Women have been creating an increasing presence in the world of health and fitness. According to the International Health, Racquet, and Sportsclub Association (IHRSA), women comprise 53% of health club memberships.

While in the past it was considered unfeminine for a woman to perspire, today's female athletes and workout buffs sweat right along with the best of them. This increase in female participation has raised some questions, though: Are there special considerations for female participants and athletes?

A Heaping Helping of Hormones

It's no secret that a woman's hormones play a huge role in how she feels, but the effects of hormones go beyond just mood. You can blame good old estrogen, at least in part, for the fact that women tend to have a higher percentage of body fat and water retention.

But this is not in vain. According to Mark Baugh, PharmD, author of Sports Nutrition: The Awful Truth, "This is a natural process which is designed to protect the fetus from the harsh environments humans live in."

Okay, so women have more estrogen and body fat than men, but why is it seemingly easier for men to lose weight? This can be summed up in one word—metabolism. It's sort of a domino effect in men. They have more testosterone, which allows them a higher percentage of muscle, and because muscle is more metabolically active than fat, it burns more calories and revs up their metabolisms.

What's Your "Fattern"?

One's "fattern," or pattern of fat distribution, seems to be an issue, too. Men's fattern tends to be highly abdominal, whereas women tend to carry heavier in their lower bodies. According to Robyn Stuhr, MA, an exercise physiologist at the Hospital for Special Surgery in New York, abdominal and visceral fat appears to be more responsive to exercise than the fat on the hips, buttocks, and legs.

Oral contraceptives (OC) may have effect on women’s body composition and exercise performance. A team of researchers has examined the effects of OC on female muscle mass. The study resutls showed that oral contraceptive use impairs muscle gains in young women. This is a new finding and will need to be studied more.

Your Reproductive Organs Are Safe

Remember back in the "good old days" when you could be excused from gym class because you had your period? Well it wasn't just high school gym class that was affected by this taboo. "Until recently," says Christine Wells, PhD, in her book, Women, Sport, and Performance, "most of the International Olympic committee members believed that sport training and competition were detrimental to proper reproductive functions in women."

We now know that these beliefs are unfounded. Physical activity—whether during the menstrual period or not—will not harm a woman's reproductive organs. In fact, Constance Lebrun, MD, a physician at the Fowler-Kennedy Sports Medicine Clinic in Ontario, says that men's testes are actually in a more vulnerable state than women's reproductive organs during certain athletic activities. Hence, the need for a cup!

What About the Menstrual Cycle?

Can certain phases of the menstrual cycle affect a woman's strength or endurance?

There are many anecdotal experiences where women can tell you that while they're premenstrual, they just don't feel up to par.

"When I'm PMS-ing," says Yaz Boyum, a professional bodybuilder and online trainer, "I just don't have as much energy and I'm hungry all the time!" Cramps and premenstrual headaches can also put a damper on how well you feel. And if you don't feel well, you're going to have to psych yourself up to perform better.

Apart from anecdotal experiences, however, research is pretty inconclusive. In Lebrun's review of the literature covering this topic, she concluded that "with the exception of a possible luteal phase improvement in endurance exercise, there does not appear to be any conclusive evidence of effects of the menstrual cycle on actual athletic performance." A study done in late 2006 on 241 elite female athletes confirmed that a woman’s menstrual cycle does not significantly affect athletic performance.

Cramps, bloating, blemishes—kind of makes you want to curl up on the couch with the latest Brad Pitt flick and your favorite pint of Ben and Jerry's, doesn't it? Instead, try going for a jog. Research shows that aerobic exercise can help ease many of the symptoms of premenstrual syndrome.

Fractures and Sprains and Strains…Oh My!

As more people get involved in athletic activities, there is a concomitant increase in sports injuries. And although some believe women to be the "weaker sex," it certainly isn't proven when numbers are compared. Studies show that it's not the gender as much as it is the sport that increases the injury risk.

The highest risk sports for women appear to be basketball, gymnastics, softball, and field hockey, according to Wells. Most injuries occur in the knee and ankle, whether you're a man or woman. However, women may score higher in knee injuries.

According to Bert Mandelbaum, MD, of the Santa Monica Orthopaedic and Sports Medicine Research Foundation, young women aged 15-20 years old suffer two to eight times more ]]>anterior cruciate ligament (ACL) tears]]> than their male counterparts.

The reason, he feels, is lack of neuromuscular control. "Women tend to run more extended and flatfooted, which puts more pressure on the quadriceps." His solution is prevention: teaching correct form and proprioception, and increasing strength and flexibility.

Nutritional Concerns

One of the top nutritional concerns regarding menstruating women, especially active women, is iron intake. Athletes are at particular risk. The reasons include the following:

  • Inadequate dietary intake of ]]>iron]]>
  • Poor absorption of iron due to nonheme iron sources
  • Increased iron losses in urine and sweat
  • Gastrointestinal blood loss (particularly common in distance runners)
  • Increased destruction of the red blood cells from foot-strike hemolysis

What's the big deal about iron? Iron deficiency can cause ]]>anemia]]>. And even when it isn’t severe enough to cause anemia, it may impair performance. As many as one out of four female athletes is iron deficient.

"People who have iron deficiency…have a reduced rate of lactic acid clearance from the blood, and they tire earlier during exercise," according to the authors of Women and Exercise . In several studies, iron supplementation improved endurance performance in women with mild iron deficiency.

The most important point about nutrition, athlete or not, is to make sure you are eating a variety of healthy foods. Do not supplement iron on your own without consulting your healthcare provider, as ]]>too much iron]]> can be dangerous, too.

Learning as We Go

As more and more women become involved in the sports and fitness scene, more attention will need to be paid to special feminine concerns. While some research has been done in this area, there are still many more avenues to explore.