What is RED-S?

What is RED-S?

Relative Energy Deficiency in Sport (RED-S), formally known as the Female Athlete Triad, is a syndrome of three interrelated conditions: energy deficiency, menstrual irregularity/amenorrhea, and bone loss. Energy deficiency, often via food restriction or obsessive exercising, typically precedes the other conditions. A lack of fuel leads to amenorrhea, irregular (or nonexistent) periods. Menstrual and hormonal irregularity leads to bone loss. Bone loss leads to injury. Injury leads to less running, mental anguish, and a desire for control. At least, this has been our experience.

What is hypothalamic amenorrhea?

For this project, we are focusing on hypothalamic (secondary) amenorrhea. Secondary amenorrhea is when a woman who has been having normal menstrual cycles stops getting her periods for six months or longer. While amenorrhea may be caused by a variety of issues, including medications, pregnancy, menopause, PCOS, stress, and adrenal issues, among active women it is often due to a combination of under-fueling and over-training. It’s referred to as hypothalamic amenorrhea (HA). Although common, missing your period is not a normal or healthy symptom of exercise. A regular period is an indicator of hormonal health, and important for bone health.

What is disordered eating?

The primary symptom of the Female Athlete Triad, which leads to amenorrhea and bone loss is energy deficiency. Energy deficiency occurs when a person consumes less energy (calories) than they expend. Energy deficiency can occur with or without disordered eating, but for many female athletes disordered eating, or full-blown eating disorders, are present.

Disordered eating is a spectrum of abnormal eating behaviors such as skipping meals, restricting certain foods, and obsessive calorie counting. Disordered eating is differentiated from eating disorders by its level of severity, but it often leads to a clinically diagnosable eating disorder. Disordered eating may lead to a range of health issues from fatigue and lack of concentration to more serious problems such as malnutrition, extreme weight loss, and mental illness, including eating disorders.


Overview from Brown University

IOC Consensus Statement

National Eating Disorder Association