What We Do

Our Areas of Research

Current Research on Female Athletes

  • Assessing Disparities in Access to Pelvic Floor Health Care
  • Women's Athletics Team Talks
  • Examining Biomarkers and RED-S Risk Profiles Across Training in Ultramarathoners
  • Multi Omics of Relative Energy Deficiency in Sport

The Stanford FASTR Team is actively seeking research participants to participate in a study assessing access to and knowledge of pelvic floor health care and pelvic floor dysfunction. Participation includes a one-time online survey about your access to pelvic floor health care and experience with pelvic floor dysfunction and an optional focus group via phone or Zoom to provide additional insight into your experience with pelvic floor health. Participants will get access to digital education and information about pelvic floor health, particularly for the female athlete.

To participate you must meet the following criteria:

  • Aged 18 or older
  • Female
  • Currently pregnant or have given birth in the last 3 years

Participate Here

This study utilizes feedback and perspectives from collegiate athletes on Stanford’s Women’s teams to guide athlete-driven team talks about sports science and sports medicine topics specific to female athlete health, performance, and well-being. To do this, athletes will first complete a pre-talk survey assessing topics of interest and interest in the field of female athlete research.  Then a 1 hour, round table discussion on topics chosen based on the survey responses will take place.

We are no longer conducting these talks as research, and are instead providing them as a service to the Stanford community. Interested in a talk with your team or organization? Email fastrprogram@stanford.edu or jlflora@stanford.edu to learn more!

Through this study we seek to learn more about the relationship between training volume and intensity and serum biomarkers as well as the prevalence of risk factors for Relative Energy Deficiency in Sport (REDs) in male and female ultramarathoners to improve health and performance. This study included both a longitudinal and cross-sectional cohort of athletes participating in the 2024 Western States Endurance Run, a 100-mile running race from Olympic Valley, CA to Auburn, CA. We followed 15 female athletes in the 4 months leading up Western States. Participants completed 4 blood draws over the course of the study, tracked all training, completed 3 surveys, and did 1 DXA scan for bone density. The cross-sectional cohort was be composed of 23 males and 25 additional females, all of whom completed a baseline survey, 1 blood draw, and a DXA for bone density.

The Multi Omics of Relative Energy Deficiency in Sport (RED-S) study, led by Dr. Morgan Smith, Wu Tsai Human Performance Alliance postdoctoral fellow, is investigating molecular and non-molecular markers associated with RED-S in female endurance athletes. This study features four main arms: participant-completed questionnaires, imaging and exercise visits, physician interviews, and a 3-month at-home data collection, including menstrual cycle tracking and ovulation testing. The two primary aims of this study are to identify relationships between standard measures and molecular data, and to characterize molecular profiles of the various RED-S risk levels. Ultimately, this will allow for earlier detection and treatment for this syndrome, improving the overall health of female athletes impacted by RED-S.

Published Research on Female Athletes

  • FASTR Pilot Study & Education Study
  • The Female Athlete Voice Project
  • Western States Ultramarathon Study
  • Pac-12 Healthy Runner Project
  • Assessing Triad/RED-S Return to Play Tools

The Female Athlete Science and Translational Research (FASTR) Pilot study delivered a series of five educational videos with content from experts in the field and stories from top athletes to female athletes to reduce incidence of the Female Athlete Triad and bone stress injuries. In this pilot study we measured engagement of female high school runners with the content as well as changes in their Triad knowledge, body image, self-compassion, and perspective on longevity in sport.

In a second round of recruitment, the FASTR Education Study included participants from 13 high schools across the US. Half of participants received the five educational videos and the other half received written handouts covering the same five female athlete specific topics. We measured engagement of female high school runners with the content as well as changes in their knowledge, body image, self-compassion, and self-reported impact on future behavior.

View the FASTR Educational Videos

 

Want to know what we learned? The findings from this study have been published in the BMJ Open Sport & Exercise Medicine Journal and are available for anyone to read! Or read the key takeaways on our Instagram.

Read the published results

The aim of the study was to utilize athlete voice and perspective to inform sports medicine, sports science research, and translational practice for female athletes. To hear directly from athletes, the study used a 3-round Delphi survey of approximately 40 female USOPC athlete participants, ages 18 years of age or older, across a range of sports and demographics. This is a first step in developing a research agenda and translational processes that are co-constructed with elite female athletes with the goal of guiding future research projects and translational practices for female athletes at any age. This work was in collaboration with Julie McCleery, PhD out of the University of Washington and the Female Athlete Program at Boston Children’s Hospital. 

The results from this study have been published! Want to learn more about what topics elite female athletes deemed the most important for their health, performance, and well-being? Check out our Instagram post highlighting the key findings and the full paper available below!

Read the pUBLISHED RESULTS

This study explores risk factors for low bone mineral density and prior bone stress injury in male and female ultramarathon runners participating in the Western States Endurance Run. This cross-sectional study incorporated a saliva genetic test, a DXA scan to measure bone mineral density of the lumbar spine, femoral neck, and total hip; lab draws to measure ferritin, vitamin D, estradiol, and total and free testosterone; and a pre-race survey to assess disordered eating traits, bone stress injuries, menstrual dysfunction in women, and training volume. Based on data from 2019 and 2021, the study showed that the genetic risk score in men was significantly correlated with BMD z-scores, but not in females. This suggests that other factors, including sex hormone levels and low energy availability, could be affecting bone health in female ultramarathon runners.

This study was featured in an Outside Magazine article about developing a “grand theory injury prevention” and looking beyond simple risk factors for injury.

Read the full scientific journal article in the Clinical Journal of Sports Medicine.

Read THE PUBLISHED RESULTS

In 2016, co-PI’s Dr. Michael Fredericson at Stanford and Dr. Aurelia Nattiv at UCLA received funding by the Pac-12 and AMSSM for the “Healthy Runner Project,” a prospective study at Stanford and UCLA in varsity distance runners to evaluate whether a nutritional intervention to increase energy availability could help improve bone mineral density and decrease the incidence and severity of bone stress injuries. Following promising results from the Healthy Runner Project, Stanford and UCLA received additional funding through a Pac-12 Student Athlete Health and Well-Being Grant to expand the program to other Pac-12 schools beginning Fall 2021. The two-year prospective study with a nutrition intervention was completed in 2022. Participating Pac-12 institutions included Stanford, UCLA, University of Washington, University of Utah, and Oregon State University. 

Read the results of this study in our journal article published in BMJ Open.

READ THE PUBLISHED RESULTS

This study, in collaboration with the Female Athlete Program at Boston Children’s Hospital, will assess the use of two screening tools designed to identify female and male athletes as at risk for the Female Athlete Triad or RED-S and the efficacy of their use in a clinical setting. Our survey was designed to address these measures and take the first steps in determining how to apply them in a clinical setting. We recruited female and male athletes, ages 15-30 within Stanford and Boston Children’s clinics.

Translating Female Athlete Research for the Public

            → Click on each image to learn more or to contact the FASTR team

Follow Along with FASTR

We are active on social media- follow us on Instagram, Twitter, and Strava for more educational content from the FASTR Team!

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