Sex Differences in Resistance Training: A Systematic Review and Meta-Analysis

Roberts, BM, Nuckols, G, and Krieger, JW. Sex differences in resistance training: A systematic review and meta-analysis. J Strength Cond Res 34(5): 1448-1460, 2020-The purpose of this study was to determine whether there are different responses to resistance training for strength or hypertrophy in young to middle-aged males and females using the same resistance training protocol. The protocol was pre-registered with PROSPERO (CRD42018094276). Meta-analyses were performed using robust variance random effects modeling for multilevel data structures, with adjustments for small samples using package robumeta in R. Statistical significance was set at P < 0.05. The analysis of hypertrophy comprised 12 outcomes from 10 studies with no significant difference between males and females (effect size [ES] = 0.07 ± 0.06; P = 0.31; I = 0). The analysis of upper-body strength comprised 19 outcomes from 17 studies with a significant effect favoring females (ES = -0.60 ± 0.16; P = 0.002; I = 72.1). The analysis of lower-body strength comprised 23 outcomes from 23 studies with no significant difference between sexes (ES = -0.21 ± 0.16; P = 0.20; I = 74.7). We found that males and females adapted to resistance training with similar effect sizes for hypertrophy and lower-body strength, but females had a larger effect for relative upper-body strength. Given the moderate effect size favoring females in the upper-body strength analysis, it is possible that untrained females display a higher capacity to increase upper-body strength than males. Further research is required to clarify why this difference occurs only in the upper body and whether the differences are due to neural, muscular, motor learning, or are an artifact of the short duration of studies included.