WHOOP Podcast - The Gender Bias in Sport: Women's Health, Research, and the Future of Female Athletics with Christine Yu

Episode Date: June 21, 2023

On this week’s episode, WHOOP VP of Performance Science, Principal Scientist, Kristen Holmes is joined by author Christine Yu. Christine is an award-winning journalist focusing on the intersection of sports science and women athletes. Christine is here to discuss her new book UP to SPEED: The Groundbreaking Science of Women Athletes and the state of women’s health and wellness in today’s society. Kristen and Christine will discuss Christine’s journalism career (2:55), the biggest inequities in health and athletics (5:00), areas for more women’s health research (7:40), young athletes dealing with puberty (9:50), the impact of hormonal birth control on female athletes (14:57), media coverage of women’s sports (19:05), the push for equal pay in sport (21:50), key takeaways from Christine’s book (24:30), a research study that Christine believes changed the industry (26:05), a story about the Australian National Field Hockey team and ACL injuries (33:05), Christine’s learnings across the continuum of a female athlete’s life (35:25), what women should be doing in perimenopause (42:17), an inequity Christine would improve today (46:15), and tips for women to achieve high performance (52:05).Resources:Christine's WebsiteChristine’s InstagramUP to SPEED Support the showFollow WHOOP: www.whoop.com Trial WHOOP for Free Instagram TikTok YouTube X Facebook LinkedIn Follow Will Ahmed: Instagram X LinkedIn Follow Kristen Holmes: Instagram LinkedIn Follow Emily Capodilupo: LinkedIn

What's up, folks? Welcome back to the WOOP podcast, where we sit down with top athletes, researchers, scientists, and more to learn what the best in the world they're doing to perform at their peak and what you can do, too, to unlock your own best performance. I'm your host, Will Ahmed, founder and CEO of WOOP, and we are on a mission to unlock human performance. This week's episode, Whoop VP of Performance Science, The Fearless, Kristen Holmes, our principal scientist, is joined by author Christine Yu. Christine is an award-winning journalist who focuses on the intersection of sports, science, and women athletes. In addition to writing, she's a seasoned grant writer and has led and managed the full cycle of program development for requests to private and corporate funders, as well as local state and federal government agencies. Kristen and Christine will discuss the biggest inequities in health sport. There will be a push to see more research around females in sport.

Young athletes dealing with puberty. Interestingly, there's about a 51% drop-off in participation in sport for females at age 18. The media coverage and investment into women's sports. There's a growing demand for more women's sports. The business case and viewership is prime for growth. The findings and takeaway from Christine's new book, Up to Speech, She talks about what it really means to take care of women throughout the entirety of their athletic careers and training methods for women to improve health and prevent injuries.

If you're new to Whoop, you can use the code Will to get a $60 credit on Whoop accessories when you enter the code at checkout. If you have a question you want to see answered on the podcast, email us, podcast at Whoop.com. Call us 508-443-4952, and we'll answer your question on a future episode. Without further ado, here are Kristen Holmes and Christine Yu. Christine Yu is an award-winning journalist and author of her newly released book Up to Speed, The Groundbreaking Science of Women Athletes. Her reported features, profiles, and essays have appeared in the Washington Post, Outside Magazine, Runner's World, Vice, and ESPNW, among others.

She also writes for trade publications, professional associations, educational institutions, in brands including Columbia University, John Hopkins University, Phillips Academy, and American Physiological Society, and REI. Christine earned her BA in our history from Columbia University and a master's of public policy from the Harvard Kennedy School at Harvard University. Christine, welcome. We're so excited to have you on today. Thank you so much for having me. I'm excited to be here. Yeah, your book is just incredible. Christine, I'd love to start off. Just tell us a little bit about your journalism career covering inequities in sport and really what got you started down this path. Yeah. So it's funny. I didn't train as a journalist. I actually, I mean, as you said, I majored in art history and I actually intended to go to medical school.

My father was a doctor. I have a family full of doctors and that's kind of what I wanted to do. But I ended up pursuing a career in the nonprofit sector, but never really lost that love and that interest in learning about health and the human. body. And so kind of fast forward into like my mid-30s. I was a little bit, I guess, of a career crisis in a way. And I found my way back to writing. I realized like how much I really enjoyed telling stories and being able to share all this incredible information with people. Growing up as a Chinese American with parents, you know, who had my career choices were essentially like be a doctor, be a lawyer, be like going to business or something. I didn't know writing in journalism really was like a viable career path. But I found my way into this and started writing about health and fitness and was lucky enough to be able to find incredible editors who let me explore this intersection, right, between my love of sports and my love of fitness and my love of science and really trying to understand how the human body works and what makes us injured, what helps us perform better, what keeps us healthy all along.

and it's been it's been incredible and I realized that so much of you know I thought I knew a lot right like being a premen major growing up in like a family with a lot of doctors and all of that but I realized how much I just didn't know and it just kind of I kept going down rabbit holes and other rabbit holes and just realizing you know that I you know had so many misconceptions about what it meant to be fit what it meant to be athletic how you were supposed to be you know, athletic in that way. And yeah, it's just been, it's been a lot of fun to be able to dive down some of these rabbit holes with incredible researchers and experts out there. Yeah. Where do you see the biggest inequities in kind of health and athletics? So a lot of it, I think, you know, a lot of what this book really focuses around is the lack of research that we have on women, right?

