Missing period? If you’re exercising a lot, this may be why

Are you missing your period, feeling fatigued and not recovering as you usually do? You may be experiencing a syndrome known as RED-S.

What is RED-S

RED-S is a syndrome affecting athletes whose energy output through exercise and activity is greater than their energy input through diet.

The abbreviation RED-S stands for:

• Relative

• Energy

• Deficiency In

• Sport

Sometimes referred to as Low Energy Availability (LEA), RED-S can have a wide range of potential health consequences, affecting many parts of the body, including:  

• Altered metabolic function

• Menstrual changes in female athletes

• Decreased muscle strength

• Impaired bone health

• Anaemia

• Irritability and reduced concentration

• Increased risk of illness and injury

Signs and Symptoms

It is important that the red flags of RED-S are detected early to maintain and improve performance and prevent long-term health outcomes. This may be challenging as symptoms can often be subtle; however, athletes participating in sports with weight categories or an emphasis on aesthetics and appearance are at higher risk. Signs and Symptoms can be psychological, behavioural, physiological or performance related and may include the following:

• Psychological: Perfectionist mindset, anxiety around food and exercise, social withdrawal due to fear of missing out on training, and feeling that only weight and performance can define you.

• Physiological: Lack of three consecutive periods or changes to a previously regular menstrual cycle in female athletes, decline in morning erectile function in male athletes, always cold, digestive issues such as constipation and diarrhoea, poor training adaptations and results.

• Behavioural: Over-training and underfuelling, training in secret, lying about the amount of training or food eaten, reduced sleep or rate of recovery, inability to take rest days.

• Performance: Increased injury and illness, poor recovery between sessions, decrease in overall performance, and results in reduced energy, reduced fitness and muscle mass, digestive issues such as bloating affecting performance.

The Bottom Line

RED-S can affect athletes in any sport at any age and gender. It is important to be aware of the signs and symptoms to ensure early detection and prevent negative impacts on health and performance. Red flags can be subtle, appear in a range of areas and result in a variety of health consequences.

If you have any health concerns related to RED-S, it is important you speak with your doctor or an Accredited Sports Dietitian.

Our friendly Accredited Sports Dietitian Shanna can help with any sports nutrition-related concerns and provides individualised nutrition advice, as every case is different.

To book an appointment, click here or call us on 07 4566 0765

References:

Relative Energy Deficiency in Sport (RED-S) Clinical Assessment Tool (CAT)

https://www.ioc-preventionconference.org/atpc/2019/wp-content/uploads/2019/07/S9.2-5_RED-S-IOC-ATPC.pdf

Written by Olivia Medway, APD