Women Are Not Small Men | Dr Stacy Sims

Finding Mastery is brought to you by Momentous Fiber Plus. Here's a stat that surprised me when I first came across it. Nearly 95% of us are not getting enough fiber. And the thing is, most people think that they are. That used to be me. I eat well, I'm intentional about whole foods, and I still wasn't hitting it consistently. And fiber matters. It's one of those quiet, unglamorous fundamentals that shapes how the rest of your system runs. Your gut, your energy, how well you absorb everything else you're putting in. So when Jeff Byers and the team at Momentous reached out about Fiber Plus, I paid attention. I've been using their products for years, and the reason I keep coming back to them, it's pretty simple. They don't chase trends. They go deep on the fundamentals and they build it to a high standard. And the same holds true for Fiber Plus. It's clean, no artificial flavors, no unnecessary additives. The cinnamon flavor uses real cinnamon bark powder and it tastes great. And I don't usually say that about fiber supplements. I mean, they built this thing right, like everything they make. Fiber Plus is NSF certified for sport, which is why it's trusted by over 200 professional teams and athletes. That's the Momentus standard, and that's why it's been part of my routine. If you want to upgrade one of the most overlooked foundations of your health, head to livemomentus.com/findingmastery and use the code Finding Mastery for up to 35% off your first order. Again, that's livemomentus.com www.thrivehealth.com/findymastery. The code is finding mastery for up to 35% off.

When someone first starts yelling at you for the rage, that right there is the physiology. It's not the person. And I think that's one of the things that really confuses marriages and partnerships when women are going through perimenopause. We see a high uptick of divorce rates in this age group. It's because there's this disconnect where the men are saying, wait, this isn't the person that I knew, what's wrong? And the woman is just so frustrated because it doesn't understand what's going on because every system in the body is affected by this change in hormones.

What has been the cost to women by relying on research that was not designed around female physiology?

So many times I've been told, why do you want to study women? We don't know enough about men. Or, oh yeah, we study women, and then you look and all the results are included with men's and they're not teased out.

One of the biggest ways that we can attenuate or slow the rate of those risk factors that start in perimenopause is Welcome back, or welcome to the Finding Mastery Podcast, where we dive into the minds of the world's greatest thinkers and doers. I am your host, Dr. Michael Gervais.

A high-performance psychologist named Michael Gervais.

Who head coach Mike McDonald and former head coach Pete Carroll brought in to work with the Seahawks. Famous for his work with Felix Baumgartner when he jumped out of space in the Stratos Project.

Olympic athletes depend on something more than just training and talent. They have to stay mentally tough.

Today's guest is the brilliant Dr. Stacy Sims, exercise physiologist, nutrition scientist, and bestselling author of Roar. She also authored Next Level. Through her research over the past two decades, Stacy has become one of the leading voices reshaping how we understand women's health and performance with a very clear message that has become synonymous with her work: women are not small men. We—

you can't study women, they're too complex. They have a menstrual cycle and that skews the results. The publication rate for women is lower than men. Funding for women's research in health and biomedical sciences is just a very small percentage of the total funding that's available. So we're still a huge uphill battle to close the gender gap.

This conversation is not for just the women in our community. If you know a woman and you love a woman, or you have a daughter, whatever, this is for you. With that, let's jump into this week's conversation with with Dr. Stacy Sims. Stacy, one of the most favorite insights that you've shared, and there's lots that you have, is that— and I wrote it down, make sure I get it right— women are not small men.

Yeah.

So can we just start with where that came from and what that means to you?

Yeah. So that was a tagline that wasn't really a tagline when I started using it. 'Cause when I was at Stanford doing my postdoc, I also picked up some teaching and it was training principles and practices. And we're talking about all the systems and it was in the afternoon and I would wake up the kids, or I shouldn't say kids, the young adults, the undergrads with women are not small men. Why? Because this is a difference in the cardiovascular system. And it would be how I would open it. And so people started calling it the women are not small men class. And then at the same time, I launched a new sport nutrition company and we were very specific. We had a women's line and the tagline for the women's line was, "Women are not small men." And that kind of took off and resonated with so many female athletes.

Yeah, I mean, first and foremost, nice job breaking through. Thanks. Right? Like, I do wanna understand, you've made a massive difference. And so I hope you can, And I just let that wash over you a little bit, you know, in life, because you're also grinding, you're on the frontier, you're, you're doing your best to make a difference. And like, it's cool. It's really cool. The question is like, for me, is, is this what you set out to do or was this a natural accident that happened? That's like, of course I need to mention this or talk about this.

I am what they call an introvert where I'm an introvert extrovert, and I never imagined any of this. I, I caught up with a friend that I've known for over 25 years just the other night because she lives in San Francisco. And she's like, I remember back in the day you were very adamant about like making things known about women and why things had to be different. And I was like, well, I didn't, I didn't remember that. She goes, no, you've been passionate about this the whole time. And I think it is just one of those things where it's like this deep drive to find equality for men and women. But I never meant to be the face of anything. It's just kind of evolved.

Where did that come from?

Wanting the passion to drive it?

Well, yeah, I'm glad that you picked up. There's two— I realize, as I said, there's two questions I was asking.

Yeah.

Where did the passion drive come from and where did the focus for equality come from?

Passion and drive, I think, is modeled from my parents. My dad was a career military man and my mom was following and supporting, and they never said that we couldn't do anything. And so it was real like, okay, let's go, let's do this. And then the competition of trying to make friends fast, fit in when you're moving around. Also school, you want to get to a good university and people around you were in the same mindset and it just kind of fell into that. And then the equality part came when the one point in time my dad actually told me I couldn't do something and it was what I wanted to do after I graduated from high school is I wanted to be an Army Ranger or Navy SEAL. And he said, "You can't because you're a girl." And right there I was like, "What do you mean? No one's ever told me I can't do something. Like, if I want to do something, I'm going to do it. And if someone says no, I'm going to prove them wrong." But at that point there was a blockage because it wasn't my dad saying I couldn't do it. It was the way the patriarchy had developed this, where they still had the mentality that women weren't as good or as strong as men, so they couldn't do the same kinds of things. And that sat with me when I went to university. And then when I was in exercise phys and seeing the representation of who was in the PDFs or in the textbooks or the examples of what was being shown as being successful in sport versus sick in sport, there were no representation of women being successful. It was all about being anemic or losing their periods or stress fractures. And the representation in textbooks is always he or they. There was no mention of female athletes being successful., but being a female athlete and, and pushing just as hard as our male colleagues for rowing, it just didn't make sense. So that kind of, you know, when you're 17, 18 years old and you wanna take on the world, that was a seed that was planted. And then everywhere I looked, I was like, that's not right. That doesn't work for women. And then questions that I had wouldn't be answered. And so many times I've been told, why do you wanna study women? You, we don't know enough about men.

We—

you can't study women, they're too complex. They have a menstrual cycle and that skews the results. Or, oh yeah, we study women. And then you look and all the results are included with the men's and they're not teased out. So it was just a series of things that happened earlier on that really kind of made this point in time where I was like, this isn't right. And I will— I know that I work just as hard as the men and my teammates work just as hard as the men. So why are we not able to get the same output and outcomes, and why are we not represented in any of the stuff that we're reading?

And when you think about the future, so you had a, first you had a model for drive and passion. You had a moment in time when your father said you can't, and it wasn't his opinion, it was actually the law at the time.

Right.

And so you bumped up against literally a ceiling of potential. Mm-hmm. And then there was an agitation in there. Was there? But you, there was nothing you could do at that time really about that law.

No.

About becoming a Ranger SEAL.

Mm-hmm.

And then, but it stoked something in you. Were you frustrated? Were you optimistic? Were you on a mission? What was the tone of how you were engaging? Or was it like, okay, well, hmm, that sucks. I don't know. And then something else flashed in front of you and then something else flashed. And at some point it was like, this is too much. Like, what was that state like?

It was frustration and a bit of anger.

It was?

Yeah.

And how did you— how did you work with that or express that? So because when I'm— when I'm agitated and angry, like, I'm not— I'm not great. I get too barbed.

Oh, yeah.

Yeah. And I don't get that from you.

No. Focus.

You get more focused.

Yeah. To prove a point.

Yeah. Okay, cool.

I don't want to be— I don't want to be wrong. In some assumptions.

Yeah.

So I need to do all the steps to either prove to myself that what I'm doing is wrong or prove to others that what they are doing is not appropriate. So it's that touchpoint of I'm angry and I'm frustrated and I need to get the answer.

I love it. So that's, that's where the drive comes from. Okay. So that is at the seed of your drive, right? There were ceilings, there was frustrations, and it was an injustice. And you're like, now hold on. If not me, then who?

Right.

Where did the if not me, then who type of thing— so that's called self-efficacy, this idea that if I point my attention here, I think I can make a difference. And you have high self-efficacy, obviously. Where did that come from?

I'm not sure. I'm really not. If you talk to my family, they never would imagine where I am now. I was this super quiet and shy child, like, very intrinsically motivated, very focused. And I mean, there was a point where we would have substitute teachers when I was a young kid and I would vomit. My mom would have to come pick me up because I was just so nervous of something being different. And I know.

And look at you on the frontier.

I know. It's weird, isn't it?

So how did that happen? This is— this gives hope, you know, a lot of hope.

Yeah. I think I found my voice really when I had to kind of fend for myself. Meaning that I was under the shadow of my older sister for most of my childhood, and she was more of a protector. And then she went to university, moved out of the house, and then I faced going to a brand new state, never been there, going to university. It was a completely new environment and had to really find that confidence. So growing up in San Francisco, for the most part, when you walk downtown, you would just pretend to be confident so you could walk downtown and not be prey, so to speak, you know. So that's one of the things they teach you as a girl. You want to walk with confidence so that you don't seem to be meek, so you don't become a mark or anything like that. So then going to university, I kind of instilled that. I was like, I'm going to walk with confidence so people think that I should be here. And then that kind of developed into, well, if I'm going to pretend I have confidence, I need to say something in the room. And then really trying to overcome that fear of having been sheltered to now having to make a mark for myself.

Yeah. If you were to design a path for high school slash college women, would you want them to do it that same way or do it differently?

Uh, I think part of the missing link for a lot of women who are going to university is they don't have any kind of, um, sociological, I guess, skill uptick, meaning that they don't actually have the ability to interact in different environments because we're all sheltered and we're told to fear things and to watch out, don't don't go walking at night, that kind of stuff. But no one ever really empowers them to say, you know what, culturally these are things we've learned, but this is how we can interact in that not quite so safe space. So that when you go to a new university or a new town, you can really get involved in the culture quickly. And I find that wherever I go, I don't want to stay in a resort or a hotel. I want to actually be in where people are actually living so I can understand their perspective and get something from that to help build my confidence as well.

Okay, cool. Now that you've— let's fast forward to kind of where you are now is you've got— you're resting on good science. You've bifurcated the difference between male versus female research, and you are pointing strongly to gender-appropriate research-based findings. What is most interesting to you right now that you, you wish that men, women, people would understand about your findings?

That when we look overall at the scientific databases that are out there, there's just a very small amount of literature that is appropriated to women still, because we think about who are the PIs, not very many women. The publication rate for women is lower than men. We see that the funding for women's research in health and biomedical sciences is, just a very small percentage of the total funding that's available. So we're still a huge uphill battle to close the gender gap.

And if I have the numbers right, according to your research in your book, 1 billion women right now, at the time that is marked this conversation, about 1 billion women are in menopause. And let's hold the athletic and the sport industry at bay for just a moment, 'cause that's where you cut your teeth, but then you're, you're onto this huge population. And is that research also dearth, or is there ample research there and you're just amplifying it?