And we've heard this, you know, in the last couple decades, especially when it comes, to things like heart health, right? You know, we hear all about how heart attack symptoms, you know, men and women might be different or how drug interactions in men and women might be different. But it's really only in recent years, right, that we've started to notice that more within the health of the fitness and sports science world. And it's, you know, there's a recent study that showed that, you know, between 2014 and 2020, so really not that very recent, The number of studies that focused specifically on sports performance and women was only 6%. And women only made up about a third of the study participants across all of these studies.

And these are in major sports science, exercise physiology journals. So there's a huge gap there, right? So a lot of what we know about the body, how athletes develop, how training adaptations happen, how injuries are prevented, are really skewed towards, you know, understanding of men and male bodies. only half of the population, right? So I think that's one of the biggest inequities that we see out there. Gosh, that's right. I, you know, I'd certainly know, I mean, you're an athlete and, you know, spent a lot of my years coaching athletes and as an athlete myself, just it is crazy how my individual, my, my physiology has never really taken into account in terms of how I was trained or how I

trained my athletes, you know, and it's just, it's, a lot of the research that we're doing at Woop right now, is kind of surfacing some of these differences. You know, there's very different things happening over a menstrual cycle, for example, and, you know, from the follicular phase, the alludeal phase, you know, in terms of heart variability and resting heart rate and our ability to kind of adapt during the different phases of the menstrual cycle and how different that is from men. And so we're really excited that we're, you know, we're trying to tackle some of these equities, Christine, that you speak of, you know, because they're far reaching.

But I think that more, I think money is being invested in female physiology research, which is super exciting. Where would you say, you know, if you were to kind of pinpoint, you've done so much research for your book, if you were to pinpoint, you know, one area that you feel like is the place to start for researchers in terms of where we can make the biggest bank for our buck, where would you say we should focus? asking for a friend. I mean, I think so there's like two ways I can answer that, right? I think what I want to say is that the place where I really want research

to focus and really pay attention to is around girls and young women because it really starts there, right? Like, to be honest, I wasn't, I must have been in my late 30s or 40s, right? when I really started to put together the fact that, huh, my menstrual cycle is more than just, you know, the couple days that I'm bleeding.

Like my hormones actually fluctuate throughout the month. And oh my gosh, maybe this actually affects how I feel or has, you know, or it doesn't, right? But like it could potentially have this influence. And I never really understood or really put together those pieces that, you know, this is a key part of my physiology that I've, was never paying attention to. I didn't learn this as a young girl or a woman, right? I didn't know at that time that what I was doing in my teenage years when I wasn't eating enough and I was exercising too much and all of that could potentially impact my future bone health. I didn't know any of that. So I mean, I don't know if it's research specific, but I think that there needs to be that investment in how we educate not only girls, but the coaches and the doctors and the parents that are working with that population so that we set them up with a really good foundation

so that they can be happy and healthy and strong and you know and perform well throughout the longevity of their career right because that's what we care about we want people to have these long active lives and not just burn out at some point right that's a beautiful a beautiful answer and yeah i think there's there's probably nothing more important than you know understanding your body, you know, and there's, and I think as a young girl, like, there's so many changes happening in the body. And maybe talk about, you know, how some of those changes. So kind of going from not having, you know, from not mentoring to getting your period. What happens to the young athlete? You know, what did your research surface? Yeah. So, right, puberty is this

tremendously hectic and disorienting phase that our lives were, we're growing and changing, you know, our hips are widening or growing breasts. All these different things are happening in a way that feels very much out of control, right? But, you know, on a, on a physiological level, right, the, as the mental cycle is starting, your hormones are starting to hurt, to surge. And in adolescence, girls lay down about 90% of their adult goal mass, you know, with during adolescence. So that means that that's the period of time where you are like, literally building the, you know, the structure of your skeleton, right? You're putting down the bricks there. Appleding. Right? Like, it's, it's, it's, it's, it's bananas. But like I said,

like, this is something I, I had no idea that, that this was happening. And, you know, by the time you reach, so we all have like a certain genetic potential, right? Of, of what our potential bone mass could be. If you don't reach that potential, there's no kind of going back in, like, backtracking. You can't go and refill that gap that you didn't reach. So what you have is what you have. And as all these bones are growing and changing, you know, the rate at which bones are growing versus the rate at which muscle is being, you know, built is different.

So you have bones growing super fast. You have muscle mass that's in girls, right? That's not keeping up pace. So that's why a lot of times, like you feel really clumsy. That's why we see some of these bio. mechanical changes that start to happen that potentially, right, could lead to some of these injury risks around ACL tears and stuff like that. But one of the researchers that I spoke what, you know, basically said you're putting a girl in this, in this bigger, like, car, right? But

you're not giving her any of the neuromuscular, like, engine power to actually control it. So that's why it feels really crazy. And I kind of use this example. When I talk to folks, it almost feels like you're blowing glass, right? You're, you're molding this structure and it's really pliable. It's very vulnerable. And it takes time to crystallize into its final form, right? So we have to be patient. We have to be careful while it is in that vulnerable form, or vulnerable is not the right word, but right, but in this kind of pliable form, right, until, you know, you have that kind of solid adult, like mature body. How does this kind of transition phase, into puberty affect participation in girls sports does it we see a huge drop off in sports in

