Exercise Is More Important for Women

Here’s an uncomfortable irony: women exercise less than men, even though they need it more.

The data is clear on the need. Almost two-thirds of all Alzheimer’s patients are women. Women are twice as likely as men to develop depression. Women experience more rapid physical and cognitive decline during and after menopause. Women lose bone density faster than men. And the protective effects of exercise on the brain, bones, and overall health are more critical for women than men at nearly every life stage.

Yet despite this greater need, women face unique biological and social barriers that make regular exercise harder to maintain. Lower oxygen-carrying capacity due to less hemoglobin. Higher baseline body fat percentage. Social conditioning that historically excluded women from strength training. A medical and fitness industry built on male data that treats women as “small men” rather than understanding their distinct physiology.[^1]

The result? Women are systematically undertrained and underprepared for the accelerated decline that hits during perimenopause and beyond.

But here’s the good news: exercise is one of the most powerful interventions available to women. It protects the brain, strengthens bones, improves metabolism, enhances learning and memory, and can dramatically slow, or even reverse, age-related decline.

This isn’t about aesthetics or weight loss. This is about protecting your brain, maintaining your independence, and ensuring you remain physically and cognitively capable as you age.

Let’s examine why exercise is uniquely critical for women, and what you should actually be doing.

The Alzheimer’s Crisis Is a Women’s Crisis

Almost two-thirds of all Alzheimer’s patients are women, particularly post-menopausal women.[^2]

For decades, the explanation was dismissively simple: “Women live longer than men, and Alzheimer’s is a disease of old age, therefore more women get it.” Case closed.

But Dr. Lisa Mosconi, a neuroscientist who specializes in women’s brain health, challenged that assumption. Her groundbreaking research showed that Alzheimer’s is not a disease of old age: it’s a disease of midlife with symptoms that appear in old age.

Alzheimer’s begins in the brain with negative changes that take years, sometimes decades, to reach the threshold where symptoms become obvious. By the time someone is diagnosed, the damage has been accumulating for 15-20 years.

And here’s the key finding: already in midlife, women show red flags of Alzheimer’s disease in their brains, whereas men do not.[^2]

Brain scans of women in their 40s and 50s reveal patterns of reduced glucose metabolism, amyloid plaque accumulation, and brain volume loss; early warning signs that don’t appear in men at the same rate or severity.

So what happens to women in midlife that doesn’t happen to men?

Menopause.

During menopause, estrogen levels plummet. Estrogen isn’t just a reproductive hormone, it’s neuroprotective. It supports glucose metabolism in the brain, protects against inflammation, and helps maintain brain structure. When estrogen drops, the brain struggles.

Dr. Mosconi’s research shows that glucose utilization in the brain, especially the forebrain, changes dramatically through perimenopause and menopause. Women’s brains shift from efficiently using glucose for energy to struggling with metabolic dysfunction, a pattern that’s a precursor to Alzheimer’s.[^3]

This is where exercise becomes critical. Because exercise provides an alternative fuel source for the brain: lactate.

Exercise Produces Lactate: The Brain’s Preferred Fuel

When you exercise intensely, whether through resistance training, high-intensity intervals, or vigorous cardiovascular work, your muscles produce something called lactate (formerly known as lactic acid).

For years, lactate was thought of as a waste product, something that caused muscle soreness and fatigue. We now know that’s completely wrong.

Lactate is a powerful fuel for the brain, and during exercise, it becomes the brain’s preferred energy source.[^4]

Here’s how it works:

When you exercise hard enough to enter an anaerobic state (meaning you’re working so intensely that your muscles can’t get oxygen fast enough), your body shifts to using glucose outside of the mitochondria through a process called glycolysis. This produces lactate as a byproduct.

But that lactate doesn’t just sit there. It enters the bloodstream and is quickly consumed by other tissues, including the heart, liver, and especially the brain. Within 20 minutes of a high-intensity workout, lactate levels can spike to 10-15 millimolar (from a baseline of about 0.9), and then drop back to normal as it’s consumed.[^4]

In the brain, lactate serves as both an energetically favorable fuel source and a signaling molecule.

Dr. Rhonda Patrick, a biomedical scientist, explains: “Lactate is used by neurons to make energy, just like beta-hydroxybutyrate (the ketone body). It’s energetically favorable. But it’s also a signaling molecule that activates brain-derived neurotrophic factor (BDNF), which is important for growing new neurons in the brain.”[^4]

Why This Matters More for Women

Remember that women’s brains experience disrupted glucose metabolism during and after menopause. The brain becomes less efficient at using glucose for energy, a problem that contributes to cognitive decline and Alzheimer’s risk.

