The Most Effective Weight Training, Cardio & Nutrition for Women | Dr. Lauren Colenso-Semple

Dr. Colenso-Semple recommends a full-body training program 2-3 times per week if that's the total frequency. This ensures each major muscle group receives adequate stimulus. If someone wants to train more often, say 4 days a week, an upper/lower body split is a good option. For 5-6 days a week, more detailed splits (like chest/back, legs, shoulders/arms) can be implemented. The choice of split also depends on personal goals; for general health and muscle growth, full-body or simpler splits are effective, while physique-focused goals might involve more tailored programs.

The key to effective resistance training for muscle growth is challenging the muscle sufficiently. This means selecting a load that allows you to train close to failure. If you complete a set of 10 reps but could easily do another 10, the weight is too light. The goal is to reach a point where you can only perform 1-2 more repetitions, or even go to complete failure, depending on the exercise and individual experience. This ensures the muscle receives the necessary stimulus for adaptation and growth.

After a sufficient warm-up, Dr. Colenso-Semple recommends at least two, preferably three, and up to four work sets per muscle group per workout. Going beyond four sets is generally considered overkill. It's important to remember that many compound exercises (like squats or bench press) engage multiple muscle groups simultaneously. Therefore, when planning a workout, one must consider how these compound movements contribute to the total set count for each muscle group. For example, if squatting, the quads, glutes, and hamstrings are all receiving a stimulus.

For most gym sessions involving machines or dumbbells, a 2-minute rest interval between sets is generally sufficient. For heavier compound movements like squats or deadlifts, extending the rest to 3 minutes is advisable to ensure adequate recovery and maintain performance. While setting a timer can be helpful, experienced lifters can often autoregulate, resting until they feel ready for the next set. For specific strength goals, such as training for a one-rep max, even longer rest periods (4-5 minutes) might be necessary to allow for full recovery and optimal performance on subsequent heavy sets.

To improve time efficiency in the gym, Dr. Colenso-Semple suggests using agonist-antagonist supersets. This involves performing a set of one exercise (e.g., bench press) and then immediately moving to a set of an opposing muscle group exercise (e.g., a row) before taking a rest. This method allows for more work to be done in a shorter period and does not seem to interfere with muscle adaptation or acute performance, unlike simply shortening rest periods between sets of the same exercise. It also helps maintain focus and prevents distractions like phone use during rest intervals.

Dr. Colenso-Semple advises moving the weight as quickly as possible during the concentric (lifting) phase of an exercise, which is typically the more difficult part. Conversely, the eccentric (lowering) phase should be controlled. The goal is not to intentionally slow down either phase, as this is not particularly advantageous. She highlights that as a set progresses and fatigue sets in, the weight will naturally move slower, even with the intention of moving it fast. This approach ensures maximal effort and muscle recruitment, which is crucial for strength and hypertrophy. The key is always to maintain control and proper form, ensuring momentum isn't doing the work.

While block periodization (e.g., three weeks of low reps, then three weeks of moderate reps) is an option, Dr. Colenso-Semple prefers varying repetition ranges within the same week. For example, if squatting twice a week, one session could focus on lower reps (e.g., 3-5) for strength, and the other on moderate reps (e.g., 6-12) for hypertrophy. This approach allows for continuous tracking of progress in both strength and muscle growth simultaneously. For beginners, she strongly advises starting in the 8-12 rep range to develop proficiency in movement patterns and reduce injury risk before exploring very low or very high rep schemes.

Dr. Colenso-Semple debunks the long-held belief in a narrow 'anabolic window' immediately after a workout. She explains that the elevated protein synthesis response to resistance training is long-lasting, extending for at least 24 hours. Therefore, whether one eats within 30 minutes or 3 hours post-workout, the impact on muscle adaptations is similar. The focus should be on consistent daily and weekly protein intake, distributed across several meals, rather than trying to 'game the system' with precise timing or dosing immediately after training. The training itself is the primary stimulus; nutrition optimizes the results.

