Coach: Women are not small men


The last 30 years has seen a sharp rise in the number of women participating in both recreational and professional sport. For example, the percentage of women competing at the summer Olympic Games has increased from 26 % in Seoul in 1988 to 45 % in Rio de Janeiro in 2016. In the field of sports science, women have often been excluded from participating in research studies due to the potential of the innate hormonal fluctuations that occur in women as part of a healthy menstrual cycle to somehow influence the results. Fortunately, this is changing and sports scientists are focusing more specifically on female athletes and their physiology in order to ensure coaches can be aware of any potential considerations for working with female athletes. In this article, we will highlight some special considerations for female athletes.



Training load is the dose of exercise that is applied to an athlete. The components of training load are:

  • Frequency – how often you train
  • Duration – how long the training session is
  • Intensity – how hard the training session was

A systematic review is a summary of all of the current scientific literature available for a given topic. A meta-analysis goes one step further and pools all the COACH available data on a topic for further analysis.
These two types of scientific literature represent the highest levels of evidence available. A recent systematic review and meta-analysis (Diaz-Canestro & Montero, 2019) investigated whether women and men respond in a similar manner to the same training load. The focus of the study was improvements in VO2max, which is a variable often measured during performance tests in a sports science laboratory. There is a strong association between VO2max and endurance performance. In other words, an elite endurance athlete will have a much higher VO2max compared to a couch potato, but if you were to measure the VO2max values of the front row of an XCO World Cup, you will not be able to select the winner of the race from those values. The most effective way to increase VO2max is through wellstructured endurance training. The results of this study showed that, for a given training load men showed greater increases in VO2max compared to women. Does this mean that women have a smaller capacity to increase their endurance performance? Of course not, but it highlights that female athletes may need to be trained differently compared to men.


The menstrual cycle is an important biological process characterized by fluctuations in the sex hormones estrogen and progesterone. The primary purpose of the changes in the levels of these hormones is to support reproduction, but other physiological systems, such as the cardiovascular and metabolic systems are also impacted by these fluctuations. In a previous article, available here, we wrote about how recovery from a training session may be influenced by the phase of the menstrual cycle. A recently published systematic review and meta-analysis (McNulty et al., 2020) examined whether training should be planned according to the phases of the menstrual cycle. The findings of the review show that during the early follicular phase, where estrogen and progesterone levels are low, performance may be very slightly reduced compared to the other phases of the menstrual cycle. However, the authors stress that the evidence available is not strong enough to support planning training based on the phase of the menstrual cycle.
It is important to note that female athletes may respond differently to training load compared to male athletes. In addition, although the evidence supporting this is still emerging, performance and recovery from training may be impacted by fluctuating levels of hormones during the menstrual cycle.

Diaz-Canestro, C., & Montero, D. (2019). Sex Dimorphism of VO2max Trainability: A Systematic Review and Meta-analysis. Sports Medicine, 49(12), 1949-1956. doi:10.1007/ s40279-019-01180-z
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. doi:10.1007/s40279-020-01319-3

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