Dr. Stacy Sims teaches us in her program Menopause 2.0

What happens to our hormones, body composition, strength, power and speed as we age??

Sex Hormones

• Estrogen
• Progesterone
• FSH
• LH

Around 5 years before we hit “menopause” we start to experience fluctuations in our hormones during “perimenopause”-as we prepare to be “un-fertile” or “reproductive”

How does ESTROGEN:  Estradiol or E2 impact our body as an athlete?

• The traditional way of training “LSD” for endurance athletes (zone 2) or hypertrophy work for strength athletes are not as effective for peri and post menopause
• We have to change how we train to improve bone, muscle and overall body composition as the “old” way we trained will not be as effective anymore

WHY doesn’t LSD or Zone Two Training work anymore for aging female endurance athletes?

1. Estrogen plays a role in preserving muscle quality and muscle mass 
2. Pre-menopause reproductive years – we have adequate estradiol E2
3. We have Estrone (E1) that can help out as well (adrenal glands)

What and where are our Estrogen receptors?

• Cell membrane of the muscle – estrogen can cross the membrane of the cell
• Estrogen Receptor 

CHATGPT:  Side Note Rabbit Hole

“Estrogen receptors are proteins located in cells that specifically bind to the hormone estrogen. Estrogen is a female sex hormone that plays a crucial role in various physiological processes, including the development and maintenance of female reproductive organs, regulation of the menstrual cycle, and bone density maintenance.

There are two main types of estrogen receptors, known as ERα (Estrogen Receptor Alpha) and ERβ (Estrogen Receptor Beta). These receptors are present in different tissues throughout the body, and they mediate the effects of estrogen when it binds to them.

The locations of estrogen receptors vary depending on the tissue or organ. Here are some common places where estrogen receptors can be found:

• Breast tissue: Estrogen receptors in the breast play a central role in breast development and function, as well as in breast cancer development.
• Uterus: Estrogen receptors in the uterus are involved in regulating the menstrual cycle, promoting uterine lining growth during the follicular phase, and preparing the uterus for potential pregnancy.
• Ovaries: Estrogen receptors in the ovaries are involved in regulating the growth and maturation of ovarian follicles, which are responsible for producing and releasing eggs during the menstrual cycle.
• Bone tissue: Estrogen receptors in bone tissue play a critical role in maintaining bone density and preventing bone loss. Estrogen helps to inhibit bone resorption and promote bone formation.
• Brain: Estrogen receptors in the brain are involved in various functions, including memory, mood regulation, and cognitive processes. They also play a role in controlling the release of other hormones, such as gonadotropin-releasing hormone (GnRH).
• Cardiovascular system: Estrogen receptors in blood vessels may influence vascular function and play a role in maintaining cardiovascular health.

These are just a few examples of the many places where estrogen receptors are found in the body.

The presence of estrogen receptors allows estrogen to exert its effects on various tissues and organs, contributing to the overall function and well-being of the female body.

What is the Estrogen Receptor ALPHA?

• Upregulate or down regulate, turn on or turn off = gene expression
• Estrogen up-gregulates signaling to these estrogen receptors 

Estrogen Receptors on the Muscle Fibers:

Estrogen receptors play a role in muscle physiology and function, although the exact mechanisms are complex and not yet fully understood. 

Here are some ways estrogen receptors may impact muscle:

