Where Are All the Female Participants in Sports and Exercise Medicine Research? A Decade Later.

Background: In 2014, Costello and colleagues published a sentinel paper spotlighting the large disparity of female versus male representation within sports science and sports medicine (SSSM) research.

Purpose: To (1) revisit the method published by Costello et al a decade later to evaluate female representation and (2) ascertain whether study designs account for menstrual status.

Study Design: Systematic Review; Level of evidence, 4.

Methods: All original and epidemiologic research of live human participants from the journals , , and the were included from January 2021 to August 2023. Number of male and female participants for each study was analyzed. A menstrual-status tiering system published by Smith et al was used to classify the consideration of female participants' menstrual status in study design.

Results: A total of 1441 studies and 40,152,860 participants were included in this analysis. This included 17,648,509 (43.95%) female participants. The mean proportion of female participants per study was 40.22%, and 103 (7.15%) studies included only female participants compared with 268 (18.6%) male-only studies. A total of 66 (5.6%) studies included menstrual-status considerations in their study design with 7.7 (0.7%) and 5.5 (0.5%) receiving a silver or gold classification, respectively, for design considerations.

Conclusion: Our investigation into the representation of female athletes in SSSM research found an increase in female participation from 39% to 43.95% of total participants over the past decade. While the overall number of female participants rose in the years 2021 to 2023, there remains a significant disparity in female representation in SSSM research compared with male participants. Additionally, we found that the inclusion of menstrual status in study designs has been limited, with few studies considering this crucial variable.