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Written by The Thriva Editorial Team
5th May 2026 • 44 minute read

Dr Lauren Colenso-Semple, a researcher in female physiology and strength training, joins Greg and Charlie to unpack the science of how women should actually train across the lifespan.

Show notes

In the gym, there's often a pattern: women on the cardio machines, men in the weights section. It's a divide that says a lot about how we think women should train, but how much of that is science and how much is just habit?

This week, Greg and Charlie sit down with Dr Lauren Colenso-Semple, a researcher specialising in female physiology and strength training, to answer the question: should women train like men? Lauren is also the co-owner of the MASS Research Review, which helps bridge the gap between cutting-edge research and practical fitness strategies for coaches and trainers.

As always, we start with the science, unpacking the key biological differences between the sexes and what they actually mean for how women should train, their risk of injury, and their relationship with exercise across different life stages. From hormonal fluctuations across the menstrual cycle to the effects of menopause, we explore how the body changes and what that means for getting the most out of your training.

From there, we move into the practice, where Lauren, Charlie, and Greg discuss tangible ways to improve our training routines. They cover:

  • How socialisation shapes women's access to sport from an early age (19:08)
  • Why resistance training is conducive to healthy ageing (26:23)
  • What you should consider before pursuing hormone replacement therapy (31:52)

Lauren walks us through what physical training can look like across different life stages, including how contraception and menopause factor into the picture.

Finally, in the experience section, we turn to your questions. How do you get back into training postpartum? Can pilates and stretching help relieve period cramps? Are there exercises we should be prioritising to better manage our cycles? Tune in to find out.

A note on language: throughout this episode, we use the term "women" for accessibility, but this episode makes an important distinction between gender and biological sex.Episode resources

Mentioned in today's episode

Transcript

Charlie: Women, women's health. Oh, I need a... what's my song? Song about... "Man, I feel like a woman. Let's go girls."

Greg: Shania.

Charlie: Shania Twain.

Greg: Very impressive.

Charlie: I saw Shania at Glastonbury. Very good.

Greg: Still going strong.

Charlie: At five o'clock on the Sunday. Yeah.

Greg: I wonder what her training programme is.

Charlie: I dunno, line dancing. Dancing in a line.

Greg: We could tee up as a future podcast guest this week. We have Shania Twain on line dancing.

Charlie: This is The Method, a podcast from Thriva about what health looks like in the real world.

Greg: I am Dr Greg Potter. I'm a scientist and health and performance consultant.

Charlie: And I'm Charlie Edmondson. While I'm a fan of sport, I'm definitely not a science expert. I've got a regular job, and I'm here to remind Greg of what life's actually like when you're not a nerd.

Greg: Be a nerd about something. I bet you are. On this show, we'll work out some sustainable changes to your routine that are actually going to make a difference to your health. And to do that, we have a simple three-step method. With the help of an expert, we first unpack the science behind one key health question. Second, we give some recommendations related to what we are speaking about on the day. And then finally, we put the practice to the test.

Charlie: Each week, we're going to hear from those who have tried and tested our recommendations to help turn a so-called ideal lifestyle into something that actually works for you.

Greg: Ladies and gentlemen, I am sitting in front of the marathon champion of the world, slash the marathon champion of my world, slash one of a couple of marathon champions of my world.

Charlie: We went quite specific and it's getting quite broad. Okay.

Greg: Tell us about the marathon.

Charlie: Yeah. It's done. Finally feels like it's been there in my life for such a prolonged period of time. But it went well. Got the time I wanted.

Greg: Superb. Good conditions for it, right?

Charlie: Great conditions, actually. Considering it was in Manchester, you never know, it can be one extreme to the other. But no, it was pretty... the sun did come out, but it was about eight degrees, so that was fine. I think we all set off a little fast though, because we thought, this is perfect running conditions, but then the sun never went away and it just got warmer and warmer. My original plan was to be really, really sensible. Then I obviously got really giddy.

Greg: There's a time for everything.

Charlie: I dunno why I tried to think I'd be really sensible, but when I ticked through 10K or even halfway, I was on for like 3:06 or 3:07. Then quickly realised that was not a good idea, so had to pay the price for sub-seven-minute miles for the first three or four or five miles.

Greg: And how did that feel?

Charlie: It was not a lovely experience. I would not like to do it again. But I wanted sub-3:15. I got sub-3:15. So I feel like for now I've made a little bit of peace with it. Someone asked me literally as I crossed the finish line, "Are you going to do another one?" And I was still nonverbal at this point. You just can't mess around with a marathon. Even if you were to walk a marathon, it's still really far. But yeah, marathon went well. Marathon was good. It's done. I can enjoy my summer now.