No, there's also a lack of research there, because if we look at the schematic of research, there's this big hole between ages of 30 and about 50 for women, because that's where it becomes very complex to create studies unless it's a public burden disease, meaning that it's going to drain on the healthcare system. So we see that there's a lot of research in peri- and postmenopausal obese women, diabetic women, women with osteoporosis, but there's not a lot for women who are generally healthy or women who are actively trying to promote their health in this age span. So we're trying to close that gap with research.

What does the lack of research cost women?

Oh, so much. I mean, I see it all the time where they get gaslit because their physician might not know everything that's happening. Or the symptomology that they're having for perimenopause is similar to someone who's just highly stressed. So if we're comparing male data to female data, if we look at two 45-year-old individuals, one male, one female, and they both have a very high-stress job, and they might be single parents, so you have the stress of parenthood, and they're both having somewhat a little bit of panic attack or anxiety, they both go to the physician. The physician would say, oh, you're having panic attack, anxiety, we have to decrease the stress. But In actuality, it is a hormone flux that's invoking this and creating bigger stress response and a trigger. So the actual solutions that are there are not going to be as beneficial or robust as a woman until the conversation of, "Oh, there's hormone flux going on, so we have to unpack this and see how we can bring sympathetic drive down," because that sympathetic drive is so elevated from this fluctuation of estrogen, progesterone.

Yeah, okay. So in training, Good psychologists, the ones that are properly trained, will not make a diagnosis without understanding biology.

Which is fantastic.

Yeah, it's really good. And my supervisor, Dr. Valerie Maxwell, was exceptional. Before any time, any time before I was about to make a diagnosis, she's like, have you looked at the bloods? Have you called for bloods? And I go, no, but it's— this is me early in my career, like, in being supervised. No, it's classic. Look at the 7 symptoms, consistency over time. Like, that's the profile. And I'll never forget, early on she goes, what's the difference between anxiety and hypothyroid?

Hmm, good question.

Yeah. Hyperthyroid, meaning like an active thyroid.

Right.

And I go, I'm not sure. She said, right, you should sort that out, Mike. And so it was the beginnings of a really important understanding of the difference between gender and similarities. There's lots of similarities and there's real structural differences. So Can you just open up— let's— what do you think? Do we go, do we go perimenopause, menopause, and kind of open some of these, your best practices and findings up? Would that be good? Or would you rather go— would you rather speak to the application of what to do if you are in one of those two?

I think people need to understand what it is before they can take the steps, because depending on how your symptomology is and how you're feeling, will indicate what kind of steps you need to take.

There you go. Okay, so let's do structural stuff first.

Yeah.

And let's hit perimenopause while we're at it. It's the— you said the 10 years before the onset. And look, this conversation is for both genders, all genders.

Yes.

This conversation is not for just the women in our community. This is for like, if, if you know a woman, probably, and you love a woman, this is or you have a daughter, whatever, this is for you to understand. Okay, teach us.

And the other thing is women have a bit of a ceiling when it comes to advocating for themselves because it's a more of a male-driven society, especially the medical community. So having men in the conversation also helps drive action.

And what do you hope men would do more or better or less?

So I think instead of trying to fix things, We see that happens a lot where you'll have your partner saying something and then it's the fix it or the ignore it. And we don't want that. We want to vent. We want to have someone just listen so that when we come back and say, I think I have a solution, or I need help finding a solution, then that's when action can be taken. But when someone first starts yelling at you for the rage, or, you know, having really bad panic attacks, that right there is the physiology. It's not the person. And I think that's one of the things that really confuses marriages and partnerships when women are going through perimenopause. We see a high uptick of divorce rates in this age group, and people are saying, oh, it's because the kids have left. But no, it's because there's this disconnect where the men are saying, wait, this isn't the person that I knew, what's wrong? And the woman is just so frustrated because it doesn't understand what's going on and has severe mood swings or night sweats or body composition change because Every system in the body is affected by this change in hormones.

It's an agitated state.

It is.

To say the least. And it's— look, the symptom list is remarkable, right?

You read it. Overwhelming. Yeah, you read it. Anyone who reads it, it's like, oh, I'm in perimenopause. Even men, they read it and they're like, oh yeah, that could be me.

That could be me too. Yeah. But to be clear, do men have a quote unquote menopause? Is there a thing where things change hormonally other than maybe a testosterone drop? Is there a thing? Finding Masters is brought to you by LinkedIn Jobs. If you've ever hired for a small business, you know the real cost isn't just the salary. It's the time that you lose when the fit is off, the momentum that stalls when that fit doesn't work. And that's the pressure of having to get it right while you're still running everything else. That's why I'm paying attention to LinkedIn Hiring Pro. It's built for the reality of hiring when you're operating lean. You describe the role in plain language, and then HiringPro helps you draft the job post, surface the right candidates, and then narrow to a shortlist without turning hiring into another full-time job. And when applications start coming in, it doesn't leave you buried in resumes. It streamlines screening, including AI-powered interviews for initial conversations. How about that? So that you can spend less time searching and then more time connecting with the people who match what you need. With HiringPro, you can hire with confidence knowing you're getting the best talent for your business. In fact, those hiring with LinkedIn are 24% less likely to need to reopen a role within 12 months when compared to their leading competitor. Join the 2.7 million small businesses using LinkedIn to hire. Get started by posting your job for free at LinkedIn.com/Mastery. Again, that's LinkedIn.com/Mastery. Terms and conditions apply. Finding Mastery is brought to you by Sunlighten. I'm really excited about a new partner of ours. Something that I've come back to again and again is when I invest in recovery with the same intention that I bring to my work, everything gets better. My energy, my focus, my ability to show up fully for the people that I'm with and the work that I care about. That's why I am so bought in on the Sunlight and M-Pulse intelligent sauna. I was first introduced to their team a few months ago and was so impressed by what they've created. This is one of the most advanced infrared saunas that they've built in over 25 years of pioneering this technology. That's right. They've been at this game for 25 years. I had one installed in my home a few months ago and it's made a real difference. I feel more refreshed, more grounded, more relaxed, and it's become a consistent part of how I recover, how I reset every day. I'm using it to support muscle recovery, for improved oxygen delivery, and for nervous system recovery. And what I love most, I don't have to leave my home. They're offering the Finding Mastery community up to $2,100 off. Simply head to Sunlighten.com and use the code Mastery for this great discount. Again, That's Sunlighten.com and use the code mastery for up to $2,100 off.

Not really. When we look at aging and looking at the scope of aging, most things are, are scaled in a linear fashion. And then when you get to the ages 40 to 60, we see a discernible effect of aging in both sexes, but it's more pronounced in women because in that period is a significant ovarian shutdown. So we're seeing this downturn of these ovarian hormones, which again affects every point in the body. For men, we start to see a little bit of functionality decline, total body functionality decline, and, you know, around 50, 55. And then we start to see a decrease in testosterone, which then exacerbates a lot of the functional decline.

And functional means, I don't know, when I'm working out, I don't put on muscle or burn fat as easily as I once did.

Yep.

But maybe I need to adjust my methodologies to be more efficient with like, I know we'll get into it, like HIIT training or sprinting or something like lifting heavy weights as opposed to the moderate sledge of zone 2. Yeah, whatever. Yeah, we'll get into that. Okay, so it's different for men and women, check. And for women during the perimenopause cycle, there's a hormonal flux and we're talking about estrogen and progesterone.

And somewhat testosterone as well.

Right, so testosterone decreases as well.

It's not associated with the ovarian function, but when we're under high states of stress, we see testosterone takes a dive. So we see a lot of natural levels dropping in women who are perimenopausal. And then, and then people are like, but it's not associated with the ovarian shutdown. What's going on is because when you are so tired but wired all of the time from that sympathetic drive your body's under a significant amount of stress, and it interrupts our natural pulses through, um, the day or the 24-hour cycle. So testosterone starts to come blunted and drop off.

Okay, and sleep is compromised. Now you've got like a snake eating its tail because, um, we need sleep.

Yep.

You've got a sleep issue that's coming on from the irritation, the agitation, the higher cortisol the night, the, the sweat, you know, that— so there's a, there's a compounding effect that takes place when hormones change as well, which of course affects psychological and emotional/behavioral outputs. Okay, do you want to get into the hormonal changes and what actually is happening? Is that of value to you?

Yeah, to explain. Sure.

Yeah, please.

Yeah, I always bring people back to puberty because everyone talk, you know, knows the teenage angst of kids growing up. And we see around age 8 or 9, girls start to become a little bit more self-conscious and then boys start to become more aggressive. And this is when we start seeing what we call an epigenetic change from expression of sex hormones. So there isn't a lot of progesterone yet for our girls because they haven't started their menstrual cycle. But we start to see these changes and we see the mood changes, we see body comp changes. We see interactions within society is different. We see the efficacy is different.

At 8 and 9?

Yeah. And it starts to progress. And then when they talk about hitting the teens, especially 13, that's a really significant point in time where you really do start to see all these changes is right on the cusp of girls starting their menstrual cycle and boys getting a boost of testosterone so that you have this really dichotic switch. So if we're talking about— we know all of these things that are happening in puberty, including body composition change. We get to the other end in perimenopause, we have about 10 years of the body winding down all the hormones that have been hitting every system of the body.

Um, why do we wind those down?

That's something no one really knows yet. It's 2026 and no one is really sure why women go through menopause.

I heard a really I heard it was a super thoughtful, non-scientific opining from somebody that— an opinion from somebody that I really have high regard for. And it was a conversation that two people were having about— they're both men that were like 55, and they're like, okay, let's talk about peptides, let's talk about HRT, hormonal replacement therapy, let's talk about like how— and one of the folks in this conversation said, you ever think that we're supposed to not have this, all this testosterone? And the other two look like, get out of here, right? It was like a kind of a moment of banter. And he repeated, he's like, look, I don't know about you guys, but I want to be more sensitive. I want to be more connected. I don't want to be kind of in this rage hormone kind of alpha male thing. Like, I want wisdom. I want to be more of who I'm supposed to be as a wise man than like this young kind of lion that's— or this old lion that's trying to be a young lion. I just— I really appreciate that. Again, there's no evidence, there's no real science there that we— that this conversation is pointing to. If you are philosophically going to think about that for women, what would that be?

Well, I always work in the social cultural context of things, right? One of my colleagues is a really good sociologist, and so she's a sociologist in the female athlete space. So we work really closely together. So when I think about it, it's like, why do we have this drive to stay young, right? Why is it that we're now saying, men, you need to, you know, use testosterone, and women, you need to lean into menopause hormone therapy, and everyone should be on the peptide bandwagon, and we want to live to be 150. I'm like, but that is a social construction right there where there's these images that people need to be young to be successful. And we know that that's not true. We can look at other cultures. We look at like more of the Asian cultures and the wisdom comes with the elders. And it, there's no press really to stay young because it's not about you're no longer important. You are very important. We can look in the wild too. And we know, I like the whale analogy. I'm sure people have heard whale analogy before. So whales also go through menopause. And then when the female whale that has gone through menopause, she becomes the one that chaperones and herds and oversees the entire group of whales. So there is different pockets within biology and within other cultures that don't have this press like Western culture to stay young and viral and angry and productive in the sense that we see it. So if we're thinking about borrowing from other cultures, It's more of that relaxed of now women are in other cultures like, you know what, I don't care. I am me. I have all these experiences and I can share my experiences with you and we can talk about what you're going through because I've already done it so I can help you. But I feel like in, especially in the US, there isn't an eye to that, meaning that there isn't the, the want for women to share their experiences to the younger. But they'll share, like, we'll share experiences in our, in our own population group or our own age or we'll share what we did with someone who's older, but it doesn't seem to trickle down the other way.

Yeah, I'm nodding my head to everything you're saying. I think that that idea— you're describing a wise woman, you're describing of wisdom. So let's get into like what happens when a woman goes through a perimenopausal cycle or experience.

So if we're looking at how long perimenopause is, like I said, it could be up to 10 years.

Okay.

