Location
Moultrie, GA
Start Date
7-5-2025 1:00 PM
End Date
7-5-2025 4:00 PM
Description
Introduction: Many elite athletes train their whole lives to reach elite status. For another set of athletes, their sports careers were cut short for one reason or another. The underdiagnosing of the Female Athlete Triad (Triad) or Relative Energy Deficiency in Sport (RED-S) might be the reason for some athletes. A few main barriers have prevented the medical community from accurately diagnosing athletes suffering from the Triad and RED-S.
Objective: This study investigates the critical barriers to early and accurate detection of the Triad and RED-S. Key obstacles include insufficient research, limited physician education, and inadequate awareness among athletes and their support networks. This research identifies these gaps and proposes targeted solutions to mitigate underdiagnosis, enhance clinical recognition, and safeguard athletic health and performance.
Methods: A thorough literature review was conducted to study the importance of education and awareness in effectively identifying the Triad and RED-S among athletes. To be selected, studies had to be published after 2010 and be included in a peer-reviewed journal. The only databases used were Google Scholar and the Philadelphia College of Osteopathic Medicine Library.
Results: One of the first barriers is that the prevalence of RED-S and the Triad is unknown to the medical community. Current research estimates that the prevalence of RED-S is between 22- 58%. One estimate claims that among endurance sports athletes, the prevalence of RED-S can be as high as 23-80% in females and 15-70% in males. Another major challenge to adequately diagnosing the Triad and RED-S is the physicians’ awareness of the condition. Awareness of RED-S and the Triad varies vastly among medical specialties. Awareness was highest among orthopedic surgery, obstetrics and gynecology, and physical medicine and rehabilitation/rheumatology. Awareness was lowest in psychiatry, radiology, and anesthesia. The last barrier to effectively identifying RED-S and the Triad is that athletes and their entourage ( coaches, parents, sports medicine staff) lack knowledge. One study showed that 78% of collegiate female track and field athletes and 70% of collegiate coaches did not receive education on RED-S.
Discussion: These highlighted barriers have prevented the medical and athletic community from adequately diagnosing athletes suffering from the Triad and RED-S. Physicians, athletes, parents, and supporting sports staff must be educated on proper nutrition and the signs and symptoms of the Triad and RED-S. More research is also needed to help the medical community understand the prevalence of RED-S and the Triad and develop effective ways to diagnose patients. There needs to be an awareness campaign to educate healthcare professionals about RED-S and how to screen patients. Medical schools should educate students on using current screening tools like the Low EA in Females Questionnaire (LEAF-Q) and RED-S clinical assessment tool (RED-S CAT). Lastly, the medical community must take an interdisciplinary approach to diagnose and treat Triad and RED-S. This might include working with nutritionists, athletic trainers, team staff, and psychologists.
Embargo Period
12-3-2025
The Underdiagnosis: Addressing the Underdiagnosis of the Female Athlete Triad and Relative Energy Deficiency in Sport
Moultrie, GA
Introduction: Many elite athletes train their whole lives to reach elite status. For another set of athletes, their sports careers were cut short for one reason or another. The underdiagnosing of the Female Athlete Triad (Triad) or Relative Energy Deficiency in Sport (RED-S) might be the reason for some athletes. A few main barriers have prevented the medical community from accurately diagnosing athletes suffering from the Triad and RED-S.
Objective: This study investigates the critical barriers to early and accurate detection of the Triad and RED-S. Key obstacles include insufficient research, limited physician education, and inadequate awareness among athletes and their support networks. This research identifies these gaps and proposes targeted solutions to mitigate underdiagnosis, enhance clinical recognition, and safeguard athletic health and performance.
Methods: A thorough literature review was conducted to study the importance of education and awareness in effectively identifying the Triad and RED-S among athletes. To be selected, studies had to be published after 2010 and be included in a peer-reviewed journal. The only databases used were Google Scholar and the Philadelphia College of Osteopathic Medicine Library.
Results: One of the first barriers is that the prevalence of RED-S and the Triad is unknown to the medical community. Current research estimates that the prevalence of RED-S is between 22- 58%. One estimate claims that among endurance sports athletes, the prevalence of RED-S can be as high as 23-80% in females and 15-70% in males. Another major challenge to adequately diagnosing the Triad and RED-S is the physicians’ awareness of the condition. Awareness of RED-S and the Triad varies vastly among medical specialties. Awareness was highest among orthopedic surgery, obstetrics and gynecology, and physical medicine and rehabilitation/rheumatology. Awareness was lowest in psychiatry, radiology, and anesthesia. The last barrier to effectively identifying RED-S and the Triad is that athletes and their entourage ( coaches, parents, sports medicine staff) lack knowledge. One study showed that 78% of collegiate female track and field athletes and 70% of collegiate coaches did not receive education on RED-S.
Discussion: These highlighted barriers have prevented the medical and athletic community from adequately diagnosing athletes suffering from the Triad and RED-S. Physicians, athletes, parents, and supporting sports staff must be educated on proper nutrition and the signs and symptoms of the Triad and RED-S. More research is also needed to help the medical community understand the prevalence of RED-S and the Triad and develop effective ways to diagnose patients. There needs to be an awareness campaign to educate healthcare professionals about RED-S and how to screen patients. Medical schools should educate students on using current screening tools like the Low EA in Females Questionnaire (LEAF-Q) and RED-S clinical assessment tool (RED-S CAT). Lastly, the medical community must take an interdisciplinary approach to diagnose and treat Triad and RED-S. This might include working with nutritionists, athletic trainers, team staff, and psychologists.