Women and Sports Performance

Research studies in sports science and sports medicine have historically focused more on male athletes than female athletes and this underrepresentation of women in research studies raises concerns about the generalisability of findings to female athletes.

This lack of comprehensive understanding hinders the development of targeted interventions and recommendations for female athletes.

The resources on this page are designed to provide an introduction to the topic of women and sports performance with a particular focus on the scientific evidence base. 

Critical Questions to Consider

Recommended Reading 

Bruinvels, G., Hackney, A. C., & Pedlar, C. R. (2022). Menstrual cycle: the importance of both the phases and the transitions between phases on training and performance. Sports Medicine, 52(7), 1457-1460. https://doi.org/10.1007/s40279-022-01691-2 

Burden, R., Shill, A. L., & Bishop, N. (2021). Elite female athlete research: stop searching for the ‘magic P’. Experimental Physiology, 106(10), pp. 2029-2030. https://doi.org/10.1113/EP089884 

de Borja, C., Chang, C. J., Watkins, R., & Senter, C. (2022). Optimizing health and athletic performance for women. Current reviews in musculoskeletal medicine, 15(1), 10-20. https://doi.org/10.1007/s12178-021-09735-2 

Cano, A., Ventura, L., Martinez, G., Cugusi, L., Caria, M., Deriu, F., & Manca, A. (2022). Analysis of sex-based differences in energy substrate utilization during moderate-intensity aerobic exercise. European journal of applied physiology, 1-42. https://doi.org/10.1007/s00421-021-04802-5   

Carmichael, M. A., Thomson, R. L., Moran, L. J., & Wycherley, T. P. (2021). The impact of menstrual cycle phase on athletes’ performance: a narrative review. International journal of environmental research and public health, 18(4), 1667. https://doi.org/10.3390/ijerph18041667 

Colenso-Semple, L. M., D'Souza, A. C., Elliott-Sale, K. J., & Phillips, S. M. (2023). Current evidence shows no influence of women's menstrual cycle phase on acute strength performance or adaptations to resistance exercise training. Frontiers in Sports and Active Living, 5, 1054542. https://doi.org/10.3389/fspor.2023.1054542 

Cowley, E. S., Olenick, A. A., McNulty, K. L., & Ross, E. Z. (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 

Davenport, M. H., Nesdoly, A., Ray, L., Thornton, J. S., Khurana, R., & McHugh, T. L. F. (2022). Pushing for change: a qualitative study of the experiences of elite athletes during pregnancy. British Journal of Sports Medicine, 56(8), 452-457. https://doi.org/10.1136/bjsports-2021-104755 

Donnelly, G. M., & Moore, I. S. (2023). Sports Medicine and the Pelvic Floor. Current Sports Medicine Reports, 22(3), 82-90. https://doi.org/10.1249/jsr.0000000000001045 

Emmonds, S., Heyward, O., & Jones, B. (2019). The challenge of applying and undertaking research in female sport. Sports medicine-open, 5, 1-4. https://doi.org/10.1186/s40798-019-0224-x 

Elliott-Sale, K. J., Minahan, C. L., de Jonge, X. A. J., Ackerman, K. E., Sipilä, S., Constantini, N. W., ... & Hackney, A. C. (2021). 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 Medicine, 51(5), 843-861. https://doi.org/10.1007/s40279-021-01435-8 

Hackney, A. C. (2021). Menstrual cycle hormonal changes and energy substrate metabolism in exercising women: a perspective. International Journal of Environmental Research and Public Health, 18(19), 10024. https://doi.org/10.3390/ijerph181910024 

Hirschberg, A. L. (2022). Challenging aspects of research on the influence of the menstrual cycle and oral contraceptives on physical performance. Sports Medicine, 52(7), 1453-1456. https://doi.org/10.1007/s40279-021-01616-5  

Hutchins, K. P., Borg, D. N., Bach, A. J., Bon, J. J., Minett, G. M., & Stewart, I. B. (2021). Female (under) representation in exercise thermoregulation research. Sports Medicine-Open, 7(1), 1-9. https://doi.org/10.1186/s40798-021-00334-6 

Langan-Evans, C., Reale, R., Sullivan, J., & Martin, D. (2022). Nutritional considerations for female athletes in weight category sports. European journal of sport science, 22(5), 720-732. https://doi.org/10.1080/17461391.2021.1936655 

Lebel, K., Mumcu, C., Pegoraro, A., LaVoi, N. M., Lough, N., & Antunovic, D. (2021). Re-thinking women's sport research: looking in the mirror and reflecting forward. Frontiers in Sports and Active Living, 3, 746441. https://doi.org/10.3389/fspor.2021.746441 

L’Heveder, A., Chan, M., Mitra, A., Kasaven, L., Saso, S., Prior, T., ... & Jones, B. P. (2022). Sports obstetrics: implications of pregnancy in elite sportswomen, a narrative review. Journal of Clinical Medicine, 11(17), 4977. https://doi.org/10.3390/jcm11174977 

Jackson, T., Bostock, E. L., Hassan, A., Greeves, J. P., Sale, C., & Elliott-Sale, K. J. (2022). The legacy of pregnancy: elite athletes and women in arduous occupations. Exercise and Sport Sciences Reviews, 50(1), 14-24. https://doi.org/10.1249/JES.0000000000000274 

