Optimizing Performance and Health: Nutrition Considerations for Female Athletes in Strength and Conditioning

Abstract

Nutrition and dietary intake are key factors for exercise and sport performance. While a substantial body of research highlights the impact of nutrition on exercise, many dietary and nutrient recommendations are based on research studies only conducted in men. However, the distinct physiological, neurological, and hormonal changes across a woman’s life cycle significantly affect nutritional needs. This narrative review explores key recommendations for calories, carbohydrates, fats, proteins, and select supplements, highlighting the absence of sex-specific guidelines in current dietary frameworks for strength and conditioning female athletes. The review synthesizes current literature to provide practical guidance for coaches, sport dietitians, and health practitioners to optimize both performance and health outcomes for female athletes.

INTRODUCTION

Since the enactment of Title IX by the National Collegiate Athletic Association (NCAA) over 50 years ago, female participation in sports and exercise has exponentially increased (8). Today, women represent over 47% of all student-athletes in Division I championships and hold more than 25% of NCAA head coaching and athletic director positions (8). This increase in female athletic participation has amplified awareness of their unique physiological and endocrinological needs, prompting researchers, coaches, and health care practitioners to consider sex-specific recommendations.

Nutrition plays a crucial role in optimizing training and performance while being essential for recovery and overall health. However, research on sports nutrition tailored to female strength and conditioning athletes remains limited, leading to the potential misapplication of nutritional strategies (e.g., caloric intake models, carbohydrate recommendations) designed for male athletes (61). Literature examining sex differences and female-specific nutritional strategies emphasize the impact of sex hormones. Men have testosterone, which has a well-established role in increased muscle anabolism, making muscle more responsive to strength and hypertrophy gains (46). Female sex hormones (estrogen and progesterone) fluctuate throughout the menstrual cycle and life stages (e.g., pregnancy, menopause), differentially affecting metabolic pathways relevant to nutritional needs and muscle responsiveness (16,18,35,51,75). Yet, only about 31% of female-specific dietary interventions consider the menstrual cycle, and only 4 studies have compared the effects of various nutritional interventions at different phases of the menstrual cycle (61). In the absence of robust scientific evidence, female athletes are targeted on social media for training and nutrition advice related to “cycle syncing” and other female-specific considerations from people lacking the appropriate education, credentials, and scientific basis to provide nutrition advice.

Nutrition misinformation can harm an athlete’s health or performance, with studies indicating that up to 47% of female athletes may be at risk of inadequate caloric intake due to inconsistent recommendations (3). In addition, female athletes are more likely to experience Relative Energy Deficiency in Sport (REDs), a mismatch between an athlete’s energy intake and the energy expended in exercise, than that of male athletes (17,109). This underscores the critical role of coaches and sports dietitians in addressing nutrition considerations specific to female athletes. Regular interactions between coaching staff, sports dietitians, and female athletes provide a valuable opportunity to implement evidence-based nutrition strategies that support optimal performance and health.

AIMS AND METHODS OF THE NARRATIVE REVIEW

The recent publications of a systematic review (61) and other narrative reviews examining nutrition recommendations for active women and female athletes (43,70,92,95,113) have highlighted the need to comprehensively examine the available studies evaluating the role of nutrition in female athletes. Therefore, this narrative review will focus on physiology and nutrition recommendations specific to strength and conditioning, providing practitioners and female athletes with fundamental background knowledge and understanding of nutritional considerations related to optimal performance and health. To this end, the article is organized into the following major sections: (a) sex differences and strength and conditioning, (b) nutritional considerations for female athletes participating in strength and conditioning, (c) dietary supplementation, and (d) practical application. A literature search of peer-reviewed articles was performed using PubMed and Google Scholar to identify relevant articles to include in this narrative review. Studies were reviewed if they examined recreationally active to elite athletes, reported nutrition information related to strength and conditioning performance, and were specific to women.

