SHE LEADS SCIENCE
She Leads Science is a podcast where women share their journeys in medicine, public health, and scientific discovery. From the lab bench to the park bench, from classrooms to policy rooms, we will explore how women are shaping the future of health. With each episode, we will bring you real stories, practical wisdom, and fresh perspectives from women at every stage of their careers.
SHE LEADS SCIENCE
Mary Jane De Souza and Nancy Williams - THEY Lead Science
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In this episode of She Leads Science, host Dr. Liz Joy sits down with pioneers Drs. Mary Jane De Souza and Nancy Williams to explore the science and leadership behind the Female Athlete Triad. Together, they trace their paths into research, reflect on navigating male-dominated fields, and discuss how their work reshaped the understanding of energy deficiency, menstrual function, and bone health in physically active women. The conversation unpacks the physiology of energy deficiency and examines the long-term consequences for reproductive and skeletal health. They also address persistent misconceptions, gaps between science and clinical practice, and the importance of translating complex research into actionable care. Finally, they reflect on mentorship, leadership, and the power of collaboration between scientists and clinicians to drive meaningful change in women’s health. Highlighted below are recent publications on the expansion of our understanding of the Female Athlete Triad, and its translation into clinical care.
De Souza MJ, Williams NI, Misra M, Nattiv A, Joy E, Barrack M, Ricker EA, Gorrell S, Koltun KJ, O'Donnell E, Mallinson RJ, Salamunes ACC, Woodruff K, Fredericson M, Plessow F. 2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 1: State of the Science and Introduction of a New Adolescent Model. Sports Med. 2026 Feb;56(2):327-373. doi: 10.1007/s40279-025-02333-z. Epub 2025 Dec 31. PMID: 41474493; PMCID: PMC12982264.
Williams NI, De Souza MJ, Misra M, Nattiv A, Joy E, Barrack M, Ricker EA, Gorrell S, Koltun KJ, O'Donnell E, Mallinson RJ, Salamunes ACC, Woodruff K, Fredericson M, Plessow F. 2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 2: Clinical Guidelines for Screening, Diagnosis, Treatment, and Return to Play for Adolescents and Adults. Sports Med. 2026 Feb;56(2):375-427. doi: 10.1007/s40279-025-02332-0. Epub 2025 Dec 31. PMID: 41474492; PMCID: PMC12982345.
Tempo: 120.0
SPEAKER_02Welcome back to She Leads Science. I'm your host, Dr. Liz Joy. Today I have the absolute privilege of speaking with two pioneers whose work has fundamentally shaped how we understand women's physiology, exercise, and health, Dr. Mary Jane D'Souza and Dr. Nancy Williams. Dr. D'Souza is a distinguished professor at Penn State and a leading expert on energy deficiency, menstrual function, and bone health in physically active women. Dr. Williams from Penn State as well is internationally recognized for her work on reproductive endocrinology and the physiologic consequences of energy deficiency. Together, their research has been fundamental to what many now know as the female athlete triad. Today, we're going to talk about how they got here, what they've discovered, and what it means to lead science that truly changes how we care for women. All right, ladies, warm-up question to both of you. Mary Jane, we're going to start with you. When someone asks you what you do, how do you describe your work these days?
SPEAKER_00Thanks for having us, Liz. It's very much appreciated. I think what I do is try to help women safely participate in sport at the highest level that meets their potential for performance standards that are out there. That's awesome. Because that's what that's what female athletes want.
SPEAKER_02Right? Yeah, absolutely.
SPEAKER_01Nance, your turn. I I think it's um it's an interesting question. Sometimes it depends on the audience. So if I was at a cocktail party, I wouldn't say I'm a menstrual cycle researcher. But in my heart of hearts, I kind of feel like that's a big part of my identity. Um, but as a faculty member, I often just say, you know, I do research and things around the female athlete triad, but I also teach and I do translation and stuff like that. So it's a little bit of a multifaceted answer, depending on the situation. Okay, that makes sense.