• Muscle growth and repair: Estrogen receptors in muscle cells may contribute to muscle growth and repair. Estrogen can stimulate the synthesis of muscle proteins, leading to an increase in muscle mass. Additionally, estrogen may play a role in muscle regeneration and recovery after exercise-induced damage.
• Muscle strength: Estrogen receptors may influence muscle strength by modulating the contractile properties of muscle fibers. Some studies suggest that estrogen can enhance muscle contractility and force production.
• Fat distribution: Estrogen receptors are involved in regulating fat distribution in the body. In women, estrogen tends to promote a higher percentage of body fat compared to men. Fat tissue itself can also produce estrogen, creating a complex feedback loop between estrogen levels, adipose tissue, and muscle.
• Exercise response: Estrogen receptors may influence how the body responds to exercise. Some research indicates that estrogen can affect exercise performance and endurance, potentially impacting athletic abilities.
• Hormonal interactions: Estrogen receptors interact with other hormones, such as growth hormone and insulin-like growth factor (IGF-1), which are essential for muscle growth and repair. Estrogen may modulate the signaling pathways involved in muscle adaptation to exercise.
• Muscle inflammation: Estrogen receptors may be involved in regulating inflammation in muscle tissue. Estrogen has anti-inflammatory properties, which could help reduce exercise-induced muscle inflammation and promote faster recovery.

It’s important to note that the effects of estrogen on muscle are likely influenced by various factors, including the individual’s age, sex, hormonal status, and exercise regimen.

Moreover, the interplay between estrogen and other hormones, such as testosterone, can also impact muscle physiology.

Research in this area is ongoing, and further studies are needed to fully understand the intricate mechanisms through which estrogen receptors interact with muscle tissue. Additionally, the role of estrogen receptors in muscle health and exercise adaptation may have implications for athletic performance and rehabilitation strategies in both males and females.- CHAT GPT

Myosin Heavy Chain: how the muscle contract with actin and myosin

• Estrogen receptors are stimulated -> maintains integrity of myosin heavy chain = strong muscle contraction = myosin grabs onto actin = muscle contraction = preserve muscle quality 

Estrogen on our satellite cells (baseline cell triggers us to grow muscle)

• Estrogen impacts the receptors – build muscle and build lean mass plus mitochondria in our skeletal muscle
• We are better at handling oxidative stress (see below from CHATGPT)
• We are able to handle inflammation 
• Estrogen affects the muscle by being involved in muscle maintenance and preserving muscle quality – the quality of muscle contraction

CHATGPT:  Oxidative stress is a physiological condition that occurs when there is an imbalance between the production of reactive oxygen species (ROS) and the body’s ability to neutralize them with antioxidants. 

• ROS are highly reactive molecules containing oxygen that are generated as natural byproducts of cellular metabolism. In small amounts, ROS play essential roles in cell signaling and immune response. However, when their production surpasses the body’s ability to neutralize them, oxidative stress can occur.
• Excessive oxidative stress can lead to damage to various cellular components, including lipids, proteins, and DNA. 
• This damage can result in cellular dysfunction and is implicated in various diseases and aging processes. 
• Conditions associated with oxidative stress include cardiovascular diseases, neurodegenerative disorders, cancer, diabetes, and inflammatory conditions.

The role of estrogen in oxidative stress is complex and can have both pro-oxidant and antioxidant effects, depending on the context:

• Antioxidant effects: Estrogen has been shown to possess antioxidant properties. It can increase the production of endogenous antioxidants, such as superoxide dismutase (SOD), catalase, and glutathione peroxidase. These antioxidants help neutralize ROS and protect cells from oxidative damage.
• Anti-inflammatory effects: Estrogen can modulate the expression of various inflammatory mediators, which can indirectly impact oxidative stress. By reducing inflammation, estrogen can help lower oxidative stress levels.
• Pro-oxidant effects: In certain situations, estrogen can act as a pro-oxidant, promoting the generation of ROS. This effect may be context-dependent and could potentially contribute to oxidative stress in specific tissues or cellular environments.
• Hormonal influence: Estrogen can influence the activity of various enzymes and signaling pathways involved in ROS production and detoxification. The effects of estrogen on oxidative stress may vary depending on hormone levels, receptor expression, and the type of tissue or cell involved.

Estrogen’s effects on oxidative stress can be influenced by factors such as age, menopausal status, and overall hormonal balance. 

