Sex differences in the physiological responses to exercise-induced dehydration: Consequences and mechanisms?

Physiological strain during exercise is increased by mild dehydration (~1-3% body mass loss). This response may be sex-dependent but there are no direct comparative data in this regard. This review aimed to develop a framework for future research by exploring the potential impact of sex on thermoregulatory and cardiac strain associated with exercise-induced dehydration. Sex-based comparisons were achieved by comparing trends from studies that implemented similar experimental protocols but recruited males and females separately. This revealed a higher core temperature (Tc) in response to exercise-induced dehydration in both sexes, however it seemingly occurred at a lower percent body mass loss in females. Although less clear, similar trends existed for cardiac strain. The average female may have a lower body water volume per body mass compared to males, and therefore the same % body mass loss between the sexes may represent a larger portion of total body water in females potentially posing a greater physiological strain. Additionally, the rate which Tc increases at exercise onset might be faster in females and induce a greater thermoregulatory challenge earlier into exercise. The Tc response at exercise onset is associated with lower sweating rates in females, which is commonly attributed to sex-differences in metabolic heat production. However, a reduced sweat gland sensitivity to stimuli, lower fluid output per sweat gland, and sex hormones promoting fluid retention in females may also contribute. In conclusion, the limited evidence suggests sex-based differences exist in thermoregulatory and cardiac strain associated with exercise-induced dehydration, and this warrants future investigations.