at the statement and what you’re saying because this is what I mean you’re viewing it through the maylands. Like you’re like adding this extra bit of physiology on top. That’s the way we’ve all been conditioned to think. But it’s not adding extra complexity, it’s understanding that this is just how a woman is, it shouldn’t be extra complex, right. So having a one track recycle is going to give her any more information to make it easier. And it’s not about her having a negative performance on the X rays, it’s just being prepared. So knowing that these factors of physiology can impair performance, nutritionally, it’s through some training interventions, you can maximize performance at that worst time, so they won’t have a negative points. But it’s understanding that you first need that baseline data to understand how a woman responds across a month, so that you can overlay your training. So again, it’s not a complexity, when you break away from the mindset that we’re all in from coaching and periodization, even periodization is a male model. Three weeks on four weeks off the macro cycles, and micro cycles, those are all based on male data. So if we were to periodized, based on female data, it would be super easy. But we are so conditioned to thinking about, it’s too complex to add on to this, because she’s a woman that has this physiology, or there’s not enough funding, right. So I wrote a paper about how you design a research project and study to maximize funding with women in different phases and how you can pair them. And it’s just changing mindset and changing the way you think, instead of just going status quo. So I understand people find it really complex and confusing. But again, it’s like breaking out of that tradition that we’ve all been so ingrained in and saying, oh, wait a second, you know, this is just natural. This is how she is and this is how it happens. So let’s, let’s think about periodization and different model,


Trevor Connor  56:42

you may actually be giving me too much credit here, I was actually calling it a laziness, you don’t want to see it as male or female, you just want to see it as neutral and kind of put everybody in a box. And it just so happens that that box is the male model, not the female model we’re going to go is I’ve seen this with a lot of coaches, the coaches who are willing to take the time to say, I’m going to understand my male athletes, I’m going to understand my female athletes suddenly find they get a lot of athletes flocking to them because they’re doing something that other people aren’t doing, and producing better results. And we’ve talked to a few coaches who have been very, very successful coaching female athletes, because they take the time to understand the differences in physiology. And the same thing, researchers are always looking for something unique to research. And as you pointed out, a whole bunch of these things haven’t been research, here’s a great opportunity is the better way to look at it.



Yeah, or just go back and redo all the research has been done in women, and you’ll be set for your entire career.


Chris Case  57:40

I’m curious, you said that periodisation and females, it could actually be a simple model. Could you dive into that a little bit? What would that look like?



Yes. Basically, when you’re thinking about working with women’s physiology, you know that you can maximize a really hard sessions in such around this first 14 to 21 days. So the first three weeks and then that last week is more of a maintenance phase. But when you get really specific about it, you want to do vo two efforts, you want to do your strength power, the first about 10 days and then when you think oscillation who Okay, how is she she flat or not. You can go out there do race simulation, you can do TTS, it’s all about maximizing the stress to the body during exercise to facilitate recovery and adaptation. So the other thing that often is done is like two hard days, one easy day two hard days one easy day. And that’s a model that can work for women. But when you start adding one extra hard day in the sex difference in muscle enzyme doesn’t allow them to recover well. So then if they have like, two hard days in a moderate day, and then an easy day, they’re not going to do very well when you go back into that model. So it’s just understanding a little bit, two on one off two on one off, and that can be the basic idea. And then when you overlay that on, you have that 14 days of time where you can do really high intense stuff, then you can really start to maximize that adaptation and your female athletes.


Trevor Connor  59:03

So then let’s get to the obvious question here. So you can really structure your training around the cycle, which is great. But let’s say you have a target race like nationals. Unfortunately, the one thing you can’t do it say, well, nationals is June 28. So I’m going to make sure I’m on day five of my cycle on June 28, so that I can perform my best you don’t have a choice there. No, you don’t. So how do you address it? If your target race ends up being right at the point in the cycle that you don’t want it?