Greg: Hot girl summer.

Charlie: Summer coming in hot.

Greg: This is all quite relevant to today's episode, I believe.

Charlie: It is. So today we are speaking with Dr Lauren Colenso-Semple. Lauren is a researcher and science communicator who specialises in women's health, exercise and nutrition. I'm actually really looking forward to speaking to her. I think it's going to be very interesting. Lauren's known for breaking down the science in a really accessible way, which will be great for me, hopefully, and challenging a lot of the myths we see online around fitness, hormones and diet. So yeah, it's going to be a good one, I think.

Greg: I think the last few years, a lot of women have become interested in alternative activities.

Charlie: A hundred percent.

Greg: Like bouldering. My sister absolutely loved it when she tried it. She's not in the routine of going, but I think she'd get into it if she had access to a wall nearby on a regular basis. And then activities like Hyrox have really taken a certain population by storm in recent years.

Charlie: Anything with mixed doubles I think is great. I love it. I see a lot of couples doing it. It feels a lot more accepting. It's a hype that's stuck around and will stick around. It's been great for making gyms feel a bit more accessible to everyone. When I did Thai boxing, it was a class of 80% males, maybe 85% males. Pretty male-dominated environment. But that gym is actually run by a female, which is really lovely. The reason I went to that gym was because it's owned and run by a female, but it's one of the only Thai boxing gyms I could find that's owned by a female. So yeah, not the norm, I don't think.

Greg: I actually think that's a really important point about mixed doubles. That really does open the door to a lot of people who wouldn't previously have considered that.

Charlie: A hundred percent. It allows people to push themselves out of a comfort zone, but with someone they feel comfortable with. I love it.

Greg: And also get bragging rights.

Charlie: A hundred percent. The women have to do the men's weights.

Greg: Yeah, it's not like tennis.

Charlie: Not like tennis. Right. Shall we bring in Lauren?

Greg: Hello.

Charlie: Hi Lauren. Welcome to The Method.

Lauren: Hi. Thank you for having me.

Greg: Have you trained today, Lauren?

Lauren: I haven't, it's the morning for me and I'm an afternoon trainer.

Charlie: Are you? I am 99% of the time a morning trainer, otherwise I procrastinate. But it's sunny today, so straight after this I'm going on my bike outside.

Lauren: Very nice.

Greg: We're going to cut straight to the chase and jump to the science of how our bodies respond to exercise, some of the things that females might need to consider that males don't necessarily. We've specified males and females, because while we might occasionally say men and women today, we're speaking about biological sex. Perhaps we could start with some sex differences in hormones and focus on women of reproductive age. So what are some of the high-level sex differences in hormones? Feel free to speak about menstrual cycle here too.

Lauren: The clear hormonal differences are testosterone. Men tend to have 10 to 15 fold more testosterone than women, which contributes to a common belief that there must be these real divergent responses to training. But we also have fluctuations in oestrogen, progesterone, follicle-stimulating hormone, luteinising hormone, and those fluctuate throughout the menstrual cycle. If you're on a hormonal contraceptive, meaning you're introducing exogenous hormones, then we no longer experience those fluctuations. But your hormone profile at any given couple of days is shifting if you are somebody who has a menstrual cycle.

Charlie: So not everyone obviously has a regular cycle. I think it can be anywhere between 21 and 35 days, which is a huge range, and it can be different month by month. Some people might also miss periods within their cycle. Does cycle length or cycle symptoms affect how women should be thinking about their training?

Lauren: You bring up a really, really important point. If you Google image the menstrual cycle, you'll see this very clean picture of "here's where ovulation is, it's right in the middle, and this is the normal cycle. It's 28 days and oestrogen peaks here." I have only ever seen a picture like that in one person ever. All the other hormones I've measured in women, the profiles are completely different than that kind of cookie-cutter image. There's so much variability in the timing of the hormone fluctuations, also the magnitude. So you can have a 28-day cycle but not ovulate until day 20, or you can have a 30-day cycle and ovulate on day 10.

When we talk about this whole cycle-syncing conversation, it really does assume that everyone has these two very clean 14-day phases. They'll often say you should be lifting really heavy or doing high-intensity interval training for this week, and then for this week you should be doing pilates or light stretching. Some of these recommendations are as extreme as that, which is clearly not aligned with principles of good training. If you're constantly switching up what you're doing, then we aren't going to see any of those adaptations that we want. We need consistency. We need progression over time.

What I would say is we just need to make the decision for ourselves based on how we feel. If we want to adjust in some way, we can. But it's very unlikely that you as an individual actually experience those shifts, because only about 13% of women have a 28-day cycle. When we say should you consider it in your training in terms of trying to align the intensity of the training or the type of exercise you are doing, no. But should we be mindful of implementing some component of autoregulation if we experience symptoms? Absolutely.

