I came across some research recently that actually blew my mind.
I had been reading about longevity science, the rapidly growing field studying how we might live not only longer, but remain healthier for more of those years.
It is difficult to spend much time online now without coming across it. There are podcasts about biological age, articles about reversing ageing, supplements claiming to support longevity and experts debating everything from protein and fasting to strength training and cold-water immersion.
Longevity has become big business too. One industry report calculated that global investment in longevity companies reached US$8.49 billion in 2024, more than double the previous year.
Some of this research is genuinely exciting. I am 70. I walk regularly, ride my bike and do Pilates, and I want to remain active for many years. Of course I am interested in anything that might help us maintain our strength, mobility, independence and mental sharpness as we grow older.
But what startled me was discovering how little of the research underpinning our understanding of exercise and healthy ageing has been conducted specifically on active women, particularly active women in midlife and beyond.
You may have seen claims that only one percent of longevity research is conducted on active women. I could not find credible evidence to support that precise figure, and I do not want to repeat a dramatic statistic simply because it makes a good headline.
The figures we do have come mainly from sport, exercise and physiology research, rather than an audit of the entire longevity field. They cannot tell us exactly how well active older women are represented across all longevity research. But exercise is an important part of healthy ageing, and the gaps in this evidence are concerning enough.
Women remain underrepresented in exercise and physiology research. Studies often fail to analyse women’s results separately from men’s. And once we narrow the focus from “women” to active postmenopausal women in their 60s, 70s and beyond, the evidence becomes thinner still.
It made me wonder: if women generally live longer than men, why do we still know so little about how active women age?
Women are included in the research, but that is not the whole story
At first glance, the figures do not look quite as alarming as the “one percent” claim.
A study published in 2023 examined 972 research papers involving nearly three million participants in three major exercise science and physiology journals. It compared papers published in 1991 with those published in 2021 and found that women’s representation had increased between those two years.
That sounds encouraging.
However, in 2021, women still made up an average of only 36.3 percent of participants per paper. In studies with smaller datasets, defined as fewer than approximately 3,000 participants, the average was slightly lower, at 35.6 percent.
Another major review of sport and exercise research, examining papers published between 2014 and 2020, found a similar imbalance. Women accounted for 34 percent of participants, while male-only studies substantially outnumbered female-only studies.
A separate audit, published in 2025, found some progress. Across research published from January 2021 to August 2023, women represented nearly 44 percent of all participants. Yet only about 7 percent of studies involved women exclusively, compared with almost 19 percent that studied men alone.
The 44 percent figure is not directly comparable with the earlier 36.3 percent figure. One counts participants across all studies combined; the other is an average percentage per paper. The audits also cover different selections of journals.
Numbers alone do not tell the full story, either.
A study may include both women and men but still not be designed to discover whether they respond differently. If women form a relatively small part of the group, researchers may not have enough data to analyse their results separately.
Women may be present in the room, in other words, without their experience being clearly visible in the findings.
The research becomes thinner as the questions become more specific
Researchers writing in the British Journal of Sports Medicine have specifically called attention to the “invisibility” of women in midlife and beyond within sport and exercise science. The phrase stayed with me because invisibility is exactly what appears to happen.
We start with research into human health. We then look at research involving women. We narrow it further to women who exercise regularly, then to postmenopausal women, and finally to active women in their 60s, 70s and 80s.
The more specific the question becomes, the harder it can be to find research that directly reflects the women we are asking about.
A systematic review examining how older women and men respond to exercise found only 19 eligible studies that reported results in a way that allowed the researchers to compare the sexes. Across those studies, women accounted for just 33.7 percent of participants. The findings suggested there may be some differences in responses, but the studies varied considerably, making firm conclusions difficult.
This does not mean we know nothing about exercise and older women. We have strong general evidence that physical activity matters for healthy ageing, and emerging research continues to examine its effects in women over 60.
But it does mean there are still gaps when we ask more precise questions.
Does an active 70-year-old woman respond to strength training in the same way as a sedentary woman of the same age? Does a lifetime of cycling, walking or dancing change how her body responds to a new exercise program? Do older women need different combinations of strength, aerobic activity and recovery? What difference do menopause, hormone therapy, previous injuries and muscle loss make?
These are not small or obscure questions. They are questions millions of women might reasonably expect longevity research to answer.