girls by age 17 i think this it's 51 percent of girls drop out of sport compared to boys in that's a phenomenal number yeah and it could be from from a variety of things it could be you know something as simple as you know being embarrassed about the breasts and not having sports broads because like one and two adolescents and girls say that breasts are a barrier to physical activity they feel embarrassed about it they might not like i said might not have sports bras to wear it might be painful but you know yeah and but these are all things we just expect girls to kind of grin and bear bear it right and just suck it up and deal with so it could be anything from that it could be that, you know, up until puberty generally, you know, boys and girls, like athletic

progression is pretty even, right? Like, they kind of stepwise progress at the same level. And then once you hit puberty, you tend to see this fork in the road where boys continue to progress, whereas girls seem like, again, their performance either stalls or steps back. And that can be really frustrating to feel like I'm doing everything I should be doing. I'm, you know, I'm working really hard, but my body doesn't feel like itself. It doesn't respond the way that it used to. And that can be discouraging and it can be, you know, enough for for girls to step away from sport as well. Yeah. I think it goes back to your main point, which is we just need, we need more education. You know, we need to help young women and coaches and, you know,

people who are teaching health and in middle school and high school understand how to communicate how to make these changes feel less intimidating and how to help coaches understand how to train athletes during these really, I think, tender periods of time where, you know, we want to try to keep women who want to stay in sport active in sport. And yeah, I think I love how that ties into the education. I think that's just so, so key. Maybe just touch on, you know, I think a lot of, you know, you go to the pediatrician, you know, you've got a, you know, a child who's going through puberty, has their menstrual cycle, they're experiencing all sorts of these new symptoms. And the pediatrician's like, well, just go on the pill. What's your thought on

hormonal birth control? So there are a number of reasons, right, why someone might take hormonal birth control. From the research I've seen and from the experts that I've spoken with, right, like, I'm not a medical professional. I mean, that wouldn't be my first course of action, right? because, again, the menstrual cycle is so critical to girls maturation process and their physiological development that you need that surge of estrogen, you need that surge of ovarian sex hormones in your body, right, to support bone growth and bone health. So, I mean, just backing up a little bit, right, like hormonal birth control, you're introducing external hormones into the body, which essentially overrides the body's natural normal hormone levels

in order to prevent pregnancy. But in doing that, you, again, you're suppressing these natural fluctuations in hormone levels that are absolutely critical to development. And by taking hormonal birth control, you can mask whether or not your mental, like, a mental cycle actually happens or whether or not a mental cycle is actually, like, regular. And in doing that, you know, it might seem like everything's fine. And, you know, a girl is, you know, say on the pill getting, you know, kind of bleeding every month. But it might not be a true picture of what her hormonal health actually is. And that's where you kind of get into a lot of gray area and a lot of danger because you're not letting the body just kind of set itself up into the rhythms it needs to go in.

Yeah. And as a result, you kind of miss those signals, you know, that might tell you to change direction in terms of maybe nutritionally or just hydration. I mean, there can be a period of behaviors that you need to take on in order to, you know, help with some of the symptoms. But to your point, you know, the birth hormone of birth control can just mask all of that, right? So you're not actually having those symptoms, which in a way is kind of a not a good thing. Absolutely, because one of the concerns most doctors have, especially around adolescence, is relative energy deficiency in sport or reds, which is essentially when the body doesn't have enough fuel to support activities of daily life or your training and exercise and all of that. And one of the manifestations of that is you have irregular or abnormal or, you know, an absent menstrual cycle. So again, when you're on something like the pill, it, it can hide those signs. So you think that everything is fine. You think everything looks is normal when underneath in your body, you know, it might not be. And so it's, and your body

starts to, you know, make these subtle adjustments and changes that can affect your, your, your, you know, the bone architecture, how much bone you're putting down and all of that. So yeah, I mean, it's, it's, it's, it's complicated, right? Like there's no one easy answer. but I think it also plays into the idea that, you know, puberty for girls is seen as this setback in athletic progression. And so a lot of times there's this tendency or this desire either to stall puberty to change your menstrual cycle, thinking that might be a fix for it too. So I fear sometimes that, you know, by taking a pill that's also kind of playing into that

that narrative there. Yeah, yeah, that's great. Well, I wanted to cover just a couple things from a policy lens and just get your take on it. So how do you feel, you know, do you feel like the media industry is beginning to kind of cover, you know, more women's athletics and, you know, how, what's the data around that? Like, I'm not really sure. I know that obviously men are getting way more coverage than women. But, yeah, what does the data say? Yeah, I don't know if there's any updated numbers, but the number that I always hear and kind of quote is it's something like 4% of media coverage is dedicated towards women's sports, which again is kind of bonkers to me because we have all these amazing women athletes out there doing incredible things.

I mean, you just, for the NCAA tournament, the women's final, it was like 10 million viewers, which is amazing. and so great. Incredible. Yeah. Like about time, actually, frankly, right? I know. Alamada, Iowa. And, you know, watching these women play is, it's incredible.

