5 Why do we need to study women separately?
Research lacking female participants has many implications for female athletes, not least that we may never know if something that is safe for men is also safe for women. Or it may be that some types of training are more beneficial for women than men.
Dr Stacy Sims is an exercise physiologist who used her own experiences of rowing to ask uncomfortable questions about why female performance can vary significantly on different days. In Activity 5 she explains the impact the menstrual cycle can have on the fuel used by females during exercise and other variations that affect female sporting performance.
Activity 5 Are women the anomaly or is it really the men?
Timing: Allow about 15 minutes
Watch the TedTalk below by Dr Stacy Sims as she explains her own experiences of gender differences in performance as an academic and an athlete. Watch from 01:17 (‘I was a cross country runner for most of my life…’) until 06:10 (‘… if we work on skill and development we’ll be fine’). Then answer the following questions:
- What differences does Dr Sims identify between male and female athletes?
- What are the differences between males and females that occur at puberty?
Download this video clip.Video player: boc_sfps_1_session1_activity5.mp4
Transcript
[MUSIC PLAYING]
[CLAPPING]
STACY SIMS
Hello. So I’m going to start by telling you a little bit of story. And I’m sure that people who already know me might not even know this about me. But when I was a little girl, I was super into princesses, specifically Wonder Woman and Princess Leia. I was a girl that would skip brownies, wear my Underoos and my mom’s boots, just to watch Wonder Woman and feel empowered by her showing her strength, her speed, her skill, talking back-- which I wasn’t allowed to do.
And I really felt empowered by these women because they did not stop when they were told to, they wouldn’t take no for an answer. So I grew up with the ideal that women could do what they wanted to do, as long as they had the drive for it.
AUDIENCE
Yeah!
STACY SIMS
But this ideal was challenged frequently, and still is. I was a cross-country runner for most of my life. But when I got to Purdue University, I decided to join the crew team, for a bit of a change of pace, but also it meant that I was near the water.
And in this group of eight women, we trained hard. We trained on point, we raced hard, we raced with purpose. We did the same training as the men, the same race schedule as the men. Basically, we were training like men.
But there were times when we were flat in the boat, even though we had the same recovery and the same training schedule as the men. And it really started really getting under my skin a bit, going, what’s going on? And at the same time, I was in the undergraduate kinesiology program studying exercise physiology, nutrition. And part of the requirement was to actually be a participant in the labs.
For example-- this is one that I really remember, it sticks out well-- it was me and two guys, and we had to run on a treadmill for two hours one week. And then the next week, do the exact same thing. The first time I did it, I ran and it was awesome. Two hours, no issues whatsoever. No water, just people going, I can’t believe you’re running for two hours on the treadmill.
The following week, first half an hour was OK. But the last hour and a half felt like five years. I was like, what is going on?
And we started looking at the results and it was really interesting to see my results showing that in the first trial, I was using a lot of fat as fuel, which is great because you have an opportunity to go for a long time. But the second trial, I burned through a lot of carbohydrate and then I was having a really difficult time to fuel myself. And I thought that was interesting.
But what was even more interesting is that there was no difference for the guys at all. So I asked. I was like, well, why is this?
And the response was women are an anomaly. So we don’t necessarily study women in sport nutrition or exercise science. And I stopped and I looked, and I looked at myself, and I looked around, and I thought, surely, with 50% or more of the population being female, aren’t the men the anomaly and they don’t know it yet?
[LAUGHTER AND CLAPPING]
So, as an academic and an athlete, I really started asking these questions. I was like, well, why is it that our boat is flat? Maybe it has something to do with the fact there are sex differences from birth that no one talks about. And why is it that women feel a little bit less tolerant to the heat right before their period starts? Oh my gosh, did I just say that word, ‘period’?
[LAUGHTER]
And why is it that after two days of really intense training, feel a little bit flat? So I started asking these questions and these questions were what drove and drive my research all the way through grad school at Massachusetts, PhD at Otago where, in fact, I was asked, why do you want to study women? We don’t know enough about men.
[LAUGHTER]
Research position at Stanford University, same thing. Right now, I’m a senior research scientist at the University of Waikato’s Adams Center of High Performance, and even now I get pushback from physicians, from sports scientists, from doctors, even from athletes. Why do we need to study women separately?
And so, I really say, well, you know why we need to study women separately? Because we have this thing called the menstrual cycle. We also have this thing called an XX, versus an XY. And we are not the same from birth.
So if we think about it really, when does this conversation really need to start? It needs to start at the onset of puberty. And the reasons for that is the onset of puberty, we have this huge shift. We see boys that lean up, they get strong, they get fit, they get fast, they get aggressive.
And then we see girls, and their hips widen, their shoulder angle changes so that we don’t hit our hips when we’re running. We put on a little bit of body fat, we feel ungainly, uncontrolled, and we start to set back a little bit. And it is punctuated by the fact that we get periods. But no one talks about it. And this is one of the reasons girls drop out of sport because no one talks about it.
No one talks about that this is just a temporary change and if we work on skill and development, you’ll be fine. But let’s look at this woman, Marie, comes in with her mom. She’s 15 years old and she's been on top of her game in swimming for a very long time.
But now all of a sudden, she’s starting to feel flat, tired, her times are slowing down. She’s putting on body weight and in response to that, she’s cut her calories. And so I ask her about her period because I’m the period woman.
[LAUGHTER]
And so I ask, how are your cycles? And she mumbles and turns bright red and says, I don’t have to worry about that anymore. And I pause, and I talked to her and I asked her about her coach. She has a male coach who was very successful in his swim program but he doesn’t mutter the word ‘period’.
