Stacy Sims and Perimenopause Exercise: What the Research Actually Says for UK Women

Dr Stacy Sims framework for perimenopausal women rests on heavy resistance training, short sprint intervals, jump training, and protein-forward fed-state nutrition.

You are in your mid-forties. Sleep has become a light, interrupted thing. Your jeans fit differently, and the weight seems to settle around your middle. Your usual walks feel harder but somehow less effective. Then, on a podcast, you hear a woman called Dr Stacy Sims. She says, lift heavy weights, do sprint intervals, eat more protein, and cut back on the long, steady cardio. It sounds bold, maybe even a bit extreme. Is this backed by real science, or is it another wellness trend? This article is here to give you a calm, clear walk-through. We will look at who Stacy Sims is, what the research in her books and papers actually recommends, what a sensible UK-based week might look like, how it fits with NHS advice, and where to take it with a pinch of salt. The goal is to help you make an informed choice for your own body.

Who is Dr Stacy Sims and why is her name everywhere

Dr Stacy T. Sims is a New Zealand-based exercise physiologist and nutrition scientist. Her academic career has included research roles at Stanford University, AUT University, and the University of Waikato. She has authored or co-authored over 170 peer-reviewed papers focused specifically on female physiology, training, and nutrition. This deep research background is the source of her credibility. She is best known for two main books. The first is *ROAR* (2016), which discusses female-specific training and nutrition across the lifespan. The second, and the one driving most current interest, is *Next Level* (2022), co-written with Selene Yeager, which focuses entirely on the menopause transition.

Her 2019 TED Talk, titled *Women Are Not Small Men*, captures her central thesis. For decades, most exercise science research was conducted on male subjects. As a result, the standard advice given to women—often to use lighter weights, do more cardio, and eat less—does not account for important physiological differences, particularly as women approach and go through menopause. Her work argues that the perimenopausal period requires a specific, evidence-based shift in exercise and nutrition strategy.

The Sims framework for perimenopause and menopause training

The framework Dr Sims outlines for perimenopausal and postmenopausal women rests on five distinct pillars. These are heavy resistance training, sprint interval training (SIT), short HIIT sessions, jump training (plyometrics), and a protein-forward nutrition approach. The unifying principle behind all five is the response to declining estrogen. Estrogen has anabolic, or muscle-building, and bone-protective effects. As its levels fall, the body’s natural signals for maintaining muscle and bone weaken. Therefore, Sims argues, the external training stimulus must compensate by becoming heavier and more impactful, not lighter and longer. The focus shifts from duration to intensity and dose.

Heavy resistance training, 2-3 days a week

This means performing compound, multi-joint movements like squats, deadlifts, presses, rows, and hinges. The prescription is typically 5 to 10 repetitions per set, for 2 to 3 sets, with 2 to 3 reps left ‘in reserve’. This means you choose a weight where, after completing your set, you could have performed just one or two more repetitions with good form. ‘Heavy’ is relative to your own strength and experience; the point is to provide a genuinely challenging load for your muscles and bones. This directly aligns with recommendations from the Royal Osteoporosis Society for loaded movement and from NICE (guideline NG23) for weight-bearing exercise in menopause.

Sprint interval training (SIT), 1-2 days a week

SIT involves very short, all-out efforts. You go as hard as you possibly can for 10 to 30 seconds, followed by a full recovery period of 2 to 3 minutes of easy movement. A session consists of 4 to 6 of these rounds. This can be done on a bike, running up a hill, on a rower, or by running. Sims often cites a 2010 study from *Medicine & Science in Sports & Exercise* where postmenopausal women in their 50s performed 20-minute SIT sessions three times a week for eight weeks. The results showed fat loss, lean mass gain, and an average 12 percent improvement in VO2 max. The key is the brevity and maximal effort.

HIIT, no more than 1-2 sessions a week

High-Intensity Interval Training here is distinct from sprint intervals. HIIT sessions involve bursts of 30 to 60 seconds at 80 to 90 percent of your maximum effort, with shorter recoveries of 1 to 2 minutes. The entire session, including a warm-up and cool-down, should be kept to around 30 minutes. While SIT primarily trains the anaerobic system, HIIT improves cardiovascular fitness and metabolic flexibility—the body’s ability to switch between burning fat and carbohydrate. The cap on frequency is important. For perimenopausal women, excessive high-intensity work can lift cortisol and impair recovery, so more is not better.

Jump training (plyometrics), 2-3 short doses a week

This is about introducing brief, impactful forces to stimulate bone. The doses are intentionally small: 10 to 20 jumps in a session, with full recovery between sets. Examples include box jumps onto a sturdy step, broad jumps on grass, or skipping with a rebound. Bone responds to dynamic impact, not just slow loading. Evidence suggests that plyometric training can help preserve bone mineral density at the hip and spine in postmenopausal women. If you have joint concerns, you can modify this with gentler, low-amplitude movements like pogo hops on the spot.

Protein and fed-state training

Nutritionally, Sims advises active perimenopausal women to consume 1.8 to 2.2 grams of protein per kilogram of body weight per day. This should be spread evenly, aiming for roughly 30 grams of protein at each main meal and 15-20 grams in any snacks. She also recommends training in a fed state, especially for morning workouts. This means having a small amount of protein and some carbohydrate, like a banana, before you train. The rationale is that fasted training during perimenopause can spike cortisol and may blunt the body’s adaptive response to the exercise.