Charlie: What about people who are on the pill or using other sort of hormonal birth control?

Lauren: It changes the hormone profile because now we don't have those big peaks and troughs that we would have throughout the menstrual cycle. We have a fairly consistent low level of hormones, and then if you're taking a withdrawal pill, a placebo pill for a couple of days, then we might see a slight shift. But in terms of how we respond to exercise or how we perform, how we adapt, we don't see any influence of cycle phase or hormonal contraceptives on performance or on exercise-induced adaptations like strength, muscle growth, power, et cetera.

Charlie: So there's no scientific evidence to say that there would be a reason for heightened DOMS around a period of menstruation?

Lauren: Shouldn't be. But you know, when we look at the data, we're always looking at group averages, and so that is not going to account for every single individual's lived experience, which is always an important point. I can say we shouldn't expect that we would have changes in performance or in how we adapt. But I know that there are some people who say "I feel or perform my worst during this time." It's not consistent for everybody. There are women who tell me, "Day one of my period, I lift the heaviest. I'm always getting a PR on the first day of my period." And then there are the women who say "I couldn't possibly think about lifting weights on day one of my period." So everything in between.

But I think we just need to make the decision for ourselves based on how we feel. If we want to adjust in some way, maybe it's that an exercise is really uncomfortable today, so we're going to swap that exercise out for something else. Or maybe the load just feels really heavy today and we can still do it. Objectively the strength hasn't changed, but it just feels more difficult. Sure, we can make the decision to switch something up or reschedule the session altogether, but we can also make the decision to push through. The only thing I caution against heavily is planning on feeling poorly or planning on performing worse. Because when you set those expectations, then you're inevitably going to perform worse.

Charlie: I think it's the mental side of things, especially if you are doing events or racing. The likelihood is you're going to be on your period at some point of this or a key training session, and going into it already thinking, "I'm going to feel terrible during this," you probably are going to feel terrible.

Greg: And if we move now to the menopause. What are some of the changes that are happening in a woman's body during the menopause, and how, if at all, do you think those should or might affect how somebody exercises?

Lauren: The menopause transition varies a lot from one woman to the next. For some women this can be a period of months. For others, it can be a couple of years. During that time, you're often experiencing erratic hormone fluctuations, and that's the major factor. It's not that the general principles of how you train should change. It's that if you're experiencing symptoms that are affecting your sleep, you're having hot flashes, or affecting your motivation, then all of that can have a downstream effect on adherence to a training programme.

If you're chronically under-slept, then you're probably not going to perform your best. You're probably not going to feel as motivated to work out consistently. So if we can manage those symptoms, it can be incredibly helpful. But there's nothing about the hormonal changes across the menopause transition that are tanking your metabolism or making you lose muscle mass at some kind of precipitous rate. The general principles of exercise apply, and we want to perform goal-oriented training. Resistance training should be a part of that because muscle mass maintenance is very important. But that's true as we age for men and for women.

Greg: And if you pan back and think about men and women across the lifespan, what are some of the high-level ways in which the two sexes differ in their strength, power, endurance and flexibility?

Lauren: The biggest difference is due to testosterone during puberty. When boys have a surge in testosterone, that coincides with an increase in muscle mass. So if you take two untrained adults, one male, one female, the male will be stronger and more muscular than the female on average. But when we think about how you actually respond to training, then some of those differences we see, if we test people who have never exercised, really start to disappear as we become more trained. Which shows us that testosterone is not the be-all and end-all, but it does give a male an edge in terms of the starting point.

Greg: So just to play back what we've covered so far. We first spoke about some of the differences between the sexes in their hormones. Obviously there are major differences in the sex hormones, and differences in other hormones might be a bit more subtle. We then spoke about the menstrual cycle, which seems to vary a lot, both between women but also within a woman. So it's not like one person consistently has a 26-day cycle and another a 29-day cycle. Instead, for a given individual, it can fluctuate quite a lot. It might tend to drift over the course of someone's reproductive lifespan. The pill might override some of those fluctuations because in some ways you're masking those natural changes, but fundamentally it doesn't really change things. And the important thing is that a woman should autoregulate her training in response to how she feels. So maybe doing less of certain exercises while trying to maintain the intensity if she's not feeling so good at a certain phase in her cycle. The menopause, of course, is a time of massive change, but it varies a lot between people, and fundamentally the types of exercise that people are doing should probably stay much the same. While physical capacities such as strength do vary between men and women, women seem to generally respond very similarly to men in relative terms. Like men, they should be focusing on building long-term health as the goal.