And they're amazing athletes. And so it's heartening to start to see some of that media coverage start to expand. Obviously, there's a lot more work that we need to be doing around that, a lot more coverage. And I think, you know, there's one. kind of criticism around it is a lot a lot of times our coverage of women and women sports is often in relation or in comparison to men right like right the criticism is that you know women aren't as exciting or you know blah blah blah blah but you think about the fact that men's sports has had centuries to develop right and to become the thing that it is they've had this

this opportunity to try to fail that had people invest in it. And yet in reality, women's sports is still in its infancy. And yet we are expected to perform, you know, perform in the sense of like gaining like viewership or readership or whatever it is at the same level as men's sports, which has like I said, like had this long runway to get to where they are, whereas women are just expected to like all of a sudden jump up to this this you know high level and it's not really fair and it's not fair also considering you know that people don't invest in women's sports either so you know it's in a way it's it's it's a system that's rigged against us right um yeah but i'm hoping that it's starting to change that in you know we like i said with especially with like

the NCAA tournament we're starting to see some of that coverage change and we're respecting the women's game for what it is. It's the women's game and how they play and how it's unique. And I definitely appreciate that. We see that with professional soccer as well, which is fantastic. Yeah, yeah. It's, yeah, maybe just talk a little bit about the, just all the work the women soccer is done in kind of shifting pay scales and creating equity there. What's your, what's your take on just pay and women? I mean, they need to be paid like 10, 20 times, you know, they were. that they're getting paid, given all that the work that they are doing, you know, for, you know, in not only just their work on the field, but like you said, with pay equity. Exactly.

And advocating for all of this change. It's fantastic. You know, I will say, I think one of the things that the women's team, you know, for sure can also be credited with is really starting this conversation around menstrual cycles, too. And it's important. to athletics and to athletic training because there were all those stories that came out after the 2019 World Cup, right? That all the players track their menstrual cycle and the lead up to the World Cup.

And, you know, I have some issues with in terms of how the media kind of positioned it, but it brought a lot of awareness to the fact that this is an issue. This is something that we need to be paying attention to. This is part of the physiology and part of the bigger picture of what it takes to be, you know, an active person. Right, right. Women's soccer, kind of our U.S. national team has just been the trailblazers.

You know, they have, I think to your point, like, I don't know that you can, you can pay any of those women enough, you know, for the work that they've done and how they've impacted athletics for female athletes, you know, for females across the world. So it's, it's pretty amazing. And it's not just, I mean, it's not just. this team right like it starts way back in the 90s and it starts with yeah right like and as an organization yeah for sure like I remember you know watching the 99ers win and that was I mean that was huge right in terms of lifting up women as like legitimate athletes that this is something you can legitimately do and really setting off this you know this this enthusiasm for girls to play sports.

Yeah. Yeah. Yeah, I think the skill and the drama and, you know, everything that I think people expect from a men's game is so present in that entire tournament and just so inspiring. And yeah, I think really was kind of set the stage, I think, for everything that has come, you know, thereafter. So really exciting.

I want to dig into the book a bit, up to speed, the groundbreaking science of women athletes. We kind of touched on it a little bit. So, you know, what are your hopes for the book? You know, what do you want readers to take away from the book after they read it? I really hope that this book starts more conversations about what it really means to support and take care of and nurture girls and women in their, like, active lives and in their athletic lives. The book definitely, you know, it's not only for. for professional or elite, you know, athletes, it's really, my concern is about anyone and everyone

at all ages and stages of their active lives and how we can help them be happier and healthier and, you know, feel good for the duration of, you know, their life, right? And however long they want to be active and pursue the adventures that they want to pursue. So my hope is, that it starts these conversations to really understand, you know, where the blind spots are and have been in the past, what we can be doing better to support girls and women in sport and what questions like we still need to be asking, right? And what information do we still need to really kind of continue to push this forward? I love that.

You know, would you, is there one kind of research study that you, think has really changed the way the industry is looking at women's health or that was you know kind of particularly revealing so i think you know one of for me at least one of the studies that was really revealing is around concussions and i think that there's often this narrative around women's bodies that it is deficient or weaker or more frail compared to to men, right? Because men have always been the standard in sports and in science. They've always been what we've been compared to. So when we look at injury rates like concussion, and if women seem to be getting concussed more often, then it's like, well, what's wrong with women, right?

Like, what's wrong with our bodies that is making it such that our injury risk is higher, right? So I think some of the, you know, the stats that we see are things like, you know, women could be like one and a half to two times more prone to concussion than men. But some of the interesting research that we've seen is that I believe it's at the high school level. If, yes, you see the disparities between boys and girls. Girls tend to take longer to get back to sport. You know, their symptoms tend to be worse. they tend to linger longer. However, when researchers looked at the time in which those individuals actually sought medical care, right?