But lactate provides an alternative fuel pathway. By producing lactate through high-intensity exercise, women can bypass the glucose metabolism problem and provide their brains with the energy it desperately needs.

As Dr. Stacy Sims, an exercise physiologist specializing in women’s health, explains: “We’re finding more and more research showing that part of the development of dementia and Alzheimer’s in the plaque is a misstep in brain metabolism. When we’re looking at brain metabolism, the brain uses a lot of glucose, but it also uses lactate.”[^3]

She continues: “For women doing that high-intensity work and being able to produce lactate allows the heart and the brain to use that preferential fuel, which feeds forward to reducing the misstep in brain metabolism that occurs.”[^3]

In other words: Exercise literally feeds your brain when its normal fuel system starts failing.

Exercise Improves Learning and Memory (Especially Right Before You Learn)

Beyond providing fuel, exercise directly enhances cognitive performance, learning capacity, and memory formation.

The research is unambiguous: exercise acutely improves performance on all types of brain and memory tasks.[^5]

Studies show that exercise:

Improves recall and retention of material
Enhances cognitive flexibility (your ability to switch between different types of thinking)
Boosts focus and attention
Increases processing speed
Enhances problem-solving abilities

The timing matters, but not as much as you’d think. Research shows benefits whether you exercise before, during, or after learning.[^5]

But the strongest effects come from exercising just before learning.

Dr. Andrew Huberman, a neuroscientist at Stanford, explains: “Several studies point to improvements in executive control and function (that context-dependent switching of knowledge and your ability to think in a very agile way) if people did a high-intensity interval training session just before they do that bout of cognitive flexibility learning.”[^5]

Even short bouts of exercise can enhance learning. You don’t need to spend an hour in the gym. Even 10-20 minutes of elevated heart rate activity before a learning session can improve cognitive performance.

The Mechanisms: BDNF and Lactate

Two primary mechanisms explain how exercise enhances learning:

1. Brain-Derived Neurotrophic Factor (BDNF)

Exercise triggers the release of BDNF, which acts like “miracle grow” for your brain. BDNF:

Promotes the growth of new neurons (neurogenesis)
Increases connections between neurons
Enhances neuroplasticity (your brain’s ability to adapt and change)
Improves memory consolidation
Protects against cognitive decline[^6]

BDNF is “activity-dependent,” meaning it’s released when neurons are active, and it works best on neurons that are already active. This creates a powerful feedback loop: exercise makes you more alert and engaged, which increases neural activity, which enhances the effects of BDNF, which strengthens those active neural pathways.

2. Lactate as a Cognitive Enhancer

As we discussed earlier, lactate produced during intense exercise serves as both fuel and a signaling molecule in the brain.

Dr. Rhonda Patrick summarizes the research: “People that are compared working hard, working out hard, vigorous exercise versus moderate to light exercise: they make more lactate. And that lactate has been shown to correlate with improved cognition scores, improved impulse control.”[^6]

Lactate increases neurotransmitters including:

Norepinephrine: Boosts focus and attention
Serotonin: Improves mood and impulse control
Dopamine: Enhances motivation and reward processing

This explains why so many people report feeling mentally sharp, focused, and productive after a workout. It’s not just psychological; it’s biochemical.

Exercise Boosts Energy Directly and Indirectly

One of the most common complaints as people age, especially women after menopause, is chronic fatigue. They wake up exhausted. Simple tasks feel overwhelming. The energy just isn’t there anymore.

The irony is that the solution to low energy is often more energy expenditure: specifically, exercise.

Direct Energy Boost: Building More Mitochondria

Your cells contain powerhouses called mitochondria that convert food and oxygen into ATP, the energy currency your body runs on. When your mitochondria are healthy and abundant, you have energy. When they’re dysfunctional or depleted, you don’t.

As Dr. Mark Hyman puts it: “Your mitochondria are the energy factories. If you have poor functioning mitochondria, you’re going to have low energy. You’re going to be weaker. You’re going to have lower muscle mass. So the key to longevity is keeping your mitochondria healthy and keeping them strong and actually having more mitochondria.”[^7]

Exercise is the single most powerful way to build new mitochondria and improve their function.

Resistance training builds muscle tissue, which is packed with mitochondria. High-intensity interval training (HIIT) and sprint training trigger mitochondrial biogenesis, the creation of new mitochondria. Endurance training improves mitochondrial efficiency.

