Health Myths of the Female Athlete | Myth 3

By Elissa Rosen, MD, CEDS
The following is the third installment of a four-part series on the Health Myths of the Female Athlete

Myth 3: The only medical problems that can be found in athletes with low energy intake are amenorrhea and bone density loss.

Truth: In the 1990s the ACSM coined the term female athlete triad. (4) This term describes the relationship between low energy intake in athletes, loss of menstrual cycle, and low bone density. The scope of the problem of low energy intake as it relates to the female body is actually broader than amenorrhea and low bone density. An ongoing negative energy balance due to continued low energy intake in an athlete can ultimately have an adverse impact on nearly every organ system in the body. The International Olympic Committee (IOC) published an expert consensus statement in 2014 to define a new, more broad term called relative energy deficiency in sports or RED-S. (5) RED-S attempts to expand upon the concept of the female athlete triad and bring recognition to the fact that amenorrhea and bone density loss are only two of the many body systems that can be impacted by low energy intake.


4.     Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP; American College of Sports Medicine.. American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc. 2007 Oct;39(10):1867-82. PubMed PMID: 17909417.

5.     Mountjoy M, Sundgot-Borgen JK, Burke LM, Ackerman KE, Blauwet C, Constantini N, Lebrun C, Lundy B, Melin AK, Meyer NL, Sherman RT, Tenforde AS, Klungland Torstveit M, Budgett R. IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. Br J Sports Med. 2018 Jun;52(11):687-697. doi: 10.1136/bjsports-2018-099193. PubMed PMID: 29773536.