Since the onset of perimenopause, 51-year-old Sims found that those activities made her feel “drained ... and gross” and no longer had the same effect on her body.

Based on her own experience, alongside an emerging body of literature, Sims believes that the long, moderate workout doesn’t provide the body with the stimulus needed to offset declining oestrogen.

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What menopausal women need to prioritise, she suggests, is the strong external stimulus that comes from high-intensity interval training (HIIT) or the shorter, more intense sprint interval training (SIT). True HIIT is not to be confused with 45 or 60-minute classes marketed as HIIT, which have too many sets and insufficient recovery between them.

“If it’s done properly, it has a post-exercise response that increases growth hormone and increases testosterone, which brings cortisol down,” says Sims, adding that it invokes the parasympathetic response we need for sleep.

The work of Professor Abbie Smith-Ryan, director of the Applied Physiology Laboratory at North Carolina University, has explored the effects of HIIT and SIT on midlife women. She says just one HIIT session a week can result in positive adaptations – two to three is ideal.

HIIT and SIT activate mitochondrial changes which improve fat oxidation, the cardiovascular system, stimulate muscle and overcome metabolic inflexibility (the inability to switch fuel sources during exercise, which can be a contributor to weight gain).

“This method of training can also target belly fat, which increases in perimenopause, [and] be better for injury prevention, as there is less time under tension/stress,” Smith-Ryan says. And it’s all in 10 minutes of work – 20 if you include recovery.

It does not mean women should not also do moderate or low-intensity exercise, she says: “But HIIT will definitely give women a bigger bang for their buck.”

Sims adds that, if someone is not exercising at all, then just starting to move regularly is most important. Short bursts of more intense exercise can be phased in gradually and need to be accompanied by mobility work and warming up.

“It takes longer to warm up now that we’re older,” says Sims. “My friends and I laugh, we want to go for a 20-minute run, but it takes us an hour and a half.”

Though Sims says the consensus is “building” that perimenopausal and menopausal women need separate physical activity guidelines, not everyone agrees.

Dr Mandy Hagstrom, an accredited exercise scientist and researcher from UNSW, says each woman’s experience is different and can vary from day to day, particularly during perimenopause, when hormones can fluctuate wildly.

“The evidence we have is so all over the show we can’t synthesise it,” Hagstrom says. “Population-level advice will be challenging because variability between women is so big.”

What we do know, she says, is that exercise of any form can mitigate changes and symptoms resulting from menopause. Hagstrom doesn’t believe there is enough evidence to show HIIT and SIT are superior but agrees that we don’t have to become more moderate with age.

“Strength training would be my recommendation because muscle is linked with falls, metabolic control and body comp regulation,” she says, adding that only a quarter of women do two strength sessions a week. “It’s not inevitable that the change in hormones is going to rob your body of what it used to be.”

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