And we start to see early symptoms in our late 30s. And how that develops for a lot of women in their late 30s is they might stop sleeping as well. They have changes in their appetite. They're putting on more body fat at a faster rate than what they ever have before. And there's a change in gut microbiome diversity. So we have a decrease in the gut bugs that allow us to stay thin for the most part, and overgrowth of the, Vaila, that really encourages the body to hold on to body fat. Why? Body's super stressed. High stress.

Oh, so because of the stress, not the hormone, but also because cortisol is a hormone, right?

Yeah, but also because of our sex hormones. We start to have a decrease in our sex hormones and the gut bugs that would unconjugate them. So what happens is your sex hormones are released in a pulse and they hit some of our target tissues in action. So they go to certain receptors in the body, but then there's still some that's circulating that didn't quite hit those receptors that they needed to. So they get shot to the liver where they're bound by sex hormone binding globulin. And so this little composition of sex hormone binding globulin and our sex hormones gets pushed into our intestines through bile, and then we have gut bugs that will unconjugate or release the sex hormones from the sex hormone binding globulin and shoot them back out to do a job.

So you want your sex hormone binding globulins to be low? In general. Yeah, let's stay here. I know it's a super narrow thread, but how do you— what is a set of best practices to help that happen?

I don't know.

Neither do I. That's why I asked.

That's— I'm like, that's a good question. There isn't— like, it's one of those things where you get your bloods tested and you follow over time. We do see that the more diverse your, your gut microbiome is, the better profile you have across the board.

Yeah, to detangle, or what did you call it, deconjugate?

Unconjugate.

Unconjugate. Break New word for me. I like it. So that would be an interesting bit of research, men and women alike, I think. But yeah, that's a really nice one. Okay. Because we're chasing the increase in estrogen, progesterone, testosterone, but actually the thing that is not allowing it to be effective, we don't know much about.

Correct.

Brilliant. Okay, let's go back to the winding down.

Yeah.

Some of the more important understandings so we can get to some, some maybe solutions or steps folks can take.

Yeah. So we start seeing this wind down and we see changes in brain and brain structure and we see changes in blood lipids. All of a sudden, women who didn't have a problem with cholesterol all of a sudden have high low-density lipoprotein or LDL and high total cholesterol. And they're like, "What's going on? Like, I haven't changed anything, it's the same." And we start to see changes in muscle mass, we start to see changes in bone density, soft tissue, soft tissue injuries come up all the time. People are like, "Why do I have plantar fascia? Why am I starting to get these calf niggles?" Because our muscles are getting weaker, we lose power first. A lot of the mood and mood changes as well is part of the brain and the way the brain is changing. The decrease in our gut microbiome is also affecting how our body is producing neurotransmitters, especially dopamine and serotonin and melatonin.

The feel-good and sleep-good.

Right.

Yeah.

And then unfortunately, right now, because of the way that most of us grew up who are in this 45+ age group, is a social construct was you're starting to put on body fat, so you need to eat less and train more. Let's do calories in, calories out, which is the opposite of what you should be doing because you're already putting on more body fat by the signal your body's highly stressed. And you start restricting calories, it's going to exacerbate it. So we see an increase in the rate of lean mass loss when people start really restricting calories and increasing their training load or their exercise load. So they get in what we call low energy availability state. It's really prevalent and people don't realize how prevalent it is.

Is this— is there a difference between men and women on this piece?

We're starting to see that low energy availability is becoming relatively rampant in men too.

Can you talk about time-restricted feeding and eating, like the interval?

Yeah.

Can you talk about that a bit and the difference between gender?

Yeah, so if we're looking at what we call intermittent fasting versus time-restricted eating, so intermittent fasting is the trend to hold your fast or not eat from like 7:00 PM to noon the next day. So you're getting this really long period of time where your body is supposedly resting from digesting. We see from population research that when you break your fast late like that, you are effectively phase shifting your circadian rhythm, which is a bigger deal for women than men because women's circadian rhythm is a little bit shorter than men's. So we start to see this change or a shift in the way our body is normally pulsing its hormones.

Wait, you're blowing my mind. There's— this is why I was so excited to sit with you. There's a difference between male and female circadian rhythm.

Yeah. Yep. So it's—

That's a little bit of a mind bender for me. That's a really cool insight.

So it makes sense, right? If you and your wife are watching TV at night and she's like, "Oh, I'm really tired, it's 9 o'clock." You're like, "What's going on? I'm not tired." It's because her melatonin is starting to rise and she hits a first wave peak about 9 and the second one's at 11. Yours is at 10 and at 12. So there's about an hour difference.

I see, okay.

So when you're like, "Oh, my wife gets out of bed really early and gets out." It's because her body is ready to go. She's a little bit off-kilter than what you are because of the circadian rhythm change.

Very cool insight.

And so when we're starting to look at the way that we change our circadian rhythm, it's through light and dark exposure and food. So if you're getting up and although you're seeing the light, you're still not eating, your body's like, whoa, what's going on? And we start to see with women specifically, we have a higher cortisol peak in the morning which is our cortisol awakening response. We both men and women have that to wake up.

Yeah. So you can do some good work with a little bit of cortisol in your system.

Right, exactly. It's not the evil hormone that everyone puts it out to be.

Yeah.

For women with that rise, we also have an increase in what we call our acylated ghrelin. So that's the active form of our hunger hormone. At the same time, we also have a rise in peptide YY, which is an active form of a satiation hormone.

So the hunger hormone kicks up, ghrelin. And so you're naturally hungry.

But you also have peptide YY that's kind of blunting that hunger, which is why women will say, "I don't feel hungry in the morning." Oh, yeah, very cool, okay. When you have cortisol that's coming up, there's an association with cortisol and the acylated ghrelin. So you have hunger hormone that comes up with cortisol. If you don't eat and cortisol stays elevated, then there's no message to the brain that there's food coming in. So what happens is, because you also have the elevation of your peptide YY, you don't feel hungry, so you kind of keep pushing it out. And this is causing a misstep in the way that your body normally has cortisol responses throughout the day. So your response to a stress is going to be higher from a cortisol perspective. So that's why we see more astute kind of responses to daily stressors. We also see there's a change in our luteinizing hormone pulse or testosterone pulse, because hormones aren't released in a linear fashion. They're pulsed throughout the day in response to environment, but also your circadian rhythm. So if women aren't eating within that first half an hour or an hour of waking up, okay, then that cortisol still stays elevated and your appetite hormones become dysregulated. So we start to see this when women are holding their fast till 12 or after. They actually don't get any metabolic control that they're after from fasting. We don't see a better glucose uptake. We don't see any change in blood lipids. We don't really see a change in body composition.

So if your last morsel, super applied, if your last morsel was at 7:00 PM, dinner's done, and you wake up at 6:30, you're suggesting, or the data suggests, to eat before, if you're female, to eat before noon.

Definitely, within half an hour to an hour waking up. If you break your fast early, so maybe it's 8 or 9 o'clock and you have food, then you will get a lot of the metabolic control from the fast. Because what we say is time-restricted eating is you have dinner and you don't have anything after dinner, and then you have food when you wake up. So you're getting a 12 to 14-hour overnight fast. If you're holding that overnight fast longer period of time, that's where you start to have this dysregulation and disruption.

And what happens for folks, women that do that?

So it's effectively phase shifting. So what we mean by that is we start to see a change in melatonin production. So instead of that 9 and the 11, it's blunted, so it's not as potent, and it's delayed. So this is— this interrupts sleep. People can't get into proper sleep because they don't have the melatonin to really tell the brain, yep, okay, we're phasing into sleep.

So if melatonin normally would be produced around 9 o'clock, for a woman, and you've prolonged the drop of melatonin at 9 PM because you've changed your fasting from, let's say, 8 AM to, I don't know, 11 AM, then you're literally pushing back 2 hours the melatonin that will help you sleep.

You are literally creating an environment where your brain can't get into good sleep because you've blunted how much melatonin is being produced and you've changed when it is being produced. So if we were to tell women, you're having a really a lot of problems sleeping, I always say, let's see where you're eating. Let's back up the food, let's front load the calories. And then if you really want calorie restriction or to have a fast, we do it from 6 PM to when you wake up. So that could be 7 or 6:30 or 7. So you are getting at least that 12-hour fast that's beneficial for health, but you are not phase shifting your circadian rhythm. It's like they're in perpetual jet lag. So when you can do that, then you start falling into a normal circadian rhythm and you start feeling sleepy at 9. You can fall asleep by 10 or so. You can catch the next wave of the melatonin as it rises and then starts to come down. Your core temperature follows that same signal so that your core temperature will drop the way it is supposed to to get into a deep sleep. And you don't have all these awakenings throughout the night.

Somebody wakes up, maybe they're not exactly hungry, but they could eat, maybe the family's eating. Is your recommendation— and let's say that that woman at this point has the opportunity to go to the gym early in the day. Work out before, or eat before working out, or wait and work out in a fasted state?

Having something small before she works out is the ideal.

Protein mostly based, like cottage cheese or kefir?

It doesn't have to be a lot.

A couple eggs?

Yeah. So if we look at Abby Smith Ryan's research from UNC, she's done quite a bit in this area and found that if you're going to do a strength training circuit, then you're looking around 15 grams of protein. So that's not much at all. And if you're going to do some cardiovascular work with the strength, then you just add 30 grams of carbohydrate, which is not a lot at all. So it's just a very small kind of pre-training snack.

Is the research still that there is a window, an optimal window post? Or is that just male?

This is the argument, right? So if we look at it, we see that most of the research that's been done that way has been done on young men for the most part and a very small amount of younger reproductive year women. When we're looking at the optimization for adaptation, You want to provide fuel as close to the end of exercise as possible because your body's gone through a breakdown state during exercise. So it needs the building blocks to rebuild. And if we are looking at as you age, you become more what we call anabolically resistant to both exercise and protein. So that means your body doesn't respond as fast or as well to those. But if you provide those building blocks pretty close to the end of exercise, then you're going to get more of the feedback signals for adapting. So it's not so much the window that's necessary, it's an age-related thing, like how old are you and what adaptations do you want? We know that the older you get, the better it is to fuel close to the end of exercise. When you're younger, you can get away with a little bit of a gap. But I try to tell women, you want to eat breakfast pretty close to the end of exercise if you're doing it first thing in the morning, because again, we're trying to— front-load our calories and prevent any kind of energy availability misstep, because we want to keep our hormones in this pulse and keep our circadian rhythm pretty sound so that we can sleep. Because you can't do any kind of body composition change if you have poor sleep, full stop. Full stop.

And if you are not getting the right, um, benefits from nutrition, hormonal benefits from nutrition, you got a problem. And if you are waiting to eat one meal at 7 PM, you're probably not going to get enough macros in, and now you're in a, in a compromised state.

And throughout the day, and your micronutrients— we see like very short eating window, people are not getting enough of their micronutrients, they become micronutrient deficient. So that's low vitamin D, low copper, low selenium, um, just a lot of the trace elements, which then can affect your entire system.

Okay, this is great. Primes— if you're going to work out early in the day, prime something, a little bit of protein. If you're going to do cardio, add a little bit of carbs to it. Uh, workout and fuel is— if you're in your 40s, 50s, 60s or later, fuel as soon as you possibly can. Um, and, and you are not interested then in intermittent— the benefits that I know, let's say, from the early research on intermittent fasting, you're saying that's mostly male-researched and/or beneficial for men.

Yes, and it's primarily clinical, and a lot of it is still done on rats.

So what about autophagy?

So autophagy is some of the parts of your cells. So you break down and you have cellular debris, and your body will pick up that debris and excrete it or use it for some of the parts. It's kind of recycling in a good way.

Yeah, you want to get rid of the, the kind of senescence, the zombie cells, the, the non-useful —parts, yeah.