Right, and I get this question all the time. So then it doesn’t become a training aspect. You’re training for that race and you’re training appropriately with your physiology for that race. But say that race happens two days before your period starts and from history and from data, you know that your athlete is going to have dead legs and feel flat not going to have that much Mojo. This is where you look specifically at why that happens. So we know it’s an inflammation cycle. We know that you can’t access carbohydrate rich Well, because estrogen is elevated, we know that core temperature is elevated, we know that estrogen progesterone cross the blood brain barrier and affect central nervous system fatigue. So then you look at nutrition interventions to counter that. So then you’re looking Okay, well, we know that magnesium helps with sleep. We also know that magnesium is lost significantly during the high hormone phase, because metabolism is a little bit elevated, so a zinc, so we have the woman increase her zinc and magnesium intake during that timeframe. We also know that the dead legs and the bloating and the flatness is all from inflammation. So we start looking at what do we implement that five days before the race that dampens that inflammation, we need them to sell their food a little bit more to increase total body sodium, taking things like branched chain amino acids before and after each session to mitigate that central nervous system fatigue, it’s not about protein synthesis, it’s about mitigating that central nervous system fatigue, that helps as well, and then keeping on top of protein intake to enhance recovery because progesterone is catabolic. So it’s understanding that yes, you’re training and you’re working for this race. And when the race falls on the time, you don’t want it to understanding why you feel like you do, you can put in really good specific nutrition interventions to counter all of that, and then you can fly,


Chris Case  1:01:18

maybe we should back up and hit that from sort of a, from the beginning, really the the Masters female athlete, there’s a whole other scenario there that is extremely important to maximizing their potential, their training their performance, maybe start by explaining what hormonal changes are taking place.



Sure. So mid late 40s, women start to have a variation in estrogen progesterone, testosterone, so ratios change, they’ll still get their period, but the training and the food that they’re used to eating is not going to work for them. And I get this a lot. Now like I don’t understand I’m putting on belly fat, I’m not recovering well, I need more time off. And it’s because of the different ratios and the way, you’re starting to have a tapering down of estrogen, progesterone, and testosterone. And with that comes metabolic changes. So when they become more sensitive to carbohydrates, so if they eat too many of the like grain based carbohydrates, then they’ll have more of a stimulus put on Donal adiposity. And then as they get into perimenopause, where they won’t have a period for like four months, and then they’ll have one because the estrogen progesterone are tapering off and dropping off but not completely gone. This is where things start to go really awry, where they’re not recovering, because they’re not building lean mass they’ve lost like I said, the live loss the stimulus from estrogen, which is anabolic by itself. And they also are starting to lose some of the neuromuscular responses for fast twitch and developing power. So this is changing up the training a bit by putting more power base stuff more strength based stuff, plyometric, and box jumps, counter box, or counter jump movements for power and also bone health. So having a look at what kind of training they’re doing to maximize health from a bone skeletal aspect, but also maintaining muscle integrity. And then when you get into postmenopause, the first five years after the onset of menopause, you have a significant decline in lean mass and bone. And that’s the biggest health concern. But when you’re thinking about it, from an athletic standpoint, if you’re losing lean mass and bone, you’re going to be susceptible to injury, stress fractures, poor performance, not making up getting slower, and it’s very soul destroying when you’re so used to being competitive. So again, things to really look at doing is we know that running is not enough of a stress to increase bone mass multi directional movement, and one of the best things to do is 10 minutes of different jump in plyometric moves. It’s multi directional causes different stress load on the body. So it encourages the bone turnover and increasing bone density. We also know that that kind of work also stimulates neuromuscular response and maintaining muscle integrity. So what I mean by that is maintaining the neuromuscular firing for fast twitch and power, but also the stimulus for muscle protein synthesis.



So when we look at, let’s see, you know, all these women who are older trying to race and they’re going out for a long, slow rides, and I was like, that’s the worst thing you could do because you’re getting into this catabolic state. You’re increasing cortisol, you’re decreasing your body’s ability to build lean mass through that cadre of what you’re doing and most people are most women as they get older, lose their appetite as well, because there’s a muting of appetite hormones, salsa muting of the thirst sensation. So when they go out on these long rides, they’re not doing their performance or their body any benefit. So again, it’s changing up training. is changing up their food habits by increasing protein across the board. And then looking at types of carbohydrates, they’re eating more from watery fruits and veggies to increase total body water, and also supplies and carbohydrate, and then also what they’re eating when they’re writing. Because we also know that the gut microbiome comes into play. And if you’re eating a lot of sugar based stuff in a hot hypoxic environment, then you’re going to promote the growth of the bacteria that craves simple sugar. And we already don’t have an appetite, then you start craving simple sugars, it just becomes this whole backlash. So it is a whole new area of discussion and research.


