Conduct a comprehensive scoping review of sport science and medicine (SSM) research in highly trained, elite and world-class female athletes.
Scoping review.
PubMed (MEDLINE, EBSCOhost), Scopus, SPORTDiscus (EBSCOhost), Web of Science and base-search (grey literature).
Peer-reviewed and grey literature informing the health and performance of highly trained, elite and/or world-class female athletes (>16 years of age), with mixed-group studies retained when data were reported separately. Sports that require physical exertion or highly skilled movements were included. The search was restricted to English with no date limits.
3,867 (1970–2025) records including 3,250 (84%) original studies reporting 4,374,571 participants [31% female (n=1,368,170)] were reviewed. 3,221 (99%) studies included athletes [world class, n=433 (13%); elite, n=1,873 (58%); highly trained, n=1,302 (40%)] across 102 different sport disciplines from 74 different countries. 135 (4%) studies included athletes with disabilities, 58 (2%) retired and 37 (1%) masters athletes. Physiology (n=1,059 studies, 33%), performance analysis (n=947, 29%) and injury (n=820, 25%) were the most common SSM general themes; equipment (n=84, 3%), law (n=17, 1%) and business (n=8, 0%) were least common. Health-related SSM themes included musculoskeletal (n=364, 22%), mental (n=243, 15%) and cardiovascular (n=183, 11%) health; pelvic floor (n=26, 2%), breast health (n=11, 1%) and (peri-)menopause (n=2, 0%) were least common.
Research in high-performing female athletes is increasing, however persistent gaps remain in participant representation, geographical coverage and health-related themes. Targeted, co-created and multidisciplinary research approaches are needed to improve equity, relevance and impact in female athlete health and performance.