Recovery Capacity in Menopause: 4 Studies Revealing Why Rest Isn’t Enough
13 Feb 2026 · 18 min
Debra Atkinson examines four studies on how menopause affects recovery from exercise. Well-trained postmenopausal women recovered from muscle damage like younger women did. Estrogen amplified muscle growth in a 12-week resistance program. Sleep deprivation after hard exercise shifted inflammatory and hormonal responses, suggesting recovery quality matters more than rest alone.
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Hey, welcome back. Whether you're an OG— that means old goat, like greatest of all time, by the way. Somebody asked behind the scenes, what is OG? You, if you've been here for a moment or two, thank you for that. And if you are brand new joining us for the first time, this is for you too. We are zooming out from cycle phase, meaning if you're having— still having a period on a regular basis, or you're in post-menopause, or Late perimenopause and irregularly cycling. We have talked about that in the last episode. If you didn't hear it, you may wanna go listen to it, but stay with me right now. We're zooming out from cycle phase talk to the bigger framework, which is pre versus peri versus post-menopause, and using the standard staging system researchers use to define the transition. and then we unpack what the research says about recovery capacity. Because as you heard in the last episode, if you've listened to that last solo episode about your hormonal stage and intensity, and if the two are really tightly woven or not so much in terms of output, not feeling or perception, go and listen to that if you haven't. But today We really talk about something we opened up, which is recovery capacity. So we talk about it not necessarily changing your output performance, but it may be changing the way you feel. That's really recovery capacity somewhat. Recovery capacity in menopause, why does it matter? How do you know whether you're recovering? I had this question very recently on YouTube. So if you're not following there, that's another place to get just synopsis of input on certain topics. If you've been listening to those recent episodes, you know that I'm going to unpack today 4 science studies that are kind of an offshoot from last week that provide some insight into recovery across the menopause stages in trained and untrained individuals. So one thing that keeps coming to mind for me— well, 2, all right? Number 1 is being greedy and doing things just because we can. I was there. I was greedy in my probably 40s to 50s, 40s to 56, really greedy. A lot of endurance activity, always strength training with significant weight as well. So really, when you look at that, I thought this is great insurance. And I still think to some effect it, it's true. I was at least able to see I wasn't losing strength. I was getting bone density work and I was maintaining power, but I was also asking so much of my body at a time when we know, you know, we're in perimenopause. I wasn't having those roller coaster impacts, at least not until my mid-50s, but it was definitely happening. We can't deny that. But, you know, we are more likely, if we're greedy during a certain point in our life, we will find the threshold of return not only gets smaller, but we may actually be increasing or accelerating our aging. Not the desired effect. Can we agree on that? The number 2 thing I want to point out here is the importance of balancing stimulus and recovery. And I found with more recovery, I personally am exercising less, but it's counting more. It's giving me more results. I continually come back to that since 2013 at 49. So I wasn't— again, I wasn't having hot flashes and night sweats and, and some of the signs and symptoms that are so obvious and such a nuisance, right, for a lot of you who might be listening. But again, you know, it's— I had to remind myself I didn't have to do so much. I kept thinking with guilt almost, right? And I love to work out more and I wanted to, and I— but there is also a nagging voice in your head, I think, think, for me at least, that I should be doing more. Like, if I want to get really ahead of it and really increase my fitness level, I should do more. And I want you and I want me to put that down because your objective scores, your measures, are telling you how much lean muscle mass do you have, how well are you sleeping, what's your heart rate variability, what's your percent body fat. How do you feel at the end of a workday? Do you have energy left to do other things and play? All of that is giving you feedback about how well it's working. And sometimes we just need to put that guilt down and say, wow, you know, this is actually working pretty well. Why do I think I want more? Right? So let's break these 4 studies down. I'm gonna do this in really short order and please come to the show notes if you want more.
Here's a little secret. I love to work hard. I love to go hard exercise-wise. Love to lift hard.
Love to get the volume in. I love to get breathless and come back after a day of outdoor activity and play tired, good tired.
What I don't love is the way I feel the next day. I just don't bounce back quite as fast as I did.