Trevor Connor  1:05:40

So we talked before about birth control pills, that’s kind of the default, they put athletes on birth control. It seems like when a woman goes through menopause, it’s almost just a given they’re going to put them on hormone therapy. What’s your feeling about that? Is that the same sort of thing where it’s just a really not well thought out, accepted norm? Or is there a good reason for that?



So the interesting thing is before menopause is almost nothing on women unless they are included in studies with men and generalized. Once the onset of menopause happens, there’s a plethora of Research on Women, but it has nothing to do performance, it has to do with health metrics. And I was involved with the Women’s Health Initiative study at Stanford, my boss and mentor there, she was the leading PCI for the whi which was the big huge study responsible for having all these concerns and creating these concerns about menopause hormone therapy. And when you go back and look at it, nobody in the study was highly active. I did quite a few stats on that, and none of them were athletes. But the generalized recommendation that’s come out is if you have really bad symptoms, and you need to attenuate them and diet and and exercise interventions aren’t working, you can potentially go on hormone replacement therapy for a very short amount of time and not have adverse health effects. But say, you’ve gone through menopause perimenopause, and then you decide to go on it for bone health. later on. That’s when all the problems that you read about with breast cancer and dementia, stroke and atrial fibrillation come into play when women get on at a later time. So the debate really is, when is it appropriate to use it from a performance perspective, what we’re finding is those women who are leaner and maintain muscle mass, have less symptoms and end up not having to use HRT, there’s women who have more body fat, lose lean mass, and aren’t training that hard, tend to have worse symptoms, and can’t control them and end up having to go on HRT. So again, it’s sort of a self selected process. From a performance perspective, we don’t know because no one’s done any of that. It comes down to when you think about any kind of exogenous hormone that you’re taking, what is it really going to do to you, we don’t have the data to show, I always recommend Well, well, let’s try to increase lean mass, let’s use some adaptogens that we know can control some of these hormonal effects. And then when we look at pre menopause, women who do a lot of training that and that moderates the hormones to make cycles a little bit easier with less PMS, then if we put that kind of training in and have you do more high intensity stuff, or power based stuff, then we can attenuate that complete decline at a rapid rate. So then the symptoms aren’t as bad.


Trevor Connor  1:08:33

So am I hearing this correctly, you’re basically saying that this is true for all or most women, that those who stay fit and active before and when they’re going through menopause, tend to come out of it much more successfully?



Yes, exactly. And you’ll hear these women, you’re like, Oh, my mom didn’t have any symptoms, but I have all these problems. And then you look and like, they’re the ones who just go for a walk. Or they might be the ladies who lunch in a spin class, you don’t want to sweat, but they’re exercising, but their moms had a very active life. Because when their moms were in their 50s, we didn’t have all these gadgets and gadgets that allowed us to supposedly have an easier life, right? So they had to run around and do stuff. And by the nature of their lifestyle, they were leaner and fitter than what their kids are, it’s a context thing as well.


Chris Case  1:09:21

We talked about the situation for masters athletes and the changes that take place during menopause. Let’s look at the younger women out there and the changes that take place during puberty and just the things that are going on and what that means for younger female athletes.