Charlie: Well done, Greg. That was very good. So now we'll move to the practice section. In the practice section we look at how we can apply the science of sex differences so we can make exercise more beneficial and enjoyable.

So from a personal point of view, I'm really curious about this one. Obviously I've grown up with two brothers, ended up doing a lot of sport, Thai boxing, bouldering, triathlon, in typically very male-dominated spaces. I'm really aware that obviously it's not everyone's experience and a lot of women don't necessarily feel as comfortable as I have in those environments. From your experience, do men and women tend to approach training differently in terms of the spaces and the sports that they feel drawn to or are comfortable in? And how much do you think that it's biology versus confidence or exposure to these spaces?

Lauren: I think that's a huge piece of it because often, girls are not exposed to resistance training. So we have people who are now in midlife who never lifted weights and grew up in a time where they thought lifting weights makes you bulky and "I'm going to turn into a bodybuilder overnight." I think as a society we've shifted away from that, but there's definitely still an element of that. Historically, the exercise programmes that the fitness industry markets to women are largely ineffective. Things like group fitness classes that aren't giving you a sufficient intensity or load, constantly switching things up. Being really into this cycling class for six weeks and then thinking "well, it's not giving me results, so I'm going to switch to pilates", and that's not giving me results, so I'm going to switch to a bootcamp class.

Often the goal is fat loss. Exercise doesn't do much for fat loss if we aren't paying attention to our diet. Instead of looking at exercise as a weight-loss tool, we need to be looking at exercise for long-term muscle growth, muscle maintenance, bone health, and overall physical function as we age. That's a framework through which the fitness industry hasn't presented exercise to women. A lot of women know that lifting weights is really important, but it's very confusing about where to start.

Charlie: Definitely. It's really relatable in the spaces I see. Even I lift weights a lot and I become muscular quite quickly. I get comments from men and women about being muscular. It's almost like there's still a bit of an apprehension of, "oh, you are really muscular." And I'm quite proud. Yes, I am.

Greg: I was just going to add that something I notice with my unusually itinerant lifestyle is how much attitudes to exercise, but also the actual practice of being physically active, varies from place to place. In countries like the UK and the US there's been an evolution in recent years. I remember training in my early teens and there were very few women or girls in the gym. Nowadays you walk into any town in the UK and you can find a chain gym, and there'll be females of any age from 16 up lifting weights and lifting with a lot of effort, which is the thing that matters. Whereas in so much of the world, you don't see women exercising full stop. Some places you barely see women outside of the home. So there's still a lot of work to be done at a global level. But on that subject, Lauren, if you had to pick a single type of training that you wish that all women did, and that isn't necessarily lifting weights per se, what would that type of exercise be?

Lauren: I read an analysis the other day. I think it was over 26 or 29 countries, millions of people. What's the percentage of people that are actually meeting those physical activity guidelines, the 150 minutes plus two strengthening sessions? And it was 17% of adults. That might be a higher estimate than what's really going on, because you're more likely to report if you're somebody who actually does exercise. Clearly, despite being told "do this," it's not resonating with people, because there's not enough context given or actual instructions. What does that mean? What does that look like? What is vigorous, what is moderate, what is muscle-strengthening?

But if it were up to me, I would have everybody do resistance training. I think it's so underrated when we think about what it means to decline as we age. If we are losing muscle with age, then ultimately we're losing our sense of physical independence. We want to be able to maintain our capacity to move in full ranges of motion, to catch ourselves when we fall. Maintaining muscle and bone is such a key component of that. You don't have to do a tonne to get a major result. If you go from nothing to doing two 30-minute workouts per week, there's a huge benefit there. And it's never too late to start. You can start at 70 and still gain some muscle.

Greg: Charlie's an interesting example here, because she recently took up bouldering, which is going to get you a lot stronger through your elbow flexors, your biceps, through your back muscles and so on. And probably you're going to gain some muscle along the way too.

Charlie: I have, yeah, my back has completely changed. When I've been in there, they're like, "oh, you must have been bouldering a while." I think it's because I've put on muscle quickly. My body seems to change quickly, so it looks like I've probably been doing it for a lot longer than I have. I've said this to Greg previously, it's the first sport that I've found that is a real combination of knowing I need to be really strong to do it, but mentally you can't focus on anything else but what you're doing in front of you, otherwise you are going to fall off the wall.

Greg: The danger forces your hand, Charlie.

Lauren: That's also an example of when we talk about exercise, people often think, "oh, I have to go get on the StairMaster, or I have to go to a commercial gym," when actually what people tend to adhere to really long term is physical activity that they enjoy, which might not look like structured exercise. It could be hiking with friends, or kayaking with friends, or rock climbing with friends. So it's important to underscore just overall physical activity long term, because it's not about what we do for the next two months. It's about what we do for the next 15 years.

