An honest look at women’s health and sports science, and what needs to be done to level the pitch.
With the contribution of Hebe Ide and Douce de Boisgelin
The problem
Until women are represented in sports science, the data is only 50% correct. In 2020, only 6% of sports science studies focused on women1. This means that for women, most of what we currently know about sporting science is based on the wrong body physiology.
This disparity is driven by a mixture of biological, historical, and politico-economic factors. Current research is heavily based on male physiology due to their 24-hour cycle, which introduces a “reliability” in testing. By contrast, women with varied menstrual cycles (on average 28 days), introduce hormonal fluctuations that affect performance, metabolism, and recovery2. These are deemed as harder to track, especially as it would require large sample sizes, and long study periods to establish patterns, which inevitably require higher costs. Hence, frequently the message seems to be that male studies are faster and cheaper to run, stalling research and advancements in women’s health and performance. To further complicate matters, a large percentage of women globally are currently on contraception, which alters hormonal cycles, masking the true effect of different natural hormonal cycles on health, disease and performance3. However, these barriers show only part of the problem.
Historical bias in science and medicine have meant that for decades, the male body was the “default” across many areas including biomedical and sports research. Consequently, women were excluded under the guise that findings in men would be applicable; a mindset that has been proven incorrect4. Regardless, such bias has created persistent knowledge gaps in areas like injury risk, recovery, and nutrition, leaving female athletes worldwide with an incomplete package for success. Furthermore, until recently, there were few mandates requiring sex-specific analysis in overall medicine, including sports science, meaning that researchers could publish male-only studies without addressing applicability to women5. Additionally, commercial interests, such as sports equipment and supplements, have historically targeted male athletes, while women’s sports have generally received less media coverage and sponsorship. These factors further impact research priorities and lead to a reduced incentive for funding studies on women and sports science.
However, in the last decade we have seen a push for equity in research design6 and wider advocacy for the importance of appropriate science7, enabling great athletes like X and teams like the UK lioness to remain victorious. To achieve this, we need continued open conversations surrounding the need for women’s sports science and better education to encourage women worldwide to partake in research building the needed knowledge base on women’s health in sports, levelling the playing field and enabling great athletes to reach their full potential with reduced risk.
The education gap – a personal insight
Douce de Boisgelin, founder of Girls in Motion, knows firsthand the extent of the education gap in women’s health and sport’s science. From age twelve, she attended an all-girls school in the UK, home to one of the strongest physical education systems in the world. Alongside regular PE lessons, she trained as a competitive fencer six times a week from age nine, going on to represent GB for several years. In a male-dominated sport, she pushed her body to prove herself. It wasn’t until she was 24 that she discovered she’d been training against her physiology:
“I was bewildered when I discovered that my intense training had so many potential impacts on my menstrual cycle,” she recalls, “the first thing I did was book a full gynaecological scan. Over a decade, I put everything I had into fencing, but if I’d known that it could harm my reproductive health, I would have trained very differently.”
That’s a 14-year education gap, half of which she spent working against her body. If a gap this size exists in countries with world-class resources, there is a gaping chasm in places such as rural India. Girls in Motion is working to close this chasm, by bringing sports education to girls in rural India – a demographic rarely hailed as the country’s future athletes. Through medical screenings that monitor haemoglobin levels and teaching on the connection between sport and reproductive health, the programme is both vital and empowering.
Training with the body, not against it
Ignoring the menstrual cycle can put women’s reproductive health at risk. Research indicates that up to 61% of female athletes experience menstrual disorders8, including amenorrhea, defined as the absence of menstruation outside pregnancy, breastfeeding, or menopause. Amenorrhea is more than a temporary disruption; it is a frequent indication of underlying health concerns. In many cases, it reflects that the body is under excessive strain, which can have long‑lasting effects on reproductive health and bone density9. Because menstrual cycles reflect hormonal balance, amenorrhea highlights energy deficiency, disrupted hormone function, and reduced bone strength, all of which heighten the risk of stress fractures and long‑term osteoporosis. For athletes, this is especially serious, as amenorrhea is a hallmark of the Female Athlete Triad, a serious health syndrome linked to excessive training, low body weight, and inadequate nutrition. Advancing research into women’s physiology in sports science is essential for providing the insights needed to prevent these conditions and help athletes train in harmony with their bodies rather than against them.
