310: Why Female Physiology Still Needs Greater Attention in Sport with Dr Candice Macmillan

Why Female Physiology Still Needs Greater Attention in Sport with Dr Candice Macmillan

This week on the Science for Sport Podcast, host Richard Graves welcomes Dr Candice Macmillan, lecturer at the University of Pretoria, sports physiotherapist, and course author of “Contraceptives and the Female Athlete” on the Science for Sport platform.

As women’s sport continues to grow professionally around the world, understanding the unique physiological considerations of female athletes has never been more important. Yet many practitioners still feel underprepared when supporting athletes through topics such as the menstrual cycle, hormonal contraceptives, and their potential implications for performance, wellbeing, and decision-making.

Drawing on her background as a sports physiotherapist, researcher, and academic, Dr Macmillan explores how practitioners can better support female athletes through education, communication, and evidence-based decision making.

The conversation covers the complexity of hormonal contraceptives, how different types influence physiology and behaviour, and why awareness of factors such as testosterone suppression and symptom tracking may be crucial for athletes and support staff alike.

Perhaps most importantly, Dr Macmillan explains why empowering athletes to ask the right questions about their own health may be one of the most powerful tools practitioners can provide.

This episode offers valuable insights for sports scientists, strength and conditioning coaches, physiotherapists, and performance staff working across elite sport — while also opening up a conversation that continues to shape the future of female athlete support systems.

In This Episode You Will Learn

• Why female athlete health remains one of the most misunderstood areas in elite sport
• The difference between hormonal and non-hormonal contraceptives
• Why the contraceptive pill is not a single solution and varies widely in composition
• How hormonal contraceptives can influence testosterone levels and athlete behaviour
• Why symptoms may impact performance more than hormone levels themselves
• The importance of tracking menstrual symptoms for informed medical decisions
• Why practitioners must help athletes learn the language to describe how they feel
• The role communication plays between athletes, coaches and medical staff
• How policy and education are shaping the future of female athlete support in sport

About Dr Candice Macmillan
Dr Candice Macmillan is a lecturer at the University of Pretoria, a qualified sports physiotherapist, and holds a PhD in Sports Physiotherapy.

Her work focuses on female athlete health, injury prevention, and performance, with a particular interest in how physiological factors influence training, recovery, and long-term athlete wellbeing. Through her academic and applied work, she aims to bridge the gap between research and real-world practice for practitioners working in sport.

Dr Macmillan is also the author of the “Contraceptives and the Female Athlete” course available on the Science for Sport platform, where she helps practitioners better understand the complexities of hormonal contraception and its potential implications for female athlete performance and health.

Her research and teaching continue to contribute to a growing body of work aimed at improving education, awareness, and practical support for female athletes across sport.

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