The DOI matches its Crossref record; 59 of the 59 references it cites were found in a registry or an index.
Sex differences in human performance
Abstract
Sex as a biological variable is an underappreciated aspect of biomedical research, with its importance emerging in more recent years. This review assesses the current understanding of sex differences in human physical performance. Males outperform females in many physical capacities because they are faster, stronger and more powerful, particularly after male puberty. This review highlights key sex differences in physiological and anatomical systems (generally conferred via sex steroids and puberty) that contribute to these sex differences in human physical performance. Specifically, we address the effects of the primary sex steroids that affect human physical development, discuss insight gained from an observational study of ‘real‐world data’ and elite athletes, and highlight the key physiological mechanisms that contribute to sex differences in several aspects of physical performance. Physiological mechanisms discussed include those for the varying magnitude of the sex differences in performance involving: (1) absolute muscular strength and power; (2) fatigability of limb muscles as a measure of relative performance; and (3) maximal aerobic power and endurance. The profound sex‐based differences in human performance involving strength, power, speed and endurance, and that are largely attributable to the direct and indirect effects of sex‐steroid hormones, sex chromosomes and epigenetics, provide a scientific rationale and framework for policy decisions on sex‐based categories in sports during puberty and adulthood. Finally, we highlight the sex bias and problem in human performance research of insufficient studies and information on females across many areas of biology and physiology, creating knowledge gaps and opportunities for high‐impact studies. image
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In the citing paper
“Across all levels of competition, male runners typically outperform female runners in events ranging from middle-distance to ultramarathons.”
From Ageing, Sex Differences, and REDs Risk in Endurance Runners: An Integrated Cross-Sectional Study Protocol (2026) · cites this paper as [1]
In the citing paper
“This performance disparity is primarily attributed to sex-specific physiological characteristics, including higher maximal oxygen uptake (VO2max), greater cardiac stroke volume, elevated haemoglobin concentrations, and larger skeletal muscle mass in men, which collectively enhance oxygen transport and utilisation during prolonged exercise.”
From Ageing, Sex Differences, and REDs Risk in Endurance Runners: An Integrated Cross-Sectional Study Protocol (2026) · cites this paper as [1]
In the citing paper
“the current evidence linking menstrual-cycle phase to performance outcomes remains mixed and inconclusive.”
From Ageing, Sex Differences, and REDs Risk in Endurance Runners: An Integrated Cross-Sectional Study Protocol (2026) · cites this paper as [1]
In the citing paper
“These differences largely reflect divergent hormonal environments, with testosterone promoting muscle hypertrophy, erythropoiesis, and aerobic capacity, thereby supporting higher aerobic power and endurance performance in male athletes [1,2,3].”
From Ageing, Sex Differences, and REDs Risk in Endurance Runners: An Integrated Cross-Sectional Study Protocol (2026) · cites this paper as [1]
In the citing paper
“Meanwhile, existing summaries are often limited by small sample sizes, cross-sectional designs, non-athlete populations or a narrow focus on a single determinant of endurance performance [21].”
From Effects of Aging on Determinants of Endurance Performance in Women Masters Athletes: A Scoping Review (2026) · cites this paper as [21]
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Citations
Cites
Heart Disease and Stroke Statistics—2021 Update: A Report From the American Heart Association
Virani, S. S., Alonso, A., Aparicio, H. J., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Cheng, S., Delling, F. N., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000950 · Cited by 5,784 · cited 1×
“…inclusion of females in clinical trials has contributed to inappropriate treatment options and poor health outcomes for females and even exacerbated cardiovascular mortality rates (Kim et al., 2010; Melloni et al., 2010; Shannon et al., 2019; Virani et al., 2021; Zucker & Prendergast, 2023).”