My first wake-up call about this was after days on end of hiking and my knee wasn't as happy as it used to be. And that was a huge wake-up call. It was almost for a moment like, is this it? Turns out though, the secret to healing, recovery, and resilience isn't just luck or good genes. It's stem cells. These are your body's built-in repair crew. But as we age, the system slows down. Fewer cells, weaker signals, slower recovery. It's exactly why Qualia Stem Cell was created.
Your stem cells are powerful.
Make sure they stay that way with Qualia's innovative new stem cell formula. And here's what I love about it. You only need to take it 4 days a month, preserving your body's regenerative capacity over time with cumulative results. So if you too have ever felt like your body just doesn't bounce back or isn't keeping up in the first place like it used to, whether it's after a tough workout, after getting sick, or just the wear and tear of life, this is for you too. Qualia Stem Cell was designed to support your body's natural repair systems, helping you heal, recover, and keep going strong. And right now you can try it for up to 50% off at qualialife.com/flipping. And here's a bonus: use the code flipping for an additional 15% off your order. That's Q-U-A-L-I-A life qualia.com/flipping.
Your body's built to repair itself.
Qualia just helps you do it better. And a big thanks to Qualia for sponsoring this episode.
Study number 1, it's called Exercise-Induced Muscle Damage in Postmenopausal Well-Trained Women. I know you're out there, I know you're listening, you're probably walking, you're the ones doing the weight training right now, so good for you. So in this study from 2021, really fair fairly new. This was published in the Orthopedic Journal of Sports Medicine. Why does it matter? You know, it definitely tests the narrative that postmenopausal women can't recover from hard training. It's not true. Here's a protocol. They took resistance-trained women, had over a year of lifting. We call that in our Halo Method of assessing women and where they should be, what's ideal, what are their priorities— we call that experienced, right? Over 1 year consistently at least twice weekly strength training. They have them do an eccentric squat protocol, 10 times 10. So 10 sets of 10 repetitions with long eccentric contraction. Now, if you don't know about eccentric contractions, like when you're hiking downhill, you're running downhill, you're going downstairs. If you have bad knees, you know what I'm talking about, but it's harder on your muscle. As well. There will be more muscle damage, more fatigue, more soreness. Okay, compared it to eumenorrhoeic versus postmenopausal women who had a cycle to those who don't anymore, postmenopausal. Okay, so measured muscle damage biomarkers, performance and soreness. So that's going to be subjective Do you have soreness?
Yes.
All right, key findings: there's no significant difference between postmenopausal and premenopausal women in their creatine kinase. So why are we taking creatine, right? To help those markers. Myoglobin, LDH, inflammatory cytokines. So that, that is the inflammatory response after exercise. We want it, by the way, but if it's out of control, you're gonna feel that inflammation for days on end. That's not what we want. The counter movement jump performance, that means basically you're jumping and then immediately exploding and jumping again, decreased post-exercise in both groups and then recovered similarly. Muscle soreness increased similarly across groups. When postmenopausal women are trained, their muscle damage and recovery response to eccentric lifting looks basically the same as younger women.
We're not broken.
We certainly are not fragile. Are you kidding? Look behind you at all the things you've done in your life so far. I don't think so, right? Backwards and in heels is kind of my saying. So these were trained women. Does not mean recovery is identical in untrained, sleep-deprived, or highly stressed populations. That would probably change it. But know this, it's not based on your hormonal phase. Study number 2, transdermal estrogen plus resistance training in early postmenopause. So 2 years ago, 1 year ago, you hit menopause. Now you're doing resistance training and you use the patch. Okay, so this study was in 2021 as well. This is one of the cleanest random controlled studies that answers, does hormonal environment change how strongly you adapt to training. So they had early postmenopausal women previously untrained, so they weren't used to strength training.
Oh, I hope you gasped.