And that's where the whole idea of fasting and calorie restriction and everything came from. It's like, okay, if we do this, your body is going to have the drive to use some of the parts because you're not feeding it. But if we look at exercise, and one of the massive feedback that happens after exercise is autophagy, because what's happening during exercise, you're not building during exercise.

Yeah, you're tearing, you're breaking stuff down.

You're creating a pretty stressful environment. Exactly. So that's how you— I mean, that's the stress, and the response to the stress is let's go in and clean up, let's repair, let's rebuild, let's clean up. So autophagy from exercise is— can be a greater response from an autophagy standpoint than fasting. Oh, very cool.

So when— this is another reason why fitness is so important. Yeah, right. Okay, so let's go, let's let's kind of float up a couple levels really quickly. There are hormonal flux happening in the perimenopause, perimenopause, um, phase. And you're— you've already pointed to the power of nutrition from a cadence perspective. You're pointing to the power of sleep. Now, sometimes sleep is compromised if you've got hot flashes or there's some stuff happening there, so I think we should knock that down. And you are pointing to the power of fitness for efficiency of your system running, let alone we haven't gotten to the bone health and muscular strength and mobility and all that stuff. But so what's the big— what are the big rocks?

The way that I scope it is we need sleep first, right? So sleep and then movement and physical— or movement, nutrition are kind of the next steps depending on personality and motivation. And then the one that is not rated at all but is important across all of them is your social support being in nature and mindset, because we see that the research of doing a run or walk outside versus on the treadmill, you have massive differences with regards to how you feel and how your body responds.

100%. That research, just for folks that are unclear, can you walk through the benefits of being in nature?

When we are in nature, we have the natural light, right? And so that allows our body to go, "Oh, okay, I'm outside. What am I doing?" The fresh air. And it creates a greater dopamine response. We also see that we have a, a better ability to take on stress, so we're more stress resilient. There's the whole grounding trend that came from people, feet on the ground itself, again, because the touch of nature to the skin creates a sensation and a feedback response that is more relaxing and parasympathetic driven. If you were to bring that inside to a gym or a treadmill, you don't get any of that.

Yeah, and the parasympathetic is that rest and digest, the recovery mechanism. And the Ferguson. Ah. Ah, there it is. The wonder that comes from like being outside with things that are living and breathing. Has the grounding research moved from fringe to mainstream?

It's still a bit fringe. It still is. Yeah. It's getting traction, but it's still a bit fringe.

Yeah. I grew up surfing and being in the— you did as well— the saltwater. There's something— we're calling it grounding because you're walking on grass or something, but there's something about the sand. There's something about the Mother Nature's ocean, you know, that is like remarkably, I don't know, grounding. I'll use the word, but you're actually in water, so it sounds like it's a weird thing. Finding Mastery is brought to you by ProtonVPN. When I work with high performers, one of the things that we talk about is taking real responsibility for the things that are 100% under your control. The discipline to be great with the things that are in your control is a mark of mastery. Your digital privacy is one of those choices, and it's one a lot of people hand over without ever deciding to. Think about how much your life now lives online. Your conversations with loved ones or colleagues, your finances, your work. And it's far more exposed than many of us realize. Most of us just accept that as the cost of being online. But it doesn't have to be that way. You can decide to take some of that ownership back. That's where ProtonVPN comes in. ProtonVPN is a secure service designed for people who want to protect their privacy and their online life. And if you travel a lot, it's great. It encrypts your connection so what you do online stays yours. And what I respect is that it's built by a team that treats privacy as a core value, and they've got a track record to back it up. Right now, Proton VPN is offering you 70% off a 2-year plan when you go to protonvpn.com/mastery. That's protonvpn.com/mastery for 70% off with a 2-year plan. Again, protonvpn.com/mastery. Finding Mastery is brought to you by Leesa. We are serious about recovery. Sleep sits right at the center of that practice. I have been fortunate to work with some of the most extraordinary performers for the last two decades, and sleep and recovery are foundational, full stop. It's where the body and the brain repairs, and that's why finding a mattress that supports your recovery matters so much. A great mattress, it's not something that you stumble into. It is a choice. You find it on purpose the same way that you'd approach anything that really matters in your life. We've worked with Leesa for a long time now because they get it. They build beautifully crafted mattresses tailored to how you actually sleep, your position, your feel, your preferences, all of it. You can take their sleep quiz and find your match in about 2 minutes. Premium material, serious comfort, full body support no matter how you rest. Rest. One of our teammates here at Finding Mastery picked one up recently. Can't stop talking about it. Says that they're waking up more rested than they have in years. Right now they're having a July 4th sale. Go to Leesa.com for 30% off select mattresses, plus you get an extra $50 off with the promo code Mastery exclusive for our listeners. That's Leesa, L-E-E-S-A.com, and use the promo code Mastery for 30% off select mattresses, plus an extra $50 off when you use the code Mastery.

I know, but one of my things that I love to do the most in the summer is ocean swimming. I'm not a big swimmer. I hate the pool. I'm so slow in the pool and I get so bored. But ocean swimming, it's the slush, slush of the water and you're seeing things and you're going and you're exploring.

Yeah, this is the terrifying part for many. Yeah, the seeing of things.

Yeah, no, that's That's good. Or on the board and you're paddling.

It's the same thing. Yeah. Yeah. Okay, so there is some research that just seeing Mother Nature, there's a kind of second-tier benefit. And then seeing a picture of Mother Nature, there's some benefit there as well, but it's obviously weaker. Yeah. Yeah, so be out. Outside. Yeah, with nature. And I also just maybe remind myself that I am nature. Nature is not just the ocean or the pond. Like, we are nature. Yeah, we are organic. Yeah, completely organic. And people forget that.

Yeah, they think they're an algorithm or a linear progression. And so if I do X, then Y will happen. Yeah. And it doesn't work that way.

Okay, so sleep, um, what are some best practices to help people outside of what you just laid out is get your nutrition in early so that you get the melatonin drop appropriately. What are some other things if somebody is working through hot flashes or they're struggling or they're waking up in the middle of the night, what are some guidance for women?

One of the things about awakenings throughout the night that are not related to hot flashes is people aren't eating enough. We've done some CGM glucose monitoring through the night with looking at awakenings, and there's a really high correlation between hypoglycemic effects and awakenings. So this is one of the first concerns I have when a woman is like, I'm not sleeping, I'm waking up a lot. That's why we look at diet and make sure that she's eating enough. And if she still gets a point where she's not eating enough, then we might have her eat some yogurt half an hour before bed so that she has slow-release proteins that are going to help prevent that hypoglycemia. So you just want to put that in the nutrition box. When we have things like severe night sweats, hot flashes, inability to sleep well, There are tools in toolbox for that. You can look at using some pharmaceuticals. You can look at using adaptogens, which are really potent. I mean, we see the use of ashwagandha, rhodiola, holy basil. All of these really help. One of the other things—

I love that you bring those— sorry to interrupt. I love that you bring those up because you and I were introduced by Jeff Byers from Momentous, which you trust Momentous. Yes. I trust Momentous. And they have all three of those. Well, no, they have two of them.

They have ashwagandha and rhodiola.

Yeah. And what was the third one you mentioned? Holy basil. Yeah, I don't think they have that in their stack. Not— oh, not yet. Nice job. Yeah. So do we need to be careful with the brands that we are choosing for ashwagandha or rhodiola?

100%.

Yeah. Yeah. Meaning, meaning that if you go get something off the shelf, you're not sure what you're getting, right?

Because things— supplements aren't regulated for the most part, and Unfortunately, people gravitate to the less expensive one, and most of the time those have fillers and flow agents, maybe some metals and stuff in it. So that's why— I mean, I'm not plugging Momentous, but I am plugging Momentous because I love them. Oh yeah, because they're super clean and very careful what goes in their stuff. So when you're reading the label, you know that it's there and they're third-party tested.

NSF for Sport. Yeah. Meaning what's on the label is inside the bottle. Yeah.

Yeah. And that's really important when you're looking at the supplement industry coming from high performance world where like you can't buy anything off the shelf. You have to have something that's NSF or certified for sport. I'm like, everybody should have that opportunity. Like you shouldn't just go buy something off the shelf.

Full stop. I can't even begin to have a conversation about supplements with anybody without it being NSF because they're mostly elite athletes or whatever. It's the standard. It's the standard. So can you take too much ashwagandha? And maybe explain what ashwagandha does and rhodiola. Yeah, can you explain how they work and why they're important for sleep?

Yeah, so if we're looking at adaptogens, and that's ashwagandha, rhodiola for the most part that we're talking about, they are plant compounds that come from plants that are stressed. So we see they're in high deserts, they're in really extreme conditions, so they have to adapt. To those kinds of stressors. So these plant compounds come from these, this naturally derived adaptation that the plant has. So they come into your body and they read the stress, so to speak, in your body. And it's like, oh, there's lots of cortisol, but that doesn't necessarily need to hit all the receptors. So we're going to go blunt some of these receptors so you don't have as strong a response. So with ashwagandha, it's really good at helping with that. And with rhodiola, it can work two ways. It can either bring you up and make you focus, or if you are just on the cusp of like needing to wind down, it'll help you wind down.

It's amazing. I know. Both of those are amazing. Yeah. Ashwagandha for me, like, just takes this edge off.

Now, can you take too much? You can. So I go to the lowest effective dose. Don't go the pharmaceutical route or the Western route of more is better. Because it's not. Is it 150?

What is the milligram? I can't remember.

So for ashwagandha, it's 400 total in a day.

400 total in a day? Yeah. And do you split it? I do.

You do? Yeah. Yeah. Okay. Afternoon, you start to get that high stress from everything that's going on, and you also start to lose energy. I use ashwagandha to level me out.

And you'll take 200? Yeah. Yeah. Yeah. At that point.

Yeah. And I also use shashandra. I don't know this. So this one does the opposite. It really brings you focus. So it, it works on some of your serotonin receptors as well. So instead of having kind of a flattening, it just makes you focus.

All right, um, fantastic. So, uh, let's keep going. So what are some ways to work with hot flashes?

Yeah, so we see that you do want a cool room, definitely a cool room, um, and One of the things that we found using environmental stress— this was a study that I did with one of the top complementary alternative medicine researchers from Colombia. She came over, she's best friends with my mentor at Stanford, and she was really interested. She's the one who told me about adaptogens, and we did some research on adaptogens, but also she wanted to understand what were hot flashes. So we put women in a heat chamber and we were able to kind of mark what, what the onset of a hot flash was and be able to quantify it through skin temperature and internal temperature. So we quantified it, and then we had them do controlled hyperthermia. So that means small amounts of time in the sauna to bring their temperature up. They would have massive hot flashes in the sauna, but then over the course of 5 or 6 exposures, it became less and less severe. And when they got out, they didn't have as many or as severe. So if we're talking about the temperature control of the hypothalamus and the way that we start to have a misstep in the way that our estrogen, progesterone are not in the brain anymore, the hypothalamus is like, what's going on? Do I need to vasodilate? Do I need to constrict? I don't know. So when you are increasing the blood temperature that goes through the brain, the hypothalamus gets hypersensitized to that heat. And then it starts to understand that's what hot means. So when you get out into a natural environment, you don't have as much of that perturbation of the hypothalamus.

So it works. What is the difference between men and women when it comes to saunas?