In this article, the words “woman,” “women,” and “female” are used. These terms refer specifically to cisgender women aged older than 18 years who are premenopausal. This interpretation is based on existing research literature and aligns with self-identified gender identity. Currently, research on this topic, which includes all individuals who identify as female and participate in sports, regardless of gender identity or expression, is limited.

SEX DIFFERENCES AND STRENGTH AND CONDITIONING TRAINING

Strength and conditioning improves athletic performance and reduces injury risk through periodized strength training, weightlifting, plyometrics, flexibility exercises, and physical assessments (39). While approaches vary by sport, strength training remains fundamental for enhancing bone density (44), body composition (76,77), and strength and power (39). Both men and women gain muscle size and strength from strength training (45,77,87), while absolute strength gains tend to be greater in men. However, studies show similar relative increases in strength and hypertrophy between sexes (2,45,50,87,110), with some suggesting women may experience greater relative strength gains (1,48,50,76,85,87,99). In a randomized controlled 12-week progressive dynamic resistance training trial of 580 adults (342 women, 243 men), women gained significantly more relative isometric strength and dynamic strength with resistance training than men (22 versus 16%, and 64 versus 40%, respectively) (45). Women showed greater upper-body strength gains in 12 of 17 studies examining sex differences in response to identical strength training programs, while hypertrophy and lower-body strength gains were similar between sexes (87). Taken together, sex differences in response to strength training exist, underscoring the need for tailored training programs and nutrition recommendations that maximize these benefits in female athletes.

PHYSIOLOGICAL AND METABOLIC DIFFERENCES BETWEEN SEX

Sex differences in skeletal muscle influence exercise performance and adaptability (5). Men generally have more skeletal muscle mass (12), greater glycolytic capacity (65,88), and faster contractile properties (32), leading to higher maximal strength. By contrast, women have a higher proportion of type I muscle fibers (86), greater oxidative capacity (88), and enhanced mitochondrial function (19), contributing to superior fatigue resistance and ATP resynthesis through oxidative phosphorylation (5,32). These phenotypical sex differences also affect metabolic thresholds during exercise, which can affect nutrient timing and nutritional recommendations for female athletes.

Recent reviews have shown variations in whole-body metabolism in response to the cyclical fluctuations of female sex hormones, estrogen, and progesterone, during the menstrual cycle (37,92,113) and the potential impact of hormonal contraception on metabolism at rest and during exercise (16,92) (Figure 1). Regarding muscle metabolism during endurance exercise, women tend to oxidize more fat but less carbohydrate and amino acids than men, often leading to a glycogen sparing effect (102,103). Muscle protein synthesis and degradation rates are similar in men and women both at rest (30) and in response to resistance training (111) when normalized to total lean mass. Six days of controlled resistance exercise in active women stimulated muscle protein synthesis, but there was no effect of menstrual cycle phase on either resting or exercise-stimulated muscle protein synthesis or degradation (22). While anaerobic metabolism generally occurs at a lower capacity in women compared with men, women tend to use less glycogen during resistance exercise (40,59). A study analyzing muscle glycogen utilization through muscle biopsies in men and women found that women in the luteal phase used 18% less muscle glycogen than men after 90 minutes of cycling at 65% ${\dot{\text{V}}}_{{\text{O}}_{2\text{peak}}}$ (26). Understanding how female athletes use carbohydrates, fats, and protein during anaerobic exercise is an important foundation for nutrition recommendations in strength and conditioning.

Figure 1.

Metabolic considerations related to fluctuations in estrogen (black line) and progesterone (dashed line) across the eumenorrheic menstrual cycle with key metabolic adaptations descripted for the follicular and luteal phase (16,80,113). These metabolic differences between cycle phases may affect nutritional requirements for strength and conditioning female athletes.