SPEAKER_02So you brought up the term female athlete triad. Of course, this is a world the three of us have lived in for a really long time. But Nancy, take just a second or a minute and describe to the listening audience what the female athlete triad is.
SPEAKER_01Well, it's we we consider it um, you know, a real medical condition that speaks to the interrelationship between energy deficiency, uh, the suppression of menstrual cycles or impacts on reproductive physiology and bone health. And so, in practical terms, what we see a lot with real recreational or female athletes is that when someone is exercising too much and not eating enough, we see that the body suppresses reproductive function or the menstrual cycle. Women become amenorrhec and don't have regular periods. And if that goes on long enough, they can incur bone health consequences like stress fractures, decreased bone mineral density. And the thing that is you know undergirding all this, the driving factor, is energy deficiency. And that can happen because women develop disordered eating or clinical eating disorders, or if they simply don't eat enough. So that triad is energy-related issues, reproductive physiology, and bone health. And that's the female athlete triad. Excellent. Thank you so much.
SPEAKER_02So this is a big topic. Um, you know, we talk about it in the context of athletes and active people. And I think that sometimes people think, well, that's not that many people. Uh, but in fact, it is a potentially huge number of people, and it can have lifelong consequences. Um, and and that, you know, has a significant impact, you know, on public health, of course. So Mary Jane, I'm I'm curious, you know, really what drew you into this science and specifically into studying women's physiology and exercise.
SPEAKER_00You know, I I think for me, I I kind of got here by accident, but it became my absolute passion. I got here because my very first master's class, um, my mentor was um an amazing woman named Mimi Murray, who was a sports psychologist. And um she knew me from my undergrad, and we had to write a paper. And she said, you know, DeSouza, you stay and wait for me. Uh, I have to speak to you after class. And at the end of the class, she said, um, I just want to tell you that you're gonna write your paper on exercise and the menstrual cycle. And I was dumbfounded because I said, Uh I can't do that, I don't know anything about it. And you know, that was the absolute best thing that happened to me because learning and studying and researching the physiology around the menstrual cycle and various supporting areas for women's health were transformative for me, and I quickly began to realize how much work had not been done in the area, and that quickly became my passion. And if you were asking me, would you if you could start over, would I do anything differently? And I would say absolutely not, because this area has just such a huge need and gaps that exist of what we don't know. And it's just not realized or appreciated how much we don't know and how much there is to learn in order to explain our science in translatable ways to folks. And I think that's that for me is um how I got here and why I stayed.
SPEAKER_02Awesome. We're gonna talk more about that because I think that's one of the areas where I think you've really excelled is translating that science, you know, into practice and policy and actions that people can actually take to both prevent and improve management of the female athlete triad. So, Nancy, now it's your turn. Um, you know, was there a defining moment that led you toward reproductive physiology and energy balance?
SPEAKER_01You know, you take a physiology textbook, and the last chapters are always a reproductive physiology. It was never kind of like my favorite part of a physiology course. But like Mary Jane, I met some incredible mentors during my doctoral training. I got to be a part of their team. And Beth Bullen and Janet MacArthur were studying the effects of exercise on the menstrual cycle, true pioneers in the field. And once I began to get interested and learn more, as often happens, just learning more about something makes you feel more invested and more interested. And I really realized that I wanted to be a part of what they were trying to understand, which was is this something about exercise itself, or is it something about weight loss or caloric restriction that starts to kind of mess up the menstrual cycle, disrupt the reproductive axis? And once I heard Janet MacArthur say endocrinology is elegant, then I was just kind of sold on the physiology surrounding this whole topic. So that really meant a lot to me to be partnered and be able to be working with a team that was so impassioned by this work.
SPEAKER_02It's so interesting to hear you talk about that. You know, I think my introduction, you know, to the female athlete triad before I even knew what it was called was a roommate that I had in college, you know, who had lost a lot of weight, um, who uh didn't have any periods, and she had a bunch of stress fractures. And I can remember thinking, I wonder if she has all these stress fractures because she doesn't get her period, you know, and and that, you know, just having that observation and and the curiosity um to actually, you know, kind of stick with this, you know, that was that was a long time ago for me. Um, and and yet here I am still talking about it um many years later. So, Mary Jane, you both entered fields, physiology and kinesiology, that you know are historically centered around males. Um, did you ever feel like you were pushing against the grain, you know, and uh maybe this is a little provocative, but in some ways, are you still pushing against the grain?