Hewett, T. E., Myer, G. D., Ford, K. R., Heidt, R. S., Colosimo, A. J., McLean, S. G., van den Bogert, A. J., Paterno, M. V., & Succop, P. (2005) · The American Journal of Sports Medicine · doi:10.1177/0363546504269591 · Cited by 3,577
Policy: NIH to balance sex in cell and animal studies
Clayton, J. A., & Collins, F. S. (2014) · Nature · doi:10.1038/509282a · Cited by 1,816
Endurance exercise performance: the physiology of champions
Joyner, M. J., & Coyle, E. F. (2008) · The Journal of Physiology · doi:10.1113/jphysiol.2007.143834 · Cited by 1,307
Testosterone dose-response relationships in healthy young men
Bhasin, S., Woodhouse, L., Casaburi, R., Singh, A. B., Bhasin, D., Berman, N., Chen, X., Yarasheski, K. E., Magliano, L., Dzekov, C., et al. (2001) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.2001.281.6.e1172 · Cited by 967
Appendicular skeletal muscle mass: effects of age, gender, and ethnicity
Gallagher, D., Visser, M., De Meersman, R. E., Sepúlveda, D., Baumgartner, R. N., Pierson, R. N., Harris, T., & Heymsfield, S. B. (1997) · Journal of Applied Physiology · doi:10.1152/jappl.1997.83.1.229 · Cited by 966
McNulty, K. L., Elliott-Sale, K. J., Dolan, E., Swinton, P. A., Ansdell, P., Goodall, S., Thomas, K., & Hicks, K. M. (2020) · Sports Medicine · doi:10.1007/s40279-020-01319-3 · Cited by 812 · cited 1×
“…beliefs, human motor performance varies minimally in magnitude across the menstrual cycle in eumenorrheic females as a group (D ʼ Souza et al., 2023; McNulty et al., 2020; Piasecki et al., 2023) and also varies little due to contraception options that might alter hormone fluctuations, such as…”
Maximal oxygen uptake in athletes
Saltin, B., & Astrand, P. O. (1967) · Journal of Applied Physiology · doi:10.1152/jappl.1967.23.3.353 · Cited by 798 · cited 1×
“…(ml O 2 ·kg − 1 ·min − 1 ) is about 10–20% larger in males than females (Bunc & Heller, 1989; Durstine et al., 1987; Jensen et al., 2001; Jones, 2006; Joyner & Coyle, 2008; Loe et al., 2013; Pate & O ʼ Neill, 2007; Pollock, 1977; Riley-Hagan et al., 1992; Saltin & Astrand, 1967; Støa et al., 2020).”
Sex-specific genetic architecture of human disease
Ober, C., Loisel, D. A., & Gilad, Y. (2008) · Nature Reviews Genetics · doi:10.1038/nrg2415 · Cited by 787
Gonadal Steroids and Body Composition, Strength, and Sexual Function in Men
Finkelstein, J. S., Lee, H., Burnett-Bowie, S.-A. M., Pallais, J. C., Yu, E. W., Borges, L. F., Jones, B. F., Barry, C. V., Wulczyn, K. E., Thomas, B. J., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1206168 · Cited by 782
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Cited by
Neteca, J., Veseta, U., Liepina, I., Volgemute, K., Dzintare, M., & Babarykin, D. (2024) · Nutrients · doi:10.3390/nu17010063 · Cited by 13
Vangsgaard, D., Noumi, M., Hayden, K. A., & Doyle-Baker, P. K. (2026) · Healthcare · doi:10.3390/healthcare14081080
Oreská, Ľ., Kundeková, B., Varga, L., Stebelová, K., Okuliarová, M., Payer, J., & Sedliak, M. (2026) · Sports · doi:10.3390/sports14030121
Metadata
- Authors
- Hunter, S. K., & Senefeld, J. W.
- Affiliations
- Movement Science Program, School of Kinesiology University of Michigan Ann Arbor Michigan USA
- Department of Kinesiology and Community Health University of Illinois Urbana‐Champaign Urbana Illinois USA
- Venue
- The Journal of Physiology
- Publisher
- Wiley
- Published
- 2024-08-06
- Volume
- 602
- Issue
- 17
- Pages
- 4129-4156
- ISSN
- 0022-3751
- 1469-7793
- Cited by
- 153
- References
- 59
- Language
- en
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