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Since only 11.5% of astronauts worldwide have been female, these issues are largely understudied. The physiological nuances affecting the female body in the spaceflight environment remain inadequately defined since the last thorough published review on the subject. A PubMed literature search yielded over 2200 publications. Using NASA's 2014 review series \u2018The effects of sex and gender on adaptation to space\u2019 as a benchmark, we identified substantive advancements and persistent knowledge gaps in need of further study from the nearly 600 related articles that have been published since the initial review. This review highlights the most critical issues to mitigate medical risk and promote the success of missions to the Moon and Mars. Salient sex\u2010linked differences observed terrestrially should be studied during upcoming missions, including increased levels of inflammatory markers, coagulation factors and leptin levels following sleep deprivation; correlation between body mass and the severity of spaceflight\u2010associated neuro\u2010ocular syndrome; increased incidence of orthostatic intolerance; increased severity of muscle atrophy and bone loss; differences in the incidence of urinary tract infections; and susceptibility to specific cancers after exposure to ionizing radiation. To optimize health and well\u2010being among all astronauts, it is imperative to prioritize research that considers the physiological nuances of the female body. A more robust understanding of female physiology in the spaceflight environment will support crew readiness for Artemis missions and beyond.<\/jats:p>","DOI":"10.1113\/ep091527","type":"journal-article","created":{"date-parts":[[2024,11,2]],"date-time":"2024-11-02T15:39:33Z","timestamp":1730561973000},"page":"3944-3967","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Women in space: A review of known physiological adaptations and health perspectives"],"prefix":"10.1113","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0756-068X","authenticated-orcid":false,"given":"Millie","family":"Hughes\u2010Fulford","sequence":"first","affiliation":[{"name":"UC Space Health University of California San Francisco (UCSF) San Francisco California USA"},{"name":"Department of Medicine UCSF San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2662-2994","authenticated-orcid":false,"given":"Danielle J.","family":"Carroll","sequence":"additional","affiliation":[{"name":"UC Space Health University of California San Francisco (UCSF) San Francisco California USA"},{"name":"Department of Surgery UCSF San Francisco California USA"},{"name":"Department of Bioastronautics University of Colorado Boulder Boulder Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2023-9337","authenticated-orcid":false,"given":"Heather C. 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