Discussion/support regarding "Next Level" by Simms & Yeager

avondale

DIS Veteran
Joined
Oct 24, 2017
This thread is meant for discussion about the book "Next Level" by Stacy Simms and Selene Yeager. The book is about going through menopause, how physically active women are affected, and what they can do to keep their health and performance from suffering. The thread is also for support for those who have read it, are discussing it, or otherwise are interested in the topic. @PrincessV recommended the book on The Running Thread 2023.
 
This book was extremely timely for me, as I just turned 50 and am perimenopausal. I can definitely identify with several descriptions of this stage, such as rather abruptly putting on a lot of visceral fat.

I just finished the book this morning. I have quite a few things that I'm hoping to chat with others about...

The first thing I thought I'd mention was the book's recommendation about recovery meals/protein. It recommends 30 - 40g of protein within 30 minutes.

First, this is a really short timeline. I usually run after work and before dinner, so I eat dinner afterward. In principle, this works, but trying to clean up from a run and then get a decent meal in me within 30 minutes is hard. On the weekends with my longer runs, it's even more difficult. Other thoughts on this?

Second, the book mentions that usually recovery meals have a 3:1 carb:protein ratio. It kind of says that "yeah, you should do this" but then never mentions the carbs part again that I recall. So that means if you have 30g of protein, you need to also include 90g of carb. That's 120g of food, which is 480 calories! Again, for an actual meal, this is probably a reasonable amount of calories, but it's maybe 25% of the calories for the day, so if it's not a "meal", it's a big chunk of calories.

Curious if anyone has been following these guidelines, or if not, if you're planning to try to do so.
 
I feel like I should get this book because I’m definitely experiencing some peri-menopausal stuff. And I don’t have any close relatives that have gone through menopause “normally” to get a sense of how my family reacts.

I haven’t read this book, but I have Simm’s other book “Roar” which is not specifically tailored to the menopausal phase. In Roar she says that (ideally) the protein should be within 30min, and carbs within 2 hours.

From just a Marco standpoint, I focused hard on upping my protein this summer. I tracked my normal eating habits, and I was getting about 60% of what she suggests (0.8-1.2g/pound depending on type of training.) More protein definitely makes a difference in how hungry (and hangry) I was. And I did lose about 10 pounds that I put on during my winter mental health stuff. For whatever that’s worth.
 
I haven't read "Roar". There are some things that she specifically says are similar to discussions in "Roar" and other places where she mentions that the menopausal advice/situation is different than that for younger women that were more the focus in "Roar". Overall, I think it's helpful for her to make these distinctions because it might be confusing for someone who reads both books.

That's useful about the longer window for carbs!
 




I'm also here. Turning 43 in January and if I recall correctly, my mom started menopause around the time I got my first period, so she would have been around 44. I'm also an "older" first-time mom (had my son the month before I turned 39), and between the stress of pregnancy, parenting an infant during a pandemic, and getting older, my body has definitely changed. :P
 
Okay, I’m back and ready to chat!

For background, I’m approaching 53 and have been experiencing significant health issues for years, for which none of the many doctors and specialists I’ve seen have had answers. Chronic, debilitating joint and soft tissue pain. Heart palpitations. Chronic fatigue. Severe anxiety. Difficulty recovering from even relatively easy workouts. Hot flashes - 10 or more per night making sleep impossible for days at a time. Wacky thyroid fluctuations: I’ve had a thyroid autoimmune disease for 20 years, always well managed with meds, but now I’m constantly moving between feeling just right, overmedicated, and under-medicated. Periods all over the place after being as regular as a Swiss watch for decades: one went on for 6 straight weeks.

Full honesty? It’s been so bad at times, I wished not to wake up at all or ever again some days.

