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2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013
Open accessAbstract
The Female Athlete Triad is a medical condition often observed in physically active girls and women, and involves three components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction and (3) low bone mineral density. Female athletes often present with one or more of the three Triad components, and an early intervention is essential to prevent its progression to serious endpoints that include clinical eating disorders, amenorrhoea and osteoporosis. This consensus statement represents a set of recommendations developed following the 1st (San Francisco, California, USA) and 2nd (Indianapolis, Indiana, USA) International Symposia on the Female Athlete Triad. It is intended to provide clinical guidelines for physicians, athletic trainers and other healthcare providers for the screening, diagnosis and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad expert panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision-making regarding sport participation, clearance and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team and implementation of treatment contracts. This consensus paper has been endorsed by the Female Athlete Triad Coalition, an International Consortium of leading Triad researchers, physicians and other healthcare professionals, the American College of Sports Medicine and the American Medical Society for Sports Medicine.
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“LEA is associated with unfavorable health and sport performance consequences, as illustrated by LEA-related conditions such as Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S) [8,9].”
From Considerations of Low Carbohydrate Availability (LCA) to Relative Energy Deficiency in Sport (RED-S) in Female Endurance Athletes: A Narrative Review (2023) · cites this paper as [9]
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“Prospective studies to date illustrate a causal relationship between LEA and menstrual disturbances [9,10,11,12,13,14].”
From Considerations of Low Carbohydrate Availability (LCA) to Relative Energy Deficiency in Sport (RED-S) in Female Endurance Athletes: A Narrative Review (2023) · cites this paper as [9]
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“current findings show a strong correlation between Triad and negative bone health outcomes, such as increased bone stress injuries and decreased BMD [6,7,9,11,14,15,16,17,18].”
From Considerations of Low Carbohydrate Availability (LCA) to Relative Energy Deficiency in Sport (RED-S) in Female Endurance Athletes: A Narrative Review (2023) · cites this paper as [9]
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“However, specific attention should be paid to female (vegan) athletes due to the phenomenon of the female athlete triad, a complex disorder that develops as a consequence of a dysfunctional interrelation between menstrual dysfunction, low energy availability, and decreased bone mineral density, that can have serious health implications [278,279].”
From Nutritional Considerations for the Vegan Athlete (2023) · cites this paper as [279]
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Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., Meyer, N., Sherman, R., Steffen, K., Budgett, R., et al. (2014) · British Journal of Sports Medicine · doi:10.1136/bjsports-2014-093502 · Cited by 1,469
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Mental health in elite athletes: International Olympic Committee consensus statement (2019)
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Nutrition and Athletic Performance
(2016) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000852 · Cited by 1,305
Energy Availability in Athletics: Health, Performance, and Physique
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Metadata
- Authors
- De Souza, M. J., Nattiv, A., Joy, E., Misra, M., Williams, N. I., Mallinson, R. J., Gibbs, J. C., Olmsted, M., Goolsby, M., Matheson, G., & Panel, E.
- Affiliations
- University of California, Los Angeles (US)
- Intermountain Healthcare (US)
- Harvard University (US)
- Pennsylvania State University (US)
- University of Waterloo (CA)
- University of Toronto (CA)
- Hospital for Special Surgery (US)
- Stanford University (US)
- ORCID
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2014-01-24
- Volume
- 48
- Issue
- 4
- Pages
- 289-289
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W2115199077
- Cited by
- 661
- References
- 251
- Citations by year
- 2026: 50 · 2025: 57 · 2024: 66 · 2023: 79 · 2022: 53 · 2021: 70 · 2020: 76 · 2019: 59 · 2018: 44 · 2017: 32 · 2016: 29 · 2015: 27 · 2014: 17
- FWCI
- 41.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD060827)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Keywords
- female athlete triad, low energy availability, disordered eating, menstrual disorders, amenorrhea, osteopenia, osteoporosis, return to sport, risk stratification, multidisciplinary team management, treatment contract, screening and diagnosis, female athletes
- MeSH terms
- Adolescent, Adult, Child, Energy Metabolism, Female, Health Status, Humans, Indiana, Medical History Taking, Patient Care Planning, Patient Care Team, San Francisco, Sports Medicine, Absorptiometry, Photon, Bone Density, Treatment Outcome, Practice Guidelines as Topic, Risk Assessment, Patient Selection, Recovery of Function, Early Diagnosis, Female Athlete Triad Syndrome, Athletic Performance, Young Adult
About these checks
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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