Time to tackle female ageism in sport and exercise science, urge researchers in BJSM article
The paucity of attention given to older women in sports and exercise science studies has been criticised by researchers in an article published online today (7 February) in the British Journal of Sports Medicine.
The article’s first author is Kelly McNulty from the department of sport, exercise and rehabilitation, faculty of health and life sciences at Northumbria University.
Change is needed – not only for the sake of the growing numbers of female athletes, but women’s health in general – point out the authors, citing their own 2021 report on the sex data gap.
This showed that out of 5,261 studies, from across six popular sport and exercise science journals, women and girls made up just over a third of the total number of participants, a figure that is likely to be even lower for women from mid-life onwards, they suggest
The hormonal changes that women experience – throughout the transition between regular periods and the last one (known as the perimenopause) can generate particular physical and psychological symptoms, they note.
Postmenopausal issues side-lined
On average, women will live a third of their lives postmenopausally, and so will be at heightened risk of osteoporosis, muscle loss (sarcopenia), cardiovascular disease and dementia, as a result of depleted hormone levels. The impact of hormone replacement therapy (HRT) is another factor to throw into the mix, the authors explain.
These hormonal changes potentially not only affect women’s quality of life, but also their willingness to take part in physical activity, their athletic prowess, and their response to training.
‘However, the full consequences of these reproductive hormonal profiles on participation rates as well as health and performance outcomes, alongside strategies to overcome any negative effects, are relatively under-researched in comparison with other reproductive hormonal milieus experienced by females (eg, the menstrual cycle), write Dr McNulty and her colleagues.
Based on their 2021 data, and updating it to 2022, the authors estimate that women in mid-life and beyond account for only nine per cent of total study participants, with only 16 per cent of female-only studies focusing exclusively on older women.
They set out key research priorities to redress the imbalance: the influence of perimenopause and postmenopause on participation in sport, exercise and physical activity; the role of exercise and dietary changes to manage symptoms and optimise health and wellbeing outcomes during perimenopause and beyond; and the influence of perimenopause and postmenopause (as well as HRT) on performance and training responses.
We hope that this commentary will act as a call to action for the sport and exercise science research community to bridge the current data and knowledge gap for perimenopausal and postmenopausal women [Kelly McNulty et al]
'Poor' methodological practices
And they emphasise that much of the existing body of relevant research has used ‘poor methodological practices (ie inconsistencies in the terminology used to describe menopausal status, pooling of premenopausal, perimenopausal, and postmenopausal participants, and failure to report other criteria, such as HRT use), which further limits the translational reach and impact of the current data available on women in midlife and beyond’.
Just as the ‘typical 70 kg male’ is commonly considered the default universal representative in sport and exercise science studies, in those that do focus on women, ‘it appears that naturally menstruating women, between the ages of 18 and 40 years, have been considered as an adequate proxy to represent all females’ the authors point out.
‘We hope that this commentary will act as a call to action for the sport and exercise science research community to bridge the current data and knowledge gap for perimenopausal and postmenopausal women,’ they conclude. ‘Ultimately, this will enable practitioners and researchers to better support female athletes and patients across the lifespan.
To access the full version of the article – titled Invisibility of female participants in midlife and beyond in sport and exercise science research: a call to action doi: 10.1136/bjsports-2023-107165 – clickAuthor: I A McMillan