SPEAKER_00Yeah, I I think that it's difficult for women to hang in there and realize that some of the obstacles that they're maneuvering around or jumping over are because we are in a man's world, and I'll say still, unfortunately, and um it's difficult. I have I continue to think it's difficult to navigate, but I think you have to sort of put blinders on, and you have to address issues in the spirit of what is right, what will help the science, as opposed to making it personal, and even then you may not be given the opportunity that the guy over there might be getting, and um I think that kind of suppression on women is unfortunately alive and well, and maybe in current political times getting worse, unfortunately. But for me, it's always been about hanging in there because it's the right thing to do, and the the my purpose of messaging to that one girl that I might help um is the reason that you have to stay in it. You you cannot um give up on it because you face obstacles. I I think you have to take a deep breath, turn the cheek, and keep going.
SPEAKER_02Yeah, that commitment to science is so incredibly important on so many levels, and this one in particular. Um, Nancy, I'm wondering if there were moments, you know, in your career where you thought, you know, this is going to be harder than I expected, you know, especially early in your career. And how how did you navigate that?
SPEAKER_01I think I was thinking about this question on an individual basis. I've had moments where I just thought, I can't do this, I'm gonna have a nervous breakdown, old, old language. Um, I'm not up to this. And in those times, I just surrounded myself with peers and family and friends, and I kept going because eventually I figured out that that was kind of a uh a down because there are ups and downs. But I think in the larger scheme of things, this adversity that we're talking about, like you know, trying to push a women's health agenda when the country only realized that we should start funding research on women relatively early, it really takes um extra effort. And so if anything, it's made us stronger and better researchers because we have sought out the best people like yourself, Liz, to collaborate with and do things uh to, you know, to push to push research questions and their answers forward by just always having to strive to, you know, be the be the best proposal and get the grant that's funded because we know we're already, you know, swimming upstream.
SPEAKER_02Yeah, I think you speak to kind of you know what I often refer to as kind of the superpower of women, you know, that we seek out others, you know, who are going to be um supportive team members, you know, and we collaborate and um work really well together. And that you know gives us the strength and the support and um you know the energy, um, the ideas to actually you know move forward and even accelerate our science. So that's a that's a great example of that. So let's move on a little bit and talk more about the science. We've touched on it already, but um, Mary Jane, you know, well, both your work really, it's it's been absolutely foundational in defining the concept of low energy availability. Now we talk more about energy deficiency and its consequences. Um, you know, maybe for listeners who are not as deeply familiar, help us understand this core concept of energy availability or energy deficiency in simple terms.
SPEAKER_00You know, in simple terms, the whole concept is focused on the fact that you need to have enough energy in your body to fuel essential functions like your heart beating, like your metabolism, like your liver doing work, um digesting your food. You need calories that costs energy, calories. And then you need calories to move. And we move around all the time in walking around, um getting to work, getting home, and then we ask ourselves to exercise, and we do that purposefully and deliberately, but that costs even more calories. So when you add all that up, that requires your body to have a, as you say, Liz, a bucket full of energy, and the whole concept is based on the bucket. Is does it have enough energy in it, or is the amount of energy in there inadequate? And when it's too little, the body reacts, and the body reacts in a way that says, I'm going to make adjustments so I can survive. Number one, and some of those adjustments that are made cost us our health, and the health problems that are the most costly are around reproductive health and around bone health. And the bone health problems are particularly concerning because while we can pretty much confidently reverse all the reproductive problems, we're a little more sketchy on our ability to um reverse the bone health problems. So energy matters. And don't rely on your hunger cues to say, well, that's gonna make me eat enough food because it doesn't work that way. And that's the biggest problem. In order to for these athletes to flourish, they have to nourish their body and get enough food. And when they don't, that's energy deficiency.