I did. 12 weeks, uh, supervised resistance training randomized to the estradiol patch versus placebo, right? Placebo, they don't know, do I have an effective one or don't I have an effective one? Neither group. And then identical training stimulus to both groups. Key findings: muscle mass increased more in the estrogen group versus placebo. Strength and functional performance improved in both groups. Estrogen did not magically create strength, but it augments the hypertrophy. Good to know. No serious adverse events related to training. So training worked for everybody, but estrogen changed how much muscle they built. Not whether they got stronger at all. So I want to make this clear because I've said this, I've quoted studies that say there is no discrimination, there are no non-responders. If you're not on HRT, if you are on HRT, you can strength train and you will gain strength. However, in this study it did show there was more hypertrophy. And you may think, I don't want hypertrophy, but I think you do. I will just argue for you, okay? And the reason is we want a little bit more muscle mass Because if we have more muscle mass, we have a higher metabolism and we feel more energetic and we want to go do things. And the more we move our muscle, the better our blood sugar regulation, the better our insulin sensitivity, the reduction in body fat storage and belly fat, and reduction of all diseases. That's a good thing. We want that. Sign me up. Study number 3. I want to come back just for one second. I want to talk about placebo effect for a moment. You know, it would be funny to really break that last study up even further into, okay, we have patch and placebo.
We tell the people who have the patch it's the patch.
We tell some of those people it's the placebo, but they have the patch on. Then we have placebo, we tell some of them Oh, that's the patch. And we tell the others, no, it's placebo. And then looking again. So based on a study done that I shared earlier by Aaliyah Crump, by earlier I mean previous podcast, it really goes to show how important placebo effect is because those studies showed that people who had placebo, thought it was the patch, did almost as well as those people who actually had the patch, knew they had the patch, right? In this example. So this study was not done, by the way, but previous studies have looked at things like that, and thinking that you'll get the same results may give you the same results. By the way, one thing I would find true among my clients is having the input of additional hormone therapy through estradiol, progesterone as well, or testosterone gives you an edge in reducing symptoms that make it easier for you to comply. And I would say across the board, I've noticed that mostly in others, somewhat in myself. I, I've always been committed to it and able to do it, but for a while I, I wasn't a morning person all of a sudden. So moving in the morning didn't sound good. And that's like, that's what got me. I'm like, oh no, we need help because this is not my normal. And some of you have probably experienced that.
Here's a little secret. I love to work hard. I love to go hard exercise-wise. Love to lift hard.
Love to get the volume in. I love to get breathless and come back after a day of outdoor activity and play tired, good tired.
What I don't love is the way I feel the next day. I just don't bounce back quite as fast as I did.
My first wake-up call about this was after days on end of hiking and my knee wasn't as happy as it used to be. And that was a huge wake-up call. It was almost for a moment like, is this it? Turns out though, the secret to healing, recovery, and resilience isn't just luck or good genes. It's stem cells. These are your body's built-in repair crew. But as we age, the system slows down. Fewer cells, weaker signals, slower recovery. It's exactly why Qualia Stem Cell was created.
Your stem cells are powerful.
Make sure they stay that way with Qualia's innovative new stem cell formula. And here's what I love about it. You only need to take it 4 days a month, preserving your body's regenerative capacity over time with cumulative results. So if you too have ever felt like your body just doesn't bounce back or isn't keeping up in the first place like it used to, whether it's after a tough workout, after getting sick, or just the wear and tear of life, this is for you too. Qualia Stem Cell was designed to support your body's natural repair systems, helping you heal, recover, and keep going strong. And right now you can try it for up to 50% off at qualialife.com/flipping. And here's a bonus: use the code flipping for an additional 15% off your order. That's Q-U-A-L-I-A life qualia.com/flipping.
Your body's built to repair itself.
Qualia just helps you do it better. And a big thanks to Qualia for sponsoring this episode.