PREGNANCY

Research demonstrates resistance training is not only safe but also beneficial for pregnant women (27). Pregnancy introduces significant physiological changes, including increased energy demands (72), altered nutrient requirements (51,75), changes in cardiovascular function (28), hormonal shifts, and fluctuations in metabolic rate (72) that can affect nutritional requirements during strength and conditioning training. Adequate nutrition intake for pregnant athletes is vital as the athlete’s nutritional status not only influences the pregnant person’s health but also pregnancy outcomes and the health of the fetus. During pregnancy, energy requirements remain similar to those of nonpregnant people in the first trimester but increase by approximately 340 calories per day in the second trimester and by 452 calories per day in the third trimester (29,54). Pregnant athletes may require even greater caloric intake to ensure proper body function and weight gain throughout each trimester due to exercise’s energy demands. Pregnant athletes may struggle to meet caloric and macronutrient needs due to nausea, food aversions, heightened satiety, and digestive discomfort, which can make it challenging to consume sufficient energy and key nutrients for both performance and fetal development. Alongside taking a prenatal vitamin to meet micronutrient needs, creatine monohydrate supplementation may be beneficial in pregnant athletes for its safety and potential performance enhancement (94). A prospective cohort study found dietary creatine aided in maintaining creatine concentrations throughout pregnancy and did not adversely affect fetal growth (25). Postpartum athletes should also be mindful of increased caloric needs, as breastfeeding can require an additional 500 calories per day (54).

Coaches and dietitians play an important role in supporting pregnant athletes by adapting training plans, monitoring caloric intake, and providing emotional and physical guidance to navigate body changes. Coaches may need to modify strength and conditioning training programs from vigorous activity to moderate or light activity to account for the increased demands of pregnancy, focusing on maintaining fitness while ensuring the safety and well-being of both mother and fetus (27,31). Sports dietitians can assist by calculating accurate caloric requirements to ensure pregnant athletes meet their energy needs, including additional nutrients for fetal development and maternal health. In addition, pregnancy can bring physical transformations that may affect an athlete’s confidence, so addressing body image changes is essential.

NUTRITIONAL CONSIDERATIONS FOR FEMALE ATHLETES IN STRENGTH AND CONDITIONING

Coaches, dietitians, and health care providers who work with female athletes must be aware of REDs and its association with low energy availability (EA) (17). REDs negatively affects health by suppressing metabolism, reproductive function, and musculoskeletal, immune, and cardiovascular health (73). The condition stems from low EA, defined as inadequate caloric intake relative to exercise expenditure, with <30 kcal/kg fat-free mass/day as a diagnostic threshold in women (63). This can result from insufficient caloric intake, increased exercise, or both. The recommendation for athletes to avoid low EA is to consume approximately 45 kcal per kg of fat-free mass (63,64). Subclinical low EA (30–45 kcal per kg of fat-free mass) may be tolerated for short periods of time during a well-constructed weight loss program (17,43). Strength and conditioning is recommended during return to performance for athletes experiencing REDs, so coaches must be aware of nutritional needs (11).

CALORIC INTAKE

The significant contribution of anaerobic metabolism makes quantifying energy expenditure of resistance exercise challenging. Doubly labeled water and indirect calorimetry accurately assess energy expenditure (112), but due to limited access, predictive equations serve as practical alternatives. An analysis of 1,430 active participants using 11 different resting metabolic rate prediction equations found variations in accuracy and precision, highlighting the importance of selecting equations based on populations with similar characteristics (78). Wearable devices estimating caloric expenditure are popular among athletes, yet 4 of 5 validation studies found either poor correlation or significant differences in absolute energy expenditure values between monitors and indirect calorimetry following resistance exercise (69,89).

