Female (Under) Representation in Exercise Thermoregulation Research

Abstract

Background Despite an increasing rate of women participating in professional sports, emergency services, and military settings where they are exposed to exertional heat stress, our understanding of female thermoregulation and the detrimental effects of heat on women’s performance, especially regarding the menstrual cycle, is limited. This review aimed to quantify the representation of women in exercise thermoregulation research between 2010 and 2019 and the frequency that these articles reported details pertaining to female participants’ menstrual cycle to determine the volume of novel research that is directly relevant to this growing population. Methods Original exercise thermoregulatory studies published in three major sports medicine databases (PubMed, MEDLINE, and SPORTDiscus) between 2010 and 2019 were surveyed. Articles were screened to determine the number of female and male participants in the study and whether studies involving women reported menstrual orientation or phase. Research involving healthy adult participants and an exercise protocol with a thermoregulatory outcome measure were included in the review. Results A total of 1407 articles were included in the review, involving 28,030 participants. The annual representation of women ranged from a mean of 11.6% [95% credible interval (CI); 9.2, 14.3] to 17.8% [95% CI; 15.2, 20.6] across the 10 years, indicating studies predominantly included men. Nonetheless, there was a small statistical increase in the overall proportion of women, with a mean overall proportion change of 0.7% [95% CI; 0.2, 1.2] per year. The increase appeared to be driven by a reduction in the number of studies including only men, rather than studies including more women alongside men, or increased women-only studies. Less than one third of articles involving women reported the menstrual orientation of participants and less than one quarter reported both menstrual orientation and phase. Summary/Conclusion This study shows that women were proportionally underrepresented in exercise thermoregulation research during the past decade and the majority of studies did not report menstrual cycle details of female participants. Researchers should consider including women in future work where their inclusion could contribute meaningful data that enhance the evidence-based and ultimately improves our comprehension of women’s thermal physiology.

Auditing the Representation of Female Versus Male Athletes in Sports Science and Sports Medicine Research: Evidence-Based Performance Supplements

“…Whereas others have audited numerous topics within a defined set of SSSM journals over a specified period [ 2 , 3 , 4 ], we examined all published literature (~50 years) on a narrow range of topics across all available SSSM journals. Indeed, our findings are similar to the 21% representation identified in an audit of a specific SSSM topic across all journals [ 5 ]. The low total involvement of female participants in the present audit reflects both the lower number of studies involving female-only cohorts, as well as lower numbers of women within the sample among the 14–33% of studies with mixed-sex cohorts.…”

“…Investigations on exclusively female cohorts accounted for 0–8% of studies across different performance supplements, similar to the 4–13% previously reported across a range of exercise/sports themes [ 2 , 3 , 4 , 5 , 6 ]. There is no evidence that the attention drawn to this inequity in research participation [ 3 ] has yet translated to changes in practice, since the proportion of female-only studies published over the previous 5 and 10 years (0–7% and 0–8%, respectively) is similar to the overall time period.…”

“…Female-targeted research related to sports science/sports medicine (SSSM) has failed to mirror the increase in participation and popularity of women’s sport [ 1 ]. While many aspects of women’s sport gain parity with their male counterparts, audits show a substantial under-representation of women as study participants, with female-only projects accounting for just 4–13% of all studies [ 2 , 3 , 4 , 5 , 6 ]. Of the multiple explanations [ 1 ], the complexity of female physiology represents a long-standing challenge, with the additional intricacy, time and expense involved in study designs being a deterrent to many researchers.…”

Methodology Review: A Protocol to Audit the Representation of Female Athletes in Sports Science and Sports Medicine Research

“…The urgency of the need to address the sex disparity across SSSM research is receiving substantial publicity within scientific literature (Elliott-Sale et al, 2021;Hutchins et al, 2021;Martínez-Rosales et al, 2021) and popular/social media (Yu, 2018(Yu, , 2021. It is therefore important to efficiently direct the current enthusiasm for research on the female athlete into high-quality and meaningful outputs.…”

“…Conducting such audits across SSSM topics may produce information to help direct future research activities in a systematic and expedient manner. Examples of such audits are beginning to appear (Brookshire, 2016;Costello et al, 2014;Cowley et al, 2021;Hutchins et al, 2021). However, implementing a more standardized audit protocol will optimize the outputs and interpretation of such audits, ensuring that comparisons can be made across time and across SSSM topics.…”