Women need different types of exercise from men and, particularly as they age, resistance training is key, says Niki Bezzant in this edited extract from her latest book.

Exercise physiologist Stacy Sims has spent her
career studying female exercisers, and the differences between men and women when it comes to sport and movement. She’s been vocal in highlighting the fact that women, as she puts it, are not small men.

Sims describes midlife couples doing the same fitness boot camps or F45 classes: the man will get stronger and fitter and more sculpted, while the woman gets frustrated because the same thing isn’t happening for her; instead, she’s just getting exhausted and racking up injuries.

New Zealand-based trainer Tracy ­Minnoch-Nuku describes her own experience in similar terms. She used to be, she says, “the cardio queen”. But as she hit perimenopause, she started to find her recovery slower and her body hurting more.

She sees it in the women she trains, too, and it affects their relationships with fitness. “I see lots of women who have continued to train at the gym or go to classes or do Zumba,” says Minnoch-Nuku.

“And then they slow down because they’re hurting. So then they leave the gym because they don’t see a programme that speaks to them, or all they’re left with is a [high-intensity] workout and that’s hurting.

“And they’re not recovering so they can go back the next day. They’re told: you’ve gotta do it every day. So they go to a yoga studio or a Pilates studio. Now, there’s lots of things about that that are really awesome, but they’ve left out the fundamental space or experience that they need for their body for health in midlife.”

What she’s referring to is the fact it’s emerging that women need different types of exercise from men, and we also need different exercise as we age. And we’re going to be better off focusing on quality, not quantity. Women have very different things going on in our bodies, at every stage of life – and of course that’s in large part due to our hormones. Oestrogen has a role to play in this story. As we know, we have oestrogen receptors in our muscles, and as we age and the hormone declines, the signals to those receptors get weaker. It means we tend to lose muscle mass quite dramatically. That’s on top of the normal muscle loss that happens with ageing in all people. In women, the decline is more dramatic.

Sims explains what she and her fellow researchers have discovered: there’s a particularly big change in body composition in the three to four years leading up to menopause. “That’s when that massive amount of change happens, where we see a significant decrease in lean mass and an increase in fat mass. Then a few years after menopause itself – so, early post-menopause – things start to kind of level out.

Sims and colleagues also found that as we age, we tend to develop a negative nitrogen balance, meaning we’re losing more than we’re taking in. Nitrogen is used by the body to make amino acids, the building blocks of protein (which is used to make muscle), so we can end up not processing the protein we consume as well as we need to, to create lean mass.

This can lead to changes in body composition, a loss of strength, and potentially weight gain, particularly in the abdominal area.

Central obesity

Midsection fat (or visceral fat, which is deep inside the abdomen, hanging out around our organs) is really not great for our health. So-called abdominal obesity – which can happen in people of any weight – is one of a number of risk factors that together with high blood pressure, low HDL (”good”) cholesterol and insulin resistance are known as metabolic syndrome. Together, these can lead to a higher risk of stroke, heart disease and type 2 diabetes.

Changes in the levels of oestrogen and progesterone, explains Sims, “signals the body, ‘Hey wait, we’re in a weird state. We need to start conserving fat.’ And it’s primarily in the middle, in that abdominal area. So when we start to lose oestrogen, our body really needs an external stimulus to create a stress that’s going to take the place of oestrogen.”

The muscle stimulus that our bodies need will come from resistance training. And here’s where it’s a case of going heavy. Sims recommends focusing on shorter workouts with heavier weights. No mucking around: we need to, in her words, lift heavy shit. “The heavier the loads, the better,” she says.

Sims explains how this works: “We have better crosstalk from the muscle to the fat cells when we’re lifting heavier loads. Then the fat cells are like, ‘Oh, you don’t need me. Okay. I don’t have to store as much, especially if it’s visceral fat.’”

That sounds hard! I don’t care if I can’t lift heavy shit!

Fair enough – me neither, really. I’m never going to film a reel of me deadlifting a massive barbell. But I do care – and you probably do, too – about being able to get up off the floor easily. Or being able to get into and out of cars or boats or baths. Or being able to carry the groceries inside … Our parents’ and grandparents’ generations were not big on strength training, and we see that coming back now, in the form of falls and frailty.

It doesn’t matter if you can’t lift a 100-kilo barbell. But it might matter to you that you’re able to live independently in your 80s and 90s. And that’s why it’s really good to get into the habit of strength training now.

Also: heavy is relative. What’s heavy to you might not be heavy to someone else – but who cares? The point is, it’s hard to do for you. So ignore the Instagram lifters, and choose weights that are challenging – but still safe – for you.

If you’re just starting out, that might not be any weights at all; it might simply be your body weight. That will still challenge your muscles if they haven’t been challenged in a while.

Brainpower in strength

There’s more. Strength work is not only good for the muscles – it’s also good for the bones, heart and brain. Fascinating evidence is emerging of the protective effect of strength training on the brain. It appears that there’s a link between muscular strength and cognitive function, and that resistance training has positive effects on brain health, possibly reducing some of the markers for dementia.

It’s also known that strength training is great for building bone; it not only helps support the bones with strong muscles, but also actually stimulates bone to build and regenerate. And recent studies specifically looking at the effect of strength training on heart health have found exciting things: regular strength training lowered the risk of high blood pressure by 32% and decreased the chance of developing metabolic syndrome. In a 2019 study, researchers found that lifting weights for less than an hour a week could reduce the risk for heart attack or stroke by 40-70%.

Strength training is also a mood booster. Minnoch-Nuku is a testament to this. “As I’m squatting – using a pretty reasonable weight, I’m doing eight to 10 reps and I’m struggling at that last rep – as I’m doing it, my head space is like, this is so good for me … It’s such an empowering kind of space to be in. Now I feel like I’m going to be that 60-year-old kick-ass woman. I feel that emotion and joy coming into my life again, you know. And that’s through my strength training.”

The Everything Guide: Hormones, health and happiness in menopause, midlife and beyond, by Niki Bezzant (Penguin Random House, $45), is out now. To read more about why “dumping the diet” is advised, go here.