"For active women, menopause hits hard. Overnight, your body doesn't feel like the one you know and love anymore--you're battling new symptoms, might be gaining weight, losing endurance and strength, and taking longer to bounce back from workouts that used to be easy. The things that have always kept you fit and healthy just seem to stop working the way they used to."--

Résumé
A comprehensive, physiology-based guide to peak performance for active women approaching or experiencing menopause—from the author of Roar, renowned exercise and nutrition scientist Dr. Stacy Sims

For active women, menopause hits hard. Overnight, your body doesn’t feel like the one you know and love anymore—you’re battling new symptoms, might be gaining weight, losing endurance and strength, and taking longer to bounce back from workouts that used to be easy. The things that have always kept you fit and healthy just seem to stop working the way they used to. 

But menopause doesn’t have to be the end of you kicking ass at the gym, on the trail, in the saddle, or wherever you work out. Once you understand your physiology, you can work with it—not against it—to optimize your performance. That’s where Stacy Sims, PhD comes in. In Next Level, you’ll learn the underlying causes of menopause: the hormonal changes that are causing all the symptoms you’re feeling, and their impact on your wellness and performance. Then, what you really came for—what to do about it. Inside you’ll find science-backed advice about training, nutrition, sleep and recovery and supplements, as well as sample exercise routines, meal plans, macronutrient planning charts, and case studies from real women Stacy has coached through the transition. It’s the ultimate guide to navigating the Next Level.

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The Stats. The Stigma. The Silence.

How we think and talk about menopause matters.

Life expectancy for women is about 81 years, and the average age at which women hit menopause is 51. In other words, nearly 40 percent of your life is likely to happen after menopause. Factor in those five to seven perimenopausal years when your hormones start to go haywire and you could easily be living half, if not more, of your life on some part of your menopause journey.

When you look at it that way, it’s all the more upsetting how negative all the messaging around menopause is and has been for centuries. In the time of Hippocrates, menopause was described as “climacteric syndrome,” which was understood to be the stage of a woman’s life when she had a weakened uterus, was losing power, and was no longer of much use to society.

The Puritan times weren’t much better. If you pore through the historical archives on the witch hunts and identify who was killed at the stake, you find that peri- and menopausal women were primary targets. They were “mad with menopause,” or they were using herbs and other natural medicines to help treat other women (so they had to be witches), or they were simply “old crones” who needed to be eliminated for the betterment of society.

Menopause finally surfaced as a recognized medical condition in the 1880s, but the terminology didn’t improve. It was described as the “death of the womb.” The “experts” of the time also believed that when a woman stopped menstruating, she was no longer able to release “toxins,” and it was those toxins that would build up and induce symptoms of high heat in the body, profuse sweating, craziness, and “hysteria.” The response of the medical community was to call women insane and lock them up.

Things didn’t really get much better even in what we would consider modern times. In the early twentieth century, Sigmund Freud and his followers argued that menopause was a neurosis—again implicating menopausal women as insane. The lack of hormones and the aging process were causing women to go crazy. Even into the latter half of the twentieth century, physicians argued that at ages 45 to 50 women were prone to developing hysterical fits. (Don’t worry if reading all this is actually giving you hysterical fits . . . that’s a natural and healthy response!)

Moving into the 1960s, physician Robert Wilson wrote a best-seller called Feminine Forever, which described menopause as a disease and “living decay” that should be treated so that women could maintain their youth and sex appeal, That’s pretty much what you would expect from a male-centric culture. It was never about us. It was about them.

Fast-forward to today. Though there have been vast improvements in the medical understanding of menopause is, the messaging in the United States and other Western societies, sadly, has not improved. Menopause today is still viewed as our society’s arbitrarily established dividing line between sexual, attractive, and even powerful young women and suddenly old, weak women who can no longer contribute to society.

In fact, even now, women “of a certain age” (a phrase I detest) simply “disappear.” We basically stop seeing them represented in popular entertainment. Media outlets like Vulture have even made charts showing that as actors like Harrison Ford, Denzel Washington, Johnny Depp, and Tom Cruise get older, the actresses who play opposite them do not—and in fact they are often cast opposite much younger women.

It’s no wonder women feel like their lives are over as they age—they’re being sent the message that they should just disappear or relegate themselves to the shadows. And when they do finally see some representation, it’s often a dated stereotype. Google “menopause” and look at the depictions in the content you find. Compare the depictions of a woman in her sixties with those of men in their sixties. You’ll find that there are very different perceptions of what aging is for a man versus what it is for a woman. Rue McClanahan was just 51 years old when she was cast as one of the Golden Girls! That’s what we’re shown on television and in other media: men can still be strong and powerful, maybe even more so as they become “distinguished” with age, while older women are often shown stooped over with a “dowager’s hump” rather than depicted as strong, lean, powerful, or attractive.

After menopause, women are usually dismissed. Is it any wonder that women, especially active women who want to be strong and powerful, are so reluctant to talk about menopause?

Perception Matters

How we view aging culturally and societally influences how we view it personally, and those combined views have an impact on how we actually experience menopause, physically as well as psychologically, according to a study published in Menopause online, which found that impressions of aging can affect the severity of symptoms.

Lead study author Dr. Mary Jane Minkin, a professor of obstetrics, gynecology, and reproductive health at Yale Medical School, told Reuters Health: “In societies where age is more revered and the older woman is the wiser and better woman, menopausal symptoms are significantly less bothersome. Where older is not better, many women equate menopause with old age, and symptoms can be much more devastating.”

Taking this idea a few steps further, a 2018 study published in the Alexandria Journal of Medicine found a significant and direct relationship between a woman’s attitude toward menopause and her body image and risk for depression. Women who had negative attitudes toward menopause were more likely to view themselves n…