So by the time they actually saw a concussion expert or something like that, if boys and girls saw their medical provider at the same time, those differences disappeared, right? So if there was an actual biological, physiological, whatever difference, those differences should persist, no matter when someone goes and sees a doctor. And similarly, at the NCAA level, you know, you see same thing, right? You see some differences in the concussion rates between men and women. But when folks disaggregated the data by division level, right? So at Division I schools, the rates between men and women and kind of their symptoms and outcomes

was relatively the same. But when you looked at Division 2 and 3, then those differences started to diverge, right? And so men would get better, men's outcomes would be better compared to women's. And so the thought is that maybe it's the resources, right? Because if you're at a Division 1 school, you know, athletics tend to be prioritized, right? You have the resources. You have the athletic trainers on staff at the fields or whatnot. But when you go down to Division 2, Division 3 level schools, you might not have as many.

resources. And so that athlete trainer covering three sports. Yeah. And that trainer will probably be at the football game or the basketball game or something like the men's football game, men's basketball versus, you know, women's soccer game or something like that. And so that can affect how soon someone gets care or how soon someone is evaluated. What's interesting too is they also looked at the type of sports. So whether it was full contact, limited contact, no contact. Also, what was interesting looking across the data was that men in limited contact sports, so like gymnastics, also had worse outcomes. Again, because it reflects the athletic department's potentially, reflects the athletic department's priorities, right, and where they're putting in their

resources. So it just opens up this wider framework to think about, well, maybe, yes, there could be, and there are, you know, some for sure about, you know, biological, physiological, anatomical differences between men and women. But that's not the only part of the story, right? There's this larger context we as humans live within, right? There's all these environmental factors that can also affect our injury rate. There was another interesting studies, too, when we look at knee injuries, because, again, women are like two to eight times more prone to ACL tears. And when researchers looked at dancers, right, because dance is also this sport that you're jumping, you're landing on one leg, you're doing all this movement. But we don't see

the same disparities in knee injuries there. And when researchers evaluated men and women dancers and men and women team sport athletes, the dancers and the male team sport athletes all landed using similar biomechanical patterns, right? They minimize the hip wobble and the knee wobble, so they're less prone to injury. The women teen sports players didn't, right? They landed differently. There was a lot more hip instability.

There was the knee collapsed inside, which is a sign, right, a potential risk factor for knee injury. And so, again, the thinking there is, like, a lot of those dancers grew up learning how to move their bodies, learning how to land, learning these safe ways to protect the and practicing and have that opportunity. So again, it kind of goes back to like, what if there's, there are more factors here at play than we've been thinking about.

Yeah. I read in your book that you tore your ACL skiing. I've joined my ACL in my right knee twice. I actually just tore my ACL in my left name. No, you did not. In February. No. Yeah.

Dang. I mean, if you're tearing your ACL, given everything that you know, there's no who. I mean, yes. And my mother's like, can you just stop? Like, maybe just stop. I'm like, I don't really want to stop, but. Yeah. Oh, sorry.

That's okay. Sorry. Yeah, it's, you know, we just had Dr. Kidi Ackerman, who I think you covered in one of your articles at some point on the podcast. And we're talking about injuries and recovery. And yeah, this is an area that she thinks a little. lot about. But yeah, I think, you know, the predisposition of female athletes in ACL is is really interesting. And, you know, having some just ACL prevention incorporated into the

training as a young athlete is really a part of this kind of education that you talk about, you know, just knowing how to jump in land safely and how to actually train athletes to ensure that that's incorporated into the fabric of the training, you know, so we can equip women, you know, with the paraproception, you know, to be able to understand how to move their body in space and be able to land and, you know, to kind of prevent these injuries. Yeah. So more research in that area. Yeah.

And those programs tend to be, you know, have good outcomes in terms of preventing future injury. Right, right. Do you know the data of, you know, has there been any longitudinal studies that kind of look at, you know, individuals who go through this versus not and what they all? outcomes are. So I'm not, off the top of my head, I'm not sure about the lunch tool data, but I do know there was a study with the Australian Australian field hockey team, national field hockey team in which they did, you know, it was in the lead-up to the 2016 Olympics. They had, I think there was like four ACL tears or something on their team, which is, which is a lot for field hockey. Yeah. Yeah. That was my school. And they, and then. And then,

then they implemented, you know, this program, or, you know, they tried to identify what some of the factors were, and then they implemented a program. And over two years, there were two or three years, I want to say, like, there were no ACL injuries at all, you know, since they had implemented that program. And it was something as some, it wasn't a lot. It was like, you know, 10 minutes incorporated into the beginning of, you know, whatever, recession that they were doing or you know maybe it was a little bit more when they were first starting off but then like the maintenance phase it was literally like 10 minutes you know a couple

times a week and so it just goes to show like it's it's not a huge burden right in terms of of what it could be it's not like you're doing this whole separate workout and you know they were able to incorporate it so that you know it fit whatever training goal you know the team had for that day. So yeah, I mean, it was a phenomenal kind of example of what could potentially happen. That's incredible. I love the Australian Institute of sport is, yeah, one of the more respected kind of institutes in terms of their just leaders in innovation in terms of health and injury and just training practices. So I'm not surprised that they were leading the charge there. That's that's super cool do you so kind of thinking about training more on just like the performance

you know kind of track like what is there anything that you kind of learned in in the research of just how training changes across the kind of continuum of the female athlete so going from you kind of high school to kind of menopause how does what is what does that what do the changes look like and where where do you feel like the gaps are in the research Yeah. So, I mean, like we talked a bit about kind of puberty, right? And I think in order to account for a lot of those changes, you know, there are things that coaches can do in terms of like decreasing training intensity or training load, especially at times in which girls are growing the fastest that can reduce the risk of overuse injuries and growth plate injuries and stuff like that. And just paying attention to to the maturational stage of the girls and kind of where they are and working with them, right? So that the. they're not constantly fighting and feeling like I'm doing, I'm doing what I should be doing and I'm not getting anywhere. Right.

