The bodybuilding industry is no stranger to drama and issues. And the latest comes in the form of a study saying female bodybuilders have a higher sudden cardiac death risk.
Not what you wanted to hear, right?
Well, the research isn’t getting any better, and we need to get to the bottom of this to understand the cause of the risk.
When looking at the latest research on female bodybuilders, it should make anyone in the sport stop and think for a second.
A large European study published in the European Heart Journal looked at mortality and sudden cardiac death (SCD) rates in women who compete in bodybuilding. This is the first big analysis of its kind.
The results aren’t just numbers. They reveal a real and serious issue in a group of athletes we often think of as the picture of health. Are they really putting their lives at risk?
In this article, I’m going to dive deeper into this research and provide you with everything we currently know about a potential connection between female bodybuilders and higher sudden cardiac death risk.
Disclaimer: This article is for informational purposes only and is not meant to treat or diagnose any condition. It is recommended that you speak with your doctor before starting any exercise program, making changes to your nutrition plan, or adding any new supplements into your current regimen.
What the Research Looked At
While I’d like to break apart this study and say that it was only with a small group of participants and that they didn’t look at a long timeframe, this isn’t the case.
This study wasn’t a small snapshot that we can brush off. Researchers tracked female bodybuilders over 16 years, from 2005 to 2020. They included nearly 9,500 women who competed in international events across divisions such as Women’s Bodybuilding, Women’s Physique, and Figure.
They then calculated death rates per 100,000 athlete-years. Basically, standardizing how often deaths happened relative to how long athletes were followed. This included various subgroups like juniors, masters (35+), amateurs, and pros.
I’m not going to lie… that’s a solid design for spotting patterns over time.
What They Found
Let’s look at what the researchers actually found of importance and what we need to fully understand from this research.
1. Deaths and Age
Out of those athletes, 32 deaths were identified during the study. The average age was roughly 43 years old when these athletes died.
Here’s how the causes broke down:
- 10 were sudden cardiac deaths (about 31% of all deaths).
- 5 were non-sudden deaths.
- The rest were a mix of traumatic and non-traumatic causes.
- Around 13% were due to suicide or homicide. That figure was over four times higher than what’s seen in male bodybuilders.
As someone who writes for bodybuilders and athletes for a living, that last part jumped out to me. It suggests we can’t just focus on the physical side. There are mental and social stresses in this sport, too.
2. SCD Happens More in Pro Female Bodybuilders
The risk of sudden cardiac death wasn’t equal across the board. It was the highest among professionally competing female bodybuilders. In fact:
- Pros had an SCD rate of about 54 per 100,000 athlete-years.
- Amateurs had a much lower rate (only around 2.5 per 100,000 athlete-years).
If you crunch the numbers, that’s a shocking difference. Professional competition (with its higher demands and stressors) appears strongly linked to this increased risk.
3. Around Competitions
Another point that caught my eye: several of the deaths occurred within a year of competition, and both SCDs in that group were around events. This suggests not just long-term training effects, but acute stress or strain tied to the competitive cycle.
How Does This Compare to Male Bodybuilders?
When researchers compared these findings with similar data from male bodybuilders, trends were interesting.
- SCD was still the number one cause of death in both sexes.
- But women had a lower overall death rate than men.
- Their sudden cardiac death rate was also lower than men’s in terms of incidence rate ratio.
That doesn’t mean female bodybuilders are “safe.” It just frames the risk relative to male athletes.
Why Is This Happening to Female Bodybuilders?
Honestly (and unfortunately), we don’t have a simple answer yet, and the study didn’t claim cause and effect. That’s an important point to understand. But several risk factors are likely involved, including:
- Extreme training and stress on the heart.
- Acute weight management tactics like dehydration.
- Use of performance-enhancing drugs (PEDs).
The study couldn’t accurately measure how much each factor contributed. But it did note that toxicology reports confirmed PED use in a few cases.
Interestingly, among professional women who died, only two had autopsies. One had a normal heart, and the other showed myocarditis. That contrasts with what we see in male athletes, where structural heart changes like enlargement are common.
This might signal different biological adaptations between sexes, or it could reflect how differently male and female athletes use substances or train. We simply don’t know the true answer yet.
Beyond the Numbers: Mental Health Matters
Another striking finding was the high proportion of deaths due to suicide or homicide. That rate was much higher than in male bodybuilders.
As someone who talks to athletes regularly as a certified strength coach and sports nutritionist, that shocked me. The pressures in competitive bodybuilding (especially for women) can be intense. They deal with body image stress, performance expectations, and often a culture that glorifies extremes.
We can’t ignore that when we talk about the health of female bodybuilders.
What We Can Do Moving Forward
The study authors made clear recommendations, and I agree with them.
- We need better medical screening for competitive athletes.
- Education about heart risk and PED use should be standard.
- Monitoring and regulation in the sport should be tighter.
This isn’t about fear-mongering. It’s about ensuring the sport evolves in a way that protects the athletes who love it.
Personally, I don’t think the IFBB does enough to ensure the health of their competitors. But my stance on this is nothing new.
In fact, I took a ton of heat for publishing an article a few years ago where I put the blame of bodybuilder deaths on the IFBB for not pushing health screenings, offering health coverage (which many bodybuilders don’t have), and the lack of care given to the athletes.
But as usual, nothing happens within the IFBB when someone calls them out for potential negligence.
They promote the extreme look. And while they don’t promote the use of steroids or anabolics, they’re not naïve to think that every competitor who steps on stage isn’t using something. So, where should the blame fall?
Should Female Bodybuilders Be Worried?
According to the findings of the study… YES.
While female bodybuilders may look invincible, they aren’t. They work hard, often harder than most people could imagine. But hard work shouldn’t come at the cost of life.
This research exposes a problem we’ve known about anecdotally for years. Now, we have actual data that backs it up.
If you’re a competitor, coach, or fan, you need to take this seriously. This isn’t about pulling everyone out of the sport. It’s about pushing for safer practices, smarter preparation, and health-first strategies in a sport that deserves better.
Author Bio:
Matt Weik, BS, CSCS, CPT, CSN, is a globally recognized health, fitness, and supplement industry expert with over 25 years of hands-on experience. He is the founder of Weik Fitness and one of the most prolific writers in the space, known for translating complex science into clear, actionable content. Matt holds a Bachelor of Science in Kinesiology from Penn State University and multiple industry certifications, giving his work both academic credibility and real-world authority. His writing has been featured on thousands of websites and in 100+ magazines worldwide, including FLEX, Muscular Development, Iron Man, and Muscle & Fitness UK, and he has authored 30+ published books. Trusted by leading supplement brands and media outlets alike, Matt is widely regarded as one of the most knowledgeable and reliable voices in health, fitness, and sports nutrition.