A marathon runner doesn’t look that different from a non-athlete in terms of muscle size. But take a biopsy of their muscle tissue and you’ll find a much higher density of mitochondria, and those mitochondria are more efficient at producing ATP.[^8]

Dr. Terry Sejnowski, a computational neuroscientist, emphasizes: “You can replenish your energy by exercise. Exercise is the best drug you could ever take. It’s the cheapest drug you could ever take that can help every organ in your body. It helps your heart, it helps your brain, it rejuvenates your brain, it helps your immune system. Every single organ system in the body benefits from regular exercise.”[^9]

Indirect Energy Boost: Improved Metabolism and Hormone Function

Exercise doesn’t just build mitochondria; it improves how efficiently your body uses energy:

Improves insulin sensitivity: Allows cells to absorb glucose more effectively
Enhances fat oxidation: Trains your body to use fat for fuel at rest
Reduces inflammation: Chronic inflammation is exhausting; exercise lowers it
Balances neurotransmitters: Improves mood and reduces the mental fatigue associated with depression and anxiety
Improves sleep quality: Better sleep means better recovery and more daytime energy

For women specifically, exercise helps offset the metabolic disruption that occurs during menopause. Dr. Stacy Sims explains: “We need to look for an external stress to change our insulin sensitivity and improve our blood glucose control. We need to do proper high-intensity work to create a stress that’s high enough to have the brain say, ‘This is a really strong stress. I need to invoke changes within the skeletal muscle to store more glucose and use more free fatty acids.’”[^1]

In other words, exercise sends a powerful signal to your body: adapt or die. And in response, your body gets stronger, more efficient, and more energetic.

Compound Exercises Are Especially Powerful (Bones Release Lactate That Goes to the Brain)

While all forms of safe exercise provide benefits, compound exercises (movements that engage multiple muscle groups and joints simultaneously) are particularly powerful for women.

Compound exercises include:

Squats (engaging legs, glutes, core, back)
Deadlifts (engaging entire posterior chain)
Lunges (legs, glutes, core, balance)
Push-ups (chest, shoulders, triceps, core)
Rows (back, biceps, core)
Overhead presses (shoulders, triceps, core)

Why are compound movements so effective?

1. They Build Functional Strength

Compound movements mimic real-world activities. They train your body to move as an integrated system, improving balance, coordination, and the kind of strength that prevents falls and maintains independence as you age.

2. They Build Bone Density

Resistance training, especially compound movements that load the skeleton, triggers bone remodeling. Your bones respond to mechanical stress by becoming stronger and denser.

This is critical for women, who lose bone density rapidly after menopause when estrogen drops. Osteoporosis and fractures are major causes of disability and mortality in older women.

Dr. Stacy Sims emphasizes: “Progesterone and estrogen are responsible for bone growth and bone density. We can’t rely on our hormones for that anymore after menopause. We have to look for an external stress. This is where exercise comes in.”[^1]

3. They Maximize Lactate Production

Here’s where it gets fascinating: bones themselves produce lactate during exercise, and that lactate goes directly to the brain.

When you perform compound movements, especially under load, your skeletal muscles aren’t the only tissues producing lactate. Your bones, which are metabolically active tissues, also produce and release lactate into the bloodstream.

Dr. Stacy Sims explains: “Lactate production happens especially from compound exercises because bones release lactate that goes directly to the brain.”[^3]

This creates a direct communication pathway between your skeleton and your brain. Your bones are literally telling your brain: “We’re being challenged. Make adaptations. Grow stronger. Stay sharp.”

4. They Trigger Myokines

Compound exercises, particularly resistance training, also trigger the release of myokines, hormone-like signaling molecules released by skeletal muscle during contraction.

Myokines communicate with other organs, including your brain, fat tissue, and liver. They:

Mobilize abdominal fat (especially important for post-menopausal women)
Increase metabolic rate
Improve insulin sensitivity
Reduce inflammation
Support cognitive function[^1]

The more muscle mass you engage, the more myokines you produce. This is why full-body compound movements are more effective than isolation exercises for overall health.

All Safe Exercises Are Beneficial (Just Move)

Before you think you need to become a powerlifter or CrossFit athlete, let’s be clear: all forms of safe exercise provide benefits.

The goal isn’t perfection. The goal is consistent movement.

What Counts as Exercise?

Exercise simply means moving your body against resistance or at an elevated intensity. This includes:

Walking (especially brisk walking or walking uphill)
Swimming
Cycling
Resistance bands
Bodyweight exercises (squats, push-ups, planks)
Yoga or Pilates (especially more challenging forms)
Dancing
Hiking
Sports and recreational activities

Dr. Gabrielle Lyon, a physician specializing in muscle-centric medicine, shares: “My dad was doing resistance bands with bicep curls in Ecuador. I’m okay with that. If you want to do that, and that’s how you’re going to do your upper body or your arms, fine.”[^10]

The point is to move, challenge your body, and do it consistently.

