This 2014 Female Athlete Triad Coalition consensus statement provides the first standardized clinical guidelines for screening, diagnosis, treatment, and return-to-play (RTP) decision-making for the female athlete triad — defined as low energy availability, menstrual dysfunction, and low bone mineral density — in physically active girls and women.
When you see a female athlete with stress fractures, menstrual irregularity, or low BMD, screen actively for all three triad components using the PPE questionnaire and apply the cumulative risk stratification tool to guide clearance — because each component amplifies fracture risk, and returning an athlete to sport without addressing energy availability first will continue to erode bone regardless of any other intervention.
Remember that oral contraceptives mask the problem without treating it, and bisphosphonates require specialist co-management in this age group given teratogenicity risk.
This 2014 Female Athlete Triad Coalition consensus statement provides the first standardized clinical guidelines for screening, diagnosis, treatment, and return-to-play (RTP) decision-making for the female athlete triad — defined as low energy availability, menstrual dysfunction, and low bone mineral density — in physically active girls and women.
When you see a female athlete with stress fractures, menstrual irregularity, or low BMD, screen actively for all three triad components using the PPE questionnaire and apply the cumulative risk stratification tool to guide clearance — because each component amplifies fracture risk, and returning an athlete to sport without addressing energy availability first will continue to erode bone regardless of any other intervention.
Remember that oral contraceptives mask the problem without treating it, and bisphosphonates require specialist co-management in this age group given teratogenicity risk.