I live in an area that skews toward older ages and poorer health, and figured out long ago that if you seem outwardly to appear younger and/or more healthy than a doctor’s average patient, you often get written off as being ”fine” because you’re measured against the general population. I have been, anyway. I’ve had a doctor tell me straight-up, “Most of my patients can barely walk - you’re doing great if you can run at all!” It wasn’t until I saw a middle-aged, female practitioner at a sports med outfit that someone agreed that going from training for and nailing Dopey year after year with no major issues to not being able to run-walk more than 3 miles without feeling like death was a huge red flag that *something* was off. And it wasn’t until I saw my chiropractor for pain associated with lifelong scoliosis that someone said, “You know, it could be perimenopause…” - and at that, only because she happens to be the same age, a runner, and dealing with similar issues herself - and also not getting answers because she appears young(er) and fit.

I had heard of Stacey Sims, I think from an Another Mother Runner podcast, but didn’t think too much of the menopause discussion, because again: the medical community never once mentioned that as a possibility. But after spending way too much of my time and money on useless tests and copays, and diving deep into depression as I tried to accept that I was suddenly old, unfit, washed up, and my body would never again respond as it has for 50 years, I Googled some issue one last time, stumbled onto a Runner’s World article that described EVERYTHING I’ve been dealing with, stated that ALL of it is classic perimenopausal symptoms, and a light bulb went off! That led me to Next Level looking for answers.

I still don’t have everything solved. I don’t even have some of the things solved some days! But the #1 thing I gained from the book was this: perimenopause/menopause isn’t a stationary event - it’s not just BAM hormones drop and you’re done… it’s a roller coaster of ups and downs and in-betweens, and the old way of linear training isn’t working because of those fluctuations. The book has helped me give myself grace to change things up, to skip a workout altogether, to go hard when I feel good and go easy when I don’t. As a lifelong recreational athlete, that’s been a really, really hard adjustment to make. I grew up in the “if it doesn’t hurt, you’re not working hard enough” era and that still jams things up. But I’m trying, and the changes I’ve made have, indeed, helped!

I’ll dive into some of what I’ve taken and tried from the book in another post. I’m just hugely relieved and grateful and that we’re here, talking openly about this. I really hope we’re starting to open the door to more and more open discussion about aging and the female athlete, so our daughters and their daughters and beyond will be better equipped with the information they’ll need.
 
Just checked out the ebook from my library and I'm ready to dive in! I'm 46, 47 in March, so I must be getting close to this phase. Though I haven't seen my OB/GYN in 7 years so I have no idea where I'm really at. And yes, I know I really need to go. I'll be back to discuss once I read a little!
 
The first thing I thought I'd mention was the book's recommendation about recovery meals/protein. It recommends 30 - 40g of protein within 30 minutes.

First, this is a really short timeline. I usually run after work and before dinner, so I eat dinner afterward. In principle, this works, but trying to clean up from a run and then get a decent meal in me within 30 minutes is hard. On the weekends with my longer runs, it's even more difficult. Other thoughts on this?

Second, the book mentions that usually recovery meals have a 3:1 carb:protein ratio. It kind of says that "yeah, you should do this" but then never mentions the carbs part again that I recall. So that means if you have 30g of protein, you need to also include 90g of carb. That's 120g of food, which is 480 calories! Again, for an actual meal, this is probably a reasonable amount of calories, but it's maybe 25% of the calories for the day, so if it's not a "meal", it's a big chunk of calories.

Curious if anyone has been following these guidelines, or if not, if you're planning to try to do so.
Numbers are not my thing, and I don’t have the time or interest for counting anything - grams, calories, or minutes! I also deal with chronic low blood sugar, so I’ve made a habit for 40 years of eating every few hours and making sure each meal and snack has a good mix of complex carbs and protein to keep my blood sugar level up without crashing. My approach to adding more protein so far has been simple:

Some kind of high-protein food as soon as I finish my workout: Greek yogurt, protein shake, cottage cheese, mini-Gouda cheese with crackers, hard-boiled egg, etc. On weekdays, I exercise after work, so this is basically an extra snack between workout and dinner. Weekends, it usually comes between bfast and AM snack times. No, it’s definitely not 30g, but by the time I add in dinner or my usual AM snack, I’m probably hitting that in total.