SPEAKER_02Love that. Great explanation. Nancy, I'm gonna pivot to you. Um, your work, you know, has really clarified some of these neuroendocrine mechanisms. Um, and can you explain what actually happens physiologically when energy availability is too low? But before you, before you answer that as a scientist, I'm gonna I'm gonna share with you and and with our audience uh how I often explain it to patients. Um, because you know, these big terms, you know, sometimes go over the head of you know a 16-year-old, you know, female athlete that I'm trying to explain, you know, why why she should care about this. So I often start by saying that the loss of menstruation or amenorrhea is a protective mechanism in the setting of significant energy deficiency, whether that's a result of dietary restriction andor high levels of exercise, because you know, as Mary Jane pointed out, the brain's job is to protect the self. And in the absence of sufficient energy to sustain normal female physiology, you know, in this case, reproductive physiology, it shuts down the reproductive cycle, or as I'll say, menstrual periods, as a strategy to prevent pregnancy, because pregnancy would place a further energy drain on the affected female. And we know that that's true from back in the days of the plague, right? When women didn't have enough calories, you know, and the birth rate plummeted, you know, during times of famine. During times of famine, the birth rate plummets because, you know, again, in the absence of sufficient energy intake, the body shuts off reproductive physiology, you know, and I it's a strategy, you know, to to prevent further energy drain on the affected female. So I guess what I'm getting around to is in some ways the impact of energy deficiency is protective, right? It's preventing you know, further energy drain by turning preventing pregnancy, but in the other case, it's detrimental. So am I close?
SPEAKER_01Well, yeah, I think the 30,000-foot view, this is this is a common um uh tool, a physiology for all mammals. So humans are not unique, human females, and you know, they the ultimate goal is for us to reproduce. So there's a um evolutionary drive to protect um reproductive physiology and make sure that toggling on on and off is really in sync with energy availability. So that kind of all makes sense when you realize that uh sheep, goats, horses, you know, squirrels, all all all sorts of species of mammals um will suppress reproductive function during times of energy deficiency. As for the neuroendocrinology, it's continuing to evolve, but we have learned so much in the last few decades about the metabolic signals that connect changes in circulating fuels. Um, that's one definition of energy availability, to uh the hypothalamus and the neurons that control the synthesis and secretion of gnetotropin-releasing hormone, and then consequently the rest of the reproductive axis, gnetotropins, and then ultimately ovarian function. So energy deficiency affects every level, ovaries, pituitary hypothalamus, but the real controller, the thermostat, if you will, is really the hypothalamus and the neurons that secrete GNRH. And so that's where the metabolic signals really are important and act to either turn up or turn down the ability of the reproductive axis to succeed in ovulation and pregnancy.
SPEAKER_02Excellent. Um, Mary Jane, you talked a little bit about um, you know, the relationship that energy deficiency and the loss of menstruation, you know, impact bone health, you know, as a as a consequence. Um what do you think you know clinicians offer and often underestimate, you know, about those consequences?
SPEAKER_00In my mind, I think they underestimate the effect of the energy component alone impacting bone. They think it's solely related to the estrogen and it's it's not. It's relate, it's related to a lot of these metabolic changes that that um occur in response to this energy deficient environment, and that environment is very bad for bone growth and for optimizing bone health. And I think physicians don't quite get that component, and I think it's in my opinion manifested when they mistakenly think that they have a female athlete who is not getting her period, and it's been a bunch of years, and they put them on an oral contraceptive to fix it. I think that that to me cues cues me to say physicians aren't getting it because one if you just Give them estrogen in the form of and any estrogen. If you just give them the estrogen, you're not fixing what caused the problem. And what caused the problem is the energy deficiency. So I think that whole um pathway ends up giving athletes this false sense of security because they're getting what they think is a period where it's simply withdrawal bleeding from these um from the ethanol estradiol and the different progestins and contraceptives. And uh that has nothing to do with restoring menstrual function other than further suppressing it. And the other concern I have is first pass effects of oral contraceptives, because if you're taking the pill, it's affecting the liver, and that causes the um hormone from the liver, IgF1, insulin like growth factor one, to be suppressed by 30, 40 percent when you're on an oral contraceptive, which is very detrimental to bone health, especially in amenorrheic athletes. Those are my major concerns. Yeah, that's the same thing. And I see this all the time. I see it all the time.
