Female Athlete Triad for the General Population

by Kyle Ryan, PhD, CSCS,*D, TSAC-F, RSCC*D, USAW II, and Lou Maquaire
Personal Training Quarterly October 2025
Vol 12, Issue 2

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This article shares strategies for personal trainers about treatment and prevention of the female athlete triad.

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This article originally appeared in Personal Training Quarterly (PTQ)—a quarterly publication for NSCA Members designed specifically for the personal trainer. Discover easy-to-read, research-based articles that take your training knowledge further with Nutrition, Programming, and Personal Business Development columns in each quarterly, electronic issue. Read more articles from PTQ »

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REFERENCES

  1. Atakan, MM, Li, Y, Koşar, ŞN, Turnagöl, HH, and Yan, X. Evidence-based effects of high-intensity interval training on exercise capacity and health: A review with historical perspective. International Journal of Environmental Research and Public Health18(13): 7201, 2021.
  2. Casey, M, Fowlie, J, Charity, M, Harvey, J, and Eime, R. The implications of female sport policy developments for the community-level sport sector: a perspective from Victoria, Australia. International Journal of Sport Policy and Politics11(4): 657-678, 2019.
  3. Cassidy, S, Thoma, C, Houghton, D, and Trenell, M. Highintensity interval training: A review of its impact on glucose control and cardiometabolic health. Diabetologia 60(1): 7-23, 2017.
  4. Charlton, BT, Forsyth, S, and Clarke, DC. Low energy availability and relative energy deficiency in sport: what coaches should know. International Journal of Sports Science Coaching 17(2): 445-460, 2022.
  5. Coelho, AR, Cardoso, G, Brito, ME, Gomes, IN, and Cascais, MJ. The female athlete triad/relative energy deficiency in sports (RED-S). Revista Brasileira de Ginecologia e Obstetrícia 43(5): 395-402, 2021.
  6. Eime, R, Harvey, JT, Charity, M, and Westerbeek, H. Participation of Australian women and girls in traditionally maledominated sports 2016-2018. International Journal of Sport Policy and Politics 14: 545-561, 2022.
  7. Elhamalawy, A. Review of the pros and cons when comparing high intensity interval training to moderate intensity continuous training. International Journal of Research in Medical Sciences 12(2): 630-633, 2024.
  8. Gasner, A, and Rehman, A. Primary amenorrhea. StatPearls Publishing. 2023. Retrieved 2025 from https://www.ncbi.nlm.nih.gov/books/NBK554469/.
  9. Gimunová, M, Paulínyová, A, Bernaciková, M, and Paludo, AC. The prevalence of menstrual cycle disorders in female athletes from different sports disciplines: A rapid review. International Journal of Environmental Research and Public Health 19(21): 14243, 2022.
  10. Heikura, IA, Uusitalo, ALT, Stellingwerff, T, Bergland, D, Mero, A, and Burke, LM. Low energy availability is difficult to assess but outcomes have a significant impact on bone injury rates in elite distance athletes. International Journal of Sport Nutrition and Exercise Metabolism 1-30: 2017.
  11. Karkos, P, Kuśmierczyk, K, Jurga, M, Jurga, K, Grodziński, B, Sztemberg, E, et al. Health problems among women in sports: The female athlete triad. Quality in Sport 18: 53927, 2024.
  12. Kolber, MJ, Beekhuizen, KS, Cheng, MS, and Hellman, MA. Shoulder joint and muscle characteristics in the recreational weight training population. Journal of Strength and Conditioning Research23(1): 148-157, 2009.
  13. Lages, AS, Rebelo-Marques, AR, and Carrilho, F. Défice energético relativo no desporto (RED-S). Revista de Medicina Desportiva Informa 9(5): 14-16, 2018.
  14. Lodge, MT, Ackerman, KE, and Garay, J. Differences in knowledge of female athlete triad and relative energy deficiency in sport in female cross-country athletes. Journal of Athletic Training 59(8): 836-844, 2024.
  15. Maron, BJ, Haas, TS, Murphy, CJ, Ahluwalia, A, and Rutten Ramos, S. Incidence and causes of sudden death in U.S. college athletes. Journal of the American College of Cardiology63(16): 1636-1643, 2014.
  16. Mountjoy, M, Sundgot-Borgen, JK, Burke, LM, Ackerman, KE, Blauet, C, and Constantini, N. IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. British Journal of Sports Medicine 52(11): 687-697, 2018.
  17. Pantano, KJ. Current knowledge, perceptions, and interventions used by collegiate coaches in the U.S. regarding the prevention and treatment of the female athlete triad. North American Journal of Sports Physical Therapy 1(4): 195-207, 2006.
  18. Poon, ET, Li, H, Gibala, MJ, Wong, SH, Ho, RS, Poon, ET, et al. High-intensity interval training and cardiorespiratory fitness in adults: An umbrella review of systematic reviews and meta-analyses. Scandinavian Journal of Medicine and Science in Sports 34(5): e14652, 2024.
  19. Rauh, MJ, Tenforde, AS, Barrack, MT, Rosenthal, MD, and Nichols, JF. Sport specialization and low bone mineral density in female high school distance runners. Journal of Athletic Training 55(12): 1239-1246, 2020.
  20. Senefeld, JW, and Joyner, MJ. Strength-endurance training classes: Health benefits and injury rates of an emerging cornerstone of physical activity. Mayo Clinic Proceedings 95(3): 437-439, 2020. 

 

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