Must read: “Next Level” by Dr. Stacy Sims

I’ve been promising some book “reviews” or recaps, but I keep prioritizing reading over writing! Spare time is in short supply, and the unread-or-partially-read book pile is embarrassingly tall. But I’ll tell you about a couple of good ones in this post and the next.

First up is Next Level: Your Guide to Kicking Ass, Feeling Great, and Crushing Goals Through Menopause and Beyond, by Dr. Stacy Sims and Selene Yeager. I’ve heard Stacy Sims on several podcasts this year (I linked to this one from the Run to the Top podcast in my last post), and I learn something from every sentence she utters. I expected the book to be the same, and it does not disappoint. These pages are packed with useful information, written in an engaging and totally comprehensible style. You don’t need a PhD in endocrinology or physiology to grasp what’s going on in your body – thanks to Sims and Yeager.

Part 1 explains the physiological causes and effects of menopause, and Part 2 tells readers how to offset or manage the symptoms and effects while staying active and strong. As the authors point out, society has long been telling post-menopausal women (especially athletic ones) to slow down and dial back workout intensity, to accommodate the physical changes. But as Sims says in the book and in interviews I’ve heard, this will just make women slower, heavier, and weaker. Next Level teaches active menopausal and post-menopausal women how to jazz up their metabolism and offset the “inevitable” muscle loss that occurs with age. The two biggest keys are High Intensity Sprint Interval Training (SIT) and lifting heavy weights (or put more colorfully, in the words of the authors, “lifting heavy sh*t”).

Image borrowed from somewhere

Sprint Interval Training: Studies show that sprint interval training is a relatively quick route to increasing lean muscle mass and reducing fat. “When you do SIT, your body pumps out more human growth hormone (HGH), increases testosterone, decreases estrone (the less desirable form of estrogen produced by fat tissue), and counteracts cortisol. The result is a reduction of cortisol and lower stress levels overall. With less cortisol, you have less stimulus for putting on body fat. With more HGH and testosterone (both of which are anabolic, or muscle-making), you have an increased stimulus for putting on lean muscle. When you follow up that SIT session with some protein (see chapter 10 for nutrition advice), you’ll really maximize those body composition changes” (page 81-82). An example of a SIT session might be doing 8 seconds of all-out “sprint” (e.g., on a bicycle, treadmill, or rowing machine) followed by 12 seconds of slow, easy motion (rest) – for 20 minutes. Do this 2 or 3 times/week (the chapter includes other suggestions and schedules, as well). “The key to SIT is not overdoing it. High-intensity training is strong medicine” (83).

Image from PrimeWomen

Lift Heavy Sh*t: But lifting heavy weights is even more effective than SIT when it comes to transforming the menopausal and post-menopausal physique and metabolism. “If you do nothing else, do this: lift heavy sh*t!” (page 87). “There’s a tendency for women to lift lighter weights for high repetitions, like picking up five-pound dumbbells and lifting them 20 times. This is often called ‘body sculpting’ by trainers, who promise women that they can ‘tone up’ without ‘getting bulky muscles.’ This mindset needs to go because it’s misleading, misguided, and honestly not helpful for women whose sex hormones, lean muscle mass, and strength are on a precipitous decline. This type of lifting will build muscle endurance, but that’s not what you’re looking for at this stage of the game. You need muscle strength” (page 88). The authors explain that lifting heavy weights activates more muscle fibers and nerves, which strengthens neuromuscular connections and also signals the body that more energy is needed. It improves posture and stability, creates stronger bones, and even improves cardiovascular health – because the demands of lifting teach blood vessels to dilate and constrict more readily, leading to improved circulation. The book includes a number of warm-up routines and weight-lifting “circuits” (in the interview I linked to in my last post, Sims recommends an easy-to-remember workout formula: 3-5 sets of 3-5 reps of 3-5 exercises — e.g., squat, deadlift, bench press — with 3-5 minutes of rest between each set).

This mindset needs to go because it’s misleading, misguided, and honestly not helpful for women whose sex hormones, lean muscle mass, and strength are on a precipitous decline. (Body sculpting) will build muscle endurance, but that’s not what you’re looking for at this stage of the game. You need muscle strength…

The authors also discuss nutrition timing and the importance of matching caloric and nutrient intake to energy demands/expenditures, so as not to enter a “breakdown state” and further deplete lean muscle mass. They advise against intermittent fasting for female athletes in or around menopause, because it requires the athlete to work out in an energy-deficient state, leading to lean muscle breakdown (they also point out that much of the calorie restriction research cited over the years was done on men, with the assumption that the findings apply equally to women; but as Sims often says, “women are not small men”). “How you eat around (workouts) – the food you have on board when you start, the food you fuel yourself with during a session, and the food you put in afterward – directly affects how you recover and how you adapt” (page 175). “Eating proper recovery food within 30 minutes of a stressful exercise session pulls your body out of that breakdown state, lowers cortisol, and stimulates your body to start the repair process: pulling carbohydrate back into the liver and muscles and synthesizing that protein into strong, lean muscle tissue. That helps improve your blood sugar control and body composition” (page 176). Skipping a post-workout snack because you think it will help you burn fat actually has the opposite effect: “(The) body ends up in a highly stressed state, with high blood sugar, and is more apt to store body fat and slow down metabolism.” Remaining chapters deal with hydration, supplements, core strength and bone strength, the importance of sleep, and strategies for dealing with some of the symptoms of menopause during the transition. This book is absolutely PACKED with information for menopausal and post-menopausal women who want to remain (or become!) physically active and strong. I’ve been touting it to friends and family for weeks. In terms of bang for the buck, it’s the best $20 you’re going to spend for a long time.


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