While not as commonly used in sports nutrition, the 2023 Dietary Reference Intakes (DRI) for Energy, based on doubly labeled water, may allow for more accurate caloric estimations across the female lifespan (e.g., adolescence, pregnancy). By incorporating physical activity levels and life stages, these equations are a practical tool for coaches, athletes, and sports dietitians working with a variety of female athletes (1) (Table 1). For example, a 21-year-old female strength and conditioning athlete who is 5 feet 7 inches (170 cm) and weighs 160 pounds (72.7 kg) would be considered active (physical activity level 1.6–1.9) (105). Thus, her total energy expenditure (TEE) would be approximately 2,570 calories per day [TEE 5 710.25 – (7.01 × 21) + (6.54 × 170) + (12.34 × 72.7)]. A study examining the accuracy of the DRI equations, compared with doubly labeled water, in female tennis athletes found there was only a 1% difference in the measurement of calories per day, with the DRI slightly underestimating energy expenditure (−74 calories/day), highlighting the accuracy of using these predictive equations in a female athlete population (74).

Table 1.

Total daily energy expenditure (TEE) equations for females by life-stage group from the 2023 Dietary Reference Intakes (1). These prediction equations estimate dietary intake to maintain energy balance in healthy, normal weight individuals of a defined age, gender, weight, height, and level of physical activity consistent with good health. These equations include variability in physical activity by incorporating physical activity level (PAL), representing four categories as sedentary, low active, active, and very active as a variable. Most strength and conditioning female athletes should be considered active. In the cases of pregnancy, lactation, and childhood (birth to 18 years of age), the committee also incorporated into the equations an allowance for growth, tissue accretion, and milk production in addition to TEE.

Girls, 3–18 years
Inactive	TEE = 55.59 – (22.25 × age) + (8.43 × height) + (17.07 × weight)
Low active	TEE = − 297.54 – (22.25 × age) + (12.77 × height) + (14.73 × weight)
Active	TEE = − 189.55 – (22.25 × age) + (11.74 × height) + (18.34 × weight)
Very active	TEE = − 709.59 – (22.25 × age) + (18.22 × height) + (14.25 × weight)
Women, 19 years and above
Inactive	TEE = 584.90 – (7.01 × age) + (5.72 × height) + (11.71 × weight)
Low active	TEE = 575.77 – (7.01 × age) + (6.60 × height) + (12.14 × weight)
Active	TEE = 710.25 – (7.01 × age) + (6.54 × height) + (12.34 × weight)
Very active	TEE = 511.83 – (7.01 × age) + (9.07 × height) + (12.56 × weight)
Pregnant women in their second and third trimester of pregnancy
Inactive	TEE = 1,131.20 – (2.04 × age) + (0.34 × height) + (12.15 × weight) + (9.16 × gestation)
Low active	TEE = 693.35 – (2.04 × age) + (5.73 × height) + (10.20 × weight) + (9.16 × gestation)
Active	TEE = − 223.84 – (2.04 × age) + (13.23 × height) + (8.15 × weight) + (9.16 × gestation)
Very active	TEE = − 779.72 – (2.04 × age) + (18.45 × height) + (8.73 × weight) + (9.16 × gestation)

TEE = total energy expenditure; kcal/d = kilocalorie per day; TEE is in kilocalories/day; age is in years; weight is in kilograms; height is in centimeters; gestation is in weeks; inactive = physical activity level (PAL) ≥1.0 <1.4 (sedentary); PAL ≥1.4 <1.6 (low active); PAL ≥1.6 <1.9 (active); PAL ≥1.9 <2.5 (very active).

If coaches and dietitians have access to body composition measures using devices such as dual-energy X-ray absorptiometry, bioelectrical impedance, or waist-to-hip ratio measurements, energy requirements can be estimated more accurately (1,83). Recent prediction models based on doubly labeled water data from 3 independent adult databases show that incorporating waist circumference or fat mass improves accuracy, even without known physical activity levels (83). The models were programmed into a user-friendly web-based app available at http://www.pbrc.edu/research-and-faculty/calculators/energy-requirements/.

With regard to the menstrual cycle, resting energy expenditure is slightly increased during the luteal phase when compared with the follicular phase and with oral contraceptive use. However, these effects are small (+42 to +46 kcal/d) (16,24,53). Female athletes may be encouraged to consume slightly more calories during the luteal phase or if using oral contraceptives, particularly if hunger or fatigue are increased.

