More female athletes are participating and competing in endurance events, yet injury rates are higher than male athletes. To level the playing field, coaches need to understand the unique biophysiological considerations when working with the female athlete. Adolescent female athletes must manage puberty and menstruation while participating and performing. Pregnant athletes must adapt to changes related to the growing baby, yet balance participation and performance without significant deconditioning. Postpartum athletes must navigate return to sport along with healing from childbirth and recovering from pregnancy-related changes while also managing their mental health, pelvic health, bone health, etc. Finally, the master's female athlete must maintain performance while navigating menopause and the effects of changing hormones. Recognizing relative energy deficiency in sport, menstrual cycle abnormalities, bone health, and pelvic floor dysfunction can assist the athlete in getting referred to the appropriate health provider and prevent potential short- and long-term injuries. This evidence-based article will provide practical approaches to recognize and screen common issues affecting female athletes during the different lifespan stages and provide resources and recommendations to help the athlete to stay healthy and in the game.
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