Men are from Mars, Women are from Venus… While this usually refers to things like the ability to multitask or find “missing” items around the house, there is no denying that physiological differences between men and women can also be light years apart. For decades, sports science and biomedical research have largely focused on male athletes, leading to a significant gender gap in the understanding of female physiology. One study found that within 5261 studies, across six popular sport and exercise science journals, females accounted for only 34% of total participants, with as little as 6% of studies focusing exclusively on females (1, 2).

Despite a recent growing interest in research in sport and exercise science with women as participants, the overall research quantity in this area is still significantly lower compared to research with men as participants (2). As a result, the effects of estrogen and progesterone on women’s responses to exercise and adaptations to training are still not fully understood. Numerous reviews (3, 4, 5) and meta-analyses (6, 7) have summarised and examined data spanning almost 50 years. Still, all have concluded that more, better quality studies are needed before a consensus on the effects of ovarian steroids (primarily estrogen and progesterone) on training and performance can be reached. What this means is that all the available sport and exercise advice, whether in guidelines, books, and podcasts, is largely based on the flawed assumption that women are ‘little men’. Consequently, for instance, women need to train the same, but maybe do shorter distances, fewer reps, or eat less food. 

As a result, advice on training, recovery, and performance often fails to meet women’s needs, resulting in a missed opportunity for reaching full athletic and performance potential. Mainstream exercise guidelines fail to account for the unique hormonal and physiological differences experienced by women, and not only this, they fail to recognise changes that occur to women throughout their lifespan. For instance, between puberty and menopause, circulating concentrations of oestrogen fluctuate fivefold and progesterone greater than 50-fold over a 21- to 35-day cycle (8). Dynamic changes to physiology along with these significant hormone perturbations have a domino effect on endocrine and metabolic systems; fluid balance and thermoregulation; cognition, reaction times; macronutrient needs and utilization; recovery, sleep, and immunity. All of which have a direct impact on physical activity, training capacity, and exercise performance. 

These unique and often very individualised hormonal complexities, and the associated difficulties with ensuring a standardised methodology,  are cited as reasons for excluding women from research studies. But that’s not the only reason. Underrepresentation of women in exercise science and physiology research is associated with authorship gender (9). This study found that the percentage of women participants per published article was up to 50% less when either the first or the last author was a man compared with when the first or the last author was a woman; and that a greater percentage of women as authors of an article and as editorial board members of a journal was associated with a larger number of women as participants within a study. Another analysis found that studies led by women tended to have higher quality of female-specific methods (10).  

The way forward – how do we bridge the gap?

To bridge this gender gap, systematic changes are needed at multiple levels. Firstly, researchers must actively prioritize the inclusion of female participants in studies and develop methodologies that account for hormonal fluctuations rather than excluding women due to perceived complexity. Additionally, increasing the number of women in leadership positions within sports science, research, and editorial boards is essential, not only for improved representation, but also for improved quality of female-specific research outputs. The lack of female role models in sports and exercise science can perpetuate the cycle of gender bias. Breaking this cycle is essential to ensure that future generations do not perceive gender bias as normal and continue to pass it down to new practitioners joining the field.

Collaboration between researchers, athletes, coaches, and policymakers can also drive change. Educating sports professionals on the importance of sex-specific approaches to training and recovery will help shift the current paradigm. Integrating menstrual cycle tracking, menopause considerations, and hormonal influences into coaching strategies should become standard practice rather than an afterthought.

In the interim, women can take charge of their training by adopting a ‘citizen scientist’ approach. This means tracking their own physiological responses, using wearable technology, journaling their performance in relation to their menstrual cycle, and making data-driven adjustments to their training. By paying close attention to their body’s signals, women can optimize their training strategies, adjusting intensity, nutrition, and recovery based on their unique hormonal profile.

Furthermore, women should seek out and contribute to communities that advocate for female-specific training knowledge. Engaging with platforms, coaches, and experts who acknowledge and apply research on female physiology will provide valuable insights and support. Ultimately, addressing the gender gap in sports science requires a dual approach: structural changes to research methodologies and institutions, coupled with empowered individual decision-making by women in their own training journeys. By advocating for better representation in research and taking a proactive role in understanding their physiology, women can maximize their athletic potential and drive the shift towards more inclusive and effective sports science.

References

1. Cowley ES, Olenic AA, McNulty KL and Ross EZ. (2021) “Invisible Sportswomen”: The Sex Data Gap in Sport and Exercise Science Research. Women in Sport and Physical Activity Journal 29: 2, 146-151 https://doi.org/10.1123/wspaj.2021-0028
2. Costello, J.T., Bieuzen, F. and Bleakley, C.M. (2014), Where are all the female participants in Sports and Exercise Medicine research?. European Journal of Sport Science, 14: 847-851. https://doi.org/10.1080/17461391.2014.911354
3. Lebrun, C.M. Effect of the Different Phases of the Menstrual Cycle and Oral Contraceptives on Athletic Performance. Sports Medicine 16, 400–430 (1993). https://doi.org/10.2165/00007256-199316060-00005
4. Constantini NW, Dubnov G, Lebrun CM. The menstrual cycle and sport performance. Clin Sports Med. 2005 Apr;24(2):e51-82, xiii-xiv. doi: 10.1016/j.csm.2005.01.003. PMID: 15892917.
5. Thompson B, Almarjawi A, Sculley D, Janse de Jonge X. The Effect of the Menstrual Cycle and Oral Contraceptives on Acute Responses and Chronic Adaptations to Resistance Training: A Systematic Review of the Literature. Sports Med. 2020 Jan;50(1):171-185. doi: 10.1007/s40279-019-01219-1. PMID: 31677121.
6. Elliott-Sale KJ, McNulty KL, Ansdell P, Goodall S, Hicks KM, Thomas K, Swinton PA, Dolan E. The Effects of Oral Contraceptives on Exercise Performance in Women: A Systematic Review and Meta-analysis. Sports Med. 2020 Oct;50(10):1785-1812. doi: 10.1007/s40279-020-01317-5. PMID: 32666247; PMCID: PMC7497464.
7. McNulty KL, Elliott-Sale KJ, Dolan E, Swinton PA, Ansdell P, Goodall S, Thomas K, Hicks KM. The Effects of Menstrual Cycle Phase on Exercise Performance in Eumenorrheic Women: A Systematic Review and Meta-Analysis. Sports Med. 2020 Oct;50(10):1813-1827. doi: 10.1007/s40279-020-01319-3. PMID: 32661839; PMCID: PMC7497427.
8. Elliott-Sale, K.J., Minahan, C.L., de Jonge, X.A.K.J. et al. Methodological Considerations for Studies in Sport and Exercise Science with Women as Participants: A Working Guide for Standards of Practice for Research on Women. Sports Med 51, 843–861 (2021). https://doi.org/10.1007/s40279-021-01435-8
9. James JJ, Klevenow EA, Atkinson MA, Vosters EE, Bueckers EP, Quinn ME, Kindy SL, Mason AP, Nelson SK, Rainwater KAH, Taylor PV, Zippel EP, Hunter SK. Underrepresentation of women in exercise science and physiology research is associated with authorship gender. J Appl Physiol (1985). 2023 Oct 1;135(4):932-942. doi: 10.1152/
10. Cowley ES, Moore SR, Olenick AA, McNulty KL. “Invisible Sportswomen 2.0”—Digging Deeper Into Gender Bias in Sport and Exercise Science Research: Author Gender, Editorial Board Gender, and Research Quality (2023).  Women in Sport and Physical Activity Journal 32:1 https://doi.org/10.1123/wspaj.2023-0039