Understanding sex-based differences in thermoregulation is essential for developing effective heat safety protocols. Women face greater heat vulnerability through three interconnected physiological mechanisms. First, anatomical differences result in fewer active sweat glands per unit of skin surface area, with these glands activating at higher core temperature thresholds—delaying the cooling response when it matters most.
Second, hormonal fluctuations across the menstrual cycle raise the thermoregulatory set point by 0.3–0.5°C during the luteal phase, effectively narrowing the safety margin during heat exposure. Third, women typically carry higher percentages of body fat, which acts as thermal insulation and impairs heat dissipation efficiency. These evidence-based findings demand immediate revision of occupational heat exposure standards to include sex-specific safety thresholds, protective equipment specifications, and workplace scheduling that accounts for women’s physiological heat vulnerability.
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