Kimber, M. L., Meyer, S., McHugh, T. L., Thornton, J., Khurana, R., Sivak, A., & Davenport, M. H. (2021). Health Outcomes after Pregnancy in Elite Athletes: A Systematic Review and Meta-analysis. Medicine and Science in Sports and Exercise, 53(8), 1739-1747. https://doi.org/10.1249/MSS.0000000000002617 

McNulty, K. L., Elliott-Sale, K. J., Dolan, E., Swinton, P. A., Ansdell, P., Goodall, S., ... & Hicks, K. M. (2020). The effects of menstrual cycle phase on exercise performance in eumenorrheic women: a systematic review and meta-analysis. Sports Medicine, 50, 1813-1827. https://doi.org/10.1007/s40279-020-01319-3  

Nimphius, S. (2019). Exercise and sport science failing by design in understanding female athletes. International Journal of Sports Physiology and Performance, 14(9), 1157-1158. https://doi.org/10.1123/ijspp.2019-0703 

Oosthuyse, T., Strauss, J. A., & Hackney, A. C. (2023). Understanding the female athlete: molecular mechanisms underpinning menstrual phase differences in exercise metabolism. European Journal of Applied Physiology, 123(3), 423-450. https://doi.org/10.1007/s00421-022-05090-3 

Parsons, J. L., Coen, S. E., & Bekker, S. (2021). Anterior cruciate ligament injury: towards a gendered environmental approach. British journal of sports medicine. 55:984-990 https://doi.org/10.1136/bjsports-2020-103173 

Pettersen, S. D., Adolfsen, F., & Martinussen, M. (2022). Psychological factors and performance in women’s football: A systematic review. Scandinavian Journal of Medicine & Science in Sports, 32, 161-175. https://doi.org/10.1111/sms.14043 

Santos, A. C., Turner, T. J., & Bycura, D. K. (2022). Current and future trends in strength and conditioning for female athletes. International Journal of Environmental Research and Public Health, 19(5), 2687. https://doi.org/10.3390/ijerph19052687 

Sims, S. T., & Heather, A. K. (2018). Myths and Methodologies: Reducing scientific design ambiguity in studies comparing sexes and/or menstrual cycle phases. Experimental physiology, 103(10), 1309-1317. https://doi.org/10.1113/EP086797 

Skelly, L. E., Bailleul, C., & Gillen, J. B. (2021). Physiological responses to low-volume interval training in women. Sports Medicine-Open, 7(1), 99. https://doi.org/10.1186/s40798-021-00390-y 

Smith, E. S., McKay, A. K., Kuikman, M., Ackerman, K. E., Harris, R., Elliott-Sale, K. J., ... & Burke, L. M. (2022). Auditing the representation of female versus male athletes in sports science and sports medicine research: Evidence-based performance supplements. Nutrients, 14(5), 953. https://doi.org/10.3390/nu14050953 

Thompson, B., & Han, A. (2019). Methodological recommendations for menstrual cycle research in sports and exercise. Medicine and science in sports and exercise, 51(12), 2610-2617. https://doi.org/10.1249/mss.0000000000002073 

Tiller, N. B., Elliott-Sale, K. J., Knechtle, B., Wilson, P. B., Roberts, J. D., & Millet, G. Y. (2021). Do sex differences in physiology confer a female advantage in ultra-endurance sport?. Sports Medicine, 51(5), 895-915. https://doi.org/10.1007/s40279-020-01417-2 

Vogel, K., Larsen, B., McLellan, C., & Bird, S. P. (2023). Female Athletes and the Menstrual Cycle in Team Sports: Current State of Play and Considerations for Future Research. Sports, 12(1), 4. https://doi.org/10.3390/sports12010004 

Walton, C. C., Gwyther, K., Gao, C. X., Purcell, R., & Rice, S. M. (2022). Evidence of gender imbalance across samples in sport and exercise psychology. International Review of Sport and Exercise Psychology, 1-19. https://doi.org/10.1080/1750984X.2022.2150981 

Wang, A., Mehta, R., Impellizzeri, F., Massey, A., Harrison, M., Glendinning, R., & McCall, A. (2022). Can we evidence-base injury prevention and management in women's football? A scoping review. Research in Sports Medicine, 1-16. https://doi.org/10.1080/15438627.2022.2038161 

Wang, L., & Wu, Y. (2023). Current Understanding and Future Challenges in Physical Activity during Pregnancy. Journal of Clinical Medicine, 12(12), 3986. https://doi.org/10.3390/jcm12123986 

Wieloch, N., Klostermann, A., Kimmich, N., Spörri, J., & Scherr, J. (2022). Sport and exercise recommendations for pregnant athletes: a systematic scoping review. BMJ Open Sport & Exercise Medicine, 8(4), e001395. https://doi.org/10.1136/bmjsem-2022-001395 

Supplementary Reading

The Guardian (10 Feb, 2024) ‘It felt like somebody had hit a hammer through my knee’: the crisis of ACL injuries in women’s football https://www.theguardian.com/lifeandstyle/2024/feb/10/it-felt-like-somebody-had-hit-a-hammer-through-my-knee-the-crisis-of-acl-injuries-in-womens-football

Further Resources on this website

Training for Performance 

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Professor Kirsty Sale - @ElliotSale