Cookies on the Healthspan site
Men and women are physiologically different, including in muscle mass and strength,1 maximal aerobic capacity and performance,2 and anaerobic power and capacity.3 Research shows that a female's absolute whole-body strength is up to 63.5% of a male's,4 while upper body strength is 55%5 and lower limb strength is 72%.6
Interestingly, women's physiology may put them at an advantage in endurance sports. Sex differences in endurance performance are a result of how male and female athletes utilise energy from carbohydrates and fats, and exercise intensity and duration.7
Carbohydrates provide the body with an immediate energy source, but this is limited. Hence, athletes need to refuel during events. By contrast, fatty acids provide a source of dense energy that fuels longer-duration exercises such as marathon running.
During aerobic-based exercise, women preferentially use fatty acids as the dominant fuel source compared with men, who demonstrate lower rates of fatty acid utilisation, relying more on carbohydrates as the dominant fuel source.8
The relatively 'unlimited' fat reserves and the enhanced fatty acid utilisation in women versus men are thought to contribute to favourable endurance performance in women, most notably during prolonged (ultra-endurance) versus less-prolonged (marathon) endurance events.
A significant amount of sports performance research is based on men. Often a reason for this is because women are physiologically more variable, partly due to changes occurring during the menstrual cycle.9 The lack of female-specific research is unfortunate, as there are many differences between the sexes, both in terms of physiology and psychology.
Other factors specific to female athletes that may affect performance include the use of oral contraceptives, or HRT in master’s athletes. A master’s athlete is generally considered to be someone over the age of 40 years.
Female-specific issues need to be considered so that coaches can offer an individualised strategy that complements the athlete's needs. Such issues include the menstrual cycle, breast health, and trends in female injuries. Women are also more prone to nutrient insufficiencies such as iron, resulting in fatigue and depression, impacting performance.
Women are also more prone to RED-S: Relative Energy Deficiency in Sport. This used to be called the "Female Athlete Triad" (disordered eating, menstrual disturbance, low bone density) but was renamed to reflect that it also occurs in men and impacts more than the three original areas originally described.
The condition occurs when an athlete does not have enough energy to meet the demands of the amount of exercise they perform. Athletes more prone to RED-S include endurance athletes who benefit from a high power-to-weight ratio, athletes in weight category sports such as boxing, and aesthetic sports such as gymnastics and diving.
Alongside resulting in insufficient energy to achieve peak sports performance, RED-S also impacts an athlete's ability to maintain overall optimal health and other bodily functions. This can result in irregular periods, recurrent illnesses, mood changes, delayed growth and development, and nutrient deficiencies.10
Research shows that women incur more stress fractures, shoulder injuries, ankle sprains, and ACL injuries in the knee than men.11, 12, 13 Low bone mineral density can increase the risk of musculoskeletal injury. This is particularly relevant to athletes diagnosed or previously diagnosed with RED-S and older athletes during menopause.
Ligamentous laxity (very flexible joints) is more significant in women, explaining why they experience ankle sprains twice as often as men.12 Research has also shown that women are at greater risk of overuse injuries, including stress fractures, tendonitis, and medial tibial stress syndrome (damage to the shin area).14 It has also been shown that female athletes in jumping and cutting sports (football, basketball, lacrosse) are up to six times more likely to sustain a severe knee injury than males.15
Rob Hobson MSc RNutr is an award-winning registered nutritionist (AFN) and sports nutritionist (SENR) with over 15 years of experience. He founded London-based consultancy RH Nutrition, and has degrees in nutrition, public health nutrition and sports nutrition.
This article is written by nutrition professionals, and is aimed at nutritionists and athletes. It is not intended to replace advice from your own doctor or nutritionist. Please consult a professional before trying supplements.
1Ford, L. E., Detterline, A. J., Ho, K. K., & Cao, W. (2000). Gender- and height-related limits of muscle strength in world weightlifting champions, Journal of applied physiology (Bethesda, Md. : 1985) 89(3), 1061–1064
2Cheuvront, S. N., Carter, R., Deruisseau, K. C., & Moffatt, R. J. (2005). Running performance differences between men and women:an update, Sports medicine (Auckland, N.Z.) 5(12), 1017–1024
3Hill, D. W., & Smith, J. C. (1993). Gender difference in anaerobic capacity: role of aerobic contribution, British journal of sports medicine 27(1), 45–48
4Knapik, J. J., Wright, J. E., Kowal, D. M., & Vogel, J. A. (1980). The influence of U.S. Army Basic Initial Entry Training on the muscular strength of men and women, Aviation, space, and environmental medicine 51(10), 1086–1090
5Sharp M. A. (1994). Physical fitness and occupational performance of women in the u.s. Army, Work (Reading, Mass.) 4(2), 80–92
6Shephard R. J. (2000). Exercise and training in women, Part I: Influence of gender on exercise and training responses, Canadian journal of applied physiology = Revue canadienne de physiologie appliquee 25(1), 19–34
7Montero, D., Madsen, K., Meinild-Lundby, A. K., Edin, F., & Lundby, C. (2018). Sexual dimorphism of substrate utilization: Differences in skeletal muscle mitochondrial volume density and function, Experimental physiology 103(6), 851–859
8Venables, M. C., Achten, J., & Jeukendrup, A. E. (2005). Determinants of fat oxidation during exercise in healthy men and women: a cross-sectional study, Journal of applied physiology (Bethesda, Md. : 1985) 98(1), 160–167
9Bruinvels, G., Burden, R. J., McGregor, A. J., Ackerman, K. E., Dooley, M., Richards, T., & Pedlar, C. (2017). Sport, exercise and the menstrual cycle: where is the research?, British journal of sports medicine 51(6), 487–488
10Dipla, K., Kraemer, R. R., Constantini, N. W., & Hackney, A. C. (2021). Relative energy deficiency in sports (RED-S): elucidation of endocrine changes affecting the health of males and females, Hormones (Athens, Greece) 20(1), 35–47
11Beasley, L., Faryniarz, D. A., & Hannafin, J. A. (2000). Multidirectional instability of the shoulder in the female athlete, Clinics in sports medicine 19(2), 331–x
12Doherty, C., Delahunt, E., Caulfield, B., Hertel, J., Ryan, J., & Bleakley, C. (2014). The incidence and prevalence of ankle sprain injury: a systematic review and meta-analysis of prospective epidemiological studies, Sports medicine (Auckland, N.Z.) 44(1), 123–140.
13Sigward, S. M., Pollard, C. D., & Powers, C. M. (2012). The influence of sex and maturation on landing biomechanics: implications for anterior cruciate ligament injury, Scandinavian journal of medicine & science in sports 22(4), 502–509
14Brunet, M. E., Cook, S. D., Brinker, M. R., & Dickinson, J. A. (1990). A survey of running injuries in 1505 competitive and recreational runners, The Journal of sports medicine and physical fitness 30(3), 307–315
15Hewett T. E. (2000). Neuromuscular and hormonal factors associated with knee injuries in female athletes. Strategies for intervention, Sports medicine (Auckland, N.Z.) 29(5), 313–327