A sample UK week for a 47-year-old perimenopausal woman

Here is what putting the principles into a normal UK week might look like. Monday: a 45-minute heavy lower body session at the gym or home with weights—squats, deadlifts, lunges. Tuesday: a short, sharp SIT session on a stationary bike or a local hill, 6 rounds of 30 seconds all-out with long recoveries, 20 minutes total. Wednesday: rest or a gentle yoga class for mobility. Thursday: a 45-minute heavy upper body session—presses, rows, and pulls. Friday: a 30-minute short HIIT workout or a brisk, hilly walk in the park. Saturday: a brief jump training session (15 jumps) followed by a long, social walk for an hour. Sunday: rest. Throughout the day, prioritise 30g of protein at each meal, plenty of water, and a good sleep wind-down routine. This structure makes space for intensity while keeping the joy of a weekend walk.

Where Stacy Sims sits inside UK NHS guidance

The Sims framework is comfortably compatible with official UK guidance; it simply provides more specific dosing. NHS Live Well recommends at least 150 minutes of moderate activity per week plus two days of muscle-strengthening activities. NICE NG23 on menopause specifically encourages weight-bearing and resistance exercise. The Royal Osteoporosis Society calls for loaded movement at least twice a week and impact-based exercise for bone health. Sims’ work aligns with all of this but goes further by defining what ‘heavy’ and ‘intense’ mean in practice. She discourages making long, medium-intensity cardio your main focus for body composition, and advocates for protein intakes higher than the NHS general reference. A practical note: not everyone has immediate access to a gym with barbells, and heavy lifting requires good technique. Many UK GPs can refer to local strength programmes or community health gyms via social prescribing schemes.

How to start safely in the UK

If you have known osteoporosis, joint replacements, high blood pressure, heart symptoms, or are recovering from an injury, a chat with your GP or an NHS musculoskeletal physio is a wise first step. Remember, NICE supports HRT alongside lifestyle changes for many women; these approaches are not in competition. A sensible start could be a two to four week introduction. Get an assessment from a qualified personal trainer or physiotherapist to learn the basic squat, hinge, and row patterns. Then, add load very slowly. Track three simple things: the weights you are lifting, your hours of sleep, and how you feel the day after training. If your sleep worsens with added HIIT, drop a HIIT session and add a gentle walk instead. The most honest measure is what feels sustainable and positive for you this week.

What the research does not yet say

It is important to acknowledge the gaps. Most of the Sims framework is built on a combination of small-to-medium randomised controlled trials, mechanistic studies on muscle and bone physiology, and extensive consulting experience, rather than large-scale, long-term UK population trials. The strongest evidence is for resistance training, followed by evidence for plyometrics in postmenopausal women, and then HIIT. Sprint interval training has promising but smaller-scale evidence. Some specific recommendations, such as the exact protein numbers or the advice against fasted training, are well-reasoned extrapolations from the science rather than settled UK consensus. The framework is internally consistent and largely safe for healthy adults, but it is not the only evidence-based approach. A sensible UK approach is to take the core structure—prioritise strength, include some impact, ensure enough protein, reduce excessive steady cardio—and adapt the precise dose to your own life, joints, and recovery capacity.

Frequently Asked Questions

Is Stacy Sims advice safe for UK women in perimenopause?

For most healthy women, yes. The framework aligns with guidance from NICE, the NHS, and the Royal Osteoporosis Society, with more specific intensity recommendations. If you have osteoporosis, untreated high blood pressure, heart symptoms, or are recovering from injury, speak to your GP or an NHS physio before starting heavy lifting or sprint intervals. Always prioritise learning proper technique before adding significant load.

How heavy is heavy lifting for perimenopausal women?

‘Heavy’ is personal. The Sims guideline is a weight where, for 5-10 reps, you have 2-3 reps left in reserve with good form. For a complete beginner, that might be 5kg dumbbells for a goblet squat. For someone more experienced, it could be a barbell at their bodyweight. The point is that the load is genuinely challenging for you, not that you must lift a specific number.

Should I stop walking and doing zone 2 cardio in perimenopause?

No. Walking and moderate aerobic activity are excellent for cardiovascular health, mental wellbeing, and sleep. Sims’ point is that long sessions of purely zone-2 cardio are not the most efficient tool for changing body composition or building bone in perimenopause. Keep your walks. Just ensure they don’t consistently crowd out the time needed for strength and impact training.

How much protein does Stacy Sims recommend?

She suggests 1.8 to 2.2g of protein per kilogram of body weight daily, spread across meals. For a 70kg woman, that’s about 125-155g per day, aiming for 30g per main meal. This is higher than the NHS reference intake for a sedentary adult (0.75g/kg), which is set for basic physiological needs, not for supporting training and muscle retention during menopause.

Can I follow this protocol while on HRT?

Yes. The training framework is designed to complement, not replace, medical care. NICE recommends HRT for many women with perimenopausal symptoms, and lifestyle measures like resistance exercise alongside it. If HRT changes your energy levels or sleep patterns, you may need to adjust your training load. Always keep your GP informed about new exercise routines.

How long until I feel a difference?

You may notice strength gains within 2-4 weeks. Improvements in sleep, mood, and energy often emerge within 3-6 weeks, especially if protein intake and sleep hygiene are also addressed. Visible body composition changes typically take 8-12 weeks of consistency. Changes in bone density are much slower, measured over 6-12 months. The very first positive sign is often feeling more resilient and energised the day after a workout.

This article is informational only and does not replace personalised advice from your GP, pharmacist, or another qualified healthcare professional.