Did you know that most performance, training, and nutrition guidelines are largely based on research in men? That research on females is lacking? Do you know that because of this there are lots of female-specific performance and training factors that, for a long-time, have gone under the radar?
Historically inequalities have long existed when it comes to the inclusion of women participating in exercise. For example, during the early 1800s, scientists cautioned women against physical activity, with concerns that “physical effort, like running and jumping, might damage female reproductive organs and make them unattractive to men”. This view was also echoed within the elite sport environment with participation in the first modern Olympic Games limited to just men.
As the 20th and 21st centuries progressed, women gradually became an accepted part of sport and exercise, with the biggest rise in the number of women participating in physical activity and elite sport reported in the last three decades.
Specifically, the percentage of women competing at the Olympic Games increased from 26 percent in Seoul in 1988 to 45 percent in Rio de Janeiro in 2016. And looking ahead to Tokyo, this is set to be the most sex-balanced Games in history, with the same number of medals available for men and women, with women participation in the Games set to rise to an all-time high of 49 percent.
With more women participating in sport and exercise, and women continuing to pursue high-levels of performance, we as coaches, practitioners, athletes, researchers need to know more about female physiology and how this might impact on the likes of performance and training. Because just like their male counterparts, female athletes want to get stronger, faster, achieve PBs and break world records.
Mind The Gap!
Despite the increased rise of women participating in sport and the need to know more about female physiology and how this might influence performance or training, research on the female athlete still falls short of that carried out on men.
In a recent paper it was highlighted that studies exclusively on female participants account for only 8 percent of the published studies involving human participants in one academic journal. Likewise, within the top-ranked ‘sport science’ category journals only 4-13 percent of the studies were conducted exclusively on females. Therefore, research on women has not kept pace with the exponential rise in participation and what this means is that our ability to adopt an evidence-informed approach when working with female athletes is limited. This means that performance, training and nutritional guidelines are largely based on research in men.
While a lot of aspects of this research will benefit both men and women it would be naïve to assume that all research in men can be directly applied to women, given the anatomical, physiological and endocrinological differences between the sexes. As such, sportswomen will likely benefit from sex-specific research and guidelines, which consider the effects of their physiology, such as the menstrual cycle, on the likes of performance, training, and nutrition.
What Are The Reasons For This Exclusion?
Historically, this lack of female specific research in sport and exercise can be attributed to historical guidelines and perceptions of women. Indeed, the sex bias in research dates back to before World War II, where medical trials were solely conducted on men. At the time women were deemed as “protected subjects”, due to the overarching fear that any clinical testing could potentially harm unborn foetuses.
Today, one of the most frequently cited reasons for this exclusion is that women are perceived as being “too difficult”, “time consuming” and/or “expensive” to study, as women are more physiologically variable than men. Specifically, unlike men, women have a cyclical pattern of hormonal fluctuations, which means that our physiology is different across the cycle too.
On top of this — also unique to women — are the changes in these hormonal profiles across our lifespan, as well as the ability to alter our hormonal profile by using the likes of hormonal contraception. And it is these changes in hormonal profiles which are considered as major barriers to the inclusion of women in research.
But What About The Research That Has Been Done?
It would be incorrect to suggest that there is currently no research available related to active females or the female athlete. Many experimental studies, narrative, and systematic reviews, as well as books have addressed this topic and recently there has been an increased appetite for this research.
That said, an increase in quantity does not necessarily equate to quality, as often research in this area is conflicted – with some studies showing an affect and others not — and weakened by poor methodological design which limits our ability to further draw these evidence-based conclusions and recommendations.
The Great Global Hush-Up
Now it is not just the lack of research into women’s health and performance that is the issue. There is also a lack of awareness which can be attributed to the fact that for a long-time women’s health and education has been hushed-up and considered as taboo. As such, most of us grow up uneducated and ashamed about our bodies, especially our menstrual cycle.
Although this is improving, we need to strive for open conversations and increased awareness and education in this area. Having an appropriate awareness and a proper introduction to female physiology will stop us all from suppressing our biology which will not only help us in day-to-life but also in terms of our performance and training.
Performance And Training Considerations For Females
Given that research has effectively ignored the complexity of female physiology, and that we do not receive the correct awareness and education on these topics, there are a lot of performance and training considerations specifically for females that have gone relatively under the radar, including:
- The menstrual cycle
- Hormonal contraception
- Breast health and support
- Pelvic floor health and incontinence, prolapse and dysfunction
- Pregnancy and post-natal
- Perimenopause and the menopause
- Female specific injury risk and injuries
- Female specific nutrition
Therefore, to optimise performance and training – as well as health and well-being – in women, we need to be considering these factors so that we can work with, and not against, our own physiology.
Together the lack of female participants in research and a great global hush-up in this area has resulted in clear gaps in our knowledge base particularly in relation to these female-specific factors. As such, there are numerous avenues of unexplored opportunities to improve female athlete performance — whether that is winning a gold medal at the Olympic Games or beating our 5k time at our local Parkrun.
This is an excerpt from our email course on tailoring your exercise and nutrition around your menstrual cycle. To sign up for the full course click here.
Kelly McNulty is a PhD candidate at Northumbria University investigating the effect of the menstrual cycle and hormonal contraceptive use on athletic performance, as well as the adaptation to and recovery from training. She is also host of podcast ‘the period of the period’ and can be found on instagram @periodoftheperiod and twitter @periodofperiod.