Abstract

Currently, the number of people living and engaging in activities at high altitude is steadily increasing. Consequently, the physiological effects of altitude exposure have been extensively investigated to protect the health of individuals exposed to these extreme environmental conditions, alongside a notable increase in female participation driven by expanding opportunities in occupational, athletic, and residential settings. In addition to established risk factors, growing evidence suggests that cardiometabolic risk factors may increase the likelihood of developing altitude-related illnesses, while women present sex-specific physiological characteristics that contribute to metabolic disorders, including the menstrual cycle, contraceptive use, pregnancy, and menopause. Furthermore, factors such as hypobaric hypoxia, the type of activity performed at altitude, lifestyle, and emotional status may result in distinct physiological responses to altitude. However, little is known about the physiological adaptations experienced by women at high altitude, particularly regarding metabolic alterations that may contribute to impaired acclimatization. Therefore, this review synthesizes current evidence on the role of cardiometabolic risk factors and associated determinants in the development and exacerbation of altitude-related illnesses in women, aiming to identify existing knowledge gaps, guide future research, and improve prevention, acclimatization, clinical management, and women's health and safety in high-altitude environments through a comprehensive assessment of current evidence.