The sports-medical selection requires consideration of the structural characteristics of women with the particularities of the various disciplines and directing them to sports adequate to their physique. Women and elite sports – a problem that has a centuries-old history and continues to be a challenge to doctors and coaches. This is the reason for establishing an independent direction in the sports structures, related to conducting specialized scientific observations, creating differentiated training methods, preventive measures, rational nutrition, diagnostics, treatment and others. All this is part of the so-called women’s sport, an area with its own specific problems. Historically, the belief that competitive efforts would damage women’s health and reproductive function was the reason for banning their participation in the first modern Olympic Games in 1896. Subsequent events allowed individual female athletes, whose number in 1932 was about 4% of those participating in the Olympics, and in 1968 they were 14% – mainly in the disciplines of athletics, swimming and gymnastics. To date, there are only a few sports that are not practiced by women. Women have a relatively longer body compared to their height (30-31%), which explains from a biomechanical point of view their lower achievements in running disciplines and jumps in athletics, as well as rolls in gymnastics. It is worth noting existing unfounded views in the past that sports lead to a narrowing of the pelvis in young girls, which will make childbearing difficult. The analysis of studies by Bulgarian authors shows that in most sports, the absolute and relative values ​​of biacromial (shoulder) and pelvic diameters do not show significant differences between sportsmen and non-sportsmen. Pelvic diameters are smallest in gymnasts and largest in sumos, which is related to the selection in the mentioned sports, and is not under the influence of the sport itself. Increased mobility in the spine is one of the causes of lumbar lordosis in gymnasts. The type of different disciplines, with their biomechanical features, affects the distribution of subcutaneous fat on the body. It is more pronounced in the places with the least participation in the sports effort. The muscle mass in the female sex represents 30-35% of the total body mass, in contrast to the male, in which it reaches 40-45%. The musculature of the upper limbs, shoulders, spine and abdomen is less developed. For this reason, the achievements of women in throws in athletics are significantly lower. Systemic training loads affect the development of muscle mass, so that in a number of sports the difference between athletes and non-athletes is too small – for example, in judoka the percentages of muscle mass are 43.1%, in volleyball – 43.2%. Additional issues to consider for female athletes relate to their monthly physiological changes associated with the menstrual cycle.Its periodic occurrence is associated with complex dynamic relationships between the reproductive system and the entire organism. This is because of the neuroendocrine regulation that takes place between the nervous system, the hypothalamus, the pituitary gland and the ovaries. Almost all authors from different countries found a later age of menarche in sports girls than in their non-sporting peers. The first cycle is registered at an average age of 15.6 years among the world’s gymnastic elite. Primary amenorrhea is observed in 22% of representatives of rhythmic gymnastics, sports gymnastics and diving. A common reason is low body weight and poor development of fat mass. Early heavy physical exertion, competitive psychological stress, inadequate nutrition and others contribute to delayed puberty. One of the worrying consequences of amenorrhea is the reduction of bone density, which is also related to the tendency to fractures.