Michelle P. Warren, MD is founder and medical director of the Center for Menopause, Hormonal Disorders & Women’s Health, Columbia University Medical Center, and Wyeth professor emeritus of obstetrics/gynecology & medicine.

Dr. Warren is an early pioneer of the effects of eating disorders and athletics on the menstrual cycle and was the first to identify skeletal problems, including scoliosis and stress fractures that occur in young women as a result of menstrual irregularities.

ABSTRACT: It has been known since the time of Darwin that nutrition is essential for normal reproduction. The Female Athlete Triad is an entity, which has been well described, in physically active women and lean athletes engaged in activities requiring high energy. Reproductive cycles cease, bone loss or osteoporosis may develop and restrictive eating or eating disorders are common. The etiology of this triad appears to be due to metabolic adaptation to a low energy state triggered by a deficit in energy intake that is uncompensated. Multiple metabolic adaptations occur with the most clinically obvious being the amenorrhea. Although the reproductive dysfunction is reversible, silent changes occur, in particular bone loss. Recent studies suggest that the weight gain, which is sometimes necessary for reversal of the syndrome, favors visceral fat deposition. Bone changes are unique and, contrary to previous dogma, is related to poor nutrition and do not reverse with hormone therapy. These changes have powerful implications for midlife health.

About the MaryFran Sowers Memorial Lecture:
This special lecture has become a biennial event at the School of Public Health in honor of the late Dr. MaryFran R. Sower’s (1947-2011) extraordinary scientific contributions to the field of women’s health and to inspire young scholars to transcend the boundaries between varying fields of research to advance women’s health.