CARBOHYDRATES

Carbohydrates serve as the primary energy source for high-intensity activities (60–100% of ${\dot{\text{V}}\text{o}}_{\text{2}}\text{max}$), fueling muscle contractions during exercise (9,14). In a study on 6 eumenorrheic women, a high-carbohydrate diet (78% of total calories) increased preexercise muscle glycogen (+84 mmol/kg dry muscle), net glycogen utilization (+75 mmol/kg dry muscle), and extended cycling performance by 9 minutes at 80% ${\dot{\text{V}}\text{o}}_{\text{2}}\text{max}$ during the luteal phase when compared with a moderate-carbohydrate diet (48% carbohydrate) (108). However, other studies suggest that while high-carbohydrate intake (6–10 g/kg body weight) improves muscle glycogen levels in women, it may not enhance performance when glycogen depletion is minimal (61,66,84). As such, the intensity and duration of strength training sessions are important considerations for estimated carbohydrate needs.

Despite recent reviews articulating the importance of carbohydrate availability during aerobic exercise for performance and prevention of REDs (56,62,92), research examining carbohydrate intake for strength training is limited. Carbohydrate recommendations for male and female strength athletes range from 4 to 7 g/kg/d (47,58,93) (Table 2), which is similar to endurance athletes (6–12 g/kg/d) (14). Reported intakes for female athletes vary from 2.8 to 3.6 g/kg/d in bodybuilders (41,57) and 4.2– 8.0 g/kg/d in male strength athletes (42). Across 49 studies, higher carbohydrate intake did not enhance strength performance in 13 acute trials but showed benefits in 6, mainly when compared with fasted groups or during high-volume training (10+ sets per muscle group) (42). For female strength athletes specifically, a high-carbohydrate diet may not be optimal (107). Research indicates that women use significantly less muscle glycogen during strength training than men (10), suggesting carbohydrate loading before training or competition may be unnecessary. Instead, prioritizing protein intake is crucial, as excessive carbohydrate consumption could reduce protein intake needed for muscle repair and growth.

Table 2.

Recommendations for daily and exercise carbohydrate intake (47) for both male and female athletes. New research that considers ovarian hormones and sex-based differences suggests there may be future recommendations specific to fueling female athletes (56). Based on the current literature, strength and conditioning female athletes should consume 3-7 gram/kg/d of carbohydrates depending on the duration and intensity of their weekly exercise.

Daily Carbohydrate Target Based on Type of Activity
Low intensity or skill-based activities	3-5 gram/kg of body weight
Moderate exercise program (≤ 1 hour/day)	5-7 gram/kg of body weight
Endurance program (1-3 hours/day of moderate to high intensity exercise)	6-10 gram/kg of body weight
Extreme Commitment (≥ 4-5 hours/day of moderate to high intensity exercise)	8-12 gram/kg of body weight
Strength and power exercise programs	4-7 gram/kg of body weight
Training Carbohydrate Target Based on Time of Activity
Maximal exercise lasting less than 45 minutes	None required
Maximal exercise lasing about 45-60 minutes	Less than 30 grams/hour
Team sports lasting about 90 minutes	Up to 50 grams/hour
Submaximal exercise lasting more than 2 hours	Up to 60 grams/hour
Near-maximal and maximal exercise lasting ≥ 2 hours	Up to 70 grams/hour
Ultra endurance events	60-90 grams/hour

Depending on training intensity and daily activity levels, female strength athletes should aim for 3–7 g/kg of body weight from low-glycemic, fiber-rich carbohydrate sources. If female athletes feel fatigued during strength and conditioning sessions, ingesting carbohydrates at a rate of 30–60 g/h during exercise has been recommended (92). This approach supports overall health and strength performance while ensuring adequate carbohydrate intake (15). Carbohydrate supplementation such as liquid, gels, and powders may be necessary if female athletes experience difficulty consuming the required carbohydrates through whole foods.

