For decades, women’s health research has been underfunded and underrepresented in medical studies. Science is beginning to catch up across genetics, metabolism, oncology, neuroscience, and preventive medicine, but one area remains overlooked. Oxygen.
Oxygen is not a gender-neutral story
Understanding how women process oxygen is central to women’s health, performance and longevity. Research published in The Journal of Physiology (University of British Columbia, 2015) examined how respiratory muscles use oxygen during intense physical effort.
The study found that respiratory muscles consume 13.8% of a woman’s total oxygen during intense exertion, compared with 9.4% in men.
Women typically have:
- Lungs are approximately 10–12% smaller than those of men of equivalent height
- Conducting airways with 26–35% less luminal area, even when matched for lung size
- Lower haemoglobin concentrations, around 10–12% less than men on average, reducing total oxygen transport capacity in the bloodstream
In other words, a larger share of a woman’s oxygen supply is used simply to power breathing.
These differences mean women must dedicate more oxygen to breathing during high-demand situations. This is not a weakness. It is simply physiology.
Oxygen and the midlife transition
Oxygen is the molecule that powers almost everything in the human body. It fuels mitochondrial energy production, drives muscle performance, supports brain function and determines how efficiently tissues repair themselves. For women, oxygen metabolism becomes even more critical in midlife.
Oestrogen is not merely a reproductive hormone. It is a key regulator of mitochondrial efficiency, vascular tone and cellular energy production. Research shows that oestrogen supports mitochondrial respiration and oxidative metabolism in muscle and brain tissue.
As oestrogen declines during perimenopause and menopause, measurable physiological changes occur.
Multiple studies of ageing and aerobic capacity show that VO₂ max can decline by 10–15% per decade after midlife, with the steeper end of that range more pronounced in postmenopausal women.
Mitochondrial efficiency also slows, reducing how effectively cells convert oxygen into usable energy. At the same time, cardiovascular and metabolic changes can influence oxygen delivery throughout the body.
Oxygen, performance and healthspan
Every cell in the body depends on oxygen to do its work: to repair, to regenerate, to remain resilient. When that supply is optimised, everything downstream follows: energy, recovery, clarity. This is what drew me, as both a physician and a patient, to hyperbaric oxygen therapy.
Used consistently and following the right protocols, I found my endurance increasing rather than declining in my fifties. My recovery improved, my mental clarity sharpened and I was able to reach higher elevations while ski touring than I had in my thirties.
As I often tell my patients:
Midlife is not the moment when our biology begins to fail. It is the moment we begin to understand it. When you support your cells with what they truly need, especially oxygen, the body has an extraordinary capacity to regenerate and perform far beyond what we expect.
It is not about reversing time. It is about understanding our biology and giving our cells what they need to perform, recover and thrive at every stage in life.
For me, the most significant intervention women can make to their health is the most fundamental one. Oxygen.
– Dr Katrin Dreissigacker
Sources: The Journal of Physiology, 2015 · Journal of Applied Physiology, 2018 · Acta Physiologica, 2024 · Circulation, 2005