The Minimum Effective Dose

You don’t need to spend hours in the gym. Research suggests that the minimum effective dose for maintaining health is:

Frequency:

3-4 days per week (minimum 2 if that’s all you can manage)

Duration:

30-45 minutes per session
Shorter (15-20 minutes) is fine if intensity is higher

Types:

Mix of cardiovascular exercise (moderate and high intensity)
Resistance/strength training (2-3 days per week minimum)

Intensity:

Moderate intensity where you can talk but not sing (Zone 2)
High intensity where talking is difficult (HIIT, sprints, or heavy resistance)

For women specifically, Dr. Stacy Sims recommends: “We’re looking at doing short, sharp, high-intensity cardio or power-based resistance training three times a week, and cardio can be two to four times a week. Less volume, more quality.”[^1]

Safety First

“All safe exercises are beneficial” means avoiding:

Exercises with poor form that risk injury
Excessive volume or intensity without adequate recovery
Movements that cause pain (discomfort is okay; pain is not)
Training when acutely ill or injured

If you’re new to exercise, start with:

Bodyweight movements
Light resistance bands
Walking or gentle cycling
Movements you can control and perform with good form

You can always progress over time. The important thing is to start and stay consistent.

Why Exercise Is MOST Important for Women: The Menopause Cliff

Everything we’ve discussed so far applies to everyone, but the stakes are higher for women because of what happens during and after menopause.

The Biological Reality of Menopause

Women don’t age in a linear fashion like men. As Dr. Stacy Sims explains: “We see that women don’t age in a linear fashion like men. We have definitive points. We have puberty. We have our reproductive years. We have perimenopause. We have postmenopause. Each one of those is a different hormone profile that can affect the way we train.”[^1]

For men, testosterone gradually declines starting in their late 50s. It’s a gentle slope.

For women, it’s a cliff.

During perimenopause (typically starting in the mid-to-late 40s), estrogen and progesterone levels begin fluctuating wildly. Then during menopause, they plummet. This hormonal collapse has cascading effects throughout the body:

What You Lose Without Intervention

Cognitive Function:

Reduced glucose metabolism in the brain
Increased risk of Alzheimer’s disease (2x higher than men)
Brain fog, memory problems, difficulty concentrating
Mood changes, increased risk of depression

Muscle Mass:

Rapid loss of lean muscle tissue (sarcopenia)
Reduced strength and power
Slower metabolism
Increased fat accumulation (especially visceral fat)

Bone Density:

Accelerated bone loss (osteopenia and osteoporosis)
Increased fracture risk
Loss of structural integrity

Metabolic Health:

Insulin resistance increases dramatically
Blood sugar control worsens
Fat redistributes to the abdomen (visceral fat)
Cardiovascular disease risk increases

Physical Function:

Reduced balance and coordination
Loss of fast-twitch muscle fibers (the ones that prevent falls)
Longer recovery times
Increased injury risk

Dr. Mosconi’s research found that women show these red flags already in midlife, whereas men do not. The brain changes. The body changes. And if you’re not actively fighting back with exercise, the decline accelerates.[^2]

Exercise Can Slow or Reverse the Decline

Here’s the hopeful part: Exercise can dramatically slow, stop, or even reverse many of these changes, but you need to start early and stay consistent.

Research shows that women who are physically fit in midlife have:

Fewer Alzheimer’s plaques in their brains[^2]
Better glucose metabolism during and after menopause
Maintained muscle mass and strength
Preserved bone density
Better metabolic health and insulin sensitivity
Reduced visceral fat accumulation
Better mood and cognitive function

Dr. Peter Attia, a longevity-focused physician, emphasizes: “Once you reach age 65, your mortality from falls increases dramatically. But the reason you’re not afraid of falling now is because you have the power to readjust quickly. Those are very specific muscle fibers. That is the first fiber that atrophies when you age.”[^11]

He adds: “You’re already at your peak. My power is a fraction of what it was 20 years ago. I fight like hell based on the exercises I do to try to keep it as high as possible.”[^11]

Translation: Start building your strength and fitness reserve NOW, because you’ll be drawing on it for the rest of your life.

Why Starting Early Matters

You can’t wait until after menopause to start exercising. By then, you’re fighting an uphill battle against years of accumulated decline.

