Why women may get more from exercise than men
Emerging research suggests women’s cardiovascular systems may respond more strongly to physical activity than men’s, raising questions about how exercise guidelines are set.
For decades, exercise guidelines have treated men’s and women’s bodies as essentially the same. But new studies suggest that assumption may be wrong. Emerging evidence shows that women often experience greater reductions in heart disease and early death from physical activity than men, and may achieve those benefits with less weekly exercise. The findings are prompting researchers to reconsider how exercise recommendations are made, and whether one-size-fits-all guidance truly reflects how different bodies respond to movement.
What does research say about sex-based differences in exercise benefits?
Two large studies published in the past two years suggest that men and women may experience different health returns from exercise—particularly when it comes to heart disease and overall mortality risk. Together, they point to a consistent pattern: women appear to gain more protection from physical activity than men do at comparable levels. Both studies use the American Heart Association’s physical activity guidelines as a baseline: 150 minutes of moderate-intensity exercise or 75 minutes of vigorous exercise per week for both sexes.
A 2024 study in the Journal of the American College of Cardiology (JACC) examined survey data about leisure-time physical activity from over 400,000 adults. After tracking nearly 40,000 all-cause deaths during the study period, researchers found that regular physical activity was associated with a 24 percent lower risk of mortality in women, compared to just 15 percent in men.
Men hit peak mortality benefit at 300 minutes of moderate-to-vigorous activity per week. Women reached similar benefits with just 140 minutes. When women reached 300 minutes, their risk dropped even further—beyond what men experienced at any level. These results were consistent across both aerobic activity and resistance training.
The researchers controlled for confounding factors like age, BMI, alcohol use, smoking, self-reported health, and access to medical care.
Cardiologists emphasize that the comparison isn’t between men and women—but between people who move and those who don’t. “It’s showing that a woman who exercises compared to a woman who doesn't exercise—the relative benefit appears greater than if you take a man who exercises compared to a man who doesn't exercise,” says Carolyn Lam, a women’s heart health cardiologist and senior consultant at the National Heart Centre of Singapore, was serving as deputy editor at JACC when this paper was published. “The comparisons are within sex, not between sex.”
More recently, a 2025 study in Nature echoed these findings using wearable data from more than 85,000 participants in the U.K. to assess coronary heart disease (CHD) incidence. Women who met the 150-minute-per-week physical activity guideline had a 22 percent lower risk of CHD, compared to 17 percent for men.
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As weekly activity increased, the gap widened further. With 250 minutes of weekly movement, women’s risk dropped 30 percent, while men needed 530 minutes to see the same reduction. They also observed lower mortality risk among patients with existing CHD.
Taken together, these findings suggest that current exercise guidelines may not fully capture how different bodies respond to physical activity—and that researchers are only beginning to understand why. Scientists also found that women typically underreport exercise compared to men, so they ran a secondary analysis to account for this and found similar results.
Why might women benefit more?
Researchers don’t yet fully understand the mechanisms, but Lam says cardiologists have a few theories. “The mechanisms likely involve multiple systems working in concert,” she says. That could include larger boosts in HDL (the “good” cholesterol), improved blood vessel function (endothelial function), and more efficient metabolic adaptations with each workout.
One likely contributor is estrogen. “There are data that show that estrogen, the woman’s sex hormone, has some cardioprotective effects,” says Lam. “It could amplify the effects of exercise on these adaptations in our blood vessels and the heart.”
A 2017 literature review explains that estrogen (specifically estradiol, or E2) helps protect the heart by improving blood flow and reducing damage. It does this by encouraging the growth of new blood vessels (angiogenesis), increasing blood flow through vasodilation, and lowering harmful byproducts, such as oxidative stress and inflammation, which can damage tissues and organs, including the heart.
That said, this doesn’t mean women should jump to get on hormone therapy. “These are postulations,” she emphasizes. “And prospective studies haven’t proven that hormone replacement therapy provides this benefit.”
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Women’s unique exercise benefits may also depend on body size, Lam says. Women’s cardiovascular systems are tuned to be efficient with a smaller heart pump and shorter vascular tree, given that women are—in general—smaller and shorter than men.
Still, Lam emphasizes that there’s a lot more that researchers don’t know, such as the precise molecular mechanism, how these effects vary across the lifespan and through menopause, and which types of exercise boost the benefits the most.
Why are these studies significant?
These findings don’t mean that, because women benefit more from lower levels of exercise than men do, they should be exercising less—far from it. In fact, they highlight the opportunities that may still be on the table. According to the Centers for Disease Control, only 20 percent of women meet the recommended 150 minutes a week, compared to 28 percent of men. While even a small amount of exercise can help reduce mortality risk, women might be missing out on even greater benefits if they increased their weekly activity level above the recommended level.
Lam says that these findings are also significant in a clinical sense: Women with conditions like coronary heart disease are less likely to be referred to cardiac exercise rehab than men. “We really do need to make a strong message that women benefit from exercise, too,” she says.
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This kind of research also builds the case for more nuanced, sex-specific exercise recommendations. Right now, the physical activity guidelines are one-size-fits-all. But men might need a higher dose than the minimum to achieve the same results.
“It’s been remarkable that in less than 60 years, we’ve gone from ‘exercise will harm you’ to discovering that women’s cardiovascular systems may be exquisitely responsive to exercise,” Lam says. “But we’re really at the beginning of understanding women’s exercise physiology as its own field, not just as a footnote to male physiology.”