That’s really the only change I’ve made. I still eat bfast, AM snack, lunch, PM snack, dinner each day and I haven't changed those up from my norm. An average day might be:
Bfast - oatmeal made with skim milk, plus berries, a teaspoon of almond butter, drizzle of honey
AM snack - Geek yogurt
Lunch - biggish sliced chicken breast sandwich on oatmeal bread, salad with avocado (protein!) or feta
PM snack - Clif bar and banana
Post-workout - protein shake made with skim milk
Dinner - salmon, broccoli, baked sweet potato

I’m not a big eater, and find all this daily consumption a chore TBH. Just adding in the extra calories of that post-workout snack has probably done me a LOT of good from a fueling standpoint; it’s hard to say if it’s that or the extra protein, or both, but I feel much better since adding it in! I seem to have less muscle soreness after hard workouts, and more energy overall. I’ve also lost weight - which wasn’t a goal and wasn’t necessary: I was at a healthy weight to start. But it’s only been a few pounds and seems to have leveled off, so I’m not worried about it: I had a little wiggle room within the range of healthy. Just an interesting by-product that could have something to do with more calories and protein, and/or the extra weight in strength training (which is a whole separate post!)
 
I'm here, I'm 48 and perimenopausal. I haven't read the book yet, but am interested. I've been through the ringer the last two years with a myriad of unusual symptoms - weight gain, fatigue, achiness, night sweats, vitamin deficiencies, GI problems (nausea, bloating, etc.), and swollen lymph nodes/glands. I've been passed around from doctor to doctor. I even had a lymph node biopsied last spring because they were worried about lymphoma (thankfully benign). I'm currently being evaluated for some autoimmune stuff, but I'm hitting dead ends there too.

I am beyond frustrated. My gut is telling me that something is off, but I also realize that many of these symptoms are very common in women my age. To make matters worse, my OB/GYN retired earlier this year, so now I have to find someone new.

My running has suffered. I don't have any energy and I'm slower than molasses.
 
I’m sending big, big virtual hugs across the web, @michigandergirl, because I feel your post to my core! BT/DT. I’d still be running through the medical testing/specialists obstacle course now, had I not simply run out of time and money to continue. It’s frustrating and infuriating that we don’t have better knowledge across the spectrum of healthcare to understand how much hormones impact EVERYTHING, from heart, to GI, to bone density, to muscle strength, to immune functions. Even many - maybe most - OB/GYNs aren't educated in peri/menopause. Make that make sense?!?!
 
One of the big things the book covers, and that I’ve spent time learning about more beyond the book, is the hormonal changes that come with peri. That it’s not “just” that estrogen production drops, but that it can go up and down wildly and without pattern for years (like, potentially a LOT of years - Oy), before hitting menopause… and can still continue to do some weird stuff post-menopause, too.

Something I’ve done for the past few years is track EVERY weird thing my body has going on. With periods becoming so irregular, it really took 2 years’ worth of tracking to see the pattern: every time my estrogen surges, then drops, I feel ill. That “I think I’m coming down with the flu” feeling: achy joints and muscles, cranky glands, general malaise and fatigue. And in the times between, when whatever level they’re at, estrogen and progesterone are pretty well balanced, I feel good, approaching “normal.” It’s this constant, but unpredictable, cycle of ups and downs. And just to keep things fun, estrogen plays a HUGE part in thyroid function/absorption of thyroid hormone replacement meds: when estrogen surges, thyroid med absorption drops - hello fatigue, pain, brain fog - and when estrogen tanks, thyroid med absorption increases greatly - hello racing heart, sleeplessness, anxiety. I tried HRT to see if I could keep things better balanced, but it didn’t work: my own body is still producing estrogen and progesterone in fits and starts, so adding more info the mix just made the back and forth more dramatic.

Anyway, it’s that yo-yo-ing of hormones that makes it all so challenging. Some women are able to find ways to balance it out better, but I’ve not had that luck. So the book’s advice to tailor your training loads to meet your body where it’s at on any given day has been a HUGE help to me! Wake up feeling sore, tired, and blah? I take it slow and easy and my 45-min run-walk may turn into a 20min walk instead. Wake up feeling strong, rested, and ready to go? Instead of a steady 45 mins, I might make a mile or more of it sprint or hill intervals. A few weeks ago, my training plan called for a 12-mile long run, but my body was clear at mile 7 that it was NOT having it. So I walked back home for a total of 9 and called it good. 2 weeks later, I had one of the strongest half-marathons I’ve had in a while!

NGL: I do not like any of this. I like having a plan on paper and ticking off goals met. It’s a BIG mental effort to change this up, but I cannot deny that it’s working.
 
I'm SO here! I turn 53 at the end of December and have been experiencing symptoms all over the map for more than three years now. Nobody in my family has gone through natural menopause, and I don't have kids, so I had no idea what to expect.

I could pretty much copy the list @michigandergirl posted, including concern over lymph nodes. Plus my migraines increased with a vengeance (both frequency and intensity) and my ADHD symptoms went completely haywire. The docs in Utah were zero help, aside from prescribing Nurtec for my headaches. Thankfully, since moving to Vermont, I've found fantastic women-centric healthcare and am finally on a hormone combination that has brought a ton of relief. I've never taken medication for my ADHD and prefer not to add it in case it throws things out of whack, but it is super frustrating. On the running side, I still find my recovery is slow and I'm having trouble focusing on training.

I bought the book on my Kindle and have just started it, so I'm very much looking forward to catching up and discussing with all of you here.
 
I haven’t read the book yet, but will be following along. I bought it and have tried to read it a few times, but my ADD brain has a hard time with anything but fiction and drifts off to other things 😂 I’ll be 47 in February. I have hypothyroidism and Pernicious Anemia.

I was diagnosed with a stress fracture in my hip in 2019 that opened a huge can of worms and I ended up going down a really weird path that ended up with my PA diagnosis. In simple terms, I am unable to absorb B12 from food. I am on weekly B12 injections for life. I had been told for over 20 years that all my symptoms were in my head or they would just throw the word Fibromyalgia at me and offer me antidepressants.

Fast forward to a hysterectomy in 2021. I still have both of my ovaries, but within a year of surgery they decided they were going on strike. My estrogen level this time last year was ZERO and my weight was creeping up not to mention the awful fatigue that even extra B12 shots couldn’t help, horribly dry skin, night sweats and oh my with the mood swings! I have no idea looking back how I got by day to day. I am on hormone replacement therapy now and I know that’s not for everyone, but it has drastically changed my life for the better. I get my levels checked every 90 days.

As for running…I just don’t have the same enthusiasm for it right now (except for Disney race weekends). I get it done, but my heart isn’t totally there.
 
I bought the book. I have not started reading yet. I was going to say I am still taking birth control, which is basically hormone therapy. I dont even take the placebo pills. I am on low dose estrogen all year round, as of June 2023. I was taking BC and doing placebo pills once every three months but when i was complaining the the gyno about the night sweats, the fatigue and that over all this sucks feeling. She said we go to no placebo pills. It has helped.

Its been a struggle this year. My weight is up and my running always hurts. The knee has been an issue for almost 3 years now. I am super glad i am only doing the half this year at MW. I love doing the marathon but my knee won't make it yet and honestly i can't convince myself to do the training.

On the next sucky note (sorry it is a pity party for myself but i feel safe here :-) ), my mom fell on Nov 7, we were at disney for W&D, she fractured her femur. Had surgery on Nov 8. She is 82, has hypertension, diabetes type 2 and kidney disease. She was in the hospital for 2 weeks with issues, but today we did move her to a rehab facility. She has been very sedentary and has not yet been able to get out of bed at the hospital. I am hopeful for rehab but ugh.
 
Thanks @avondale for starting this thread! I was on the list for my library online but their copy expired with sooooo many people in line for it so I will probably end up buying it instead. I am turning 50 in January and am clueless about what lies ahead. No living female relatives to ask about this stuff so I’m trying to find some good sources of info.

ETA: Physical copy is available at my library! Can’t wait to read it and discuss with everyone here!
 
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