Ultra-endurance performance: Are women closing the gap? A systematic review and meta-analysis

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Abstract
Anecdotal evidence suggests that the performance gap commonly observed between men and women during traditional endurance events could be reduced during longer races. Accordingly, the aim of this study was to determine the performance gap between men and women in ultra-endurance events. A systematic search was performed in major databases until 1 st July 2024 for studies reporting the differences between top men and women in ultra-endurance events (duration ≥6 h). Only studies reporting performance in either winners or top-three athletes were considered. A random-effects meta-analysis was performed to determine the overall performance gap. A total of 15 studies met the inclusion criteria, providing performance data from 20 different events (3 swimming, 4 cycling, 7 running, 6 triathlon). Analyses revealed a performance gap of 22% (95% confidence interval 17 to 27%, p < 0.001), equivalent to a standardized mean difference of 3.21 (1.65 to 4.76, p < 0.001). A large heterogeneity was observed for the pooled differences across studies (I 2 > 95%), although similar differences were observed across sports (p > 0.1). Existing evidence shows that women do not outperform men in ultra-endurance events, and indeed a large performance gap is still observed. Given that some physiological mechanisms suggest that women might have an increased fatigue resistance, future research should confirm whether this research gap gets closer with increasing participation of women in these events.

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