Energy Deficiency Female Athletes

Have you guys ever heard of RED-S? Or even thought that men and women vary in how hard they should push with training? I’m not saying women have to be treated “dainty” because of their sex; but I’m referring to Dr. Stacy Sims most popular saying that “women are not small men.”

First let’s define RED-S: Relative Energy Deficiency Syndrome. This occurs in both females and males, but the focus of this article will be on how it affects females. It is characterized by fatigue, low mood, amenhorrea (lost of menstrual cycle), frequent injuries/delayed healing, and loss of bone density. This is caused by under-fueling for the demands of the athlete’s sport.

RED-S is often seen in athletes who develop eating disorders, which can be seen very commonly in young teens, and dancers. But RED-S affects those who don’t have an eating disorder either. There are young athletes in high school trying to balance the demands of high school, along with playing their sport 5 days/week and then training the other 2 days of the week. Leaving 0 days of rest. I see this unfortunately a lot in high school athletes, and this is where educating not only the athlete, but the parents as well that training 7 days per week leads to a decrease in performance/injuries. Collegiate and post-collegiate athletes can experience this as well with trying to maintain a significantly high training load, and not resting or fueling enough.

So why does RED-S matter? It can impair growth and development, significantly impact one’s health and lead to injuries (reducing your ability to compete), and negatively impact an athlete’s performance.

With social media blasting everywhere on the best ways to “get lean”, “lighter is faster”, “no days off”, or “the only bad workout is the one you didn’t do”, it’s hard to not get caught up in RED-S when you’re a competitive athlete. What’s not broadcasted enough is the fact that women do have menstrual cycles and hormones that affect how much training load they can actually tolerate at different points of their cycle. On top of that, posts of women with 6 packs and being rippled everywhere, can influence athletes that they have to look like that to succeed at their sport, and be “the best of the best”. But how long is that look and lifestyle sustainable? Something is going to give.

Yes, 100000%, eating right, working out, being strong and healthy is the way to go. But it is important to check in with athletes on how they’re feeling, being observant of their behaviors, and talking with them frequently about healthy lifestyles that include rest days and not feeling guilty about taking a rest day. And talking about periods is not taboo anymore; female athletes need to understand how their menstrual cycle affects their training, so they need to listen to their body if it’s screaming for rest, and when it says “lets go”.

Take homes:

1.) Fuel correctly for the demands of your sport & activity level

2.) Having a regular menstrual cycle is a measure of your hormonal health

3.) Take rest days.

I’ll leave you with this parable for some food for thought:

A woodcutter strained to saw down a tree.  A young man who was watching asked “What are you doing?”

“Are you blind?” the woodcutter replied. “I’m cutting down this tree.”

The young man was unabashed. “You look exhausted! Take a break. Sharpen your saw.”

The woodcutter explained to the young man that he had been sawing for hours and did not have time to take a break.

The young man pushed back… “If you sharpen the saw, you would cut down the tree much faster.”

The woodcutter said “I don’t have time to sharpen the saw. Don’t you see I’m too busy?” -Stephen Covey’s take on the 7th Habit. “The 7 Habits of Highly Effective People.”

References:

1.) Dudgeon, Emily. Relative energy deficiency in sport (RED-S): recognition and next steps. Relative energy deficiency in sport (RED-S): recognition and next steps - BJSM blog - social media's leading SEM voice (bmj.com).

2.) Ed. Margo, Mountjoy. The Female Athlete. Handbook of Sports Medicine and Science: The Female Athlete (olympic.org).