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Review
. 2021 May;43(5):395-402.
doi: 10.1055/s-0041-1730289. Epub 2021 Jun 2.

The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S)

Alexandra Ruivo Coelho  1 , Gonçalo Cardoso  1 , Marta Espanhol Brito  1 , Inês Neves Gomes  2 , Maria João Cascais  1
Affiliations
Review

The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S)

Alexandra Ruivo Coelho et al. Rev Bras Ginecol Obstet. 2021 May.

Abstract
in English, Portuguese

In a healthy athlete, the caloric intake is sufficient for sports energy needs and body physiological functions, allowing a balance between energy availability, bone metabolism, and menstrual cycle. On the other hand, an imbalance caused by low energy availability due to a restrictive diet, eating disorders or long periods of energy expenditure leads to multisystemic deregulation favoring the essential functions of the body. This phenomenon, described as the female athlete triad, occurs in a considerable percentage of high-performance athletes, with harmful consequences for their future. The present review was carried out based on a critical analysis of the most recent publications available and aims to provide a global perception of the topic relative energy deficit in sport (RED-S). The objective is to promote the acquisition of more consolidated knowledge on an undervalued theme, enabling the acquisition of preventive strategies, early diagnosis and/or appropriate treatment.

Em uma atleta saudável, o aporte calórico é suficiente para a necessidade energética esportiva e para as funções fisiológicas corporais, permitindo um equilíbrio entre disponibilidade energética (DE), metabolismo ósseo e função menstrual. Por outro lado, um desequilíbrio devido à baixa disponibilidade energética (BDE) por dieta restritiva, perturbações alimentares ou grandes períodos de gasto energético conduz a uma desregulação multissistêmica priorizando as funções essenciais do corpo. Este fenômeno, descrito inicialmente como tríade da mulher atleta e, atualmente, como défice energético relativo no esporte (RED-S, na sigla em inglês) tem como pilares a BDE, disfunção menstrual e alterações na densidade mineral óssea (DMO), estando presente em uma percentagem considerável de atletas de alta competição, com consequências nefastas para o seu futuro a curto, médio e longo prazo. A presente revisão foi realizada a partir da análise crítica das publicações mais recentes disponíveis e pretende proporcionar uma percepção global do tema RED-S. O objetivo é promover a aquisição de um conhecimento mais consolidado sobre uma temática subvalorizada, possibilitando a aquisição de estratégias preventivas, diagnóstico precoce e/ou tratamento adequado.

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Conflict of interest statement

The authors have no conflict of interests to declare.

Figures

Figs. 1 and 2.
Figs. 1 and 2.
Influence of low energy availability on the menstrual cycle.
See this image and copyright information in PMC

References

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