Greg: Returning to your point, Lauren, as well as a couple of conversations we had previously, one of which was with your colleague at MASS, Eric Helms. Part of the magic of resistance training is that if you structure it appropriately, particularly if you combine it with some nutrition changes that help you shed body fat, then you can also improve your cardiorespiratory fitness, at least up to a point. The converse is also true: for someone who's very sedentary, if you put them through a programme to increase their cardiorespiratory fitness, doing lots of cycling for example, particularly if that involves some sprint interval training or high-intensity intermittent training, they might gain a little bit of strength. But as something that can improve several capacities at once, I think resistance training comes out on top because you can also develop flexibility.

Lauren: I think for bone as well. When we think about bone density, why do we care about bone density? It's a proxy for fracture risk. But in order to prevent fracture, we want to prevent falls. If we have good balance, if we have good awareness of our body in space, then we're much less likely to have a catastrophic fall that results in a fracture. We can incorporate elements of balance as we are moving through a full range of motion, either if we're doing some unilateral training or if we're doing something like walking lunges. That can really help with the balance side too.

Greg: So in that instance, something like a split squat or a lunge is potentially going to have better transfer than something like a seated leg-extension exercise. There's a time and a place for that, but as something that is going to carry over better to activities of daily living, doing something where your balance is challenged and you are using one side of your body predominantly at a time, might have greater advantages for many of our listeners.

Charlie: So if we're thinking about midlife and menopause, would there be any changes that people should be making to the way they train?

Lauren: I think a challenge for women who are new to resistance training is understanding what is a challenging load and what is heavy. If you haven't experienced the feeling of lifting challenging weights, then there's a learning curve there. Proximity to failure. If I finish a set of 10, could I do another two or could I do another 10? Because if I can do another 10, I'm not lifting something heavy enough. But once we've wrapped our head around what is a challenging load, we can use a variety of tools. We can train in a variety of rep ranges, depending on what we prefer. But we need to understand that foundational principle: we want to train close to failure, and we want to keep pushing ourselves, challenging ourselves. As somebody who has coached women and also tested a lot of women in research settings, I find that it's so common for them to really underestimate what they can do.

Charlie: And were you talking there about, what is a challenging load? If it was someone that's not comfortable in the gym, would you suggest maybe they got comfortable doing the exercise just body weight? So body-weight squats, body-weight lunges, before they increased or added weight?

Lauren: I would prefer you start with machines for many people, because performing some of these movement patterns is not very intuitive. If we start getting somebody on a machine doing the compound movements, so we're getting a full-body workout, then they can start understanding within that fixed movement pattern, "okay, I can add more load," and they don't have the added component of, "I don't know exactly how to do this with a barbell on my back," or, "I'm not comfortable holding a heavy enough dumbbell in the goblet squat position." Machines can be a good entry point for somebody who doesn't have access to a coach or a personal trainer and isn't really comfortable.

Greg: I think that's very pragmatic, in part for safety reasons, because with a machine you can just easily lower the weight and set it down and not think twice. Whereas if you're trying to squat with a barbell on your back, or doing a front squat, that's not nearly so straightforward. But also one of the issues, especially with the lower body, with using something like body-weight exercises, is that some muscles aren't so straightforward to target with exercises that are practical in many contexts. Whereas with machines, someone can go in the gym, they can see that machine there, it says it's for the muscles on the front of my thighs, my quadriceps. That one next to it, that's for the muscles on the back of my thighs, my hamstrings. And that one next to it, that's for the muscles in my lower legs, the plantar flexors. That way they know that they're ticking that box. Maybe we can start to push that 17% number up towards something we'd like it to be.

But going back to the menopause. It strikes me there's been a massive change in sentiment towards the use of hormone replacement therapy or HRT in recent years. What is HRT and what are some of the factors that women need to consider if they're thinking about implementing it? I'm thinking of contraindications to use, when they might start HRT, and what type of HRT to use as well.

Lauren: Typically we're talking about an oestrogen-based hormone therapy, but if you have a uterus, you'll want to take a progestin or synthetic progesterone as well. The primary reason to use this is for symptom management. It can be very effective, because if you're somebody who has bothersome symptoms and then you manage those symptoms with hormones, then you're much more likely to adhere to a consistent, effective training programme.

That said, not all women experience symptoms, and some manage completely fine without hormone therapy. So if you're not taking it, you're also not missing out. There's a lot of misconceptions about that right now, where people think that hormone therapy is going to extend their lifespan, or that it will prevent cardiovascular disease, or that it will prevent cognitive decline. That data is not out there. One contraindication could be if you have a current or prior breast cancer, but generally speaking, we're really looking at it from a symptom perspective. Meaning you wouldn't think about going on it pre-emptively. You would wait until if and when you are experiencing the hot flashes, the night sweats, and then you would think about exploring it.

