All protocols

Choose upper/lower, total body, or another split based on what works for your life and available time, while allowing adequate rest.

For younger women, the key emphasis is working to failure to drive lean mass growth with strength.

Some literature supports emphasizing unilateral movements in older adults, not just bilateral simultaneous movements.

In mid-40s to early 50s, emphasize heavy lifting plus very easy recovery work and true high-intensity intervals, rather than spending lots of time in moderate intensity or making zone 2 the main optimization strategy.

Avoid making OrangeTheory-, F45-, SoulCycle-, or similar moderate-intensity classes the main strategy in women 40+; they are criticized for keeping women in moderate intensity, raising cortisol, and not delivering the desired high-intensity stimulus.

Long easy zone 2 work is framed as fine for mental health, nature exposure, and recovery, but not the main route for optimal health/body composition in older women.

For beginners intimidated by gyms, start with bodyweight movements at home such as lunges and squats while learning foot and knee positioning.

Use a backpack loaded with cans to add resistance for home training.

Use mobility work, such as Kelly Starrett's approach, to find movement sticking points before progressing.

Recommended as an accessible entry point before learning compound movements.

Take time to adjust seat height and machine settings to get the correct range of motion rather than just sitting down and lifting.

Use lighter dumbbell patterns such as thrusters or hang cleans to learn movement, momentum, and coordination.

Walking is framed as the very low-intensity recovery side of polarized training; if doing something long, keep it very easy.

Example polarized session: 20 minutes of heavy lower-body lifting followed by 30-second all-out sprint intervals with full recovery as needed between efforts.

Track your cycle to identify personal patterns in performance, recovery, and symptoms.

From day 1 of bleeding through ovulation, women generally have greater capacity for stress and may use this phase for PR attempts, heavier loads, and high-intensity work.

In the luteal phase, roughly the week before the next period, increase protein intake because tissue-building demands are higher.

In the luteal phase, roughly the week before the next period, increase carbohydrate intake to help hit intensities and offset higher heart rate and stress.

If you wake up feeling awful, start the workout and reassess after 10 minutes. If you still cannot hit intensities or feel horrible, switch the session to recovery-oriented work.

Prioritize fueling in and around the exercise stressor itself, including high-intensity and resistance training, to protect recovery and menstrual function. This applies even when appetite is low around ovulation. If pursuing fat loss while training hard, keep any deficit slight and away from training, around 150 to 200 calories at night.

If ferritin is low or low-normal, consider supplementing rather than waiting for overt deficiency. In active women, ferritin around 20 to 25 may be called normal, but the target discussed is closer to 50. If concerned about low ferritin, take an iron supplement every other day starting on the first day of bleeding for 10 days to improve absorption.

If only one blood draw is possible in the cycle, do it 5 to 7 days before the next period starts to capture mid-luteal estrogen/progesterone and inflammatory status.

If adding a second blood draw, do it on the second day of bleeding to assess baseline estrogen.

Adaptogenic plant used for focus and brain fog; Dr. Sims puts it in morning coffee and again in the afternoon instead of more caffeine. Described as regulating dopamine, serotonin, and cortisol.

After resistance training and before entering the sauna, drink about 8 to 16 ounces of water with a little salt.

If the sauna is very hot, move to a lower bench or the floor, and consider covering your head with a towel to protect from heat and make breathing more comfortable.

Pre-high-intensity stack: 200 mg caffeine, low-dose baby aspirin, and beta-alanine; used to enhance top-end training stress. She cautions not to stack high-intensity days back-to-back when using it.

Avoid doing two consecutive days of high-intensity work because it is a significant stress on the body.

If insomnia is significant in perimenopause or menopause, consider working with a sleep specialist.

Suggested adaptogen option; holy basil and tulsi refer to the same herb.