onset of puberty is interesting time. So girls will start to develop a couple years before boys but their period actually doesn’t happen for maybe two issues after they start getting secondary sex characteristics. And we know that if a girl has a period before the age of 13, or first period, then she’ll have more regular cycles with ovulation. If she starts after the age of 13, she’ll be regular for a good five years. And with this, this is, you know, goes back to the conversation of a physician will say, oh, you’re a regular, but you want a pill. And again, one of the worst things that you could do for a young girl who now all of a sudden is growing boobs and starting to bleed, and instead of being really thin, and meaning like narrow hips and able to go fast, her hips are widening center of gravity is off, she’s putting on more body fat, just by the nature of sex hormones, sleep is a bit off, and she might be developing before some of her friends. So there’s that struggle as well where she used to be able to keep up or she was the fastest. So there’s a lot of stuff going on. And at the onset of puberty, when all this is happening, one of the biggest risk factors for young girls is suddenly getting into the mindset of I can’t participate anymore, because I have my period, I can’t train hard anymore, because I have my period, or I need to stop eating because I’m putting weight on. So they get into like severe energy deficiency. And for the first year, we found that the best thing to do is from a training standpoint, is not to focus on the performance outcomes, but to focus on technique, strength, power, because these things you can develop in this perturbation phase, when the period and the is all over the show, and hormones are all over the show and center of gravity is changing, body composition is changing, spatial awareness is changing, injury risk is higher, but understanding and talking to the young girl and saying, Hey, you know, this is just a small phase. And what we do in this small phase, while your body is going through all these changes, is we look at pedal efficiency, we look at balance, we look at improving pure strength. So that’s that neuromuscular, low rep high heavy weights to get that neuromuscular firing activity. And then you can, you can increase aerobic capacity, but being very careful to keep them in energy balance. Otherwise, they can get into that relative energy deficiency, which creates it into Korean dysfunction, immune deficiency, bone problems, all that kind of stuff. Then when you look at what the boys are going through, with an increase in testosterone, when they’re leaning up and getting strong and growing so fast, one of the things that that comes out with that is severe aggression, because we know that testosterone is an aggressive hormone, but also there’s an increase in aldosterone with changing of thermoregulation and fluid balance. So understanding that young boys who are going through it get very aggressive and having a funnel or channel for that is going to help just in general with the peloton. I have to put that in because when you encountering young kids, and some of them are unnecessarily aggressive, a lot of people like What’s his problem? It is it is a problem. But it’s not something that’s controllable. So again, just having a different scope on it.


Chris Case  1:13:10

All right, Stacy, you are on the clock, you’ve got 60 seconds to summarize your life’s work. What are the key takeaways that people should take from this discussion we’ve had today?



Knowing that women’s physiology does affect every system in the body and the way, the best way to be able to incorporate that is have a tracking system of three months. And just seeing how the hormone perturbations affect mood affect performance outcomes, training outcomes. And then when you get that baseline amount of data, you can tailor everything around it to maximize performance and potential.


Chris Case  1:13:46

All right, Trevor, you’re on the clock. What are your take home today?


Trevor Connor  1:13:51

So I really just have one. And we said many times on the show, we don’t promote something unless we believe in it. So really, my message to anybody who is interested is Stacy’s book roar is a fascinating read. As we said at the beginning of this show, it’s really just a let’s look at the the physiology. And let’s understand the physiology, which I actually found to be a very refreshing change from some of the things I’ve read in the past. And I learned a ton from it. I’ve coached a lot of female athletes, I thought I had a pretty good understanding that there were a bunch of pages in that book where I was sitting there going, I wish I had known that a long time ago, we had a huge list of things we wanted to cover today. I think it was 20 lines long. We got through three, but they’re all in the book. So really, my recommendation is for anybody who’s interested in this, get the book. It’s a great read, Chris.


Chris Case  1:14:46

I’m just fascinated by what seems to be the potential here. There’s the potential for a lot of incredible research to take place. There’s the potential for a lot of women to take it advantage of the knowledge that we’ve discussed here today the knowledge that’s in the book and improve how they train, improve how they race and improve their performances in general. And, honestly, I look forward to having more conversations with you, Stacy. Hopefully we can have you back on the show. Because like Trevor has said, there’s so much more to discuss here that people can really dive into take advantage of and be healthier, fitter, faster, all of that, so I’m looking forward to that.


Trevor Connor  1:15:31

That was another episode of Fast Talk. As always, we love your feedback, emails at Fast Talk at velonews comm subscribe to Fast Talk and iTunes, Stitcher, Spotify, SoundCloud and Google Play. Be sure to leave us a rating and a comment. While you’re there. Check out our sister podcast developer news podcast which covers news about the week and cycling become a fan of Fast Talk and facebook@facebook.com slash fella news and on twitter@twitter.com slash velonews. Fast talk is a joint production between velonews and Connor coaching the thoughts and opinions expressed on Fast Talker those are the individual for Chris case, Stacey Sims, Brent bookwalter, and Ruth winder. I’m Trevor Connor. Thanks for listening