So heat exposure is interesting because in the reproductive years for women who are naturally cycling, they have a change in their core temperature on a monthly basis. When progesterone comes up, it increases the core temperature and the body naturally shifts its onset of sweat the way it feels hot. So you have a new baseline. So when we start looking at heat exposure, there are sex differences, not hormone differences, but actual sex differences that happen. So women will vasodilate first. So that means that the blood comes to the surface and the blood vessels open up and you're trying to offload heat first. Then they will start to sweat. Men sweat first. So they are losing body water pretty quickly in a hot environment. And that is a sex difference that's not driven by hormones per se. So when we're talking about heat exposure, women will get into the hot environment and they'll feel hot and then they'll start sweating and they'll feel cool again. Where men will start sweating and they'll start building up the heat and their tolerance isn't as great when we're talking about sitting in a sauna itself. When we're out racing, there's a little bit of a disconnect. Women will do better in a humid environment because they vasodilate and then sweat. So there's a little bit of a nuance of being in real life versus in the sauna. So we look at the benefits of heat exposure for both sexes. We see that it increases what we call heat shock protein responses. So that is So when you are in a hot environment and you start to have cell breakage, then the heat shock proteins will come in and fix that. It's just kind of like autophagy, but it's a heat-induced response. We see better cardiovascular responses. So that means if you're in a hot environment, your body's going to adapt by increasing the amount of blood that it has, red cells, the water it has, the way your heart is efficient at pumping. We also see that it will prolong training stress. So if you go into a sauna after training, it's a stress that keeps your heart rate up and all the adaptations that come with it. And we see that there are the temperature regulation responses. So if we are having a lot of hot flashes, then it helps with the hypothalamus because your brain gets really hot from the hot blood. And it also helps if you are going to a hot environment, then you're training for something to race in the heat, or say you're living in the Southern Hemisphere and it's July, which is the middle of winter, and you go to Texas and you're like, oh my gosh, it's so hot. But if you do some sauna exposure, you get to Texas, you're not that hot.

Okay, so what do, what do most people get wrong about being great as a healthy perimenopausal slash menopausal woman? Like, what do most people get wrong?

Following trends, because there's so much information out there because it's tends to be the new buzzword right now. Menopause, perimenopause, everyone's out to sell you something. And every woman's lived experience is different. So what I've gone through would be different from what my sister went through, even though we're genetically linked. And that's different from what my mom went through. Everything is individual, and I don't think that's being communicated. So how do we have a chance?

Because, yeah, yeah, because we don't have We don't have the same discernment and scientific acumen that you do. So how do we, how do we have a chance to get something right if we need to be completely bespoke, which we are? Yeah, right.

So, so I always tell women, look, the things that will really budge the needle for you with overall health and increasing healthspan, because that's where my focus now is, because we see sex differences in that the last part of the life, right, where women live longer and have poor health across it. And part of it is things like Alzheimer's and autoimmune diseases. One of the biggest ways that we can attenuate or slow the rate of those risk factors that start in perimenopause is through exercise. So if we're looking at exercise, people look at it as, oh, I don't want to do that, but it's embracing the ability to take control. Where it's not about going to a gym 90 minutes every day or going out for 10K run or slogging yourself. It's about being efficient in your movement and being very conscious that you are doing it. If you're going to get up early and do some training, then you are an athlete. And that's what I tell women. I want you to have an athletic mentality because you're doing this for you to benefit your health. So you want to have a plan. A lot of women don't have a plan. They get up and they're like, I should be doing something. So they're going to go out for a walk, but they don't really know why they're doing it. They just know that they're supposed to be doing something. So we look at exercise, it's a stress to the body, and we want to invoke a really strong stress so the body adapts the way it should without hormones. Because if we look at something like strength training, and we have all this information right now about how the brain changes because it's estrogen-starved, and we're starting to see brain fog and changes in the amygdala. We don't have long-term research to show if that's temporary, because we see that there is a new baseline post-perimenopause. So what are we doing if we're looking at some of the inherent changes that happen from muscle and a brain standpoint? We know the very first thing that happens in perimenopause is women will lose strength and power. So this is—

Is it that order or is it power first as you mentioned?

We see power first. Power first? And with that comes strength and then we see a drop in lean mass. Okay. So part of that is the way that our contractile proteins work. So we see myosin and actin are two major proteins. Myosin grabs onto actin, pulls it towards it, and that's how you have a muscle contraction, which is stimulated by a nerve. We have different things called isoforms. So there's different forms of that protein of myosin. We see a change in that, in the active form of myosin to an isoform that isn't as strong to grab onto actin. And that is part of some of the estrogen or lack of estrogen changes. The way that we can make that step up is nerve conduction. So if we are looking at lifting a heavier load, that's going to create a central nervous system response where the nerve impulse comes down and goes, oh, wait a second. We need all of these muscle fibers to work synergistically to grab each other so that we have a really strong muscle contraction to lift this load. So now we're not relying on estrogen to drive myosin. We are relying on a nerve factor. Mm. Not only that, because it is a nerve factor, we see in some new randomized controlled trials that come out that women who lift heavier loads have a change to the prefrontal cortex, and that's what we need to attenuate cognitive decline, because there's this massive sex difference in cognition and cognitive decline when we're seeing women and men in their 60s, 70s, 80s.

Is it, um, a fair kind of ramp to say the way you do your 40s is a good predictor for how your 50s might go? The way you do your 50s is a pretty good predictor how your 60s might go? Yeah. Okay. And when you say put on lifting heavy weights or a load, are we talking about half your body weight being able to, you know, what, how much load? Yeah. How much load are we talking about?

It's a journey to be able to lift heavy. So if no one is— if women who are listening to this or their partners are listening to this and trying to encourage their female friends or partners to lift, if you've never done any kind of resistance training, then I want you to have the eye to a year from now, you're going to be lifting heavy loads. Heavy loads means that you are doing 3 to 5 reps at 80% or more of your one rep max, which means that you're lifting at an 8 on a scale of 1 to 10. You might be able to eke out 2 more repetitions at really, really good form, and that is the optimal. But the journey to get there is also really important. So if you've never done any kind of strength training or resistance training, and there's a difference, Resistance training is just a push-pull. So that might be your air squats, it might be push-ups against the wall. You're using your body weight to create a resistance. Pilates. Pilates is good for isometric control, balance, proprioception. Not resistance. It is a little bit of resistance, but it's not strength. Not strength. Okay, so when we talk about strength, this is adding more load to the body, and it is being very conscious that you're trying to create that neuromuscular response. Okay. The way that I like to describe it is if we're looking at being able to do 50 push-ups and working our way to be doing 50 push-ups, are you going to be stronger? You're going to have more muscle endurance, you're going to have a little bit more neural connection. But if you're going to train to do 10 push-ups with a 20-kilo weight on your back you're going to be strong, you're going to be endurant, and you're going to have lots of neuromuscular changes to be able to push that extra 20 kilos in a proper form push-up.

Does it matter to you if we're talking about moving kind of the bottom half of your body, squats for the most part, or upper body where you're doing push-ups or pull-ups, or it doesn't matter to you? It's the signal to the nervous system and to the brain to say, oh, we need to be strong, we need to recruit, and we need to be, um, alive in this experience. Yep.

I do find compound lifting, which is your squats, your deadlifts, your bench press, your push-pull overhead, um, activates more of our stabilizer muscles. So the weaker muscles also get into the playing field of resistance training.

This is a slippery slope here. I'm wondering how you're navigating it, because I think you've done it very clearly you've said think about a year from now. The reason I'm saying slippery slope maybe isn't the right language. Let me talk out loud here for a minute, because to get somebody to lift safely heavy weights, there is a real sophistication to be able to do that and to be able to repeat it, say, in 3 to 5 days. Right. Because you and I could go, I don't know, save Grandma. We could go lift a car, maybe that, that idea. And then we're crushed and we probably couldn't replicate it because all of the stress, you know, that was going into that survival mechanism. But to do it purposely on a daily basis, would you recommend? Not daily, no. 5 days a week, 3 days a week of—

We see 1 day is minimum, minimum to maintain.

2 is— Are we talking about lifting heavy weights or strength training?

Just resistance training in general.

Resistance in general, okay.

And 3 is to actually make gains. Okay, so 3 times a week, and it doesn't have to be a lot. I think that's the other misconception where people think that they have to go do every body part and they're using all these different machines and supersetting, and it becomes really complex. It doesn't have to be like that. You can have a really effective resistance training session in 20 minutes. Yeah, where you do some mobilization, you focus on one really good compound movement, uh, could be squats, could be lunges. So you're doing a knee hinge You know, so you're just focusing. So what I mean when people need to have a plan where what is your focus, how much time do you have, and what is the goal of this session to also match the goal of the month. What does that mean?

The goal of the month?

So when we're talking about resistance training, we have to be very consistent and we also have to look at adding load, which is periodization. And I like people to think, what am I doing now so that at the end of the month I can do X, Y, Z, and the end of 2 months I can do this, this, this, this. So we start by saying, okay, resistance training for women who've never done it before. I've been saying a lot of this, or this a lot this year. I want you to have 3 10-minute wellness meetings with yourself first thing in the morning. So we know that we can't cancel meetings. We're just indoctrinated not to cancel meetings. So it's something on your calendar you cannot cancel. For the first week, I want you just to get up and use that time just for you. So you might have a cup of coffee looking out the window and you're going, okay, I see that tree and it's waving. It's saying hello, good morning, whatever it is. So you take one really positive thing from that first 10 minutes and you take that with you all day. So if you get to a stress point, then you can bring yourself back to it. The second week, I want you to add some air squats or maybe some wall pushups or something else that's a little bit of movement that's gonna start becoming that habit 3 times a week. And that's how you start your journey. Great. And then you might have a friend who wants to join. You can get an app and work together. You can meet to go do a circuit outside, or maybe you go together to a smaller, more boutique gym that's more focused on helping women develop in the whole strength training journey.

There's lots of different options. How do you adjust the narrative, which is like, oh, but I don't want to look bulky. I— if I'm— you're asking me to lift heavy weights, that's what weightlifters do, and I want to fit in my jeans. I want to, you know, like, I don't want to have all of the muscularity that— and there's some, I don't know, wild image of like, I don't know, Hulk Hogan, you know, type of thing. Yeah. Right. So how do you address that or address that?

Women have to work incredibly hard to get bulky. You might have a genetic predisposition for putting on muscle, but it doesn't mean that you can do it easily. And if you want to get super bulky, then you have to really work at it. You have to be consistent in the gym 4 or 5 times a week, doing hardly any cardiovascular work, eating a lot, a lot of protein, timed it, making sure that you're getting meals all the time. Because if we look at some of the top CrossFit athletes that are relatively, quote, bulky, they work really hard to get that muscle.

Just across, when we think about that physique, in CrossFit, or take, take the name out, I don't, doesn't matter if it's CrossFit, but that type of training at the competitive level, are they measured? Are they tested? Yep, they are now. Yeah. So this is a natural competition, right? So you can look like that and be that athletic naturally. Yes. Yeah. So there's a real sophistication to be able to have that type of transformation, right? And what you're suggesting is like, look, start a journey, wherever you are on your path, non-negotiable is like 3 times— non-negotiable is 1, ideal is 3. And then we slot in cardio at the off days.

So cardio is interesting because we see that the mindset of like zone 2 and long, slow stuff, it's not appropriate for women.

So a long walk where zone 2 is like when you can, you can have a conversation while you're walking. You got a little bit of a of a proper marathon. Yeah, yeah. But, you know, zone 3 is like you're going a little bit faster than normally, like, you know, it's not a race pace by any means, but like it's a little harder to walk, to talk and walk, right? So you're saying zone 2, and you're saying that's not good for women.

So there's, there's two ways to explain this. First, when we look at the zones, the zones are based on certain tests that have been done in the lab to differentiate what a low impact or low stress on the body is versus a super high stress. When we're testing women and men in the lab, we know that women can work at a greater percentage of their VO2 max or the maximum and still maintain aerobic steady state. What I mean by that is they might work at 88% of their VO2 max and still be able to, like, be pretty good in tempo. Men can't do that. They fatigue a lot faster at that higher, so they have to actually work. Because when we look at the sex differences, we have differences in, um, the muscle morphology. So that means that women have more endurance-type fibers, so less fast, fast-twitch fibers. And with that comes more mitochondria density, so that means we have more mitochondria in there. We also have more proteins within the mitochondria which allow women to use free fatty acids better. And there's a switch across the menstrual cycle because of estrogen, progesterone's effect on fueling. So across the menstrual cycle, women are very metabolically flexible. So we talk about zone 2— one, it's arbitrary. There's no real hard and fast research behind zone 2 because it's not a really strong stimulus to invoke mitochondrial change. So we start talking about zone 2, it's great for recovery and it's great for like getting out there, but for actually inducing metabolic change and mitochondrial change for women, just doesn't hold up to the research.