• For example, during menopause, estrogen levels decline, and this hormonal change may contribute to increased oxidative stress and associated health risks.
• It’s important to note that the role of estrogen in oxidative stress is an active area of research, and our understanding of its complexities continues to evolve. 
• Understanding the interplay between estrogen and oxidative stress is crucial for developing targeted therapies and interventions to mitigate oxidative stress-related diseases and conditions.- CHATGPT

How does Estrogen help stimulate muscle cells to grow?

• Stimulating muscles cells to grow
• Helping mitochondria maintain anti-oxidative levels
• Support anti-inflammation – as if we have TOO much inflammation and TOO much oxidation = breakdown (catabolic) or cell death (autophagy)
• Helps preserve muscle mass
• Regulates cell death by communicating within the mitochondria and satellite cells via activating the myosin chain (muscle contraction)

What are our Training Modifications as our E2 levels lower – to find solutions to lower our inflammation without depending on estradiol to help manage inflammation.

How do we lower TOTAL BODY INFLAMMATION as we age with lower levels of hormones?

• Hormonal cascade of events – signaling in the body with a down regulation of genes to have more of an anti-inflammatory response = increased total body inflammation = more risk of injuries and metabolic disturbances 
• More inflammation = more chance of losing lean body mass as the signals to the satellite cells are down regulated.

What are Satellite Cells?

• Satellite cells are a type of stem cell found in skeletal muscle tissue. They play a crucial role in muscle repair, regeneration, and hypertrophy (increase in muscle size). 
• When muscle tissue is damaged, satellite cells become activated and undergo a process of proliferation and differentiation, where they fuse with existing muscle fibers or with each other, leading to the repair and growth of muscle tissue.
• The signals that stimulate satellite cells to increase lean body mass (muscle hypertrophy) are primarily driven by mechanical tension and growth factors. 

Here’s how the Satellite Cells work:

• Mechanical tension: Mechanical tension is created in muscle fibers when they are subjected to resistance or load during activities like weightlifting or resistance training. 
• This mechanical tension activates satellite cells and triggers the muscle repair process.
• Repeated bouts of mechanical tension from resistance training lead to the cumulative activation and fusion of satellite cells, resulting in muscle growth and increased lean body mass.
• Growth factors: Several growth factors play a role in muscle hypertrophy and satellite cell activation. One of the most important growth factors is insulin-like growth factor 1 (IGF-1), which is produced in response to mechanical tension in muscle fibers. IGF-1 stimulates satellite cell proliferation and differentiation, contributing to muscle repair and hypertrophy.

Increasing insulin-like growth factor (IGF-1) and growth hormone (GH) through exercise can have a positive impact on increasing lean tissue (muscle mass) and decreasing fat mass. 

Here are some strategies to achieve increase in GROWTH HORMONE:

• • Resistance training: Engage in regular resistance training or strength training exercises. Resistance exercises, such as weightlifting, bodyweight exercises, and resistance band workouts, create mechanical tension in the muscles, which stimulates the release of both IGF-1 and GH. These hormones promote muscle growth and help to preserve lean tissue.
  • High-intensity interval training (HIIT): Incorporate high-intensity interval training into your exercise routine. HIIT involves short bursts of intense exercise followed by brief recovery periods. HIIT has been shown to increase GH secretion and improve body composition by reducing fat mass and preserving lean tissue.
  • Compound exercises: Focus on compound exercises that engage multiple muscle groups simultaneously. Compound movements, such as squats, deadlifts, bench presses, and overhead presses, elicit a robust hormonal response, including increases in IGF-1 and H. *(what if you added BStrong BFR Bands to this workout??  Growth Hormone % increase?!)
  • Sufficient intensity and volume: To stimulate the release of IGF-1 and GH, exercise with sufficient intensity and volume is essential. Aim for challenging workouts that push your limits and progressively increase the workload over time.
  • Proper nutrition: Adequate nutrition is crucial to support muscle growth and hormone secretion. Consume a balanced diet that includes sufficient protein to provide amino acids for muscle repair and synthesis. Healthy fats and carbohydrates are also essential for overall energy and hormone regulation.
  • Sleep and recovery: Ensure you get enough restorative sleep and prioritize recovery. Both IGF-1 and GH are primarily released during deep sleep, and adequate rest helps the body recover and repair after intense exercise.
  • Avoid overtraining: While exercise is beneficial, excessive training without sufficient recovery can lead to negative effects on hormone levels and overall health. Avoid overtraining by incorporating rest days into your routine and listening to your body’s signals.
  • Manage stress: Chronic stress can interfere with hormone balance, including GH and IGF-1 production. Incorporate stress management techniques, such as mindfulness, meditation, or yoga, to reduce stress levels