I think like as we get into, you know, adulthood or like kind of more mature adults, you know, frankly, I think a lot of the training looks similar as, you know, as what we've normally been doing, right, and can look similar to like what, quote unquote, has been designed for men. because a lot of those training principles do hold true across men and women. It's not like we need a whole separate, different thing, but I think there are just factors that we need to pay attention to a little bit more, right? And so, for example, you know, yes, menstrual cycle is one of them,

in large part because 80, 90% of women experience at least one symptom related to their menstrual cycle, whether that's, you know, fatigue or headaches or breast pain or mood changes or whatever it is, those symptoms can affect how you feel when you're exercising and your willingness to exercise, right? So it's not necessarily, at least the way that I see it, right? It's not necessarily like, I need, I'm in a high hormone phase, so I need to do X, Y, or Z to take advantage of that. Or I'm in a low hormone phase, so I need to do, you know, why to, you know, take advantage of those. but it's more just paying attention to what your symptoms are and how you feel good and bad so that you can start noticing some patterns and then you can make some adjustments to hopefully

mitigate those symptoms so that you can feel better and want to show up and be more consistent. And if you're more consistent, right, then you are more likely to see those training gains. So I think that's a piece of it. the area where we really just don't know a lot is unsurprisingly, metapause and kind of like the paramedopause, post-metapause population. Because for so long, we were just expected not to be active at that point in time, right?

Like, it was, you're middle-aged or whatever, you're getting old, you need to slow down and all of that stuff. Whereas now we're seeing the population of people who have grown up with Title IX in place who are reaching middle age who aren't ready to give up who aren't ready to give up their performance goals who aren't ready to give up

all the things that they do that make them feel good and make them feel like themselves and so that's the piece where right now like research-wise we don't know right we definitely need a lot more information there but there are very real changes

that happen during that period of time as estrogen drops, as, you know, other hormones kind of go haywire. And that's going to affect things like muscle function and endurance and recovery and all of those things. So as you approach that phase, again, it's paying attention to how you feel. Your training's not going to look the same as it did in your 20s and 30s. You're going to have to pay more attention to those things in the margins, right? Like things like your recovery, you're nutrition, your hydration, like those things become a lot more important as you reach that phase, as well as probably, right, shifting and making sure that you're doing things like

strength training because there is very real age-related loss to muscle strength as well as bone density, right? And the strength training can kind of help mitigate some of that and provide that stimulus that, like, estrogen was providing in your body previously. So, yeah, it's, there's a lot we still, we still need to know. But, you know, I think, If the take-home message really is, you have to pay attention to your body and listen to your body and what it's telling you. And while what I say might be the general kind of frame work, that might not apply, you know, that might not be your own personal lived experience of it, right? Sure, yeah. Yeah, this is definitely, you know, we're collecting a lot of data.

So we just have some surveys out to women. We have kind of a reproductive health kind of survey that asks, you know, all sorts of different questions, you know, based on the different phase of life folks are in. So collecting a lot of data around perimenopause and menopause and just seeing how it might track to the all the objective metrics that we're tracking around sleep and hearty variability. And yeah, so still kind of looking at those data and analyzing, but hoping, you know, we see ways that we can kind of coach women during these different inflection points, you know, and so they can kind of keep training and keep energy levels up.

And so we're excited about contributing to that science, knowing that there's just so much, so limited research out there, especially for women and kind of that peri menopause, you know, phase, menopause phase too. So we're excited about that. But I think you hit it. We had a really good podcast with Dr. Stacey Sims, who went very, very deep on, like, specific types of training for women in menopause and really

emphasized, like you did, Christine, the strength training, and just how critical that is for women to be lifting heavy weights and really prioritizing speed. So kind of higher intensity, you know, sprint interval type of training, you know, you don't necessarily need to be on the ground sprinting. Yeah. You can be on a bike and, you know, but just really getting that heart rate high. So it was great to kind of hear her, feel like she has a good, she was very confident that that was a good, it wouldn't hurt women in penipause to be doing more of that. And I think the other point that she made, and I'm curious to get your thoughts is, you know, in your 30s and your 40, you know, and you're kind of lead into kind of perimenopause, menopause, you know, what do you think women can be doing? You know, what should they be thinking about? And are there any case studies that you came across that can kind of help potentially ease

that transition to menopause? Do you have a sense of that? Or did you know, did you see anything in the research? Yeah. I mean, again, there's not a lot of it's anecdotal, right? Because because the research basis is so slim. Right. You have a beautiful case studies in your book. I mean, just beautiful, you know. Oh, thank you. But I think, you know, a lot of what states are talks about is, you know, is stuff to think about is starting to make, you know, ensuring that you are lifting weights, right? In your, in your 20s, in your 30s, so that that's part of your routine. And that's something that you're used to doing so that it's not like all of a sudden you're trying to incorporate this brand new thing as you are transitioning. And by doing

that, you are setting up your body and kind of the environment in your body. And you're to help ease some of that transition, right? Some of as your hormones start to drop off. So hopefully it doesn't feel as bad, right? Because it is really tempting, you know, as someone who is very much like kind of in that realm right now, like, it is very tempting, just be like, I just want to run slow all day, every day. Because that's like, that's how I feel. Like, I feel like I'm getting slower, so I'm just going to run slow.

