Findings from Female Athlete Conference

I’m back (and admittedly pretty bleary!) from the 2025 Female Athlete Conference (FAC) in Boston that was held last week from June 4th through the 6th. If you’ve never been to an academic conference, lemme tell you, they pack it in. Organized runs and workouts kick off at 6 a.m. sharp and from there you’re absorbing, learning, networking, and saturating your brain (and for me anyway, draining your social battery) until 8 or 9 p.m.

It’s a lot. But the energy investment of attending pays off exponentially in knowledge, understanding, connection, and honestly, just hope. I’ll be drawing on this one for months to come, but for now, here are my biggest takeaways. 

3% is Bullsh*t and It’s Time to Change

A few statistics came up repeatedly over the course of the conference: 

• 6% of studies, particularly in sports science and exercise physiology, focus exclusively on women. That’s bad, but actually it’s worse…
• When you take out the ones focused on injury and zone in on those exclusively about optimizing performance for female athletes, it’s just 3%. 
• It takes an average of 17 years for research to make its way out and actually change how stuff’s done in the real world. 

When you sit with those numbers, it starts to make sense how it’s 2025 and we still know so little about female specific performance - especially in 40+ women (who are a sliver of that sliver of research, as we discussed with researcher Kelly McNulty, PhD, in The Forgotten Athletes: Why Midlife Women Deserve Better Science episode of Hit Play Not Pause.)

To help fill the gaps and speed things up, the powerhouses behind the FAC announced the creation of a brand new Women's Health, Sports & Performance Institute (WHSP) to be based in Boston, with $50 million in funding and an interdisciplinary clinical care model with a mission to establish a place for female athletes to be treated and to drive advancements and accelerate research. Amen.

Mental Health Needs More than Lip Service 

I lost count of how many times mental health needs and issues came up over the three day conference, but it was roughly 3.5 billion. In seriousness, it came up a lot and generally in the context of how much help is needed in this area. I would love to see a whole day of this conference devoted to this issue because I think many of the key research and clinical practice topics the FAC covers extensively–like low energy availability and REDs–are often driven and/or exacerbated by mental health issues. 

Some of the statistics that stood out to me in this area*:

44% of female athletes felt overwhelmed compared to 17% of their male peers

35% felt mentally exhausted compared to 16% of males

29% felt overwhelming anxiety compared to 9% of males

28% experienced sleep difficulties compared to 17% of males.

Unsurprisingly, body image was also a big issue. Men’s sports athletes scored 20-30 points higher on all measures of positive body image. Women’s sports athletes are 3 to 4 times more likely to say social media is negatively impacting their body image. Tellingly, 35% of women who said they were at the right weight for their sport were still trying to lose weight. 

*Note: These were from an NCAA survey, which I know is not this demographic, but based on what I’ve learned about mental health issues in midlife women, I feel pretty certain we’re in a similar if not bigger boat.

Yes, the Menstrual Cycle Matters

There are countless, never-ending Instagram fights over if/how the menstrual cycle impacts training, performance, recovery, etc. When you consider how women experience their hormonal changes with mood swings, bloating, fatigue, cramps, changes in thermoregulation, sweat rate, and so forth, it makes a whole lot of sense that the menstrual cycle has some impact here. But it’s super hard to study (hence the internet fights). So one of my favorite sessions was by longtime (like 45 years of research long…) endocrine and metabolic response researcher Anthony Hackney, PhD: Hormonal Considerations in Female Athletes: Insights for Coaches, Clinicians, and Scientists.

His takeaway was that it’s just going to be really hard to draw broad conclusions with research, especially given the way it’s conducted. For one, studies tend to be short, a few weeks or a couple of months in a lab setting. There’s so much variation in the menstrual cycle even in a single woman, that you may not be able to really capture what’s happening broadly in just 1 to 3 cycles. Research doesn’t always actually (or accurately) measure hormones in the women being studied. Women can often nail their performance despite feeling crappy because of hormone-related symptoms, so it’s important to understand women’s subjective experiences (i.e. how did they feel) as well, because that’s more likely to affect training on a day to day basis. 

Speaking of subjective experiences, when you actually ask athletes to tell you how they feel about how their menstrual cycle impacts performance, you get a substantial number telling you they think it does. For instance, this 2024 anonymous survey of rugby players reported that 87.8% of athletes perceived the menstrual cycle to negatively impact performance, including decreased appetite, nausea, fatigue, strength declines, heightened emotions, and worsened focus. Sure, some of that might be social conditioning, but I’m highly doubtful it all is, considering what women have been saying, oh forever. 

Which brings us back to the need for more, better research. Can’t wait for WHSP to get up and running.