SPEAKER_02Yeah, I mean, we've done a lot of educating, you know, on the relationship between energy menstruation and bone health, you know, to athletes, coaches, clinicians, and scientists. I mean, what do you think they still get wrong about the female athlete triad?
SPEAKER_00I I just think they're not paying attention to to what's going on and trying to really understand the physiology. And if you listen to these kids, I mean, what concerns me is they're seeing physicians that are not compassionate to the problem, and they're sort of moving them through, and those those are the athletes I'm most concerned about because other problems will arise in in those athletes, and they're they're not being heard, and and that makes makes the problem compounded and adding adding on layers that may or may not be related to their eating behaviors. Um and that concerns me. And I I just when I hear that an athlete has retired and they're 17 years old, that concerns me. When I hear I see it so often that they're they're medically retiring because of recurrent stress fractures. I mean we've been doing this since 1990s, 80s, late 80s, early 90s, and the prevalence is going up. There are a lot more girls participating in sport. We we we see what's going on in the Olympics. There are, you know, now there's as many women as there are men participating in the Olympics. We've seen this crazy increase in performance capacity, but with that, we're seeing the prevalence continue to rise of the triad. Very concerning problems.
SPEAKER_02Well, my observation, you know, and talking with you know some of my colleagues is you know, stress fractures are still seen as kind of a nuisance injury, right? It's not a real, it's not a traumatic fracture, it's a stress fracture. Um, and that you know, they don't realize that you know a stress fracture can you know certainly be a season ending injury for some athletes, um, and for others, even a career-ending injury, you know, if they have a high-risk stress fracture. And of course, we've all seen that. So um, you know, stress fractures are are the real deal, and um they shouldn't be minimized in any way, shape, or form, especially when they're in the femoral neck, the stake, there's so many serious and recurrent stress fractures now.
SPEAKER_00And I I don't think we should be minimizing that problem.
SPEAKER_01You know, it's interesting, Liz. I wonder how many other injuries, if discussed in the, you know, in the doctor's office, uh and someone dives into them a little bit, lead to other major physiological behavioral issues like the triad. So you might talk about a stress fracture, but if you delve deeply enough, you could uncover a serious eating disorder, infertility. Uh, and I just wonder, are there any other examples of that? Because I think where there's a great need is for clinician education. We see time after time, physicians are not getting this in medical school. There's still a gap in just basic knowledge of this condition, the female and the male athlete triad.
SPEAKER_02Yeah, I agree. I I, you know, as you're talking, I'm thinking, okay, if somebody tears their ACL, am I thinking about other kind of metabolic derangements or other things that may be putting them at risk for an ACL tear or I don't know, a rotator cuff injury? Um, you know, the only thing that really comes to mind is is, I guess, people with you know low back pain, which I think 75% of us will experience low back pain that requires some type of you know clinical intervention in our lifetime. So super common and and maybe not metabolically um uh there's not a metabolic cause, but certainly it does prompt us thinking about other things, you know, in that abdominal pelvic core, you know, that may be contributing. But but I think you're making a really good point, right? That you know, stress stress fractures, bone stress injuries should prompt further evaluation for underlying causes that go beyond how many miles per week are you running and how often do you change your shoes? I mean, you know, that's just insufficient. So um a lot, still a lot of work to be done, you know, in that area. And of course, it's not just you know, athletes, you know, who end up um suffering from the triad. And Nancy, I wonder if you could talk about how this, you know, also shows up in recreationally active women, um, military recruits, or even just the general population.