FAT

While the role of dietary fats in all athletes has long been debated, dietary fats are essential for sustaining energy and facilitating hormonal functions critical to athletic performance and overall health (91,106). Estrogen enhances fat metabolism by stimulating lipolytic enzymes (37,115), with fat oxidation peaking in the late follicular and midluteal phases (37,80). During the luteal phase, elevated estrogen levels increase lipolysis and fat reliance, particularly during submaximal exercise (35–60% ${\dot{\text{V}}\text{o}}_{\text{2}}\text{max}$) (37,38). Compared with men, female muscle exhibits higher adipocyte lipolysis, as well as greater intramyocellular lipid content and use during exercise (20,104). Thus, high fat diets may be advantageous for female strength athletes to complement energy production derived from intramyocellular lipid content and circulating lipids while concurrently sparing muscle glycogen.

Based on general recommendations for female athletes, at least 15% but ideally 20% of total calories should be from fat (107,113). Athletes are typically advised to consume around 1 g/kg body weight per day during weight maintenance, with a range of 0.5–1 g/kg body weight if the goal is body fat loss (53). For female athletes at risk of low EA, dietary fat is especially beneficial due to its high energy density, which can help achieve a positive energy balance. Athletes should prioritize unprocessed sources of fat limiting trans-fats and saturated fats to under 10% of intake (91,101,106). A focus should be placed on maintaining an omega-6 to omega-3 ratio of 4:1 and consuming 1.2–1.6 g/d of omega-3s, particularly as they are important for reducing postexercise inflammation (90,91,101). An intervention in active women consisting of a diet rich in n-3 polyunsaturated fatty acids (≥500 g/wk of fish and seafood) combined with resistance training reported a significant increase in the hypertrophy of fast type IIA skeletal muscle fibers (+23%), an upregulation of mTOR in skeletal muscle and a downregulation of IL-1b, in comparison with resistance training only, highlighting the potential for polyunsaturated fats to positively affect skeletal muscle hypertrophy (100).

PROTEIN

Dietary protein plays a key role in regulating skeletal muscle mass by balancing muscle protein breakdown and muscle protein synthesis. Adequate protein intake, particularly during strength training, is essential to ensure that muscle protein synthesis matches or exceeds muscle protein breakdown, helping to maintain muscle mass. During exercise, women oxidize less protein than men (59), possibly due to the influence of estrogen. Some studies indicate that the oxidation of amino acids such as phenylalanine, lysine, and leucine is higher in the luteal phase than in the follicular phase (14,36,52), while a more recent study demonstrated no differences between cycle phases in whole body muscle protein synthesis (22). Strength training and adequate protein intake both stimulate muscle protein synthesis (81,82). Protein turnover and basal muscle protein synthesis rates are similar between young men and women (30,81,82,97,98), suggesting that, while studies on female athletes’ protein needs across the menstrual cycle or with hormonal contraceptives are lacking, women may respond similarly to protein intake and strength training.

In combination with resistance training, consistent protein consumption and supplementation in women can enhance fat-free mass and maximize strength gains (15,19,84,106,113). Team-sport female athletes benefit from higher protein intake, showing improved recovery, strength, and agility, particularly after intensive training camps or competitions (12,105,115,116). Similar to recommendations for men, higher protein intakes (>2.0 g/kg/d) combined with heavy resistance training are important for preserving lean mass and resting energy expenditure during both intentional and unintentional caloric restriction, which is common among recreational to elite female athletes (7,92).