Finding Mastery is brought to you by our flagship mindset training course, Finding Your Best. Anytime you feel the pull to reset, to zoom out, to refocus and ask, am I moving toward the person I want to become? It helps to remember this: lasting change comes from training, not resolutions, not short-term sprints, but deliberate practice of the skills that shape how we show up in work, in relationships, and in the moments of great intensity as well. That's what Finding Your Best is all about. It's a science-backed framework for training your mind. It's the same set of tools that we've taught to Olympic athletes, top executives, elite military teams, and artists at the peak of their craft. In this course, you'll learn the foundational psychological skills to be your very best. Full stop. And the best part is you can start any time. Right now, we're running a limited time offer on Finding Your Best. Simply head to findingmastery.com/course and use the code RENEW100 to get $100 off your registration. If you've been waiting for the right moment, this is a good one now to lean into. Spring and summer, they are powerful seasons of momentum. It's a great natural time to step into growth, to refocus, to recommit to who you want to become. And this discount will not be around for long. So go to findingmastery.com/course. Code RENEW100 for $100 off today because your future is not shaped by what you intend. It's shaped by what you train. Finding Mastery is brought to you by Fatty15. Okay, let's talk about longevity. Longevity is much more than simply adding years. It's about maintaining health and a zest and a vitality and enhanced performance as you age. And that's why I'm excited about Fatty15. It's an award-winning supplement. It's powered by C15, which is the first essential fatty acid discovered in over 90 years. Okay, so C15, it's a geroprotector. What that means is it helps to slow biological aging by strengthening your cells, basically protecting them from damage. You can think of it like kind of like a 401 for your health where you're investing in cellular, quote unquote, resilience. And I dug into the research on the relationship between C15 and heart health. I love what I saw. Fatty15 is on a mission to optimize your C15 levels to help you live healthier, longer. Get 15% off your 90-day subscription starter kit by heading to fatty15.com/findingmastery and use the code Finding Mastery at checkout. That's Fatty, F-A-T-T-Y, 15.com/findingmastery. Start investing in your long-term health today. I love this. Yeah, this is, so you would support more of a high interval training, you know, whether it's HIIT or SIT or REHIIT or maybe open up some of those and maybe take it a step further is like, why? Why is that beneficial? Yeah, so again, I'm talking about optimal, right?

So any movement is good. So if you're like, I just have the capacity of going for a walk, Great. But in your walk, I want you to pick up the pace just a couple of times. Maybe do the old school Fartlek training where you're going light post to light post and then cruising, just to be able to implement a little bit more intensity.

Is that like a jog, a sprint, or just like a walk, a faster walk? Mm-hmm. Okay.

And if you feel like jogging, go for it. It's whatever brings up that intensity. Because optimally, we wanna see women doing true high-intensity interval training a couple of times a week. In that is also what we call sprint interval training. So we talk about sprint interval training that's 30 seconds or less, as hard as you possibly can go with 2 to 3 minutes recovery between our 20 to 30 seconds.

Which is different than Tabata training, correct? Right. So you're having equal time on to equal time off? No, 20 to 30 seconds, full gas, 2 to 3 minutes. 2 to 3 minutes. Mm-hmm. Okay. So, high sprint, long recovery.

Yes, 2 to 3 minutes. And this is so that your whole body can recover to be able to hit that intensity again.

Yeah. And that, um, full gas, this is like 85% to full max, or you say 110%, go all the way, all the way, let it rip.

And most people are like, oh, I could do 4 or 5 of those. After 2, they're like, oh my God.

That's right. Yeah. You also need to be thoughtful about when you are ready to sprint.

Yeah, it doesn't necessarily mean running sprints. You could be on a bike, you could be on a bike, you could be on a rower, you could use kettlebells, you could use battle ropes. Okay, you could do sled push. It's the intent of the intensity that we're talking about with that long recovery.

And it— this is beneficial for women, also beneficial for men, but you're saying specifically this is better for women?

Yeah, it works for men too, but for women, because we have this incredible increase in visceral fat. And that's what causes what they say the minnow pot is, so that accumulation of belly fat. Because there's a disconnect between— because estrogen is anti-inflammatory. So when we start losing estrogen, we have more inflammatory responses, and the liver is perceiving that as, oh, these free fatty acids, they need to be stored somewhere else. So instead of having free fatty acids there's feedback from the liver to make— to change the form of it to esterified fatty acids and stored as visceral fat. If we have that really high, high intensity, it creates what we call myokines, which are feedback responses from the muscle which also feed to the liver and say, no, no, we don't need you to change those free fatty acids because we need those free fatty acids at rest. So it causes an epigenetic response over time to stop storing visceral fat and to help degrade or downplay the amount of visceral fat that you have.

Love this. And so this is, um, one day a week, 3 days a week. One day, 5 days is too much. Way too much. Yeah. So no more than 3, twice.

So when we talk about the sprint interval, that super high intensity, you could do one of those a week, and then you also have a little bit less intense called high-intensity interval training.

So this is like at 85% max?

Yeah. Yeah. But you have to be specific with those intervals too. It's not like going to an F45 class or, 'cause we've all been so conditioned to get out of one of those classes feeling super smashed and sweaty, but it actually puts you in that zone 3, which doesn't do anything.

For men and women or just women? For men and women. Zone 3? Yeah. Yeah, which is, zone 3 is like, It's hard. It's not overwhelming. It's hard, but for an extended period of time. Right.

And so it's too hard to be easy to create adaptations at an easier level, but it's too easy to be hard to cause the adaptations we're trying to get from exercise. We call that the junk zone. It is the junk zone.

The junk zone. The junk mile. Are you familiar with TBS, toilet bowl syndrome? No. Yeah, it's a funny phrase. I don't know if it's local here or whatever, but if you haven't been training long for a while and you're deconditioned and you go hit it hard and then you get TBS, toilet bowl syndrome, like it's, you're so full of brain kinase and lactic acid that you can't, like, you can't sit down and get back up. Like, way too sore, you blew it, you know. That, so you want to avoid that.

You want to avoid that.

Yeah. So you're really being super thoughtful about start where you are and intentionally increase the intensity. In a way that's reasonable. Correct. Yeah. And what is a good resource that you found other than a local coach? What's a good resource that you point to for folks to be coached?

So there's some really good apps out there for women who are just starting their journey and trying to understand exercise and movement. Betty Rocker is really good because it's all at home, might use a kettlebell or two, a lot of bodyweight stuff, getting you into the habit. She has some great programs. Then when you're ready to step it up and you want to work with a friend or a partner, or you want to go to a gym and you want to know what to do but you don't have the funds or want to hire a personal trainer, then you can look at Haley Babcock's Haley Happens Fitness. She does some collabs with Wanda Wright, which is a learn to lift. You can do that at home or in a gym. She also has a series of power programs that starts very beginner into very Advanced, and it has the lifting and the specific sprint and HIIT stuff in there.

Same with nutrition. What's a, what's a resource that you trust that's important?

Uh, for nutrition, that's a hard one because there's so many things out there. Um, I probably would lean into a lot of the lifestyle medicine groups that are at the universities because they're really, really understanding what Mediterranean diet is, how to improve gut microbiome. I really do love the Zoe Project and the Zoe podcast out of the UK. So Tim Spector. Oh, I know. Yeah, Zoe. Yeah, yeah, yeah, yeah, yeah. Great resource.

Yeah, he was phenomenal. He was on the podcast. He was great. Yeah, yeah. Zoe, Z-O-E. Yeah, yeah. And it's his gut biome product as well. So yeah, yeah, yeah. Okay, fantastic.

And even, I mean, just going to their website to read everything that they have is really good.

Yeah. Okay. Yeah. Is there a difference between gut biome between men and women? That's up for debate, actually.

We see there is a little bit of a sex difference, but it's very influenced by environment. And then when you start having the sex hormone changes in perimenopausal women, that's when you really start to see a sex difference in the gut microbiome, even if you're living in the same place.

Let's talk about hormones for just a moment, replacement therapy. You've done a nice— you introduced me to the idea of from hormone replacement therapy to menopause hormone therapy. Yeah. And so I think somewhere early I swallowed the idea. This was like, I don't know, 20 years ago, 30 years ago when I learned it. And unfortunately, my wife thought that it was best practice to avoid or not use hormones because of the, the risk for cancer. And so can you speak to the best, the most current, the most sound research around hormones and therapy.

Yeah, I want to give some context to the Women's Health Initiative, which is the big study that came out in the States that scared everyone off. I worked on that dataset at Stanford. My mentor was one of the PIs, so I understand that study and how it was misrepresented. So that study was initially designed to see if women who are well past menopause would benefit from using hormones, and they did not.

And that's what— that's what we missed, that slight nuance.

That nuance was not played up in— yeah, the press. Although at the very same time, there was a study going on in the UK called the Million Women's Study, and they were looking specifically at perimenopausal women and gave them exogenous hormones, and they benefited. So now you have this discrepancy in the conversations where people Commonwealth So that's New Zealand, Canada, UK, other places in Europe. They're very pro-menopause hormone therapy. Everyone should be on it for all these benefits. And then you have people in the States, they're like, oh, Women's Health Initiative causes cancer, all sorts of scary things. But then there's new research coming out. So if we can tease out those two groups and say, let's look at the research as it is now, we know for sure that the new formulations are relatively safe. There are nuances where you have to talk to your physician about your own risk factors for it. But we have transdermal, which is your gels and your patches. We have vaginal cream for estrogen. We have progesterone that is micronized, and it's an, it's an oral or a transdermal. So we want to look for micronized because this is more what they call body identical or bioidentical. But the caveat there is is because you are bringing in externally, either through the skin or you're ingesting it, it doesn't hit the receptors the same as your endogenous or natural production. And that's the part that also is not in the conversation. We talk about target tissue. So we see that when we are using exogenous hormones— so those are the— our external hormones— that the receptors don't get activated the same as the pulse from our ovarian hormones, because when you whack a whole bunch on at once, it is a flurry.

It floods it, yeah. And then it drops off. This is a little bit like, let's say, cocaine and serotonin. Yes. Right, like you just flood it, and so there's a great feeling, but then there's a, this is not how it's supposed to work. I got too much in the system and there's problems from that. Right. Yeah, and it's kind of the same thing.

Yeah, so we see from the, from when we're tracking hormone and bioavailability, like with a patch where people are told they have to change it every 2 to 2.5 days, it's because you have this massive uptick and then it starts to drop off. And if you don't change the patch, then you get to this significant lull and you have side effects and issues. Yeah. So this is the conversation that isn't being had. We do see from Lisa Mosconi's work that she has a massive grant to look at the brain during perimenopause. And initially she saw that when women are doing fMRI, so functional MRI for the brain, the, uh, the estrogen receptors lit up like, I need estrogen, I need estrogen. That was perceived in the media as the brain needs estrogen all the time, so everyone should be on menopause hormone therapy, not as this is a natural thing, the body is using what estrogen it has, and there's going to be a time where these estrogen receptors kind of wind down. We don't have the longitudinal research yet. We also don't have lots of randomized controlled trials to show, is it beneficial for dementia or not? So we don't have those studies. Cardiovascular stuff, we don't have all the longitudinal data. So right now, when we're looking at the robust data, we know that it's very effective for helping with bone health. If you have a risk factor or low bone density, yes, menopause hormone therapy is one of the ways to go to prevent osteoporosis. If you are looking for mood and anxiety, yes, it is definitely a fantastic tool in the toolbox. Hot flashes, not so much. We see that it can be beneficial, but also using something like a serotonin reuptake inhibitor with cognitive behavior therapy is really effective because it's a serotonin response in the brain that is triggering the hypothalamus. So if we're dampening the serotonin receptors or using the mechanism of a reuptake inhibitor, it helps with hot flashes. With traditional therapy? Yes, with traditional therapy. And I get backlash all the time because people think, oh, you're anti-hormone therapy. I'm like, I'm not anti-hormone therapy. What I'm anti is everyone needing to be on it because they're— it's a tool in the toolbox. It's very, very effective, but not everyone can be on it. Not everyone needs to be on it. But the rhetoric is that everyone should be on it. I'm waiting for the longitudinal research to show definitively that you need to be on it for brain health. Because if we think that this whole population before us, like my mom, she didn't have access to it and she doesn't have dementia, she's fine. Like, you see this whole population of women that didn't have access to hormones, and it's not just this previous population, but all the way back. So that begs the, the question of the story that you brought up earlier about testosterone, is do we really need to put women on a dose of hormones that they stay on for life, or do we use it just to help with the symptomology as their body finds its new state?