SPEAKER_01Well, Mary Jane actually published a study a long time ago showing that this was evident in recreational athletes, and she can speak to that. But we know now that it's a real concern for the DoD and in military populations. We see calls for research in the area. We've been funded by the DoD because of the relevance to military populations studying the triad. Um, so the basic physiology doesn't limit itself to being an elite athlete. It's simply about energy balance and chronic differences in intake and energy expenditure. And of course, it happens more frequently if there's a high caloric expenditure with purposeful exercise, but there's not a unique physiology that can be ascribed to you know various populations. It's it's there, and um we see it often in recreational exercise exercisers, dieters, chronic dieters, and now in military populations, although with the military, there seems to be more uh an additional impact of stress. So that's very interesting. So I'm not saying there aren't differences um that need to be paid attention to, but the basic physiology is uh is pretty consistent.
SPEAKER_00Mar Jane, anything you would add? I'd say it's it's alarming that in military recruits we see these um stress fractures by day 21-25 of basic training. And that's because these women may not be used to carrying a 40-pound rucksack and running with it andor marching, and they have on boots that may or may not be particularly favorable for support and absorption of ground reaction forces. And by day 21, there's this process called you know an abnormal bone formation that we call adaptive remodeling that goes on where we're seeing stress fractures at these early time points going into basic training. And it's not unimportant because a lot of times this can read result in separation from the military when they really want to do this, but if they're uh a candidate for recurrent fractures, this is a long-term problem.
SPEAKER_02Yeah, you know, and one of the areas that you know I work in as well is you know, this concept of you know, musculoskeletal failure, you know, which occurs much later in life, although its roots are much earlier, right? And that we, you know, think of musculoskeletal failure as that relationship between you know osteoporosis, you know, low bone density, osteoarthritis, and sarcopenia that again comes from being undernourished, you know, that leads then to falls and fractures um in uh aging adults. So it's interesting, you know, I think in my own career of connecting my work in the female athlete triad, you know, in you know, younger um people to now musculoskeletal failure occurring in um you know older adults. So there's definitely a continuum there. And you know, it requires um, you know, adequate nutrition, you know, appropriate amounts of physical activity, um, normal physiology in order to protect bone and you know, other aspects of you know mobility um in order to be healthy and to have a health span. So um I'm kind of interested in that arc, you know, between triad and failure.
SPEAKER_00We haven't defined what we we're seeing in these young triad um impacted women as musk musculoskeletal failure, but we could redefine it along this lifespan continuum. And I don't know, I I think it sounds like musculoskeletal failure.
SPEAKER_01Yeah, I think the important the important study to do is to follow women or to do study older women that have that have had the triad. We've we've been beyond Title IX for enough now that we need to start really looking at how this impacts people long term. I think that's a gap in the literature. Okay, well, we'll tee that up on another call another time.
SPEAKER_02So, you know, the science you guys do is amazing, and I it's been such a privilege to to work with you on it over, you know, several decades now. I'd like to shift a little bit and kind of talk about leadership. Um, I know that I think both of you have served as department chair at Penn State, correct? I have not. Not you.
SPEAKER_00Well, I don't ever want to.
SPEAKER_02But you both have been presidents of the female and now male athlete triad coalition. And Mary Jane, you serve as the coalition's executive director. Um, you know, Mary Jane, what has surprised you the most, you know, about the experience of being in a leadership role, you know, um in your lab, you know, within the coalition, in the broader community?
SPEAKER_00I think for me, if I'm extremely honest, Liz, is I think it's a battle for scientists, for physicians to carve out time to translate their work. And in my opinion, all this we can do all the science we want, but if we do not translate it, if we do not communicate it to the people that need it, I think we haven't done our job. And for me, I think one of my more I guess frustrating um points of awareness is that the science often gets overvalued when compared to the translation and the job of translation. And for me, I I I I can't see doing my work without doing translation. And I think that's frustrating, is I feel I have to fight to get people to do translational work, and I think it's the most important thing that we do because these uh exercising women, athletes, they are so hungry for knowledge, and they're going to social media, and there's so much pseudoscience out there, everybody's an expert on social media, and it's our job to at least play a role in putting real science out there, healthy messaging that will help and and uh help people to exercise and be healthy.