I ask her about her teammates. They talk about everything except for that time of the month. And so when I tell her that a period is an ergogenic aid and she should actually look to get it, she looks at me funny and goes, but it’s better if I race without it.
So if we were to actually take this conversation and look, and separate out at puberty and have our boys train like boys with the testosterone boost, and then take our girls and train our girls and work more on technique while they navigate through these changing body waters, perhaps the confidence to stay in sport would be there. But it isn’t just at puberty, it’s throughout our lifespan. So right now, we hear all these things about the Keto diet, high intensity interval training, paleo, intermittent fasting. Do all of these things.
But where do we get this information? Social media, Beyoncé, right? Some of the other famous people, do they have degrees? No. Do they know where the original research comes from? No.
If we look closely at that original research, most of it comes from obese, sedentary men who need to lose weight before surgery, and then it is just generalised over to the fitness population. And if we look at how women have been marginalised across it, they’re just assuming that this information is going to work for them as well. But it’s not the case.
So I’ll use an example of someone who usually comes to see me. We’ll say, Mel, she’s 34, 5' 5", 65 kilos, bit overweight. She’s time pressed, has a very high-stress job, but she wants to look to the eye of the future and have kids in a few years. So she’s trying to get healthy.
So she’s doing intermittent fasting and doing high intensity training a few times a week without eating first. She does yoga once a week to calm her mind. And she’s really frustrated because her husband is doing the same thing and he’s leaning up and looking hot, whereas she is getting fatigued and putting on body weight. She’s irritable, she has no focus, she says her periods are becoming a little bit irregular and she’s noticed she’s putting on a lot of belly fat.
So when I talked to her, I was like, well, let’s first track our periods. I know they’re irregular but let’s track what’s going on. Let’s put our mood down, let’s put what you’re doing against your cycle and let’s also change it up so that we’re fueling for what you are doing, so that your body has the fuel it needs to hit those high intensity sessions, get that stress and adapt.
After about a month of doing that, she’s noticed that her focus is back, she has more energy, her belly fat is starting to dissipate and her period actually came back when it was supposed to. So we continue forward and use that period tracker to actually mitigate her training and say, we do high intensity when your physiology allows you to hit those high intensities. Two months later, she’s feeling great, she’s lost weight, her periods are very regular. Taking her own physiology and working with it helped her navigate those waters, having that conversation. But if you think that having that conversation in a perimenopausal woman is difficult, wait till you get to perimenopause and post menopause. Then it’s like, [WHISTLES], tumbleweeds.
[LAUGHTER]
No one talks about it. But I’ll give you an example. Jenny comes to see me. She’s 54, she’s married, she has two teenage daughters. And over the past few years, she’s put on a lot of belly fat and she really wants to lose it and gain lean mass.
She’s starting to get some hot flushes, a couple of other menopausal symptoms. Brain fog is one she complains about. And her physician’s advice is eat more soy and let’s just do low intensity cardiovascular work-- two things she should not be doing.
We need to look to do Plyo work to maintain that bone density, and do some really good resistance training to build that muscle. But yet, with that fluctuation of oestrogen, there are two things that happen. One, hypersensitation of the serotonin in the brain starts to fluctuate. So this causes some brain fog.
We counter that by having some more protein. Protein hits the brain, counters that brain fog, also feed forward to build lean mass because oestrogen is anabolic and when it drops off, we also lose the impetus for building lean mass. By increasing her protein in and around her training, we’re able to mitigate that brain fog and also increase that impetus for lean mass development.
So as we go through it and we look at her training as well, and we match her training with her nutrition and changed it up to do more high intensity work for bone stimulus, more resistance training for lean mass development, she notices after three months that her clothes are looser, she has more stamina, she actually has some arm muscles-- which is awesome. So as we have this conversation, we kind of giggle and laugh. I want everyone in this room to turn and say, women have periods.
[LAUGHTER]
Don’t laugh. Women have periods. That’s right. We need to have that conversation because it starts at puberty. You need to open up that awareness.
The more awareness we have about it, the more awareness we are that women are not small men. We can really work with our physiology, right? Work with our physiology to improve our health outcomes, to improve our performance-- whether that be walking up the mountain, running a fast 5K, or winning Ironman-- whatever your goal is, working with your physiology.
Because if we work with our physiology, knowing that women are women and men are men, knowing that women are not small men, then imagine the outcomes. I would be out of business and the billion dollar fitness industry might only be 10 million. Thank you.
[CLAPPING]
[MUSIC PLAYING]
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Discussion
- Dr Sims identifies that female athletes use differing amounts of fat and carbohydrates as fuel for exercise dependent on which phase of their cycle they are in. Dr Sims explains how men do not experience this variation to the same extent and they also experience fewer differences in how they tolerate heat from day to day. These hormonal differences experienced by women are often seen as limiting factors to performance, but they also offer opportunities, as you shall see in Session 2.
- At puberty, males become stronger and faster due to the increased presence of testosterone and its impact on their muscular system. Females have a very different experience, as oestrogen causes them to lay down more body fat, their hips widen to facilitate childbearing, and they start getting periods that cause fluctuations in hormones, energy and mood.
Interestingly, Dr Sims makes the point that as there slightly more females than males in the world it must be men who are the anomaly, but females are regarded as such because they are more complicated to conduct research on.
You are now going to look at puberty and ask why it is such an important stage for maintaining female sports participation.