Is there benefits to starting earlier?

There is some benefit, like Yeah, there is.

Can you talk about that?

Yeah, so we see women with the APOE4 gene, which is a risk factor for Alzheimer's, the earlier they start, the greater the risk reduction is. So that's the only research we have with regards to dementia and Alzheimer's, is because it's a genetic factor.

And that is supplementing with estradiol?

Estradiol, yeah.

Estradiol? Yeah. And so E2? As it would be called. And you can get that test done, it's relatively easy. I probably— my wife and I have been testing that for years. Like, it's on a lot of basic panels. Okay, that's good to know.

And then bone density too. Say it again?

Bone density as well.

But what it's not useful for, and there have been studies that come out and has shown this, is for weight management. So people think, oh, I'm not going to get the body composition change if I'm on menopause hormone therapy.

So, and the opposite of that is I'm perimenopausal or I'm in menopause, I put on some weight, I should take hormone replacement therapy. And you're saying that's not the reason to do it?

Correct. You need to put in the lifestyle interventions to lift heavy weights.

Yeah. Do some sprinting. Eat well. Eat properly. Sleep like you are, you know, world-class lion that sleeps around most of the day if you possibly can. Yeah. Okay. Is the research accurate that there's like this 10-year window for hormones? And then what do— so what do we do when we're 62 years old?

Yeah, so we don't want to start it 10 years after menopause because we have all the data that shows that your body's gone through this wind-down process and our receptor is not very open to using exogenous hormones. It is an individual thing. So if you are 8 years, you could still have a conversation. Why do you need it? What are some of the symptoms? Some women have hot flashes for the rest of their lives, so they would benefit using it.

Oh, so there is not a 10-year window.

That's— That's been disproven.

That is disproven. So if you started, let's say, for whatever reasons, you start at 50 years old and you are taking a patch of estrogen with some progesterone is usually how it goes, I think. And you get to be 60 and things are good. Like, you're like, okay, look, I'm— I've got my lifestyles in place, nutrition, sleep, fitness. I like the way I'm thinking about aging. I'm interested in X, Y, and Z in life. I feel generally healthy. Do you stop, or do you— like, how do you know when that window, um, the benefits of that window have, have closed?

Right now we're just going on anecdotal research because we don't have the long-term studies.

That's why you say long-term studies. You want— and part of the long-term studies is knowing when does the efficacy start to fade away? Mm-hmm. Okay.

Because you'll have a lot of women right now are like, they're going to pry hormones out of my cold, dead hands. It's like—

Because it's been working really well. Because it's been working.

Yeah. But this is even people who are physicians in that space. It's like, that's a little bit irresponsible because we don't have the research to show on these existing formulations, what are some of the long-term effects or how long should we be on it? So now it's an individual choice. So if you're that 60-year-old woman and you're feeling great, you could start, going, should I be on it? Should I not? Do I want a chance to get off it? What should I do? So you could have that conversation. You could look to taper down. You could taper down the dose and see how that makes you feel, or you just completely go off it. But you do have to be careful when you completely go off it, 'cause then it's just like no hormones at all.

So there's a, you would want to titrate down. Yes. You would wanna like ease into that transition. Exactly.

Okay. Just like if you're using a serotonin reuptake inhibitor, you don't stop immediately.

100%. Right. Where are you on peptides?

GLP-1 peptides or the BC157s? All of them.

All of them. I am like— Everywhere. I'm trying to understand them because it feels like this new world is emerging. It is. And there's complexities. There's like these really wild benefits that seem to be happening. That's right. There's— we don't know long term and it's uncontrolled, it's unregulated. And so like, where are you? You're cautiously observant or you are actively engaging in research?

Like, so if we look at the peptides that are being promoted for longevity and health, so you're seeing the TB-500s, the BPC-157s, all those named, like letter-named ones. I'm waiting for the research. But the caveat is I did try it because I had a really significant knee injury and everyone's like, you got to get on the peptides, you got to get on the peptides. I'm like, well, I can't get them in New Zealand. So I was on a trip and I tried it and I didn't feel like it did anything. And then retrospectively, it's like, what were you doing? You don't know what you were injecting in yourself. There's no research behind it. But in the moment, I was so devastated by a torn hamstring and a messed up meniscus and not being able to walk. I was like desperate. So I can see how it's gotten such— like, I'm a scientist and I normally am very pragmatic about things. I want to see the research. I want to know where it's coming from. But in the moment of that, that, oh my gosh, what is going on? I'm completely injured. Everyone's telling me these things work. I tried it. But when I start really looking at it, I can see how it's gotten such gravitas in the media where you have small claims where the n might be super small. 5 men, a lot of rodent studies, and there's some efficacy. Maybe not, we look on a molecular structure, why would a gastric juice help? Like, why would a gastric peptide help? Because in the body, if gastric juice escapes, it's an acid that can cause a lot of harm. So the body has a protective mechanism, which is the BPC-157. But we don't actually know if it works outside of that specific environment. So that's the research that needs to be done. So in the whole realm of things right now, it's marketing is stronger than science. Except for the GLP-1s.

Yeah, there's a lot of research there. They're coming on their third, third class.

Yeah.

And those are looking really promising and interesting. Yeah. Okay.

Used for the right reason. Yes. Used for the right reason. Yes. Not Grammy microdosing.

And that's right. Yeah. Okay. What are the things that are absolutely still baffling you that you, you just wish that you could communicate with all sincerity and great potency that you just wish people would get this thing right. What are the things that are most important to you?

Maintaining independence for everyone, men and women. And how do we do that? By being able to be functional in our bodies. So we now are in an environment where we don't move. I had someone ask me once, just a few weeks ago, why is it that you're saying that we need to do the strength training and this high-intensity work and do all this stuff? Stuff when people 50 years ago didn't and they're fine. I was like, well, 50 years ago life was completely different. We didn't have garage door openers, we didn't have Netflix, we didn't have jobs in front of a computer that made us sit. We had jobs where we had to get up and move around and we had to go like press the fax button or something like that, you know. So there were things that allowed us to move incidentally more throughout the day, but now we see people are sitting all day. There's this massive episode of young kids not getting their peak bone density because they are not moving. And if you don't get to your peak bone density, then as you age, you're going to have more of a risk factor for osteoporosis. We see a decrease in muscle mass as well because they're not moving, so there's a higher incidence of sarcopenia. So it's like, how are we going to maintain independence and not be a drain on healthcare, which which in itself is a nightmare to navigate, to be able to be autonomous and be able to live our lives in a productive way through movement. And so all this idea about exercise being a chore, I look at it as it's independence. And we want people to be muscle-focused, muscle-centric, because what do you have to gain when you're focusing on maintaining muscle? You have the opportunity to gain confidence, to gain autonomy, to gain independence, to gain health, to gain cognition. What do you stand to gain if you're focused on weight loss? Aesthetics, maybe, maybe not. Maybe, maybe not, yeah. Maybe you get better cardio metabolic factors, but exercise does that. We know that exercise helps with cardiovascular and metabolic risk factors. We know that muscle is a massive, glucose sink. So people were having issues with blood glucose control. We have them go for a walk after dinner to use their muscle to be able to pull glucose in without insulin. Is that a good—

is that a good zone 2?

Yeah, it doesn't even have to be long. It could be 10 minutes. Yeah, it's a best practice in our family.

Like, after we eat, we'll just get up and kind of go for a quick walk. Yeah, walk the dog or whatever. But it's like, it just feels like it keeps the whole system Exactly. You know, advanced if you are advancing. Yeah. Okay. So I was gonna say, and the other bee in my bonnet is AI. It's a bee in your bonnet.

Why is that? Because if you look at the existing AI that's out there, it's an echo chamber of male data. So if we think about the way that the parameters are set and the human touch, it's still viewed through that male lens. And we think about the outliers, as we talked about at the start, there's not a lot of research and robust research in women's health in general. And so those become the nuances and the outliers. So what's being read is this echo chamber, right? So the outcomes that are coming out for women, still not appropriate. We see an incident with Open Evidence a few months ago where it was telling women that no one should be on menopause hormone therapy because it causes cancer. It's been disproven. They're just pulling on old research. We see things like our wearables, right? And we see heart rate variability. For men, it's fine. It's actually following that physiology. But for women, we have a beat-to-beat difference. It's a sex difference. We also see there's a change in heart rate variability over the menstrual cycle. As soon as you have progesterone that comes up, your heart rate variability goes down, and wearables will read that as you're getting sick, you're highly stressed, you're not recovered.

How ought women be able to use some of the monitoring data, the wearables, for heart rate variability? Finding Mastery is brought to you by AG1. Summer is here, at least for those of us in the Northern Hemisphere. You can just feel it though. Days are longer, pace picks up, and there's this sense of momentum that comes with the season. For me, that also means more travel. It's more early mornings, more late nights, and it's just really a schedule that isn't consistent as I'd like it to be. That's exactly when having a simple, reliable daily foundation, it matters. AG1 has been that foundation for me for over a decade now. One scoop in a glass of cold water in the morning, and I know I'm supporting my gut health, full stop, filling the nutrient gaps that are hard to cover through food alone. And what ends up happening is I'm giving my body what it needs to keep showing up, and that really matters to me. What I love about AG1 is that it doesn't ask a lot of me. It's one habit, one scoop, and it travels Easily. The AG1 travel packs are something I genuinely rely on this time of the year. I throw a few in my bag before a trip and the routine stays intact wherever I am. If you haven't tried AG1 yet or you've been planning to think about getting back into it, now's a great time to start. Visit drinkag1.com/findingmastery to get an AG1 flavor sampler and a bottle of vitamin D3 plus K2 free in your welcome kit with your first AG1 subscription.. It's a $72 value. Again, that's drinkag1.com/findingmastery. I want to take a second here to tell you about a morning routine that I've been using for years. For me, it's a great way to switch on my mind, to ready myself to take on the day. So before I check my phone, my emails, market updates, or text threads, I choose how to start my morning. That's always in my control. That's always in your control too. This is the same morning mindset routine that some of the world's top performers across sport, business, and the arts are using. And the best part, it only takes about 90 seconds to do. So just head over to findingmastery.com/morning to download the audio guide for free. Again, head to findingmastery.com/morning to get your morning mindset routine.

Trends over time. What does that mean? So you have to look at, at across the month what's happening. And so you can compare month to month so that you can see, oh, well, if you're regularly cycling, you can see where you're in your follicular phase, where you might have ovulated, where your progesterone came up. You're going to see that it's normal to have disrupted sleep. It's normal to have an elevation in your core temperature. How does that affect you, though, is the question. And we know that if you are having poor sleep, it's because progesterone has increased your core temperature. So maybe we look at doing some cooling mechanisms before sleep so that you can get into a deep restful sleep.

