An Evidence-Based Comparison of Female Athlete Triad and RED-s

Course overview

The female athlete triad has been most recently defined by three main components: an energy deficit, menstrual dysfunction, and impaired bone health. More recently, there has been a proposed shift in focus towards a broader, more comprehensive term for the condition previously known as Female Athlete Triad. The syndrome of Relative Energy Deficiency in Sport (RED-S), refers to impaired physiological function including, but not limited to, metabolic rate, menstrual function, bone health, immunity, protein synthesis, and cardiovascular health caused by relative energy deficiency. The cause of this syndrome is energy deficiency relative to the balance between dietary energy intake and energy expenditure required for health and activities of daily living, growth and sporting activities. Psychological consequences can either precede RED-S or be the result of RED-S. The clinical phenomenon is not a 'triad' of the three entities of energy availability, menstrual function and bone health, but rather a syndrome that affects many aspects of physiological function, health and athletic performance. The root causative factor remains an energy deficit in sport. However, the only impaired functions to be focused on are not solely menstrual dysfucntion and poor bone health in female athletes. The RED-s focus is inclusionary of these criteria, yet aims to be multifaceted by taking in to account the impacts of an energy deficit to all physiological (and even psychological) systems in all athletes. In this session, we will review and compare the recognition, evaluation, and return to play criteria for both the female athlete triad and RED-s. All aspects of RED-S will be reviewed with specific focus on the evidence-based research findings impacting the role of the therapist & athletic trainer in working on a multidisciplinary sports medicine team.