SPEAKER_02Yeah, and that is like the perfect segue because I wanted to say I really feel strongly. I wanted to say that one of the reasons why I love working with you guys so much is that you you know value uh the expertise and you solicit input from people like me, from clinicians, because sometimes I've I feel like the non-scientist in the room, but you know, I also know that I can bring a valuable, you know, expertise and lens about exactly what you're talking about, how to implement the science and the guidelines actually into clinical practice. Um, so I just want to say before we wrap things up, um, I just want to say thank you, you know. Um, and I think I I know the science is better um and far more impactful, you know, when scientists and clinicians work together and we do exactly what you're talking about, Mary Jane, and that's to translate, you know, really what is pretty complex physiology into something that clinicians, patients, and parents can actually understand and act on.
SPEAKER_00I think it's um the most important thing that we do. And I'm I'm super proud of the way we've done it. I I think our new papers do a great job of providing physicians with practical tools to do just that.
SPEAKER_02So can you take a second and just um why don't you speak to the the science paper? And Nancy, maybe you could um speak to the clinical paper and just take a second and talk a little bit about that and um where people can find them.
SPEAKER_00So the science paper, um, both papers are published in a journal called Sports Medicine, and they are available online. There's open access, so anybody can access these papers. And I think if you want to read the paper and only uh filter out like where are the most important messages. I think the most important messages in both papers are summarized by these evidence-based statements that appear throughout the paper. And we have summarized them in um some tables. And I think the science paper does a great job of letting um scientists, physicians, health practitioners understand where we are in the state of the knowledge of triad physiology. Awesome.
SPEAKER_01Nancy, the clinical paper? Well, the clinical paper, um, as you know, is with input from our great uh clinician colleagues like yourself, Liz, and it really is, I would say, user-friendly. There's a ton of really useful tables, um, algorithms for diagnosis, and we have updated our uh algorithm to actually kind of calculate the risk of the female athlete triad and guide physicians uh into their in terms of their decisions for return to play. So it's very practical. It builds on the evidence that's more uh kind of expounded on in the science paper, but it's really meant to be hands-on useful for a wide range of sports medicine practitioners. They're both published in sports medicine December 2025. We got it in just under the wire 2025.
SPEAKER_02Awesome. I'm gonna put links to both the papers um, you know, in the uh on the the uh podcast website so people will be able to find that. So um love that they're open access. Okay, you guys, we're coming to the end of our time together. So I'm gonna ask you um each a rapid-fire question. And uh Nancy, I'll let you go first. Um, who is a woman in science you would love to have coffee with?
SPEAKER_01I'm gonna pick my uh one of my mentors, um uh Janet MacArthur. She was uh um a mentor during my doctoral work, and I would just love to have coffee with her now. That I've now now near the end of ending of my career, and just kind of capture uh you know the comparisons of our trajectories, and she just meant so much to me that I I would pick just one of my own people that I got to know and and had the fortunate fortune to be mentored by. Love that.
SPEAKER_02It's it's um it's this combination of of being you know grateful, you know, and then paying it forward, right? We didn't really get a chance to talk about mentoring very much, but you guys are awesome mentors and you have definitely paid it forward in your careers. I love working with all the the grad students who are now in faculty positions all over, I think, North America. So um, maybe the world. Uh so good on you on that too. Um, Mary Jane, back to you. Who do you want to have coffee with? Bernadette Healy. Tell me more.
SPEAKER_00I think when we talk about the glass ceiling, I think she probably, as a physician, experienced it uh profoundly, trying to get the Women's Health Initiative approved and lobbied and um funding from NIH to get this giant study going and to really initiate a move toward advancing women in science and advancing the science of women's health. And uh yeah, she would be who I'd love to hear her her her stories about hitting that glass ceiling.
SPEAKER_02Yeah, love that. Pretty soon maybe there won't be any glass ceiling at all. Well, Mary Jane and Nancy, I thank you both so much for your leadership, for your science, and really for the profound impact that you've had on how we understand and care for women. And to our listeners, if you enjoyed this episode of She Leads Science, please follow, rate, and share it with somebody who needs to hear it. Thanks so much. See you later.