The time to act is NOW:

In your 20s and 30s: Build a strong foundation of muscle mass, bone density, and cardiovascular fitness. Establish exercise as a non-negotiable habit.
In your 40s (perimenopause): Increase the intensity and prioritize resistance training. This is when the hormonal changes begin, and exercise becomes your primary defense.
In your 50s and beyond (post-menopause): Maintain intensity but manage volume and recovery. Focus on power-based movements, compound exercises, and high-intensity intervals.

As Dr. Stacy Sims emphasizes: “We need to start early. We can’t rely on our hormones anymore for bone growth, muscle maintenance, or brain health. We have to look for an external stress. And that stress is exercise.”[^1]

The Bottom Line: Exercise Is Non-Negotiable for Women

Let’s recap why exercise is more important for women than men:

Women are at higher risk for Alzheimer’s disease (2/3 of patients are women), and exercise is one of the most powerful interventions to reduce that risk.
Menopause causes rapid cognitive and physical decline that men don’t experience. Exercise can slow or reverse these changes.
Women’s brains experience disrupted glucose metabolism during and after menopause. Exercise produces lactate, which provides an alternative fuel source for the brain.
Women lose bone density faster than men after menopause. Resistance training and compound exercises build bone density.
Women lose muscle mass and strength faster after menopause. Resistance training preserves muscle and maintains metabolic health.
Exercise improves learning and memory, benefits that compound over time and protect against cognitive decline.
Exercise boosts energy by building mitochondria and improving metabolic efficiency.
Compound exercises produce lactate from both muscles and bones, creating a direct communication pathway between the skeleton and the brain.

This isn’t about vanity. This isn’t about fitting into a certain size of jeans. This is about protecting your brain, maintaining your independence, and ensuring you remain physically and cognitively capable into old age.

The tragic irony is that despite needing exercise more, women exercise less. Historically excluded from strength training. Told that cardio is for weight loss and lifting weights will make them “bulky.” Given fitness advice based on male physiology. Juggling caregiving responsibilities that leave little time for self-care.

But the science is unambiguous: If you want to protect your brain, maintain your strength, preserve your bone density, and ensure you remain capable and independent as you age, exercise is non-negotiable.

Start now. Start with what you have. Start with bodyweight movements or resistance bands. Start with walking uphill. Start with 20 minutes three times a week.

Just start.

And then keep going. Because your 70-year-old self is depending on the choices your 30, 40, or 50-year-old self makes today.

References

[^1]: Dr. Stacy Sims, Exercise and Nutrition Scientist, The Diary Of A CEO with Steven Bartlett: The Truth About Exercising On Your Period, Women Were Right About Menopause

[^2]: Dr. Lisa Mosconi, Neuroscientist, The Diary Of A CEO with Steven Bartlett: The Menopause Doctor: This Diet Delays Menopause

[^3]: Dr. Stacy Sims, Exercise Physiologist, The Diary Of A CEO with Steven Bartlett: Longevity Debate: The Truth About Weight Loss, Muscle, and Creatine

[^4]: Dr. Rhonda Patrick, Biomedical Scientist, The Tim Ferriss Show: Protocols for Fasting, Lowering Dementia Risk

[^5]: Dr. Andrew Huberman, Professor of Neurobiology, Stanford School of Medicine, Huberman Lab Podcast: “How to Use Exercise to Improve Your Brain’s Health, Longevity & Performance”

[^6]: Dr. Rhonda Patrick, Biomedical Scientist, The Diary Of A CEO with Steven Bartlett: Anti-Aging Expert on How Missing This Vitamin Is As Bad As Smoking

[^7]: Dr. Mark Hyman, Functional Medicine Expert, Young and Profiting (YAP) with Hala Taha: “How Entrepreneurs Can Reverse Aging and Unlock Peak Health & Mental Health”

[^8]: Dr. Chris Palmer, Harvard Psychiatrist, Huberman Lab Podcast: “Transform Your Mental Health With Diet & Lifestyle”

[^9]: Dr. Terry Sejnowski, Computational Neuroscientist, Huberman Lab Podcast: “How to Improve at Learning Using Neuroscience & AI”

[^10]: Dr. Gabrielle Lyon, Physician, The Diary Of A CEO with Steven Bartlett: “The Anti-Obesity Doctor: If You Don’t Exercise, This Is What’s Happening To You”

[^11]: Dr. Peter Attia, Longevity Expert, The Diary Of A CEO with Steven Bartlett: “Anti-Aging Cure No One Talks About”

Additional sources:

Dr. David Raichlen, Exercise Neuroscientist, The Diary Of A CEO with Steven Bartlett: “The Brain Professor”
Dr. Wendy Suzuki, Exercise Neuroscientist, The Diary Of A CEO with Steven Bartlett: “The Shocking Link Between Exercise And Dementia”