The interest in testosterone therapy is very prevalent right now. There are misconceptions around that, because people are being told it will help them maintain their muscle mass. But testosterone therapy is only approved by menopause societies, only recommended in postmenopausal women, for low sexual desire. When we think about using it for that purpose, it's low doses to try to bump you up to maybe what your testosterone levels were slightly earlier in life, a normal range for a woman, which is low. At those low levels, we would never see any effects on the muscle.

Greg: And is it your experience that a lot of people are trying higher doses of testosterone replacement in that context and then getting some of those side effects? Or are people largely following guidelines and then maybe they're thinking, "ah, testosterone is good for my muscles," and then they're getting a nice placebo effect because of that?

Lauren: I don't think people are taking really high doses, because I don't think that a physician would prescribe that. But I do think people are going to their physician and saying, "for whatever reason, I want testosterone," they're asking for it, or they're lying about their sexual desire, because they've been told or they've read on Reddit that it will have these beneficial effects. So it's a very challenging landscape right now, and certainly there's more to learn, more research to be done. But when we actually look at the literature as a whole, we shouldn't be looking at hormone therapy for disease prevention in any way, shape or form.

Greg: It's about time to move to the experience segment. We're going to answer some listener questions, hear about your trials and tribulations out in the wild related to what we're talking about today. Just a reminder, if you'd like us to answer the questions on your mind, there is a way you have to sing them in.

Charlie: Yes.

Greg: And then send them in to us. Or you could just send a voice note via email to themethod@thriva.co and we'll include it in a feature guest episode or in one of our Q&As. We've got some great questions from you all this week, so let's get to them. Charlie, over to you.

Charlie: First one is from Zoe in London who has a question about pilates. It's a voice note.

Zoe: Hi Greg and Charlie. Love the show and thanks so much in advance for answering my question. I'm hoping that Dr Lauren will have some insight on this. So pretty consistently I have one or two days where my period starts where I have really bad back pain. I'll usually not do exercise on those days. Most of the time I will exercise definitely a couple of times a week, but I won't do it on those two days. But I did something different recently and I went to a pilates class to try and see if stretching would help with the pain. And I think it did, but it's kind of hard to tell. So I guess my question is, is there something specific, like a type of exercise or more rest or something, that I should be doing in the early days of my period? I feel like I haven't really found a good balance of activeness versus rest to help. So yeah, tell me, what should I be doing? Thank you so much.

Lauren: This really varies depending on the person. There are some women who feel like getting some movement actually makes them feel much better in terms of back pain or abdominal cramps. Others are in so much pain that they really benefit from taking a rest day. So a pilates class is a completely valid option, and really anything that's going to get the blood flowing a little bit, gets your mind off the pain, can be beneficial. But it is a bit of trial and error.

Greg: And do you think that this person might be able to work around those symptoms through selection of different exercises? For example, if they were doing resistance training and typically they were doing some exercises that loaded the core quite heavily and exacerbated that temporary back pain, switching to say machine-based exercises where that part of the body was less involved. For example, doing the leg extensions and the leg curls. Or if normally they were doing running for their cardiorespiratory fitness, or they were rowing, then they might find that something else, it could be cycling for this individual, lets them still get that training stimulus without exacerbating that pain.

An interesting example here might be using the sauna, because through the sauna you can get some of the same cardiovascular adaptations that you get through endurance exercise without loading the body the same way. That way you might still be doing something which is really good for the health of your heart and your blood vessels, and therefore things like your blood pressure, but without flaring that problem that you run into every month. Might be worth experimenting with some of those too. But Lauren, I'm just curious if you've got any responses to that.

Lauren: Yeah, I think those are all really great suggestions, and some women have a very predictable symptom day. For some people they can say, "day one I'm definitely going to have these symptoms," and so in that way you can play around with that. But at the same time, if it's only one or two days, I wouldn't be too stressed out if you're somebody who is in so much pain that you do really have to back off, or you're going to do something else entirely. But as I said, it can go the other way, where you find once you're actually up and moving, you do feel better. So it's worth trying.

Charlie: That feels like a message that was given to me constantly in PE in school when girls were always trying to say that they couldn't do PE because of period pains, and the PE teacher said, "it's proven if you move more then you'll get rid of the cramps."

The next question is another voice note, from Annalisa, who lives in Toronto in Canada and has a question about exercising postpartum, which isn't something we've touched on so far.

