For years, research in biomedical, pharmacological, and psychological fields has skewed male. Studies have often prioritized male cells, animals, and humans. This has been due to a range of factors, including researchers wanting to avoid accounting for fluctuating hormones in women and concerns over the liability of putting women of childbearing age in research trials, especially after the thalidomide tragedy, where birth defects and pregnancy losses were linked to pregnant women being prescribed a drug called thalidomide in the late 1950s and 1960s to treat nausea in pregnancy. This has led to an overall mentality that when it comes to science, the male body is the default standard. But these days, scientists are constantly learning that there are clear differences between men and women.
The male sex biases in research, however, had some real consequences, including women experiencing higher rates of adverse drug reactions—in cases nearly twice as likely as men—and being more likely to be misdiagnosed or underdiagnosed with conditions like cardiovascular disease, where symptoms can present differently between the sexes. These differences influence everything from how the body uses energy to the way in which it responds to exercise, stress reactivity, and how susceptible it is to disease.
But there are positives in these differences that give women a biological edge. Researchers are now recognizing that women have physiological advantages, particularly in areas like endurance, recovery, metabolic efficiency, and resilience.
Endurance and fatigue resistance: Research shows that women tend to have a greater resistance to fatigue during endurance training. Part of this has to do with how the body fuels itself. Women rely more on fat as a primary fuel source during aerobic exercise, which allows them to use less of their quick-burning fuel, known as glycogen, the stored form of carbohydrates in the muscles. Glycogen is limited and gets depleted over time. Using less of it for fuel can help support more steady, sustained energy during longer efforts.
Women also tend to pace themselves differently than men do. Researchers have found that they may use energy more evenly over time, which can help prevent early burnout and support more consistent performance, especially in longer-duration activities like distance running. A recent analysis of marathon runners found that women slowed their pace by about 8.7% compared to 9.5% in men. In the study, women were also about 24.5% better at maintaining an even pace overall than men.
There’s also evidence that women experience a slower onset of muscle fatigue during continuous activity. Their muscles can often keep working for longer before tiring out. While men typically outperform women in endurance sports, the gap can shrink significantly as the distances increase.
Metabolic efficiency: In addition to when exercising, women’s bodies may also be more efficient at managing energy overall. Research suggests they may have better metabolic flexibility than men. This means they are better able to switch between fuel sources like fat for longer-lasting energy and carbohydrates for quicker bursts depending on what the body needs. This can help them to maintain endurance and energy across various types of physical activity.
Recovery and muscle resilience: Some research suggests that women may experience less muscle damage and can even recover faster from certain types of exercise than men. This may be due to hormonal differences, as estrogen is thought to play a protective role in muscle repair. But it’s important to note that these enhanced recovery metrics depend on a variety of factors. This includes things like a woman’s age, the type of training she is engaging in, and where she is at in her menstrual cycle.
Related: How to maintain muscle and strength as you age
Pain tolerance and resilience: Ever hear a woman say there is no way a man could survive childbirth? While this is a cultural joke, it may reflect some real physiological differences. Studies show that women may have a higher pain tolerance in certain contexts, particularly in situations that involve longer-lasting or repeated discomfort.
Women may also use different coping mechanisms when dealing with stress, which can be beneficial in certain situations. This includes turning to their social networks to help them receive support in difficult situations, which they are more prone to do than their male counterparts.
Women’s bodies also adapt differently in certain systems. Research suggests women often have stronger immune responses, which can help the body fight off illness and recover more effectively. This may be due to estrogen’s ability to stimulate the immune system, as well as genetic factors such as immune-related genes located on the X chromosome.
Brain and longevity advantages: Women in the United States live an average of 5 years longer than men, a trend that is also reflected worldwide. Some of this is said to be due to a woman’s tendency towards having a healthier lifestyle. Women are less likely to smoke and abuse alcohol, while some reports show that women are much more likely to see a doctor than men. But research has found that women tend to have a survival advantage even in extreme conditions like famines and epidemics which suggests there may be underlying biological factors at play.
Hormones may be a factor. Estrogen, for example, is thought to support both brain and cardiovascular health, helping protect blood vessels and maintain healthy blood flow. Estrogen also has neuroprotective properties that have been shown to help reduce inflammation and maintain cognitive function, which may correlate with lower rates of Alzheimer’s disease and stroke earlier in life. Some research has also linked greater lifetime estrogen exposure to markers of brain health, including larger brain volume and lower signs of neurodegeneration.
Women’s tendency to prioritize social connections and stay more engaged with their health has also been linked to better long-term health outcomes.
Cardiovascular and metabolic differences: Women’s cardiovascular systems respond differently to stress and exercise than men’s. For example, women often have different heart rate and blood flow responses during exercise, which can affect their performance and recovery. Some of these differences may offer health benefits, particularly at certain stages of life.
Women tend to develop heart disease around 10 years later than men. This is thought to be due to the protective effects of estrogen during their reproductive years. This gap narrows after menopause, as estrogen levels decline and cardiovascular risk begins to rise, including changes in cholesterol levels and blood vessel health that can contribute to plaque buildup over time.
Women also store fat differently than men, with more held under the skin, also known as subcutaneous fat, and less around internal organs. This internal fat, called visceral fat, lines the abdominal wall, surrounds organs, and is linked to a higher risk of metabolic conditions like heart disease, diabetes, and high cholesterol. Thus, women’s typical fat distribution is generally associated with a lower risk of these conditions, at least earlier in life before hormonal changes after menopause begin to shift fat storage patterns.
The role of the menstrual cycle
Hormonal fluctuations throughout a woman’s menstrual cycle affect more than just her energy level and mood. They can also influence everything from strength and endurance to recovery. Researchers are beginning to understand how shifts in estrogen and progesterone levels across the cycle may impact energy levels, body temperature, and how the body uses fuel during exercise. Because of this, some experts suggest that training in a way that supports your cycle may help prioritize performance and recovery.
High estrogen levels in the follicular phase, for instance, support higher intensity training, while rising progesterone in the luteal phase can be a great time to prioritize lower-intensity workouts and to focus on recovery. A woman’s hormonal health is an area that has been largely overlooked in research and is something scientists are now beginning to address.
Why these advantages are often misunderstood
Women’s health differences have been long overlooked, not because they aren’t meaningful, but because research, fitness culture, and medical standards have historically been built around male physiology. Fortunately, this is starting to change. As more research begins to focus on female physiology, a clearer picture is emerging. Rather than viewing the female body as a variation of the male’s, we’re now shifting towards understanding the key differences in women’s health. This has the potential to reshape how women train, approach their health, and support their bodies across every stage of life.
Related: The most common health misdiagnoses in women—and why they keep happening
It also highlights the value of understanding what’s going on in your own body. Prenuvo’s whole body MRI can help screen for hundreds of conditions, while a Body Composition Analysis can help look at muscle mass and fat distribution as well as early markers of disease that may not yet be causing symptoms. When combined with advanced bloodwork, it provides women with a detailed view of their health, helping them make decisions based on how their own bodies are functioning, not one-size-fits-all standards.
Related: It's time for women to take charge of their health
Understanding your body is less about generalized standards and more about knowing what’s normal for you. To learn more about the benefits of Prenuvo’s whole body MRI, Body Composition Analysis, blood biomarker testing, and see which Prenuvo Membership is right for you, book a call with a member of the Patient Services Team.
