For most of the history of exercise science, the participants were men.There were reasons given — hormonal fluctuation made female subjects “noisy” data, recruitment was easier through university sports teams that were mostly male, and there was a long, unlovely tradition of assuming that findings in men generalised to everyone. The result is that a large portion of what we confidently know about training was established on young men, and then handed to everyone else with the labels changed.
This is improving, and quickly. But it’s left a specific shape of gap. Not in the fundamentals — a squat is a squat, progressive overload works the same way, and the basic physiology of muscle adaptation isn’t sex-specific in any way that changes what you should do on a Tuesday. The gap is at the life stages that only happen to women, where the standard advice simply stops and nothing takes its place.
Two of those stages account for an enormous amount of quiet, unaddressed difficulty: the year or two after having a baby, and the decade around menopause. Both are periods when the standard fitness conversation becomes not just unhelpful but occasionally harmful. So let’s talk about them.
After a baby: the six-week check does not mean what people think
Most women in the UK have a postnatal check somewhere around six weeks, and an enormous number leave it believing they’ve been cleared to resume exercise.
What that appointment usually establishes is that nothing is medically wrong. It is not, in most cases, an assessment of whether your abdominal wall and pelvic floor are ready to absorb impact and load, because that assessment takes time and specific examination that a standard appointment rarely includes.
The distinction matters, because the tissues involved have been through something substantial. The pelvic floor has supported an increasing load for months. The abdominal wall has stretched, and in many women the connective tissue between the abdominal muscles has widened — a normal, expected adaptation, which resolves for most people and doesn’t for everyone. Ligaments have been affected by hormonal changes that persist for a while, particularly with breastfeeding.
None of this means you’re fragile or that exercise is dangerous. It means the return is a graded process rather than a switch that flips at six weeks, and going straight back to running or heavy lifting because you’ve been “cleared” is how a lot of women end up with problems that are much easier to prevent than to fix.
The genuinely useful thing — and I’d put it above any programme — is a pelvic health physiotherapist. In some countries this is routine postnatal care. In the UK it usually isn’t, and you often have to ask or go privately, which is an equity problem in its own right. But a single assessment gives you actual information about your own body rather than general advice, and that’s worth more than anything I could write here.
Things that are common but not “just normal”
There’s a phrase that does real damage: that’s just what happens after kids.Leaking when you cough, sneeze, jump or run is extremely common after childbirth. It is not something you have to accept permanently. It’s a symptom of a pelvic floor that isn’t yet doing its job well, and it responds — often very well — to targeted rehabilitation. Large numbers of women live with it for decades because everyone told them it was normal and nobody told them it was treatable.
The same goes for a persistent sense of heaviness or dragging, for ongoing back pain, and for a stomach that domes into a ridge when you sit up. All common. All worth getting looked at rather than accepting.I’m labouring this because the cultural script encourages silence about it, and silence is expensive here.
The “bounce back” thing
The other harm in this period isn’t physical.The pressure to return quickly to a previous body is intense, largely commercial, and almost entirely unhelpful. It produces a predictable pattern: exhausted new parents attempting demanding programmes on broken sleep, failing, and adding that failure to an already difficult period.
The physiological reality is that this is one of the worst possible times to be aggressive about training. Sleep is fragmented, which undermines adaptation more than any programme choice. Recovery capacity is reduced. Time is not available in blocks. Whatever you attempt has to survive a night that goes badly, and most programmes don’t.
The version that works in this period is small and unglamorous: walking, gradually rebuilding the deep core and pelvic floor, some basic strength work, and a great deal of patience. The goal isn’t progress. It’s tissue quality and habit maintenance, so that when sleep returns — and it does — you’re in a position to build.
And the timeline is longer than anyone admits publicly. A year is normal. Longer is normal. The people whose recoveries appear on the internet in eight weeks are not representative and sometimes not honest.
Perimenopause: the decade nobody prepared you for
The other underserved stretch runs from the late thirties or forties through to a few years past the last period — and it’s a longer, messier phase than the word “menopause” implies.
What tends to change, physiologically: bone density loss accelerates around and after the menopausal transition, as oestrogen declines. Muscle mass becomes harder to maintain. Body composition often shifts in ways that feel unfamiliar even when nothing about diet or activity has changed. Recovery from hard sessions can take longer. Sleep is frequently disrupted, which cascades into everything else. Joints may feel different. Temperature regulation during exercise can change.
Each of those is individually manageable. Arriving together, unannounced, in a body that used to behave predictably, they’re disorienting — and a lot of women interpret the whole thing as a personal failure of discipline, because that’s the framework we’ve all been given for any unwanted change in a body.
It isn’t. It’s a hormonal transition with real physiological consequences, and the appropriate response is to adjust the approach rather than to conclude you’ve stopped trying hard enough.
What actually helps in that phase
The single clearest message from the evidence: this is when resistance training becomes more important, not less.
Bone density and muscle mass are the two things declining, and loaded resistance work is the primary non-pharmacological lever for both. Impact — jumping, hopping, brisk activity that loads the skeleton — also appears to help bone, where joints allow it. This is the opposite of the instinct many people have, which is to move toward gentler, lower-load activity as things start feeling harder.
Some other things that come up repeatedly:Prioritise sleep more aggressively than you used to, and treat disrupted sleep as a reason to reduce training intensity rather than to push through. Protein intake becomes more important for maintaining muscle. Recovery between hard sessions may need to be longer — which typically means fewer hard sessions and more easy movement, not less training overall. And strength work tends to help with several symptoms indirectly, including mood and sleep, though nobody should oversell that.
Anything involving hormone therapy is a conversation with a doctor, and a genuinely worthwhile one to have if symptoms are affecting your life. It isn’t something to work out from articles, including this one.On cycle-based training Since it comes up constantly: the current fashion is for programmes and apps that adjust training according to the menstrual cycle — heavy work in one phase, lighter in another.
The honest state of the evidence is that this is a lot less established than the marketing suggests. There are plausible mechanisms and some suggestive findings, but the research is limited, the effects appear small on average, and individual variation is large — larger, in several studies, than the average phase effect being sold.
Which doesn’t mean it’s nonsense. Many women notice real, consistent differences in energy and performance across their cycle, and adjusting training to that is entirely sensible. The distinction I’d draw is between tracking your own pattern and responding to it, which is useful, and following a prescriptive phase-based programme derived from thin population data, which is probably overreach.
