The Underrepresentation of Female Athletes in Sports Research

Considerations for Cardiovascular Health

Jie Wei Zhu; Jennifer L. Reed; Harriette G.C. Van Spall


Eur Heart J. 2022;43(17):1609-1611. 

In This Article

Abstract and Introduction


The proportion of female athletes in competitive sporting events—including the World Championships and Olympic games—has increased to nearly half of all athletes, and competing athletes increasingly include those who are peripartum. While participation in sports is closely implicated in cardiovascular health and disease, females remain underrepresented in recreational and performance sports research. This underrepresentation is marked during pregnancy, a unique biological state with substantial hemodynamic changes that have implications on athletic performance and on any underlying cardiovascular conditions. The evidence to guide recreational and performance sports is derived mainly from research in males, which has limited generalizability in females. This is a call for researchers to include female participants, including consenting pregnant and lactating women, in sports physiology research and for guideline committees to include sex-specific and peripartum-specific cardiovascular recommendations for athletes.