And it becomes a self-perpeturing cycle, right? But having that stimulus is really important. and I have to remind myself of that too. But for sure, you know, so things like the strength training. And I think the other important piece of it too is paying attention to nutrition, you know, and is in that, again, there's this tendency to be to think that, you know, especially as you get into your 40s and you start to see your body start to change again a little bit, you're starting to hold on to a little bit more weight.

You're starting to, you know, maybe get a little bit more belly fat and stuff because that's where your body wants to put on, put on the weight, to then it's tempting to restrict, right? And it's tempting to do all this crazy stuff, trying to make your body, like, change. But I think, again, it's this idea that we need to be making sure that we're providing our body with the things that it needs, the nutrients, it needs the building blocks that it needs to be able to support us in what we do. So, yeah, nutrition is a huge piece of it. because then it's, again, really easy to dig yourself into a hole if you're not paying attention

to that. And then, of course, training is going to feel terrible. Of course, you're not going to want to keep going on it. And of course, then as you get into the thick of it, all of those hormonal changes are going to feel even worse because your body, again, is like even more kind of out of whack. Yeah. Yeah, protein, right? Yeah, a lot of protein. A lot of protein. I feel like that's probably not emphasized enough. But yeah, I definitely saw in my athletes, when it went wrong, that's usually where it went wrong. You know, it's just getting enough protein, you know, to really fuel their body in the way to meet the demands of, you know, the training load, certainly, but just life load, you know, life is. Definitely. And when we don't have the protein that we

need, it just makes everything harder. Well, and I think also, you know, carbohydrates, too. I think Carms got a really, really bad rap, but it really does make a difference in terms of bone health and bone turnover and all of that. Energy levels. Exactly. Yeah. Exactly. Yeah.

No question. Yeah. I feel like a lot of really good conversations recently around just macronutrients in general and kind of getting back. I think we over-indexed, you know, for a while there on just the fat and the protein. And now we're kind of coming back to the middle, which is exciting to see. So if they're, you know, you've covered lots of different topics around inequity and, you know, if there's, if there's one thing that you feel like you could have, you would want to improve today that would kind of have an outsized impact, what would it, what would it be? I mean, I think on kind of a macro level, just getting women into more leadership positions in sport, in science, in scientific journals.

Yeah. all of these organizations, right? Like, because that's where it makes a difference. I mean, you know, just for example, last month or so, the Orlando Pride, right, announced that they were getting rid of their white uniform kits in favor of black shorts.

In response to a lot of player concerns around having to wear these white shorts, particularly during their period, right? And like, they don't get a break. You can't go to that. You know, and just afraid of, like, leaning through. And that can very much affect your, you create anxiety and affect your performance. For sure.

Yeah. 100%. Right. But it's such a simple change that, but it's something that, like, men wouldn't necessarily think about, right? And so it's like, why have we had all these years of forcing women to wear these, like, white shorts or whatnot? So, I mean, I think that that's, that's, like, a very simple example of where, like, just

having, you know, a woman's experience and input on something can make a big difference or even, you know, like, you know, someone thinking to make period products available in the locker room or in the, you know, especially in like middle school and high school or something like that. Right. Right. So because who the people who are at that table and making those decisions ultimately affect what, what research is funded, what research is approved and, you know, accepted into journals, who's funding and who's leading the research, like, at the medical institutions or at the research institutions and what questions that they're asking, who at the, on the sports level, right, like how they're thinking about the resources that they're investing in their teams to be able to, you know, again, support the women in the ways in which they need because we still see a lot of inequities, right, in terms of athletic training staff, the salaries of the athletic training staff so right like you're gonna if it were me i would take the higher paying

job with the men's team versus you know necessarily working with the women's team potentially right yeah but all of those factors make a difference in creating that that environment that can really support women to be their best so that we're not losing athletes who are not losing women until they burn out an injury and whatever else i love that i you know the uniform thing is so darn simple. And I, you know, I see it like my daughter, same sort of thing. Like, you know, they have, now they started making these like period pants that you can wear that underneath your white uniform that to kind of just help ease the anxiety, which is a great step. But let's just not make uniforms that are white. Like, it just is like the worst possible scenario for a woman who

is naturally cycling. You know, it's just, I mean, frankly, frankly, I think white pants, I have two boys, and they play baseball, and all of their uniform pants are white. I'm like, they're just impossible to clean, too. Like, I can't get them. You should be wearing my pants either. Yes, I totally agree. I have a son as well. And I'm just like, why are baseball uniforms white?

Like, you're just, yeah, just, you wear them once. And then they look like shit the rest of the season. Like, it's just like, they look good for one game. Yeah. But yeah, that's like such a, gosh, I love that you said that. But yeah, I think as a female scientist, you know, I love that that's kind of where you landed. You know, it's just like we have to, you know, we need to insert ourselves, you know,

and be really vocal about the direction of these studies and, you know, get teams together that can provide the expertise to really start to dig into these questions in a way that that can create change at scale. So I love that you said that. And I think the other thing that I just wanted to reiterate, because I think I think, it's so important is that, you know, there's just advisory boards for companies, you know, where that are making products, you know, just ensuring that they have a female perspective. So anyway, I think those perspectives, you know, are so critical. And I love that you highlighted that.

