Stress injury to bone is the result of a temporary disturbance in the equilibrium between bone resorption and bone regeneration. Knowledge of the pathophysiology of bone in health and disease currently encompasses an interactive mode that includes biomechanical, hormonal, nutritional, and genetic factors. The current study will review possible etiologic theories for stress injuries to bone with a special emphasis on gender-related factors. Females may be more at risk for a stress injury to bone because of their unique hormonal environment, and other anatomic and gender factors.