The estimated average protein intake requirement for eumenorrheic recreationally active and/or competitive female athletes is similar across different exercise types: 1.3–1.6 g/kg/d for aerobic endurance, 1.5 g/kg/d for resistance exercise, and 1.4 g/kg/d for intermittent exercise (1,68,92). These values fall within the midrange of current sports nutrition guidelines (1.4–2.0 g/kg/d) (Table 3) (68). Regularly consuming protein rich in essential amino acids, especially at least 2.5 g of leucine per serving, is crucial for optimizing protein synthesis and minimizing muscle protein breakdown (49,79,114) (Figure 2). Timing protein intake, particularly consuming it soon after resistance training, enhances muscle protein synthesis, supports muscle repair and growth, and optimizes recovery (13,21,49,68). Pre-exercise and postexercise protein intake recommendations of 0.32–0.38 g/kg are advised to support beneficial adaptations in both recreational and competitive female athletes (92). Consuming a small amount of protein (10–15 grams) before sleep can reduce the muscle protein breakdown that occurs overnight.

Table 3.

Recommendations for daily and exercise protein intake for male and female athletes based on type of activity or sport (49,68). Minimal research has explored the endogenous and exogenous hormonal effects on the protein needs of female athletes, but protein needs in female athletes appear similar to those of male athletes. Strength and conditioning female athletes should consume a minimum of 1.5 g/kg of body weight with an emphasis on pre- and post-exercise consumption of .32–0.38 g/kg.

Daily Protein Target Based on Type of Activity
Sedentary	1.2 gram/kg of body weight
Recreational exerciser	1.2 - 1.6 gram/kg of body weight
Aerobic endurance exercise	1.3 - 1.6 gram/kg of body weight
Resistance exercise	1.5 - 1.8 gram/kg of body weight
Intermittent, high intensity training	1.4 - 1.8 gram/kg of body weight
Weight-restricted sports	1.4 - 2.2 gram/kg of body weight
Training Protein Target Based on Sport
Team sports	1.2-1.7 gram/kg of body weight
Endurance	1.2-1.4 gram/kg of body weight
Strength	1.6-1.7 gram/kg of body weight
Power	1.5-1.7 gram/kg of body weight

Figure 2.

Muscle protein synthesis (MPS; solid lines) and muscle protein breakdown (MPB; dashed lines) in response to grams of protein consumed per meal. Muscle protein synthesis response is related to bolus of protein consumed. By consuming protein shortly after resistance training, female athletes can maximize muscle protein synthesis, promote muscle repair and growth, and enhance recovery. Sleep leads to increased muscle protein breakdown. Modified from Oikawa et al. (79).

DIETARY SUPPLEMENTATION

Ergogenic aids and supplementation can complement a female athlete’s nutrition to enhance energy, performance, and recovery. While the use of β-alanine, caffeine, creatine, glycerol, nitrate/beetroot juice, and sodium bicarbonate are identified by expert groups as evidence-based products that increase athletic performance, women account for only 23% of participants in studies, highlighting how specific support for their use by female athletes is lacking in quantity and quality (96). Nevertheless, recent reviews by Wholgemuth et al. (113), Sims (92), and Smith-Ryan et al. (95) provide detailed exploration into dietary supplements that may be beneficial for recreational women and female athletes. Thus, this section will provide a brief overview of the 3 commonly used supplements by female athletes: caffeine, creatine, and protein powders (4,96).

CAFFEINE

There is substantial research supporting the benefits of caffeine use for enhancing aerobic and sprint performance, reducing exercise-induced pain and fatigue, and promoting fat metabolism (33,36). The recommended dose is typically 3–6 mg/kg of body weight, consumed about 60 minutes before aerobic or anaerobic exercise (36). For instance, a 150-pound (68 kg) female athlete might consume between 204 and 408 mg of caffeine, depending on her fatigue level and the exercise session’s duration and intensity. Caffeine sources include coffee, tea, energy drinks, supplements, gels, gum, and aerosols, but athletes should be mindful of the calorie content in these products and recognize that increasing caffeine doses beyond recommended ranges does not consistently improve performance and may lead to adverse effects. Notably, there are currently no specific guidelines for caffeine use based on menstrual cycle phases or hormonal contraceptive use, as most studies have not accounted for these factors. However, early research suggests that caffeine elimination may slow during the luteal phase and with oral contraceptive use, potentially intensifying its effects (60).