Dr. Colenso-Semple asserts that the data indicates men and women respond very similarly to exercise. The idea of sex-specific programs often makes women feel considered and part of a community, but it's not grounded in scientific evidence. She emphasizes that if there were truly different optimal strategies for women, she would be implementing and recommending them herself. This narrative, while seemingly empowering, can overcomplicate fitness and lead to unnecessary program hopping.

Dr. Colenso-Semple explains that while the baseline muscularity difference between untrained men and women is due to testosterone's surge during male puberty, once training begins, both sexes gain similar relative size. She clarifies that within the normal range of testosterone (e.g., 300-900 ng/dL for men), there's no predictable relationship between one's exact level and their response to training. Only supraphysiological levels, typically achieved through exogenous hormone use, enable muscle development beyond natural potential. This means that for the vast majority of people not using steroids, their natural testosterone levels within the healthy range do not make them 'hard gainers' or 'easy gainers' for muscle.

Dr. Colenso-Semple explains that while there is an acute increase in hormones like testosterone and growth hormone after exercise, this response is not predictive of long-term muscle growth. Therefore, training specifically to maximize these acute surges (e.g., through high-rep training or supersets) is not a sensible strategy for hypertrophy. The focus should instead be on consistent, progressive training that provides a sufficient stimulus for growth, rather than on transient hormonal spikes.

Dr. Colenso-Semple notes that the introduction of the bikini category in competitive bodybuilding helped shift perceptions, making resistance training seem more 'feminine' and desirable. She points out the rarity of seeing 'incredibly jacked' women in everyday life, indicating that accidental bulkiness is not a realistic outcome. Achieving extreme muscularity typically requires immense dedication, very hard work, and often, pharmacological assistance. This reassures women that lifting weights will not inadvertently lead to an undesired physique.

Dr. Colenso-Semple states unequivocally that the short answer is no, women should not train differently based on their menstrual cycle. While acknowledging that discussing the menstrual cycle is positive, she criticizes the oversimplification that fluctuating hormones necessitate changes in exercise. She advises focusing on subjective feelings: if menstrual symptoms, fatigue, or lack of motivation occur, it's acceptable to adjust or skip a workout. However, she stresses that women are not inherently less capable during menstruation due to hormonal shifts, and the data does not support altering training for performance or adaptation benefits.

Dr. Colenso-Semple clarifies that the majority of studies on this topic focus on combined oral contraceptive pills. The data indicates no significant impact on strength, hypertrophy, or power. She notes that while there were hypotheses about potential detrimental or beneficial effects, these have not been borne out. Her rationale is that if the substantial endogenous hormone fluctuations of the natural menstrual cycle don't affect performance or exercise adaptations, it's not surprising that hormonal contraceptives, which induce changes of a similar magnitude, also don't move the needle significantly. While some individuals might experience short-term side effects when starting a new pill, these are typically due to the pill not being a good fit, rather than a general negative impact on exercise adaptation.

Dr. Colenso-Semple emphasizes that there's no reason to alter training during perimenopause or menopause because the desired adaptations remain the same: increasing and maintaining muscle size and strength, reducing fall and fracture risk, and preserving bone density. Resistance training is a key component for these goals. She debunks the hypothesis that declining estrogen directly impacts muscle in a way that necessitates different training, noting that age-related muscle loss is primarily exacerbated by physical inactivity, not solely by hormonal changes. The correlation between hormones and muscle is often oversimplified; inactivity and the weakening of nerve-to-muscle connections play a significant role in muscle and strength loss with age.

Dr. Colenso-Semple clarifies that the negative body composition changes associated with cortisol, such as 'moon face' and central fat deposition, are characteristic of Cushing syndrome, a condition involving pathologically high cortisol levels, often from steroid use. These are not typical outcomes of normal, acute cortisol increases from exercise or daily stress. She emphasizes that cortisol spikes from training are normal and necessary for blood pressure and glucose regulation, which are vital for exercise performance. These acute fluctuations do not contribute to fat storage or an inability to lose fat. She suggests that the blame often placed on cortisol for fat gain is a 'compelling pitch' to sell ineffective supplements, distracting from the more likely culprit: dietary choices under stress.