Well, and I think it's, it's so great that companies like WOOP are paying attention to it because it also gives credence to the fact that this is an important issue, right? like that companies like yours are paying attention to are gathering data or trying to do the research around it yeah um and that's all part of it yeah well thank you yeah it's it's been incredible and you know whoop has just been so so committed and supportive of ensuring that we're doing everything that we can to to support female athletes you know in their journey and you know really beef up our coaching you know based on on the data and so it's it's definitely an exciting time and there's obviously just a ridiculous amount of work to do, but

I feel like, you know, we're making, you're getting small little, little wins each quarter, I suppose. I say, the best way to describe it. I'm not coming past enough, but, but yeah, it's good. You know, I think your book really, I think inspires, you know, women to achieve their goals as it relates to high performance and just that, you know, high performance is not this kind of single moment in time that can be across your entire lifespan. What are kind of the three tips that you would give a woman to kind of help them achieve their goals of high performance? I think, you know, my first tip is something we touched upon before, right, is really paying

attention to yourself. And it's really hard kind of in this age in social media and, you know, everything else. it's so tempting to compare yourself to what someone else is doing or what's going on with someone else. Like I said, like really paying attention to what's going on in your body because that's what matters and you're the one who wants to achieve these goals and you need your body to help you get there. So it's important to pay attention to your own patterns and symptoms and rhythms and there might

be a trend. There might not be, right? But it does take a lot of trial and error because humans are. We're messy, right? Where, like, this amalgamation of cells and muscles and, like, bones and, like, all this different stuff that doesn't function like, you know, in a, like it would in a closed laboratory environment, right? So I think that's one of the things I would say is just paying attention to yourself.

The second thing I would say is, you know, again, we talked about it a little bit too, but just nutrition. I think given the, and I think we're a lot more aware of it now, but just diet culture that we are seeped in day to day, right, in telling women we need to look a certain way or to be an athlete, you need to have a certain body, can be really potentially harmful and can drive folks to do things that are contrary to what your goals are, right? Are that going to keep you from reaching your goals. So I think paying attention to nutrition and making sure that you're eating enough, eating often. So again, your body has the energy in the stores that it needs to be able to support you in your goals. Because if you're running on a HMT, you're not

going to get very far, right? And I think the third tip, I mean, I guess it's less of a tip and more of a perspective on something. But there really isn't an expiration. date on our active lives, right? When, like you said, we go through these tender periods of puberty and, you know, pregnancy, postpartum and menopause that feel like it should, we should just get off, right? Get off the highway, just give up and whatnot. But, and a lot of, again, the cultural messaging is telling us that that's the end, right? That's the end of the road for you. But there really isn't, you know, an expiration date on it. Each of those, it's a new chapter. if you will, right, in your athletic life. And as you enter those new, those phases, it requires

you to take a different approach and a different perspective on how, again, like how your body is feeling and what it needs in that, in that season, in that body in which you're in. And, and that requires some grace, right? Like, we have to be kind to ourselves, which again, is really hard. but I think like just just remembering that that that there isn't an expiration date that these are all new opportunities to redefine what your athletic life means at that point what your goals mean at that point because you can still achieve goals you can still put up muscle you can still improve your health you can still do all of these incredible things you know through the duration of your life I love it that was so perfect just a really inspiring way inspiring perspective you know, that I think will be, I think, comforting for women to hear. So thank you for writing this book, truly. You know, personally, like, I just think it is just phenomenal that I have this in my possession and I'm going to be able to, you know, refer back to it.

And I think inspire me to just, you know, really think about different types of questions that we can ask of the data potentially and where to direct our efforts and really understand the gaps that you've identified. It's just such an important work. And yeah, just very grateful for the conversation today. So thank you. Yeah. No, thank you for, you know, being interested in this, right? And for all the work that you all are doing at Woop to kind of advance this as well, because it's, you know, it is built on the work of scientists and researchers that that we're able to start to have more of these conversations. Yeah. Thank you. Where's the best place for folks to find you. The best place is Instagram. So my handle created many years ago is

CYU 888, which I never have gotten around to changing to something that probably is more author brand friendly. Perfect, perfect. Okay. Yeah, I think I now follow you, so I'm like super excited for that to just see more of the, daily updates. Well, thank you. Thank you again. And I'm so excited for this launch and hopefully we can keep in touch. Yeah, no, definitely. Thank you so much for having me. It's so super fun. Thank you to Christine You for joining the show to discuss her new book, Up to Speed, the groundbreaking science of women athletes. If you enjoyed this episode of the WOOP podcast, please leave us a rating or review. Check us out on social at Woop at Will Ahmed. If you have a

question you want to see answered on the podcast, email us, podcast at whoop.com, or call us 508 443-4952, and we'll answer your question on a future episode. New members can use the code will to get a $60 credit on WOOP accessories. Enter that code at checkout. And that's a wrap, folks. Thank you all for listening. We'll catch you next week on the WOOP podcast. Stay healthy and stay in the green. Thank you.