Women's Fitness & Metabolic Testing

Menstrual cycle phase can influence both testing results and training performance:

• Follicular Phase (Days 1 to 14):
  • • Generally better performance and higher energy
  • • Lower baseline RMR
  • • Higher pain tolerance
  • • Better suited for VO₂ max testing if you want peak performance
  • • Estrogen rising, promotes anabolic processes
• Ovulation (Day 14):
  • • Peak estrogen levels
  • • Often best performance window
  • • Some women feel stronger and faster
• Luteal Phase (Days 15 to 28):
  • • Progesterone dominance
  • • RMR increases 5 to 10% (50 to 150 calories per day)
  • • Body temperature slightly elevated
  • • May feel sluggish or retain water
  • • Performance may feel harder for same effort
• Menstruation (Days 1 to 5):
  • • Hormone levels lowest
  • • Some women feel fatigued, others feel relief as symptoms resolve
  • • If heavy bleeding, may have mild anemia affecting VO₂ max

Testing Recommendation: You can test any time in cycle. Results are valid regardless of phase. If you want to test at your physiological peak, follicular phase or ovulation is ideal. Note cycle day on intake form for context.

Training Across Cycle: Use VO₂ max zones as baseline, but recognize intensity may feel harder in luteal phase. This is normal, not fitness loss.

The menopausal transition (typically ages 45 to 55) brings dramatic metabolic shifts:

• RMR Decline: Metabolism drops average 200 to 400 calories per day during menopause due to:
  • • Loss of estrogen's metabolic effects
  • • Decreased muscle mass (sarcopenia accelerates)
  • • Redistribution of body fat to abdominal area
  • • Reduced thyroid function in some women
• Weight Gain Pattern: Average woman gains 5 to 10 pounds during menopausal transition, predominantly abdominal fat (visceral fat) which increases health risks
• Cardiovascular Fitness Decline: Without intervention, VO₂ max can drop 10 to 15% through menopause. Exercise mitigates this
• Why Testing is Critical During This Transition:
  • • RMR Testing: Know exact metabolic rate, not estimates. Adjust calories to match new reality. Prevents frustration of eating "what always worked" and gaining weight
  • • VO₂ Max Testing: Establish exercise intensity for cardiovascular protection, bone health, and weight management. Exercise is THE most effective intervention for menopausal symptoms
  • • Track Changes: Retest RMR every 6 to 12 months through transition. Update calorie targets as metabolism changes
• Hormone Replacement Therapy (HRT) Considerations: If on HRT, testing provides baseline metabolic data. Some women see metabolic rate improve with HRT. Testing before and after starting HRT quantifies effects

Exercise Recommendations for Menopause:

• • Cardiovascular: 150 minutes per week moderate intensity (Zone 2). Proven to reduce hot flashes, improve mood, maintain weight
• • Resistance Training: 2 to 3 times per week. Critical for maintaining muscle mass and bone density
• • Higher Protein: 0.8 to 1.0 grams per pound body weight to preserve muscle

Medical Clearance First: Obtain approval from OB/GYN before any fitness testing. Typically 6 weeks postpartum for vaginal delivery, 8 to 12 weeks for C-section.

• Why Test Postpartum?
  • • Establish safe baseline fitness after pregnancy
  • • Set appropriate exercise intensity for gradual return to activity
  • • Avoid overtraining during recovery period
  • • Track return to pre-pregnancy fitness levels
  • • Support postpartum weight loss with accurate RMR data
• RMR Testing for Breastfeeding:
  • • Breastfeeding burns 300 to 500 calories per day
  • • RMR testing provides base metabolic rate
  • • Add breastfeeding calories to ensure adequate nutrition
  • • Prevents undereating that can affect milk supply
  • • Supports healthy postpartum weight loss (1 to 2 pounds per week maximum while nursing)
• VO₂ Max for Return to Running/Exercise:
  • • Testing on bike or rower if pelvic floor concerns
  • • Gradual return to running after proper rehab
  • • Work with pelvic floor physical therapist alongside fitness testing
• Realistic Expectations: Fitness typically 20 to 40% below pre-pregnancy levels initially. This is normal. With consistent training, most women return to baseline in 6 to 12 months

PCOS affects 8 to 13% of reproductive-age women and has significant metabolic implications:

• PCOS Metabolic Characteristics:
  • • Insulin resistance (70 to 80% of women with PCOS)
  • • Elevated androgens (testosterone) affecting metabolism
  • • Difficulty losing weight despite calorie restriction
  • • Increased risk of Type 2 diabetes and metabolic syndrome
  • • Often lower than expected RMR for body size
• Why RMR Testing is Valuable for PCOS:
  • • Reveals true metabolic rate (often lower than predicted)
  • • Explains why standard calorie recommendations have not worked
  • • Provides accurate target for weight management
  • • Shows if metabolism improving with treatment (metformin, inositol, lifestyle changes)
• Exercise for PCOS Management:
  • • Exercise is first-line treatment alongside diet
  • • Improves insulin sensitivity dramatically
  • • VO₂ max testing provides zones for consistent aerobic training
  • • Zone 2 training particularly beneficial for insulin sensitivity
  • • Resistance training 2 to 3 times per week increases muscle mass and metabolic rate
• Nutrition with PCOS: RMR data combined with lower carbohydrate approach often most effective. Work with registered dietitian specializing in PCOS

Thyroid disorders disproportionately affect women (5 to 8 times more common than men):