Medical research has a long history of treating men as the default
The problem is not unique to longevity or exercise science.
For much of modern medical history, research frequently focused on male participants and then applied the findings to everybody. Women were sometimes considered too complicated to study because menstrual cycles and fluctuating hormones might introduce additional variables.
There were also understandable concerns about exposing a pregnant woman or developing baby to an experimental drug. In 1977, for example, US Food and Drug Administration guidance recommended excluding women of childbearing potential from Phase I and early Phase II drug trials, even if they used contraception or were unlikely to become pregnant.
In the United States, it was not until 1993 that the inclusion of women in clinical research funded by the US National Institutes of Health (NIH) became a legal requirement.
When you stop and think about that, 1993 is not very long ago.
By then, I was well into my working life. Yet medical treatments had been developed, tested and prescribed to women using an evidence base that often treated the male body as the standard human body.
We now know that this assumption was far too simplistic.
Women and men share far more biologically than they differ, of course. This is not an argument that every health recommendation needs a pink and blue version. Nor should we assume that every difference between women and men is biological. Our health is also influenced by work, caregiving, income, culture, opportunity, stress and the lives we have led.
But physical differences do matter. So it seems reasonable to ask whether those differences might also affect how we age.
Menopause changes the picture again
For women, ageing is not simply the gradual passing of time.
Menopause brings a significant hormonal transition that may affect bone density, muscle mass, fat distribution and cardiovascular health. These changes do not happen in isolation. They occur alongside all the other influences on our health, including movement, nutrition, sleep, genetics, stress and previous illness.
And yet researchers have highlighted inconsistent reporting of menopausal status and hormone-therapy use in this field. That seems an extraordinary omission when we are trying to understand how women age.
Even when postmenopausal women are included, researchers may not record whether they use hormone therapy, how physically active they were before the study or how long they have been exercising.
An active older woman is not simply an older version of a young woman. Nor is she a smaller version of an older man.
She arrives at later life with her own biological history and decades of accumulated experiences. She may have raised children, worked under considerable pressure, cared for ageing parents, moved through menopause and adapted her exercise around injuries, illness and the competing demands of life.
Some women will have exercised for decades. Others may be discovering movement for the first time at 65. Placing them in the same broad category of “older women” can conceal differences that may be highly relevant.
Being active may change what ageing looks like
This is the part that interests me most personally.
I do not exercise because I am trying to become younger. I exercise because I want to keep participating in my life.
I want the energy for the life I am living: writing about retirement transitions, travelling, spending time with my family, walking and riding. I also want to keep managing the ordinary physical demands of everyday living. I am less interested in adding years to life at any cost than I am in protecting the quality of the years I have.
That is the distinction between lifespan and healthspan. Lifespan is how long we live. Healthspan is how long we remain reasonably healthy, capable and engaged.
Longevity science increasingly talks about both. Yet if we genuinely want to understand healthspan, surely we need to study people who are already doing many of the things believed to support it.
An active older woman may have different cardiovascular fitness, muscle strength, balance and metabolic health from a sedentary woman of the same age. Her response to an exercise intervention may also be different because she is beginning from a different place.
This does not necessarily mean she will respond better. It means we should not automatically assume the average result from a mixed group describes her accurately.
The argument is not that active older women are entirely biologically unique or that existing health advice is useless to us. It is that we deserve evidence precise enough to show where the similarities end and meaningful differences begin.
Including more women is only the beginning
Recruiting more women would be a good start, but it would not solve the problem on its own. Researchers also need to ask better questions.
How old are the women? Are they premenopausal, perimenopausal or postmenopausal? Do they use hormone therapy? How active were they before the study began? Have they exercised for six months or 40 years? Are the results analysed separately, or are they folded into one overall average?
Longer-term research would help too. Many exercise studies last for a matter of weeks or months. That can tell us how people respond to a particular program, but healthy ageing unfolds across decades.
I would love to see more studies following women as they move through midlife and into their 60s, 70s and beyond. And not only women who become unwell, frail or inactive, but those who continue being active such as walking, cycling, swimming, dancing, lifting weights or practising yoga.
What helps them remain active? What changes despite their activity? How do their needs evolve? And what can their experience teach younger women about building strength and resilience before older age arrives?
These questions may not sound as futuristic as a drug that promises to slow biological ageing. But they could have an enormous effect on how millions of women actually live.