THIS SOUNDS LIKE THE WHOLESTIC METHOD approach to coaching the WHOLE athlete from the inside out!

It’s important to remember that individual responses to exercise can vary, and genetic factors may also influence how your body responds to training. Additionally, the effectiveness of exercise on hormone production and body composition may depend on factors like age, sex, and hormonal status.

Before starting a new exercise program, especially if you have any underlying health conditions, it’s best to consult with a healthcare professional or a certified fitness trainer to design a safe and effective exercise plan tailored to your specific needs and goals.

Now, let’s discuss the role of estrogen in this process:

• Estrogen and satellite cells: Estrogen receptors are present in satellite cells, and estrogen can influence their function. Research suggests that estrogen may enhance satellite cell activation and promote muscle repair and growth. Estrogen can modulate the expression of growth factors and cytokines involved in the activation and proliferation of satellite cells.
• Hormonal balance: Estrogen and testosterone are both important hormones involved in muscle growth and repair. While testosterone is well-known for its anabolic effects on muscle, estrogen also plays a role. The balance between estrogen and testosterone is crucial for optimal muscle development. In women, estrogen levels may fluctuate throughout the menstrual cycle, affecting satellite cell activation and muscle response to training.
• Menopause: During menopause, when estrogen levels decline, women may experience changes in body composition, including a decrease in lean body mass and an increase in body fat. This hormonal change may affect satellite cell activity and muscle maintenance, contributing to age-related muscle loss (sarcopenia).
• Hormone replacement therapy (HRT): Some studies suggest that hormone replacement therapy (HRT) in postmenopausal women may help maintain muscle mass and strength by influencing satellite cell activity. HRT can restore estrogen levels, potentially mitigating some of the adverse effects of estrogen decline on muscle tissue. (learn more about BIO-identical hormone replacement  therapy and avoid synthetic HRT)

In summary, estrogen can influence satellite cell activation and muscle repair, contributing to muscle hypertrophy and maintenance of lean body mass. 

However, the exact mechanisms and interactions between estrogen and satellite cells are still an active area of research, and further studies are needed to fully understand the complexities of this relationship. CHATGPT

How do we get a DECREASED SENSITIVITY TO INSULIN as our hormones decrease with age?

• Decreased progesterone levels impact the muscle update of insulin
• Decreased estrogen levels impact glucose homeostasis 
• Brain, heart and other organs do need some glucose 
• Body composition changes- body fat increased due to the decrease in the amount of fat that is REMOVED (not the amount of fat being stored)
• How do we prevent the body fat accumulation?  

What is the hormonal shift causes increase in body fat?

1. Hormonal shift creating a decreased signal to use fat
2. An increase or NO CHANGE in the amount of fat that we are storing across our tissues.

Why is their a shift in our ability to tolerate STRESS, mood changes, and reducing our resilience?

•  Hormonal shifts impacting our brain….and we also have a reduction in the stimulus for bone turnover.

Why do we start to lose bone density? 

What is the reason WHY we need to preserve the integrity and quality of our bone health?

• Bone mineral density loss results from the changes in INSULIN GROWTH FACTOR ONE and PROGESTERONE

How can we manage our body composition, strength and lean mass as we age with the decrease in estrogen?

