Impact of Sports on Female Growth and Pubertal Development: A Cohort Study

Introduction The participation of women in sports is increasing, and the rising training demands may impact growth and pubertal development. High-intensity sports are often linked to delayed growth and bone maturation due to energy deficits and intense regimens. These factors may increase the risk of injury and musculoskeletal issues. Additionally, elite athletes face higher incidences of eating disorders and the female athlete triad, affecting both physical and mental health. This article aims to examine the impact of various sports on female physiological development, particularly during puberty. Methods This retrospective observational study was conducted over six months and included female athletes aged 16-30 years involved in sports. Participants provided online consent. Data were collected through a self-administered electronic questionnaire, covering sociodemographic factors, menstrual cycle characteristics, growth patterns, pubertal development, lifestyle habits, and perceived effects on athletic performance. Responses, gathered using Google Forms® (Google LLC, Mountain View, California, United States), were analyzed using the IBM SPSS Statistics for Windows, Version 20 (Released 2011; IBM Corp., Armonk, New York, United States). Results The study included 121 female athletes (mean age: 20 years), with rugby (n=35), gymnastics (n=23), and soccer (n=22) as the most common sports. Participants generally began sports around age 11, with gymnastics athletes starting earlier than those in other sports. The median weekly training duration was six hours across three sessions, with most athletes competing nationally (n=82) or internationally (n=29). The median age at menarche was 12 years, occurring later in soccer, gymnastics, and triathlon athletes. Rugby and soccer players demonstrated greater height increases post-menarche, although seven athletes, primarily rugby players, did not reach their target familial height. Achievement of target height was significantly associated with the number of weekly training hours (p=0.019). Dietary restrictions were most common among rugby (n=7), gymnastics (n=6), and soccer (n=5) athletes. Eating disorders, primarily anorexia and bulimia, were observed in 11 athletes, particularly in rugby and gymnastics, and correlated with the age of thelarche. Injuries, notably in rugby and gymnastics, were frequent, and injury incidence was associated with the onset age of eating disorders. Conclusion This study highlights how intensive training, low-energy diets, and eating disorders negatively influence growth, pubertal development, and injury rates in female athletes. Heavy training loads combined with low-energy diets or eating disorders delay puberty, impair growth, and heighten injury susceptibility due to hormonal imbalances.