10 Summary of Session 7

You should now be aware of what RED-S is, how it is caused and its relation to bone fractures and osteoporosis. You should also appreciate the impact of RED-S on the menstrual cycle and the negative impact it has on important systems of the body. You should know what signs of RED-S to look out for and what steps can be taken to support female athletes experiencing RED-S.

The main learning points of this seventh session are:

• Relative energy deficiency syndrome (RED-S) occurs when the body uses more energy than is being taken on over a prolonged period of time.
• Low energy availability can lead to a disruption in the menstrual cycle, loss of periods, and eventually bone fractures.
• RED-S can also affect the cardiovascular, immune, digestive and endocrine systems.
• RED-S has a range of causes, but it is closely linked to the belief that being lighter will produce a better performance.
• Low energy availability disrupts the menstrual cycle resulting in less oestrogen production and a shortage of oestrogen can affect bone density.
• Low oestrogen levels in females before their menopause is a major risk factor in developing osteoporosis in later life.
• As well as disruptions to the period, other signs of RED-S are a pre-occupation with food and eating, excessive tiredness, poor recovery and a decline in athletic performance.
• RED-S can be prevented by ensuring energy intake matches the demands of an athlete’s training, recovery, and daily activities.
• The treatment of RED-S requires a team approach, including a doctor, sports nutritionist and sport psychologist.

In the next and final session, you will look at effective ways to communicate with female athletes.

You can now go to Session 8.