Study number 3, and we're going to get these last 2 in really short time. So if you want more, let me know you'd like to break things down further. HIIT in perimenopausal versus postmenopausal women. Now, recently I did study on this or a podcast And that was the last solo, but this is not this. This is from Jabor and it was published in 2021. This paper addresses intensity tolerance and adaptation, not steady-state fitness. It's not your moderate intensity. Perimenopausal and postmenopausal women were studied, 6-week HIIT program. These were very short intervals, like 6 seconds long, all-out cycling sprints and then recovery. And the objective Power output was tracked. Both peri- and postmenopausal women improved in their performance. There was zero evidence that postmenopausal women failed to tolerate it or adapt to HIIT. Improvements occurred despite hormonal differences. So again, this is really an argument for— there's no discrimination, there are no non-responders. Now, if you're sleep deprived, that could change things dramatically, but it's just hormonal phase alone does not. High-intensity training wasn't too much for postmenopausal women. They adapted like perimenopausal women. And I would argue high-intensity interval training or sprint training is more important postmenopausal when we need to fight the loss of fast twitch muscle fiber. We need to fight the loss of muscle, period. And we don't want a lot more cardio in order to break down muscle. We want to avoid that. We want to build up. So the population in this study was obese, previously untrained, so we do need to take that into consideration. So the bottom line, recovery capacity does not automatically collapse after menopause. In fact, if you stabilize, it actually may get better. Your hormones are not on a roller coaster. You kind of know the ride, you know where you're going. Menopause loss doesn't remove your ability to train hard. It changes the cost structure, and that's a very different conversation. Last study, really quickly, sleep and recovery study. So this is about sleep deprivation and post-exercise muscle recovery from 2020. So this is why most human studies explore how sleep loss changes your biology after exercise, not just how tired you feel, but how the inflammatory and hormonal recovery response shifts, which matters when we're talking about recovery capacity across life, or most importantly, hormonal stages. So the protocol participants did a— or completed about of this eccentric exercise that's like downhill, designed to create muscle damage on purpose. And they were tested under two conditions, normal sleep and total sleep deprivation after the same exercise. Researchers measured muscle strength recovery, circulating damage and inflammation markers, and hormonal responses like cortisol, namely because we know that's going to change, but also IGF-1, that's kind of a growth factor. It was designed meaning participants served as their own control under sleep versus sleep deprivation. So that's called within subject. Here's the findings. Muscle strength recovery, voluntary contraction, was not significantly delayed by total sleep deprivation. However, inflammatory and hormonal responses were altered after sleep loss. IL-6, that's a pro-inflammatory cytokine, probably reminiscent for you of discussions during the pandemic. Because it's not only an inflammatory response in times of exercise, but in illness it was higher, more inflammation after exercise in sleep deprivation. Cortisol, cortisol-testosterone ratio were elevated during deprivation, not ideal. And IGF-1 tended to be affected in ways consistent with more catabolic, that means breaking down, the protocol. We don't want that. So what this means, sleep loss doesn't always show up as you're going to be weaker the next day. So we're not trying to prove don't exercise because it's— you're going to be terrible at it. You might not. And some of you who are just like, I'll do it, you'll get great results, but you might actually not reap the benefit, and the rewards may not be there, the ones that you want. So it's going to impair coordination, power output, and endurance, no matter what. So you want to be careful. It's not your day to do agility if you're sleep deprived. Chronic partial night sleep, uh, restriction are associated with higher inflammation, disrupted anabolic-catabolic hormone balance, and weaker physiological recovery insights. These findings show that lack of sleep doesn't always simply reduce strength test numbers. You're going to get a great workout, maybe, But it could shift your recovery process, meaning you don't get the benefit from the exercise you did, and you may compromise your immune system, compromising down the road the results that you really want. So in a nutshell, we really need to pay a little bit more attention to recovery. Sleeping is crucial. Time between workouts is crucial. Nutrition is crucial. Any of those can impede your workout. But here's the other one: emotional stressors also count. In the show notes today for this little shorty, you will find the references for the science. If you want more, you can go a little deeper. If you liked this episode, you like the breakdowns of science that we're doing a little bit more of, please let us know. Comment. Behind the scenes, you can DM me on Instagram. Let me know you like it. Let me know you're looking for a certain topic and something you don't really have an answer to, and we'll go digging. For it and find it, and most importantly, interpret it so that it's science that you can use in your practical application in your workout or your exercise today. What are you waiting for? Let's start flipping 50 today.
