2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 1: State of the Science and Introduction of a New Adolescent Model

This paper is the first of two publications comprising a 2025 update to the 2014 Consensus Statement on treatment and return-to-play guidelines on the Female Athlete Triad (Triad), defined as three inter-related components including energy status, reproductive function, and bone health. The Triad is initiated by exposure to varying degrees of energy deficiency with or without disordered eating/eating disorders with primary pathological outcomes to the reproductive and skeletal systems. This first paper includes a detailed update on the scientific underpinnings of the Triad and introduces a new Triad model specific to the adolescent female athlete. Energy deficiency and "metabolic compensation" are added to the energy status continuum to describe adaptations that reflect energy conservation. Ovarian steroid hormone exposure and functional hypothalamic oligo-amenorrhea are added to the reproductive function continuum. Bone stress injury is added to the bone health continuum. Rates of change are depicted for the induction and recovery of clinical outcomes within the adult model. Evidence-based statements are presented throughout the paper and supported by a high number of level A and B grades.

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Publication Details

Journal
Sports Medicine
Published
2025-12-31
DOI
https://doi.org/10.1007/s40279-025-02333-z
Citations
1
Primary Topic
Bone health and osteoporosis research
Type
article
Field-Weighted Citation Impact
1.72
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article

2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 1: State of the Science and Introduction of a New Adolescent Model

Michelle T. Barrack, Kristen J. Koltun, Michael Fredericson, Kary Woodruff et al.
1 citations
Sports Medicine
Bone health and osteoporosis research
1.72
article

2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 1: State of the Science and Introduction of a New Adolescent Model

Michelle T. Barrack, Kristen J. Koltun, Michael Fredericson, Kary Woodruff, Aurelia Nattiv, Sasha Gorrell, Madhusmita Dash Dr. Surjya Kumar Misra, MARY JANE DE SOUZA, Nancy I. Williams, Elizabeth A. Joy, Emily A. Ricker, Rebecca J. Mallinson, Franziska Plessow, Ana Carla C. Salamunes, Emma O’Donnell
article en
1 citations

Abstract

This paper is the first of two publications comprising a 2025 update to the 2014 Consensus Statement on treatment and return-to-play guidelines on the Female Athlete Triad (Triad), defined as three inter-related components including energy status, reproductive function, and bone health. The Triad is initiated by exposure to varying degrees of energy deficiency with or without disordered eating/eating disorders with primary pathological outcomes to the reproductive and skeletal systems. This first paper includes a detailed update on the scientific underpinnings of the Triad and introduces a new Triad model specific to the adolescent female athlete. Energy deficiency and "metabolic compensation" are added to the energy status continuum to describe adaptations that reflect energy conservation. