Female trail running: a systematic scoping review.

A team of researchers searched through major medical databases to map out everything we know about female trail runners. They found 22 studies involving roughly 2,500 women and discovered that most research focused on how the body responds to trail running and how nutrition affects performance, but very little looked at injury patterns or what makes some runners faster than others. The studies they reviewed were generally well done from a methods standpoint, but here is the catch: almost nobody reported whether the women were menstruating, using hormonal contraceptives, or other female-specific details that could actually matter for understanding their physiology and performance.

The review reveals that trail running research on women exists and is growing, but it is fragmented and hard to draw firm conclusions from because researchers are not measuring or reporting things in consistent ways.

If you are a woman who trail runs or thinking about starting, you should know that researchers are paying more attention to your sport and your body's needs, but there are still a lot of unanswered questions. Studies show that trail running puts real stress on your body and that what you eat and how much you weigh matter for how well you perform, but we do not yet have a clear picture of how things like your menstrual cycle affect your training or recovery.

Injury patterns in female trail runners have barely been studied, so if you get hurt, you are not alone in feeling like the information out there may not speak to your specific situation. The good news is that researchers recognize these gaps and are starting to focus on filling them, which means better guidance for women trail runners is likely coming.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This scoping review highlights a real asymmetry in the evidence base. Most studies on female trail runners have examined physiological stress markers and body composition, and these studies tend to be methodologically sound, yet they often omit or downplay menstrual cycle status and hormonal contraceptive use in their reporting.

This inconsistency makes it harder to interpret findings or to pool data across studies in a meaningful way. Injury epidemiology in female trail runners remains severely under-researched, with only four studies in the entire landscape, so current clinical understanding of sex-specific injury patterns or risk factors in this population is quite limited.

The review calls attention to the need for standardized reporting practices and longer-term investigations that specifically track hormonal influences and energy availability. This is not a call to question the quality of individual studies, but rather an acknowledgment that the field has grown somewhat haphazardly and would benefit from more intentional, consistent methodology going forward.