• Reduced signaling for the satellite cell to build muscle with the decrease of estrogen
• We may have a decrease response to lifting weights our “old typical way” of lifting weights 

How can we use a different stimulus to get that satellite cell kicking to build more mass? 

• Don’t depend on HRT or MHT (menopause hormone therapy) to improve your anabolic signaling!  It doesn’t help wit the loss of lean mass.
• Strength training correctly to help with the myosin connection 
• When we have a decrease in estrogen – we have a down regulation (decrease) in the signaling for preventing cell death (apoptosis – programmed cell death)

Lower Estrogen ALPHA Receptor -expression of our receptors

• Myosin dysregulation = loss of strength + power
• Desensitization of estrogen to estrogen receptor sites
• Without the estrogen to bind to the receptor sites – myosin doesn’t “grab on as heavy” = less strength and power
•  When we lose estrogen = impairs muscle regeneration + force generation due to the lack of a powerful pull from myosin to create a strong contraction

WHY DO WE SEE A DECREASE IN NEUROTRANSMITTER PRODUCTION?

• We see a reduction in the SYNAPTIC TRANSMISSION with the decrease in progesterone and estrogen = nervous system involved in the signaling to contract muscles
• A reduction in ACETYLCHOLINE, a key neurotransmitters, desensitizes the receptors within the gap junction with a decrease in estrogen and progesterone.

A DECREASE IN ESTROGEN RECEPTOR ALPHA EXPRESSION on STRENGTH & POWER

• Down regulation – losing sensitivity 
• Satellite Cell + Myosin connection = impaired mitochondria regeneration without the estrogen receptor sites available = increased oxidative stress = increased need to clean up reactive oxygen species (ROS) = greater oxidative stress on cells = increase signals for cell death
• We have a reduction in our ability to REGENERATE CELLS without the stimulus of estrogen = increase in cell death

Why do we experience more TISSUE BREAKDOWN?

•  More tissue breakdown results in an increased need for fuel to help enzymes clean up the increased cell death (FASTING benefits? Clean up dead cells?)

Why do we have a decrease in INSULIN SENSITIVITY with a DECREASE IN PROGESTERONE?

• We get an impairment in our insulin signaling = reduction in the body’s ability to have a muscle contraction and update more glucose.
•  We lose the signaling to regenerate and repair cells that have been damaged from oxidation (increased oxidative stress in mitochondria)
• Damaged cells = lack of a strong muscle contraction + not able to pull glucose into muscle cell
• Insulin is not helping to pull glucose into cell = lack of fuel available for the muscle cell = see increase in lipid accumulation signal (lipids = cell membrane layer)

The WHOLESTIC Method 

Anti Aging Female Athlete 30-day Protocol

• Nutrition
  • Protein = 1g per ideal lb of body weight
    • Example !30 lbs ideal weight = 130g protein = 30-50g per meal x 3
  • Healthy fats = 60-70% to support Hormones (Adrenals)
  • Carbohydrates = 5-10% if needed around anaerobic glycogen depleting workout sessions to improve performance markers 
• Exercise
  • Lift heavy weights if experienced – 3-6 reps to muscle fatigue with good form, 3-5 sets, 2-4 x week
  • Add in HIIT (zone 4/zone 1) and SIT (zone 5/zone 1) 2-3x week when recovered
  • Add in Plyometrics in your workout that work for your body
• Sleep
  • Create a sleep routine in the evening to wind down
  • Create a morning routine to wake up in morning sunshine upon waking (outside without sunglasses)
  • Be consistent in what time you go to bed and wake up!
  • Avoid eating and drinking alcohol close to bed time (see the difference in your sleep scores!)
  • Create a sleep cave- cold and dark room without WIFI
• Stress Management
• Movement & Mobility
• Digestion & Gut Health
• Hydration & Mineral Balance
• Happiness, Play & Gratitude 

The WHOLESTIC Method Anti-Aging Female 30-day Fitness Program: Intermediate to Advanced

Option: 3 week build, 1 week recovery (late luteal phase)