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The Relative Energy Deficient Syndrome (RED-S): Problems and Treatments

Posted by SEMI on 24 December 2018
The Relative Energy Deficient Syndrome (RED-S): Problems and Treatments

The Relative Energy Deficient Syndrome (RED-S), or previously known as the female athlete triad is fairly prevalent in college athletes and poses a major long-term threat to active female athletes.

The RED-S is defined as the presence of a combination of, or individualized presence of these three symptoms:

 Low energy (with or without the presence of disordered eating)

 Menstrual dysfunction

 Low bone density for age

The Relative Energy Deficient Syndrome poses consequences to the health of physically active females, which may not be completely reversible. Hence, early diagnosis, prevention and management of the symptoms are required to ensure the health of female athletes.

Who's at Risk?

RED-S can be developed by female athletes that partake in sports that reward or require for them to maintain a certain weight and appearance, such as gymnastics and figure skating. Fashion trends that promote 'thinness', through crash diets to reach an unhealthy weight, are also contributing factors to the development of the condition.

Symptoms of RED-S

Since the characteristics of RED-S may not manifest simultaneously, some of the following symptoms of the condition should be watched out for:

 Persistent fatigue

 Extreme weight loss

 Bone density loss

 Disrupted menstrual cycles

 Stress fractures

 Disordered eating

 Extreme exercise

How Can The Symptoms Affect Females?

People suffering from disordered eating will typically exhibit erratic eating behaviours, and remain preoccupied with their weight and body image. Those suffering from disordered eating may either completely starve themselves out (anorexia) or overeat until they purge (bulimia). Most others engage in the misuse of diet pills and laxatives to maintain their low weight.

This can leave the patients prone to kidney damage, muscle fatigue, extreme dehydration, among other severe conditions. The absence of calcium from the diet can lead to a loss in bone density, which may lead to an increased risk of stress fractures.

The female, as a result of lack of nutrition, may also suffer from hormone imbalances, contributing to menstrual dysfunctions, the persistence of which can cause serious problems later on in life, during pregnancy and menopause.  

 How Can The Symptoms Affect Females?

Managing The Symptoms

RED-S is a serious disorder that needs a multi-disciplinary approach for treatment. The process begins by consulting with your physician, who then works with a team in a collaborative manner to combat all symptoms of the disorder, thereby helping you regain health.

The multi-disciplinary approach, according to the latest studies, requires intervention at both, personal and professional levels. Family members and friends of the athlete must encourage them to seek treatment and develop a healthy lifestyle that prioritises their health. A team of medical experts conducts regular check-ups and physical examinations to ensure that the dietary needs are being met and that the physical training is not being pushed to the point of athletic exertion.

If you, or a loved one, is exhibiting symptoms of RED-S or seems to be at risk, please seek medical assistance immediately.


Sports & Exercise Medicine Institute clinics are greater Toronto area based sports medicine, physiotherapy and massage therapy clinics that offer a wide range of services such as stem cell transplant, sports medicine physicians, sports podiatry and acupuncture, among others.

To learn more about us, get in touch with us by calling at 1-844-223-7364. Our services are offered in the greater Toronto area at Sheppard, St. Clair and Thornhill.

Author: SEMI
Tags: Treatment options


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