Annalisa: Hello. So I had a baby about a year ago via emergency C-section, and I basically stopped exercising when I was about one or two months pregnant. I just found that I couldn't handle going to the gym anymore. I couldn't handle the type of cardio that I had been doing previously. I was just getting really out of breath really fast and I was dealing with morning sickness, et cetera, et cetera. So I basically wasn't able to exercise for the majority of the pregnancy. After my daughter was born, she was home with me 24/7 every single day for about a year. So I just really didn't have the time or opportunity to exercise after that.

I went for a run for the first time a couple of weeks ago after she finally started daycare, and I finally had some time to really set aside and thought I would try to get back into it and get back into my old routine. Before I was pregnant, I was running two miles pretty regularly and pretty comfortably. I found that that was sufficient for me. I completed the run, and it actually went really well. According to my app, I think it was the third fastest run that I had done. So it felt pretty easy and it felt pretty good when I was running. But it completely took me out for at least two weeks. The next day I woke up and I was having pretty severe lower back pain, and significantly I was having a lot of pain around my C-section scar. It's really made me afraid to get back into exercising again. I just don't really know how to ease back into exercising the way that I used to. Obviously I can't do what I was doing before I was pregnant, but I don't really know how to train myself to get back to where I was before. So any advice that you have for easing back in and postpartum-specific exercising would be really helpful.

Lauren: Well, first, I think it's amazing that you're able to complete the run, because we lose those adaptations pretty quickly. If you're somebody who is a regular runner and then you stop running, it's really hard to get back into it and just pick up where you left off. We definitely wouldn't expect you to have maintained all of that. So really it's about easing back in a bit more slowly. Clearly if you went for that run, we probably should have tried a half-mile run on day one, and then see how that feels, and then work up from there.

The other thing I want to point out is just because you used to be a runner doesn't mean you have to go back to being a runner. I can speak from personal experience as somebody who used to love running, and then I got a stress fracture and I was in a boot for eight weeks or 12 weeks or something. It was awful. Then when I tried to go back to running, I had lost it all basically. I found that so demoralising, because I thought, "I used to love this and now I feel like I am back at square one." I started lifting weights then, and I never really went back to running. So it's also totally viable to say, "I am going to explore a different type of exercise and see if I enjoy that and see if I can do that pain-free." But whatever you choose, make sure that you're not trying to go from zero to a hundred on day one.

Charlie: Yeah, running puts very high forces through that area at high velocities as well. So actually doing some resistance training before doing any form of jogging, just exercises for the core in general but especially the sort of six-pack muscles, is likely to help with stability in that area and also potentially pain around the C-section. You could also graduate to running through other forms of similar exercise. For example, you can get some training stimulus by walking on a steeply inclined treadmill. It's not the same, but you are using the same muscles and you can certainly get your heart rate up and improve your fitness that way. Same with climbing the stairs. That way you are using those same muscles but at much lower speeds with lower forces as well. And then when you've been doing that for several weeks, then you could start jogging again. So is that the timeframe you'd recommend, then? Just thinking about, if Annalisa is thinking, "right, what's the gradual increase over a period of weeks where she's going to do half a mile?" Would it be two or three half-mile runs over the space of a couple of weeks and see how her body reacts?

Lauren: If running is the only thing that she wants to do, then I completely agree with Greg. Doing some incline walking would be good. Maybe even doing some walking lunges would be good. You can even do those at home. And then we can ease back into a short run and see how you feel before trying to do the two miles. But I like the idea of not necessarily focusing solely on running, especially because it sounds like she didn't really have a very positive experience recovering from the last run.

Charlie: It's really hard as well. I also had a stress fracture. The mental impact and the way it can make you feel so demoralised is an intense experience. I went from running the fastest 10K to being told I was potentially having femur surgery two weeks later. It's just a wild ride.

Greg: We are like a stress fracture team. I managed to break both my heels at the same time, so I was walking around in two boots on crutches for weeks looking very cool.

Lauren: Awful.

Charlie: We are a picture of health and everyone should do sports.

Greg: That was actually on a night out, but...

Charlie: Oh, Greg. Oh, oh, okay.

Lauren: That's a sport too.

Greg: Yeah. And it's a sport for your liver.

Charlie: The worst. The final question we've got is from Mel, who is an avid cyclist based in Bristol. So this is a written question. Mel has asked: "Hello. I train 15 hours a week, give or take. I'm training for long-distance cycling, and I'm doing two days in the gym and interval workouts on the bike, et cetera. There are periods where my training goes up and periods where my training goes down, but I have been noticing that I've been getting really, really sore muscles around my menstrual cycle. I'm wondering how to tailor the things that I'm doing. Is there anything I can be doing with my nutrition or anything I can be doing with the training programme itself to accommodate a cycle?"

