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Female athlete triad

MedGen UID:
319049
•Concept ID:
C1721053
•
Disease or Syndrome
Synonyms: Female Athlete Triad; Female Athlete Triad Syndrome
SNOMED CT: Female athlete triad (710072005); Female athlete syndrome (710072005)

Definition

The presence of the following interrelated signs observed in active women and girls: low energy availability with or without disordered eating; menstrual dysfunction; low bone mineral density. [from SNOMEDCT_US]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVFemale athlete triad

Professional guidelines

PubMed

A Review of Prevention, Diagnosis, and Treatment of Relative Energy Deficiency in Sport in Artistic (Synchronized) Swimming.
Robertson S, Mountjoy M
Int J Sport Nutr Exerc Metab 2018 Jul 1;28(4):375-384. Epub 2018 Jul 3 doi: 10.1123/ijsnem.2017-0329. PMID: 29722578
The IOC consensus statement: beyond the Female Athlete Triad--Relative Energy Deficiency in Sport (RED-S).
Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, Meyer N, Sherman R, Steffen K, Budgett R, Ljungqvist A
Br J Sports Med 2014 Apr;48(7):491-7. doi: 10.1136/bjsports-2014-093502. PMID: 24620037
Female athlete triad and its components: toward improved screening and management.
Javed A, Tebben PJ, Fischer PR, Lteif AN
Mayo Clin Proc 2013 Sep;88(9):996-1009. doi: 10.1016/j.mayocp.2013.07.001. PMID: 24001492

Recent clinical studies

Etiology

The female athlete triad: review of current literature.
Maya J, Misra M
Curr Opin Endocrinol Diabetes Obes 2022 Feb 1;29(1):44-51. doi: 10.1097/MED.0000000000000690. PMID: 34812202Free PMC Article
Female Athlete Triad.
Daily JP, Stumbo JR
Prim Care 2018 Dec;45(4):615-624. Epub 2018 Oct 4 doi: 10.1016/j.pop.2018.07.004. PMID: 30401345
The IOC consensus statement: beyond the Female Athlete Triad--Relative Energy Deficiency in Sport (RED-S).
Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, Meyer N, Sherman R, Steffen K, Budgett R, Ljungqvist A
Br J Sports Med 2014 Apr;48(7):491-7. doi: 10.1136/bjsports-2014-093502. PMID: 24620037
The LEAF questionnaire: a screening tool for the identification of female athletes at risk for the female athlete triad.
Melin A, Tornberg AB, Skouby S, Faber J, Ritz C, Sjödin A, Sundgot-Borgen J
Br J Sports Med 2014 Apr;48(7):540-5. Epub 2014 Feb 21 doi: 10.1136/bjsports-2013-093240. PMID: 24563388
Female athlete triad and its components: toward improved screening and management.
Javed A, Tebben PJ, Fischer PR, Lteif AN
Mayo Clin Proc 2013 Sep;88(9):996-1009. doi: 10.1016/j.mayocp.2013.07.001. PMID: 24001492

Diagnosis

Eating Disorders in the Adolescent Patient.
Ranalli DN, Studen-Pavlovich D
Dent Clin North Am 2021 Oct;65(4):689-703. Epub 2021 Aug 2 doi: 10.1016/j.cden.2021.06.009. PMID: 34503661
The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S).
Coelho AR, Cardoso G, Brito ME, Gomes IN, Cascais MJ
Rev Bras Ginecol Obstet 2021 May;43(5):395-402. Epub 2021 Jun 2 doi: 10.1055/s-0041-1730289. PMID: 34077990Free PMC Article
Female Athlete Triad.
Daily JP, Stumbo JR
Prim Care 2018 Dec;45(4):615-624. Epub 2018 Oct 4 doi: 10.1016/j.pop.2018.07.004. PMID: 30401345
The LEAF questionnaire: a screening tool for the identification of female athletes at risk for the female athlete triad.
Melin A, Tornberg AB, Skouby S, Faber J, Ritz C, Sjödin A, Sundgot-Borgen J
Br J Sports Med 2014 Apr;48(7):540-5. Epub 2014 Feb 21 doi: 10.1136/bjsports-2013-093240. PMID: 24563388
Female athlete triad and its components: toward improved screening and management.
Javed A, Tebben PJ, Fischer PR, Lteif AN
Mayo Clin Proc 2013 Sep;88(9):996-1009. doi: 10.1016/j.mayocp.2013.07.001. PMID: 24001492