If we knew what you knew, how would we be better partners to women?

Let's call it spouses. Yeah. So I've talked to my husband about that 'cause he's behind the scenes. So he's heard everything and has learned a lot. And he said that one of the biggest things is listening. And not trying to fix, because whenever you try to fix, that's when things go wrong, because it's a different lived experience for a man versus a woman. And I even find that with my 13-year-old daughter. I used to be like, let's fix this. You're— and then I'm like, wait a second. No, because now I'm, I'm trying to be her lived experience where if she vents, then I listen. And then later she'll circle around and say, can you help me with this? That's the same with partners and spouses. It's like, don't try to fix in the moment. Just listen, be supportive, know that you are there for her. Or if you're a woman with your male partner, you're there for him. And then later it'll circle around to be a fix. Because I think we have this— we need to immediately do something right away instead of going, this is what's happening. This is a lived experience. It's a little bit different than how you were a couple of months ago.

Let's figure out why. If we knew what you knew How would we be a better coach to— and I'm thinking athletics or sport— to a young athlete, to a, call it like the college-aged, maybe pro athlete, and then the advanced, you know, like 40, 30, 40-year-old that's really also on the world stage. Like, how would we coach differently? And I don't know if you'd bifurcate those three. In any way? I would. You would?

I would, especially when we're looking at our young teenage athletes. Unfortunately, the default again is the little boy, or the coaching like we would coach boys. But puberty is a massive differentiator. We see biomechanical changes in girls. We have our hips are widening, our center of gravity drops, um, our shoulder, shoulder girdle widens to accommodate for the wider hips. Body composition changes. We have poor core strength and elongation of our peripherals, our arms and our legs. And you see that with girls who used to be very confident in the sport and running around, and all of a sudden they feel very ungangly and they don't want to participate in sport. Um, so if they are in a sport and they're being coached the same way that boys are, one, they turn off because the way that we coach girls isn't to pit them one against each other. Like we do with boys, for example, soccer and corner kicks, go, go, go, go, girls are like, uh-uh. But if you have 3 girls and no one's singled out, it works. We talk about warmup. We want to warm up the posterior chain and really work on cutting motions in girls to prevent ACL injury.

There's an overwhelming ACL issue for young girls.

12-year-olds having surgery. And we know that it's because it's poor postural posterior chain strength. So that's your glutes and your hamstrings. Girls tend to be more quad dominant. They haven't been taught how to run again with the new mechanics, how to land, how to do cutting motions. So we have to look at the functionality. How are we coaching our girls for their sport with regards to function? So we do function and functional drills, then we're adding in the speed and everything. We had to bring it right back to make sure that their bodies are resilient enough to withstand the training. Where boys don't have that biomechanical change. So you can keep loading and loading and loading. The functionality can also be in the weight room. I'm not saying girls shouldn't go in the weight room. Of course they should. At what age? Any age, really. It's about adding load effectively and not— used to be, oh, you don't want to weightlift because you'll damage the epiphyseal plates and stop growth. That's not true.

No, it's not. It's clear. And that's for men and women, for men and boys and girls.

Yeah, exactly. It's is creating a very positive environment that's not gendered, because gender is very real when you're talking about a gym space, right? So you have to make it a non-toxic environment, and you can do that through the coaching mechanisms, like how are you fostering a positive environment and leaning into the way a girl interacts in her environment versus the way a boy interacts in her environment. So I think if the coaching practices at that base level were different then the rest of it would be easier too.

There you go. And would you coach an elite male athlete and an elite female athlete fundamentally differently? Or are they at the elite level, the 0.05, like the true kind of tip of the spear, are they more similar in your mind? Yeah, they are. The reason I asked you that is I answered the question just like that at an ESPNW conference. I was like, well, what did I just step into? Yeah. You know, so the question— I was on the panel and the question was, the elite level, how do you train differently? And I said, actually, they're more similar than dissimilar. They're more alike, male, female, than the other 99%. And I said, there's some obvious differences, but they are more similar than dissimilar. And it was like, I— maybe I shouldn't have said it.

I don't know. Target on your back now.

It was like this, but this is like I don't know, 12 years ago. And I'm having— I still from that, like, I have a hard time understanding how I'm off there. So hearing you say it, I go, okay, that's interesting. Like, what does that mean to you?

So it means that you're not looking at the gender, you're looking at the individual. Yeah, right. So if we're looking at the top of the top, like you have the women's Tour de France rider and the men Tour de France rider, and they're both on the same team, just women's team, men's team, would you train them differently? A little bit. You have to look at recovery, you have to look at training stress score, you have to look at intensities, and you dial that in knowing that women can work at a higher threshold of their VO2 for a longer period of time. So you would change thresholds for them, but the actual threshold workout, how much time you're spending, wouldn't necessarily be different. It's just looking at the individual. Menstrual cycle come into play? Yeah, absolutely. Are you changing the training according to menstrual cycle? Maybe not, because at that elite level, they're dialed into how they feel. So they can say, you know what, on this day I feel awful, but I'm going to have to race on that day, so let's look at some interventions to help level the playing field. They're more in tune to their body. Yeah. So when you get to the lower tiers, they've lost that, or they haven't learned it yet.

They haven't figured that piece out. Yeah. Yeah. Yeah, and then so how would you coach the, um, the NCAA or pro that's in their 20s, you know, in that age, right?

Yeah, so this would be taking into account hormone profile. Are they on oral contraceptive or not? Are they naturally cycling? PCOS, endometriosis, all of that has an effect.

Yeah, there's a, there's a difference there for sure.

Yeah, so you're looking at mood, you're looking at injury rate, you're looking at attrition. Like, are they showing up? What kind of training status are they putting in? There was a study that I found really fascinating where they blinded menstrual cycle status to the coaches and they, athletes knew of course, but didn't tell anyone. And the coaches were asked to rate the performance in that training session for 3 months. And then they matched it up. And the, when the rowers, had an RPE of lower than 5, the coaches didn't know that, and rated themselves as not doing very well because of menstrual cycle-related symptoms, it matched up with what the coaches saw. So there is something there about following menstrual cycle and listening and understanding that it does have an effect. From a molecular level, yeah, we know, but when we're talking about the whole body, there's so many other factors. But actually listening and knowing your pattern is so important. So being able to explain that to someone who's in their 20s, why it's important to track your hormone profile, not so that we can keep tabs on you, but so we know when we can push you and when to pull back. But also, if you have to be on, on the day that you don't feel so great, we have all these tools in the toolbox that we have practiced well, that we've practiced well in advance to level that playing field.

Yeah, very cool. Yeah. How, how do you think male coaches can become better? Where do they go to study and learn? So if they happen to be coaching a female athlete, like where's a good resource to invest in that? Obviously read your books, take your courses. And first point to, please point to the best resource for that.

Yeah, so what I'm finding is that the younger the coach, the more these conversations are happening. So menstrual cycle isn't taboo so much and they're able to talk to their athletes. Athletes, even like high school coaches and stuff, because it becomes a conversation amongst the girls. So the very first resource is in yourself, not being afraid, because it's out there. If we start looking at other coaching resources, we're seeing more and more coming in through the IOC. They have different diplomas for sport and sport coaching for the female athlete. The Australian, um, used to be the Australian Sports Institute of Sport, which has kind of been filtered, but you can still go to the website and they have some really good stuff about coaching the female athlete as well. And then just listening to your athletes, that's gonna guide you too.

It was a cool, I don't know if the trend is still vibrant, but when I first learned about it, it was a handful of years ago, the red dot. Have you, like the, I was like, oh, that is so good. Yeah. Just, and the red dot or the red sticker, I'm not sure exactly what it's called, but it was with some athletes I was working. And I said, what is that? And they said, oh, I'm just— I'm in my menstruation cycle. And so like, I was like, oh, cool. Like, like it's— it was almost a very cool flip badge of honor. Like, that's right. Yeah. You know, and I'm, and I'm absolutely, you know, killing it. Like, I'm great. So it was very cool. Yeah. Is that still happening on a regular basis? I don't know.

We're seeing more people use it as like Whenever you show up to practice, your coach is like, how is everyone doing today? Anyone injured? Anyone highly stressed? You know, trying to do the wellness check. And some of the questions are, anyone on their period? Anyone having, you know, menstrual cycle symptoms? It's becoming part of the health check. There you go. Which is really cool.

That's great. Yeah, good. All right, listen, you are a wealth of knowledge. I, I am super grateful to have your science and your your astute explanation of complicated science in simple ways in the world. It's helped me a lot. And this is a real gift to be able to have you here. So thank you for being here and thank you for like helping me be just a little bit better in my approach.

Thanks for having me. I appreciate it.

It's been great. And what's the, what's the best resource for folks, for you?

If you go to our website, thedrstacysimmons.com, you can sign up for our newsletter and we send it out every 2 weeks. Has a little bit snippets of science that's been translated. Also, you can see all the stuff I'm doing.

Yeah.

And, um, when's the next book? Uh, manuscript is due in September. Yes, you are writing. Oh, fantastic.

You're writing 2 right now?

Celine and I are writing one that is longevity for active women because exercise creates epigenetic changes, right? Great. And one for the puberty set.

Exactly what we were just talking about.

Right. Yeah, that's great. I was really— so this is kind of a sad— not a sad— a side tangent, but working with a group in Australia that's equivalent to Sephora in the States. It's called Mecca, and they have a nonprofit called Empower. It's about empowering girls and women throughout everything. We partnered to get all of the Next Gen curricula about coaching girls Through Puberty into all of the Australian and New Zealand curricula. So that launched on the 1st of April. Well done. I'm very excited.

When do we get it in the States?

I know we need— what, it's not a nationalized program here is the problem. That's right. You can go state to state, have to rally to get state to state.

Geez. Or, or if there is a, an organization, a corporation that is, that wants to fund Yeah. And I guess you'd have to take it through this. You still have to go through the state, though, through the school system or. Yeah. Yeah. Listen, awesome. Thank you for making a dent. It's great to meet you. And thank you for the research that you're bringing to the table.

You're welcome. Thanks. Next time on Finding Mastery, we're joined by Ross Zabo, one of the leading voices in youth mental health education, wellness director at Geffen Academy at UCLA, founder of the Human Power Project and author of Behind Happy Faces and a kids' book about anxiety. How many young people look like they're doing just fine while quietly struggling beneath the surface? Ross shares why parents often miss the signs, why schools need to teach mental health the same way they teach physical health, and how we can give kids the skills to navigate life before they reach a crisis point. Join us for this crucial conversation on Wednesday, July 22nd at 9 AM Pacific. Only on Finding Mastery.

All right, thank you so much for diving into another episode of Finding Mastery with us. Our team loves creating this podcast and sharing these conversations with you. We really appreciate you being part of this community, and if you're enjoying the show, the easiest no-cost way to support is to hit the subscribe or follow button wherever you're listening. Also, if you haven't already, please consider dropping us a review on Apple or Spotify. We are incredibly grateful for the support and feedback. If you're looking for even more insights, we have a newsletter we send out every Wednesday. Punch over to findingmastery.com/newsletter to sign up. The show wouldn't be possible without our sponsors, and we take our recommendations seriously, and the team is very thoughtful about making sure we love and endorse every product you hear on the show. If you want to check out any of our about in this episode, you can find those deals at findingmastery.com/sponsors. And remember, no one does it alone. The door here at Finding Mastery is always open to those looking to explore the edges and the reaches of their potential so that they can help others do the same. So join our community, share your favorite episode with a friend, and let us know how we can continue to show up for you. Lastly, As a quick reminder, information in this podcast and from any material on the Finding Mastery website and social channels is for information purposes only. If you're looking for meaningful support, which we all need, one of the best things you can do is to talk to a licensed professional. So seek assistance from your healthcare providers. Again, a sincere thank you for listening. Until next episode, be well, think well, keep exploring.

Come on.