Physiological sex differences affect the integrative response to exercise: acute and chronic implications
Open accessAbstract
New Findings: What is the topic of this review? We review sex differences within physiological systems implicated in exercise performance; specifically, how they integrate to determine metabolic thresholds and fatigability. Thereafter, we discuss the implications that these sex differences might have for long‐term adaptation to exercise. What advances does it highlight? The review collates evidence from recent physiological studies that have investigated sex as a biological variable, demonstrating that the physiological response to equivalent ‘dosages’ of exercise is not the same in males and females; thus, highlighting the need to research diversity in physiological responses to interventions. The anatomical and physiological differences between males and females are thought to determine differences in the limits of human performance. The notion of studying sex as a biological variable has recently been emphasized in the biosciences as a vital step in enhancing human health. In this review, we contend that the effects of biological sex on acute and chronic responses must be studied and accounted for when prescribing aerobic exercise, much like any intervention targeting the optimization of physiological function. Emerging evidence suggests that the response of physiological systems to exercise differs between males and females, potentially mediating the beneficial effects in healthy and clinical populations. We highlight evidence that integrative metabolic thresholds during exercise are influenced by phenotypical sex differences throughout many physiological systems. Furthermore, we discuss evidence that female skeletal muscle is more resistant to fatigue elicited by equivalent dosages of high‐intensity exercise. How the different acute responses affect the long‐term trainability of males and females is considered, with discussion about tailoring exercise to the characteristics of the individual presented within the context of biological sex. Finally, we highlight the influence of endogenous and exogenous sex hormones on physiological responses to exercise in females. Sex is one of many mediating influences on the outcomes of exercise, and with careful experimental designs, physiologists can advance the collective understanding of diversity in physiology and optimize outcomes for both sexes.
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Progesterone affects glucose metabolism through upregulation of GLUT1 expression to increase endometrial glycolytic metabolism, attenuating skeletal and hepatic glycolytic pathways.
“affects glucose metabolism through the upregulation of GLUT1 expression to increase endometrial glycolytic metabolism, attenuating skeletal and hepatic glycolytic pathways [82–85]”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [85]
The menstrual-cycle section says exercise substrate metabolism may vary by cycle phase, and the New Findings section discusses sex differences in muscle glycolytic capacity. Neither passage addresses progesterone-driven GLUT1 expression, endometrial glycolysis, or attenuation of skeletal and hepatic glycolytic pathways. Searches for those specific mechanisms found no supporting passage in our copy; pages were not provided. (LLM, conf=0.76)
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- Authors
- Ansdell, P., Thomas, K., Hicks, K. M., Hunter, S. K., Howatson, G., & Goodall, S.
- Affiliations
- Northumbria University (GB)
- Marquette University (US)
- North-West University (ZA)
- Corresponding author
- Ansdell, Paul
- Venue
- Experimental Physiology
- Publisher
- Wiley
- Published
- 2020-10-17
- Volume
- 105
- Issue
- 12
- Pages
- 2007-2021
- ISSN
- 0958-0670 (ISSN-L)
- 1469-445X
- OpenAlex
- W3090481852
- Cited by
- 403
- References
- 181
- Citations by year
- 2026: 59 · 2025: 84 · 2024: 85 · 2023: 89 · 2022: 58 · 2021: 27 · 2020: 1
- FWCI
- 8.93
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Experimental Physiology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Northumbria Research Link (Northumbria University) (acceptedVersion)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Keywords
- sex differences, exercise physiology, metabolic threshold, skeletal muscle fatigue, sex hormones, exercise adaptation, aerobic exercise prescription, sex as a biological variable, high-intensity exercise, individualized exercise training
- MeSH terms
- Adaptation, Physiological, Animals, Humans, Sex Characteristics, Sex Factors, Exercise, Muscle, Skeletal, Muscle Fatigue
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