Therapy

Randomised controlled trial of the effects of increased energy intake on menstrual recovery in exercising women with menstrual disturbances: the 'REFUEL' study.
De Souza MJ, Mallinson RJ, Strock NCA, Koltun KJ, Olmsted MP, Ricker EA, Scheid JL, Allaway HC, Mallinson DJ, Kuruppumullage Don P, Williams NI
Hum Reprod 2021 Jul 19;36(8):2285-2297. doi: 10.1093/humrep/deab149. PMID: 34164675Free PMC Article
Female athlete triad.
Loveless MB
Curr Opin Obstet Gynecol 2017 Oct;29(5):301-305. doi: 10.1097/GCO.0000000000000396. PMID: 28737524
Bone Health in Athletes.
Goolsby MA, Boniquit N
Sports Health 2017 Mar/Apr;9(2):108-117. Epub 2016 Nov 30 doi: 10.1177/1941738116677732. PMID: 27821574Free PMC Article
The IOC consensus statement: beyond the Female Athlete Triad--Relative Energy Deficiency in Sport (RED-S).
Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, Meyer N, Sherman R, Steffen K, Budgett R, Ljungqvist A
Br J Sports Med 2014 Apr;48(7):491-7. doi: 10.1136/bjsports-2014-093502. PMID: 24620037
Prevalence of individual and combined components of the female athlete triad.
Gibbs JC, Williams NI, De Souza MJ
Med Sci Sports Exerc 2013 May;45(5):985-96. doi: 10.1249/MSS.0b013e31827e1bdc. PMID: 23247706

Prognosis

Common Medical Concerns of the Female Athlete.
Statuta SM, Wood CL, Rollins LK
Prim Care 2020 Mar;47(1):65-85. Epub 2019 Nov 9 doi: 10.1016/j.pop.2019.11.002. PMID: 32014137
The Female Athlete Triad: Recommendations for Management.
Chamberlain R
Am Fam Physician 2018 Apr 15;97(8):499-502. PMID: 29671493
The female athlete triad.
Horn E, Gergen N, McGarry KA
R I Med J (2013) 2014 Nov 3;97(11):18-21. PMID: 25365814
Bone health and the female athlete triad in adolescent athletes.
Ackerman KE, Misra M
Phys Sportsmed 2011 Feb;39(1):131-41. doi: 10.3810/psm.2011.02.1871. PMID: 21378496Free PMC Article
The female athlete triad.
Hobart JA, Smucker DR
Am Fam Physician 2000 Jun 1;61(11):3357-64, 3367. PMID: 10865930

Clinical prediction guides

Bone health in functional hypothalamic amenorrhea: What the endocrinologist needs to know.
Indirli R, Lanzi V, Mantovani G, Arosio M, Ferrante E
Front Endocrinol (Lausanne) 2022;13:946695. Epub 2022 Oct 11 doi: 10.3389/fendo.2022.946695. PMID: 36303862Free PMC Article
Low energy availability: history, definition and evidence of its endocrine, metabolic and physiological effects in prospective studies in females and males.
Areta JL, Taylor HL, Koehler K
Eur J Appl Physiol 2021 Jan;121(1):1-21. Epub 2020 Oct 23 doi: 10.1007/s00421-020-04516-0. PMID: 33095376Free PMC Article
Endocrine Effects of Relative Energy Deficiency in Sport.
Elliott-Sale KJ, Tenforde AS, Parziale AL, Holtzman B, Ackerman KE
Int J Sport Nutr Exerc Metab 2018 Jul 1;28(4):335-349. Epub 2018 Jul 14 doi: 10.1123/ijsnem.2018-0127. PMID: 30008240
The LEAF questionnaire: a screening tool for the identification of female athletes at risk for the female athlete triad.
Melin A, Tornberg AB, Skouby S, Faber J, Ritz C, Sjödin A, Sundgot-Borgen J
Br J Sports Med 2014 Apr;48(7):540-5. Epub 2014 Feb 21 doi: 10.1136/bjsports-2013-093240. PMID: 24563388
2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013.
De Souza MJ, Nattiv A, Joy E, Misra M, Williams NI, Mallinson RJ, Gibbs JC, Olmsted M, Goolsby M, Matheson G; Expert Panel
Br J Sports Med 2014 Feb;48(4):289. doi: 10.1136/bjsports-2013-093218. PMID: 24463911

Recent systematic reviews

Energy deficiency, menstrual disorders, and low bone mineral density in female athletes: a systematic review.
Skarakis NS, Mastorakos G, Georgopoulos N, Goulis DG
Hormones (Athens) 2021 Sep;20(3):439-448. Epub 2021 Apr 22 doi: 10.1007/s42000-021-00288-0. PMID: 33884586
Prevalence of low bone mineral density in female dancers.
Amorim T, Wyon M, Maia J, Machado JC, Marques F, Metsios GS, Flouris AD, Koutedakis Y
Sports Med 2015 Feb;45(2):257-68. doi: 10.1007/s40279-014-0268-5. PMID: 25281333
Disordered eating, menstrual disturbances, and low bone mineral density in dancers: a systematic review.
Hincapié CA, Cassidy JD
Arch Phys Med Rehabil 2010 Nov;91(11):1777-1789.e1. doi: 10.1016/j.apmr.2010.07.230. PMID: 21044726
Are female athletes at increased risk for disordered eating and its complications?
Coelho GM, Soares Ede A, Ribeiro BG
Appetite 2010 Dec;55(3):379-87. Epub 2010 Aug 13 doi: 10.1016/j.appet.2010.08.003. PMID: 20709126

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