Training schedules must align with the menstrual cycle, not work against it. The table below provides a visual understanding of what this could look like in practice, however such a schedule needs to be adjusted to individual women’s needs.
| Phase | Hormonal Profile | Best Training Focus | Key Notes |
| Menstruation (Days 1–5) | Low estrogen & progesterone | Low‑intensity aerobic (swimming, yoga, light strength) | Energy reserves reduced; endorphins help relieve cramps |
| Follicular (Days 6–13) | Rising estrogen | Strength training, moderate/high‑intensity workouts | Energy & mood improve; higher injury risk due to ligament laxity |
| Ovulation (Day ~14) | Peak oestrogen & testosterone | High‑intensity training, explosive power | Testosterone supports muscle repair & growth; injury risk lower |
| Mid‑Luteal (Days 15–21) | High progesterone | Moderate exercise | Energy drains faster; overheating and fatigue more likely |
| Late‑Luteal (Days 22–28) | Progesterone dominant, metabolism increased | Moderate exercise + slow‑release carbs | Carb cravings common; focus on sustained energy foods |
Training in harmony with the menstrual cycle enables female athletes to work with their physiology rather than against it. By tailoring intensity and nutrition to each phase, they can lower injury risk, enhance performance, and protect long‑term health. Although cycles vary from woman to woman, effective training plans should place the menstrual cycle at their core. Achieving this shift will require greater awareness, education, and integration of menstrual health into coaching and sports science.
Call to action
To achieve a paradigm/cultural shift we must talk openly about womanhood, teach girls about their bodies, and transform how we research, train and perform. This is not just about sport, it is about empowerment, health, and equality.
Conversation and Education: The first step is conversation. We need to normalise discussions about womanhood and physiology, at home, in the workplace, and on the pitch. Menstrual cycle education should be embedded into the Physical Education syllabus so that girls learn to understand their bodies early, but also for those – boys and girls – that may be involved in women’s sports in the future (as trainers, researchers, innovators) understand how to effectively support female athletes. With this knowledge, women can thrive, making informed choices about training, health, and performance.
Female‑Focused Research: The second step is research. Women must be placed at the centre of sports science, not left on the sidelines. This means funding and participating in studies, and publishing findings that reflect women’s physiology. We must overcome the financial and time constraints that sacrifice knowledge on women’s health and have historically limited research, ensuring that future discoveries are inclusive and transformative.
Resources and Support: Finally, we must provide resources that empower women to train smarter, not harder. Training schedules should be adapted to protect reproductive health while maximising performance, from amateur athletes to professionals. By equipping women with the right tools and knowledge, we can ensure that every athlete has the opportunity to reach her full potential without compromising her long‑term wellbeing.
By aligning training with the menstrual cycle, women can unlock their full athletic potential while safeguarding reproductive health, an achievement made possible through robust research and education, enabling informed choices.
Talk about womanhood. Teach girls about their bodies. Transform how we train, research and perform.
Useful Links:
Nisha Dhawan TED Talk on co-designing solutions
Boots: Exercise around menstrual cycle guide
Efamol: Cycle syncing your workouts
References:
- Fox, H. (2023, September 17). Women’s health in sport: How can research gap be bridged and findings put into practice? Sky Sports. https://www.skysports.com/more-sports/news/29876/12906118/womens-health-in-sport-how-can-research-gap-be-bridged-and-findings-put-into-practice
- Schlie, J., Krassowski, V., & Schmidt, A. (2025). Effects of Menstrual Cycle Phases on Athletic Performance and Related Physiological Outcomes. A Systematic Review of Studies Using High Methodological Standards. Journal of Applied Physiology. https://doi.org/10.1152/japplphysiol.00223.2025
- Millions of women rely on contraceptives, but new Rice study shows they may do more than just prevent pregnancy. (2020). Rice News | News and Media Relations | Rice University. https://news.rice.edu/news/2025/millions-women-rely-contraceptives-new-rice-study-shows-they-may-do-more-just-prevent
- Timperley, Z. L., & Phillips, M. J. (2025). Beyond the game: exploring women’s sporting experiences and identities within Australian community sports. Sport in Society, 1–28. https://doi.org/10.1080/17430437.2025.2492629
- Merone, L., Tsey, K., Russell, D., & Nagle, C. (2022). Sex Inequalities in Medical Research: A Systematic Scoping Review of the Literature. Women’s Health Reports, 3(1), 49–59. https://pmc.ncbi.nlm.nih.gov/articles/PMC8812498/
- Prince, L. R., & Francis, S. E. (2023). Barriers to equality, diversity and inclusion in research and academia stubbornly persist. So, what are we doing about it? Disease Models & Mechanisms, 16(7). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10416775/
- Research inclusion. (2024, December 5). Nihr.ac.uk. https://www.nihr.ac.uk/about-us/who-we-are/research-inclusion
- Bernaciková, M., Gimunová, M., Paludo, A. C., & Paulínyová, A. (2022). The prevalence of menstrual cycle disorders in female athletes from different sports disciplines: a rapid review. International Journal of Environmental Research and Public Health, 19 (21). https://pmc.ncbi.nlm.nih.gov/articles/PMC9658102/#abstract1
- Dutra, E., Shufelt, C. L., & Torbati, T. (2017). Hypothalamic amenorrhea and the long-term health consequences. Seminars in Reproductive Medicine, 35 (3), 256–262. https://pmc.ncbi.nlm.nih.gov/articles/PMC6374026/