Ultra-endurance has been defined as any exercise bout that exceeds 6 h. A number of exceptional, record-breaking performances by female athletes in ultra-endurance sport has roused speculation that they might be predisposed to success in such events. Indeed, while the male-to-female performance gap in traditional endurance sport (e.g., marathon) remains at ~10%, the disparity in ultra-endurance competition has been reported as low as 4% despite the markedly lower number of female participants. Moreover, females generally outperform males in extreme-endurance swimming. The issue is complex, however, with many sportsspecific considerations and caveats. This review summarizes the sex-based differences in physiological functions and draws attention to those which likely determine success in extreme exercise endeavors. The aim is to provide a balanced discussion of the female versus male predisposition to ultra-endurance sport. Herein, we discuss sex-based differences in muscle morphology and fatigability, respiratory-neuromechanical function, substrate utilization, oxygen utilization, gastrointestinal structure and function, and hormonal control. The literature indicates that while females exhibit numerous phenotypes that would be expected to confer an advantage in ultra-endurance competition (e.g., greater fatigue-resistance, greater substrate efficiency, and lower energetic requirements), they also exhibit several characteristics that unequivocally impinge on performance (e.g., lower O2-carrying capacity, increased prevalence of GI distress, and sex-hormone effects on cellular function/ injury risk).Crucially, the advantageous traits may only manifest as ergogenic in the extreme endurance events which, paradoxically, are the races that females less often contest. The title question should be revisited in the coming years when/if the number of female participants increases.
KEY POINTS• Females exhibit numerous physiological characteristics that would be expected to confer an advantage in ultra-endurance competition. However, these traits may only manifest in the extreme distance events that females less often contest• Several aspects of female physiology unequivocally inhibit performance making it unlikely that the fastest females will surpass the fastest males in this sport• More direct physiological comparisons between male and female ultra-endurance athletes are needed, particularly when/if female participation numbers increase