DI Gioia Giuseppe, Segreti Andrea, Celeski Mihail, Crispino Simone P, Buzzelli Lorenzo, Mango Federica, Ferrera Armando, Squeo Maria R, Vespasiano Francesca, Ussia Gian P, Grigioni Francesco
Institute of Sports Medicine and Science, National Italian Olympic Committee, Rome, Italy -
Department of Movement, Human and Health Sciences, Foro Italico University of Rome, Rome, Italy -
J Sports Med Phys Fitness. 2025 May;65(5):681-700. doi: 10.23736/S0022-4707.24.16265-2. Epub 2025 Jan 13.
Endurance sports have witnessed an increase in female participation, demanding a constant and evolving reassessment of the specific physiological and health implications of female athletes. In the present review, we analyze cardiovascular, hematological adaptations and anthropometry and hormonal fluctuations highlighting sex-specific differences in response to exercise, with estrogen playing a fundamental role in modulating body composition and metabolic processes. Nutritional aspects, in particular energy availability, macronutrient distribution and hydration, are fundamental in supporting training demands and menstrual function. Nevertheless, the repercussions of nutritional deficiencies, interacting in the female athlete triad - which also includes amenorrhea, osteoporosis and eating disorders - underline the importance of comprehensive management strategies. In addition, we comprehensively discuss the multiorgan effects of physical training, highlighting the intersections between sex-specific differences, nutritional needs, and cardiovascular adaptations. Cardiovascular remodeling in female endurance athletes reveals both morphological and functional adaptations, requiring a deep understanding of effective cardiovascular risk assessment and screening. The synthesis of current knowledge highlights the complexity of the physiological landscape of the female athlete practicing endurance sports, requiring ongoing exploration and tailored interventions. In conclusion, this review aims to support a gender-based approach to athletic training and health management and research, intending to optimize performance while safeguarding the well-being of female athletes.
耐力运动中女性参与者的数量有所增加，这就需要对女性运动员特定的生理和健康影响进行持续且不断发展的重新评估。在本综述中，我们分析了心血管、血液学方面的适应性变化、人体测量学指标以及激素波动情况，强调了运动反应中存在的性别差异，其中雌激素在调节身体成分和代谢过程中起着至关重要的作用。营养方面，特别是能量供应、宏量营养素分布和水合作用，对于满足训练需求和维持月经功能至关重要。然而，营养缺乏在女性运动员三联征（还包括闭经、骨质疏松症和饮食失调）中的影响凸显了综合管理策略的重要性。此外，我们全面讨论了体育锻炼对多器官的影响，强调了性别差异、营养需求和心血管适应性之间的交叉点。女性耐力运动员的心血管重塑揭示了形态和功能上的适应性变化，这需要深入了解有效的心血管风险评估和筛查方法。当前知识的综合表明，从事耐力运动的女性运动员的生理状况十分复杂，需要持续探索并采取针对性的干预措施。总之，本综述旨在支持基于性别的运动训练、健康管理和研究方法，旨在优化运动表现，同时保障女性运动员的健康。