CREATINE MONOHYDRATE

Creatine monohydrate is one of the most commonly studied ergogenic aids, with over 500 peer-reviewed publications. Recently, it has gained attention for providing unique benefits to women for improving strength and aerobic exercise performance, having a positive effect on mood and cognition, and possibly restoring brain energy levels and homeostasis (94). Creatine monohydrate supplementation has resulted in improvements in average power and peak power during high intensity exercise in trained male athletes (23,34), with similar results in female athletes. Importantly, during high intensity exercise in the luteal phase, creatine monohydrate improved fatigue measures compared with placebo (+6% improvement in fatigue index) (34). Creatine monohydrate supplementation does not appear to increase body weight between menstrual cycle phases and instead may improve fluid balance during the luteal phase (+0.8 L) (71). Currently, evidence shows consistent recommended dosage amounts for male and female individuals. Creatine monohydrate supplementation typically follows a pattern of a loading dose of ~20 g per day for 5 days (4 × 5-g doses taken every 4 hours), followed by 3–5 g per day (55). Other recommendations suggest that a loading phase may not be necessary and simply taking 5 grams per day is sufficient (6).

PROTEIN SUPPLEMENTATION

As strength and conditioning female athletes have increased protein needs (~1.6 g/kg/d), protein supplementation can aid in meeting daily protein requirements. It is important to note that most previous studies used high biological value protein sources, such as whey or egg-based proteins, which are known to maximize postexercise muscle protein synthesis in male athletes compared with plant-based sources (49,68). As women exhibit similar protein synthesis responses to protein intake and exercise as their male counterparts, most effective protein supplementation sources may also result in similar benefits in women. According to the ISSN position stand (49), whey and casein proteins have the greatest bioavailability when compared with protein alternatives (e.g., plant sources), although it is unclear whether 1 type provides any greater benefits over the other for female athletes. Importantly, most whey protein sources include ~2.5 grams of leucine per serving, which has been considered a “trigger” for muscle protein synthesis (114). Other protein supplementation sources, such as collagen peptides, essential amino acids, and plant-based proteins, may provide additional benefits for protein synthesis when paired with other protein sources (7,52,116).

PRACTICAL APPLICATIONS

Practitioners working with female athletes must understand nutrition considerations specific to women to optimize strength and conditioning training and performance outcomes. Female athletes experience unique physiological fluctuations, particularly related to the menstrual cycle and pregnancy, which influence energy metabolism, nutrient requirements, and recovery strategies (16,38,67). For example, a coach or dietitian working with a eumenorrheic strength and conditioning female athlete might prioritize slight increases in carbohydrate and fat intake during the late luteal phase and early follicular phase to support energy levels and recovery. Adequate protein intake across the menstrual cycle with a focus on protein timing (pre-exercise and postexercise) may counteract increased muscle breakdown from exercise or protein oxidation. In addition, practitioners working with female athletes should prioritize caloric intake, as inadequate energy and carbohydrate intake can lead to hormonal imbalances, menstrual irregularities, and impaired bone health.

By being proactive in understanding these sex-specific nutritional needs, professionals can better support strength and conditioning female athletes in achieving peak performance, reducing injury risk, and promoting overall health and well-being. Nutrition research in strength and conditioning female athletes is limited by small sample sizes, menstrual cycle variability, and the under-representation of elite athletes, making it difficult to develop precise recommendations. Future research should focus on longitudinal studies that account for hormonal fluctuations, training demands, and sport-specific needs to optimize nutrition strategies for female athletes.

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Biography

Hannah E. Cabre, PhD, RDN is a postdoctoral fellow at Pennington Biomedical Research Center and a registered dietitian who specializes in in sports nutrition and female physiology research.