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The Male Athlete Triad-A Consensus Statement From the Female and Male Athlete Triad Coalition Part II: Diagnosis, Treatment, and Return-To-Play

Fredericson, Michael, Kussman, Andrea, Misra, Madhusmita, Barrack, Michelle T., De Souza, Mary Jane, Kraus, Emily, Koltun, Kristen J., Williams, Nancy I., Joy, Elizabeth, Nattiv, Aurelia·2021·Clinical Journal of Sport Medicine
DOI 10.1097/jsm.0000000000000948
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Abstract

The Male Athlete Triad is a medical syndrome most common in adolescent and young adult male athletes in sports that emphasize a lean physique, especially endurance and weight-class athletes. The 3 interrelated conditions of the Male Athlete Triad occur on spectrums of energy deficiency/low energy availability (EA), suppression of the hypothalamic–pituitary–gonadal axis, and impaired bone health, ranging from optimal health to clinically relevant outcomes of energy deficiency/low EA with or without disordered eating or eating disorder, functional hypogonadotropic hypogonadism, and osteoporosis or low bone mineral density with or without bone stress injury (BSI). Because of the importance of bone mass acquisition and health concerns in adolescence, screening is recommended during this time period in the at-risk male athlete. Diagnosis of the Male Athlete Triad is best accomplished by a multidisciplinary medical team. Clearance and return-to-play guidelines are recommended to optimize prevention and treatment. Evidence-based risk assessment protocols for the male athlete at risk for the Male Athlete Triad have been shown to be predictive for BSI and impaired bone health and should be encouraged. Improving energetic status through optimal fueling is the mainstay of treatment. A Roundtable on the Male Athlete Triad was convened by the Female and Male Athlete Triad Coalition in conjunction with the 64th Annual Meeting of the American College of Sports Medicine in Denver, Colorado, in May of 2017. In this second article, the latest clinical research to support current models of screening, diagnosis, and management for at-risk male athlete is reviewed with evidence-based recommendations.

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Cited by

See all 93

Metadata

Authors
Fredericson, M., Kussman, A., Misra, M., Barrack, M. T., De Souza, M. J., Kraus, E., Koltun, K. J., Williams, N. I., Joy, E., & Nattiv, A.
Affiliations
  • Division of Physical Medicine & Rehabiilitation, Stanford University, Stanford, California;
  • Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts;
  • Department of Family and Consumer Sciences, California State University, Long Beach, Long Beach, California;
  • Department of Kinesiology and Physiology Penn State University, University Park, Pennsylvania;
  • University of Pittsburgh, Pittsburgh, Pennsylvania;
  • Intermountain Healthcare, Salt Lake City, Utah; and
  • Department of Family Medicine, University of California, Los Angeles, Los Angeles, California.
Venue
Clinical Journal of Sport Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2021-06-03
Volume
31
Issue
4
Pages
349-366
ISSN
1050-642X
DOI
10.1097/jsm.0000000000000948
Cited by
93
References
29
Language
en

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

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Data sources

Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.