I wear women's shoes in a size 8 1/2-9 and ordered a medium size to wear over sneakers. They fit perfectly. I have already used them twice for running on snow and ice and have generally been satisfied. The only problem I had with these spikes is that they curl up when running. I had to adjust them about 3-4 times per run (once or twice per mile) to get the cleats back under my toes. They tend to crawl sideways slowly. If these boots had cleats covering the entire ball of the foot, that wouldn't be a problem. But the cleats are concentrated under the middle of the foot, so you don't get good cleat contact with the ground when you slide off. The concentration of spikes under the ball of the foot can also make walking a little uncomfortable when running. At first it's like my ankles are slipping left and right (like you're wearing platform shoes), but it's not that bad. If I replace them I'll probably look for a set that has the cleats set wider at the ball of the foot. I didn't use the heel spikes while running because I tend to walk on my toes, but they were useful when I needed to slow down in deep powder or slick ice or when running on snow/ice.
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