(REDS) is a syndrome of disease characterized by (a) low energy availability or energy deficiency (ED), (b) dysfunctional menstruation and (c) decreased bone mineral density.
(REDS) is a syndrome of disease characterized by (a) low energy availability or energy deficiency (ED), (b) dysfunctional menstruation and (c) decreased bone mineral density. Formally referred to as the Female Athletic Triad, it was renamed by the International Olympic Committee in 2014 to reflect that that the syndrome can also occur in men.REDS is most commonly seen in gymnastics, figure skating, ballet, diving, swimming and long distance running. The exact prevalence is difficult to define due to challenges in diagnostic criteria and other overlapping clinical diseases.
Disordered eating affects up to 20% of adult female athletes. Primary amenorrhea affects 7% of all college athletes while secondary amenorrhea affects 2-5% of them. Definition & Pathophysiology Although classically taught as a triad, more accurately defined as a spectrum of illness resulting from a low relative energy availability (EA) due to disordered eating.
On one end, healthy eating behaviors with occasional, short term restrictive diets and on the other end, severely abnormal disordered eating with abnormal behaviors, distorted body image, weight fluctuations, medical complications, impaired athletic performance. EA is defined as energy intake (EI) - energy expenditure (EE). Low EI occurs most commonly due to disordered eating and low EI, but can also occur due to increased or mismanaged exercise and training load.
Dysfunctional menstruation can range from light bleeding and abnormal menses, to oligomenorrhea all the way to amenorrhea. This is directly linked to low EA. Functional Hypothalamic Amenorrhea (FHA) is a term often applied to these athletes which is defined by persistent anovulation with no identifiable organic cause.
Dysmenorrhea is defined by variad degrees of decreased gonadotropic releasing hormone (GnRH), luteinizing hormone (LH), follicle-stimulating hormone (FSH) resulting in decreased release of estrogen, progesterone and alterations in menstrual cycle. Decreased bone mineral density (BMD) is the 3rd arm of this triad. Peak bone mass in adults occurs around age 20 and slowly decreases as we age.
If you are experiencing symptoms that may be related to relative energy deficiency in sport, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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