Lauren: If she's doing two resistance training sessions per week and that's where she's feeling the soreness, then I would say you have the option to just move one of those sessions, because as I said before, we're typically talking about one or two days of symptoms. So if she was going to just bump the session to another day, that might be the easiest solution. In terms of managing the cycling, if you're going to swap out those days and you're going to go for a cycle instead, you could just keep it lower intensity and that might do the trick.

Greg: And one simple change that Mel might try, if she's not already doing this, is just adding in some static stretching for the affected muscles. Doesn't have a massive effect on delayed-onset muscle soreness, but it will tend to slightly reduce that. She asked about nutrition. There are lots of nutritional factors that can affect that, of course. Things like ensuring that your protein intake is adequate, something we discussed previously, and minimising consumption of alcohol around the time of damaging exercise, that's certainly going to exacerbate that DOMS. There are some things you can do in terms of dietary supplements. A good example would be tart cherry juice and concentrate, which can reduce exercise-induced muscle damage. But as a starting point, static stretching is certainly not going to hurt.

Greg: So I'm conscious of time, Lauren, and you've been very generous with your time today. To end, what one thing would you like listeners to take away from this episode?

Lauren: I want women to really focus on the fundamental principles that will help them reach their goals. Don't focus on this must-do workout or this must-do type of physical activity if it's not something that you enjoy or will do consistently. That's the key here. We need to do something we're going to enjoy, otherwise we just won't do it. Once you find that, then make sure that you continue to progress over time. If you are willing to add in some resistance training, full-body workouts, make sure it's heavy enough, make sure it's progressive in nature, and that will really set you up for long-term success.

We're living in a time where there's just a lot of noise in the women's fitness space. I think it really encourages us to focus on the wrong things, the protein or the creatine or the additional supplements or the weighted vest. We need to remember that we know what really, really works, the most effective tool in our toolbox, and that is the training.

Charlie: Amazing. Thank you so much. It has been really lovely to chat to you. So insightful. Thank you so much.

Lauren: Thank you.

Greg: Thanks Lauren.

Greg: Charlie, what are your key takeaways from today?

Charlie: New to the gym, machines over body weight. Going to test out the machines. Actually that's how I got back into it, because I was really anxious post-injury about jumping back to where I was pre-injury. I think I might have had a day where I got giddy and I thought, "yeah, obviously I'm going to go and back-squat all of that weight," and Lauren says, "oh, it probably wasn't that much," and switched to machines, and it definitely gave me the confidence just to then creep it back up. That was my takeaway. What's yours?

Greg: My takeaway is that females respond in many ways similarly to males, and therefore the training should actually be more similar than some people might have expected. Right now there's a lot of discussion focusing on the differences between the sexes, and some of that might be a little exaggerated. The key is to do the things that we know are important for your health, train all of those different exercise capacities across the life. But maybe a key factor is manipulating your training in the short term based on how you feel, because it could be that day to day the way that you feel physically fluctuates more than males of the same age during certain stages of life. So you just need to have some flexibility in how you approach exercise. Over time, better understand your body by experimenting with different ways to work around some of those symptoms.

Charlie: You've been listening to The Method: Health in the Real World, a podcast brought to you by Thriva.

Greg: If you don't know about Thriva, it's a health tracking platform that helps you see where your health is heading and what to work on, as well as how to do it. They use painless at-home blood testing to look inside your body and see what's going on. Your tests are analysed by accredited labs, and based on the results, which are reviewed by doctors, you get personalised guidance from real people. People use Thriva like compass testing every few months to help steer their health to where they'd like it to be. It's a great tool to start feeling more empowered about your health and to get the information that you need to make progress even when life is chaotic.

Charlie: Thriva also has some great content out there that can help you get to grips with complex health questions, exactly like what we're trying to do on this podcast. And all of that is free to access. So if you want to learn more, head over to thriva.co. That's thriva.co.

Greg: And if you want to listen to Charlie sing really, really well, subscribe to the show. Come back every week for more tunes. You won't be disappointed.

Charlie: Well, unless you beg me to stop. But even then, probably not.

Greg: You can find us by email at themethod@thriva.co.

Charlie: Seriously, we'd love to hear all of your questions and your voice. We love a voice note.

Greg: Special thanks to the Thriva team and to Lower Street for helping us bring the show to life. Content direction by Rich Cousins, Hamish Grierson, Tamar Loach, Vishal Shah and Katie Yockey. Production by our resident yogi, Lise Lovati, as well as Ryan Sutton and Sam Datta-Paulin. Designed by Alex Rose.

Charlie: We are your hosts, Charlie Edmondson and Greg Potter, and we will see you next time.

Greg: Thanks and bye.

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