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Background  The purpose of this study was to investigate the effect of sex on the efficacy of intermittent post-exercise sauna bathing to induce heat acclimation and improve markers of temperate exercise performance in trained athletes.    Methods  Twenty-six trained runners (16 female; mean ± SD, age 19 ± 1 years, V̇O 2max  F: 52.6 ± 6.9 mL⋅kg −1 ⋅min −1 , M: 64.6 ± 2.4 mL⋅kg −1 ⋅min −1 ) performed a running heat tolerance test (30 min, 9 km⋅h −1 /2% gradient, 40 °C/40%RH; HTT) and temperate (18 °C) exercise tests (maximal aerobic capacity [V̇O 2max ] and lactate profile) pre and post 3 weeks of normal exercise training plus 29 ± 1 min post-exercise sauna bathing (101–108 °C) 3 ± 1 times per week.    Results  Females and males exhibited similar reductions (interactions  p  > 0.05) in peak rectal temperature (− 0.3 °C;  p  < 0.001), skin temperature (− 0.9 °C;  p  < 0.001) and heart rate (− 9 beats·min −1 ;  p  = 0.001) during the HTT at post- vs pre-intervention. Only females exhibited an increase in active sweat glands on the forearm (measured via modified iodine technique; F: + 57%,  p  < 0.001; M: + 1%,  p  = 0.47). Conversely, only males increased forearm blood flow (measured via venous occlusion plethysmography; F: + 31%,  p  = 0.61; M: + 123%;  p  < 0.001). Females and males showed similar (interactions  p  > 0.05) improvements in V̇O 2max  (+ 5%;  p  = 0.02) and running speed at 4 mmol·L −1  blood lactate concentration (+ 0.4 km·h −1 ;  p  = 0.001).    Conclusions  Three weeks of post-exercise sauna bathing effectively induces heat acclimation in females and males, though possibly amid different thermoeffector adaptations. Post-exercise sauna bathing is also an effective ergogenic aid for both sexes.    Supplementary Information  The online version contains supplementary material available at 10.1186/s40798-021-00342-6.

Sex differences in adaptation to intermittent post-exercise sauna bathing in trained middle-distance runners