• Hypothyroidism (Underactive Thyroid):
  • • Slows metabolism 5 to 15%
  • • Causes weight gain, fatigue, cold intolerance
  • • RMR testing shows actual metabolic impact
  • • Retest after medication adjustment to see if RMR normalizes
• Hyperthyroidism (Overactive Thyroid):
  • • Increases metabolism 10 to 25%
  • • Causes unintended weight loss, anxiety, rapid heart rate
  • • RMR testing contraindicated during active hyperthyroidism until treated
• Hashimoto's Thyroiditis:
  • • Autoimmune hypothyroidism
  • • Common in women
  • • Metabolism fluctuates during flares
  • • Testing helps track metabolic stability
• Exercise with Thyroid Conditions: Once thyroid levels stabilized with medication, exercise is beneficial and safe. VO₂ max testing ensures appropriate intensity

Women face dramatically higher osteoporosis risk than men:

• Statistics: 1 in 2 women over 50 will break a bone due to osteoporosis. Men: 1 in 4
• Risk Factors:
  • • Menopause (estrogen loss accelerates bone loss)
  • • Low body weight or history of eating disorders
  • • Excessive exercise with low energy availability (RED-S)
  • • Family history
  • • Certain medications (steroids, some breast cancer treatments)
  • • Smoking, excessive alcohol
• Exercise for Bone Health:
  • • Weight-Bearing Cardiovascular: Running, hiking, stair climbing. VO₂ max testing provides safe intensity zones
  • • Resistance Training: Essential. Bone responds to mechanical load. 2 to 3 times per week
  • • Impact Activities: Jumping, hopping if appropriate and cleared by physician
  • • Avoid: Swimming and cycling alone (non-weight-bearing) do not build bone density. Good for cardiovascular fitness but must be supplemented
• Testing Considerations: If diagnosed osteoporosis or osteopenia, discuss with physician before maximal exercise testing. May need to test on bike rather than treadmill to reduce fracture risk

Female Athlete Triad: Interrelated conditions of low energy availability, menstrual dysfunction, and low bone density

RED-S (Relative Energy Deficiency in Sport): Broader term including men, encompasses many body systems affected by low energy availability

• Warning Signs:
  • • Loss of menstrual period (amenorrhea) in reproductive-age women
  • • Irregular cycles
  • • Stress fractures
  • • Declining performance despite training
  • • Chronic fatigue
  • • Getting sick frequently
• Role of RMR Testing:
  • • Low RMR (below predicted) suggests metabolic suppression from chronic energy deficit
  • • Helps identify athletes not eating enough for training volume
  • • Guides nutrition intervention with sports dietitian
  • • Monitors metabolic recovery as energy availability restored
• Medical Treatment Required: If you suspect triad/RED-S, work with physician, registered dietitian, and mental health professional. May need to reduce training volume temporarily

Women face unique weight management challenges:

• Slower Basal Metabolism: Women have 5 to 10% lower RMR than men of same weight due to less muscle mass. Smaller calorie margin for weight loss
• Hormonal Fluctuations: Water retention, appetite changes, and energy fluctuations across menstrual cycle make consistent dieting harder
• Menopause Metabolic Drop: Sudden 200 to 400 calorie decrease requires dietary adjustment many women do not anticipate
• Social and Psychological Factors: Greater body image pressure, emotional eating patterns, diet industry targeting
• How RMR Testing Helps:
  • • Ends guessing at calorie needs
  • • Explains why certain calorie levels have not worked
  • • Provides realistic deficit for 0.5 to 1 pound per week loss
  • • Prevents excessive restriction that damages metabolism
  • • Empowers with data rather than fad diets

VO₂ Max + RMR Testing Combined

Most comprehensive approach for women's fitness and metabolic health:

• Complete Metabolic Picture: Know both your calorie needs (RMR) and cardiovascular capacity (VO₂ max)
• Exercise and Nutrition: Get training zones AND nutrition targets in one visit
• Track Life Stage Changes: Baseline both tests now, retest as you move through perimenopause, menopause, or other transitions
• Best Value: $300 vs. $325 separately

How we accommodate women's unique needs:

• Female Norms: All results compared to female age-matched populations
• Menstrual Cycle Noted: We ask cycle day for context but test any time
• Private, Comfortable Environment: Professional, respectful testing atmosphere
• Equipment Choice: Treadmill, bike, rower, or stair mill based on your preference and any pelvic floor or joint concerns
• Gradual Protocols: Can modify test progression if needed
• Female Tester Available: Upon request

Testing results complement medical care. Share data with:

• OB/GYN: Discuss results in context of hormone health, bone density, cardiovascular risk
• Endocrinologist: If PCOS, thyroid, or other hormonal conditions
• Registered Dietitian: Specializing in women's health, can use RMR for meal planning
• Pelvic Floor Physical Therapist: If postpartum or pelvic floor concerns
• Personal Trainer/Coach: Use VO₂ max zones to design women's fitness programs

RMR Test: $75
VO₂ Max Test: $250
Performance Pack (Both): $300 (save $25)

Can test any day of menstrual cycle. Note cycle day or menopausal status on intake form.

Fit Evaluations
311 Soquel Ave
Santa Cruz, CA 95062

Behind Hindquarter restaurant (second entrance off Dakota St.)

Phone: 831-400-9227
Email: info@fitevals.com

Call to discuss your specific women's health considerations and testing options.