Sex differences in response to exercise heat stress in the context of the military environment

Women can now serve in ground close combat (GCC) roles, where they may be required to operate alongside men in hot environments. However, relative to the average male soldier, female soldiers are less aerobically fit, with a smaller surface area (A D), lower mass (m) with higher body fat and a large...

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Bibliographic Details
Published in:BMJ military health 2023-02, Vol.169 (1), p.94-101
Main Authors: Corbett, Jo, Wright, J, Tipton, M J
Format: Article
Language:English
Subjects:
Armed forces
Blood
Body composition
Body fat
Body temperature
Employment
environment
Exercise
Exercise - physiology
Female
Females
Gender differences
Heat
Heat Stress Disorders
Heat-Shock Response
hot
Humans
humid
Influence
Invited review
Male
Males
Military Personnel
Physical fitness
Sex Characteristics
Skin
Thermal
Women
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Summary:Women can now serve in ground close combat (GCC) roles, where they may be required to operate alongside men in hot environments. However, relative to the average male soldier, female soldiers are less aerobically fit, with a smaller surface area (A D), lower mass (m) with higher body fat and a larger A D/m ratio. This increases cardiovascular strain, reduces heat exchange with the environment and causes a greater body temperature increase for a given heat storage, although a large A D/m ratio can be advantageous. Physical employment standards for GCC roles might lessen the magnitude of fitness and anthropometric differences, yet even when studies control for these factors, women sweat less than men at high work rates. Therefore, the average female soldier in a GCC role is likely to be at a degree of disadvantage in many hot environments and particularly during intense physical activity in hot-arid conditions, although heat acclimation may mitigate some of this effect. Any thermoregulatory disadvantage may be exacerbated during the mid-luteal phase of the menstrual cycle, although the data are equivocal. Likewise, sex differences in behavioural thermoregulation and cognition in the heat are not well understood. Interestingly, there is often lower reported heat illness incidence in women, although the extent to which this is influenced by behavioural factors or historic differences in role allocation is unclear. Indeed, much of the extant literature lacks ecological validity and more work is required to fully understand sex differences to exercise heat stress in a GCC context.
ISSN:2633-3767
2633-3775
DOI:10.1136/jramc-2019-001253