Background Debate persists about whether early professional competition compromises long-term career sustainability in youth athletes; evidence in women`s professional soccer is limited. Hypothesis We hypothesized that greater cumulative professional match exposure before age 18 would be associated with increased risk of sustained attrition between ages 18 and 23. Study design Retrospective cohort study. Methods A retrospective cohort study was conducted using a large multinational cohort of professional female soccer players competing in top-tier leagues in England, France, Germany, and Italy between 2010 and 2020. Players who made their professional debut before age 18 were included. Pre-18 exposure was categorized by cumulative club minutes: =250, 251-750, 751-1,750, or > 1,750 min. The primary outcome was sustained attrition, defined as a = 12-month absence from professional competition between ages 18 and 23. Analyses included Kaplan-Meier methods, Cox proportional hazards models, and multivariable regression adjusting for debut age, position, and height. Results Of 1,148 players, 406 (35.4%) experienced sustained attrition between ages 18 and 23. Higher pre-18 exposure was associated with a lower likelihood of sustained attrition: adjusted hazard ratios were 0.60 (95% CI, 0.47-0.75) for 251-750 min, 0.37 (95% CI, 0.28-0.50) for 751-1,750 min, and 0.26 (95% CI, 0.17-0.38) for > 1,750 min (P < 0.05). Greater pre-18 exposure was also independently associated with higher mean annual playing time and greater match participation between ages 18 and 23. Conclusion Among professional female soccer players, higher levels of professional match exposure before age of 18 were associated with improved career sustainability. These findings suggest that players capable of accumulating high match volumes in early professional environments are more likely to maintain long-term careers. Rather than viewing early professional competition as an inherent risk, these results support carefully supervised early integration as a means to identify and develop robust athletic trajectories. Level of evidence Level 3.
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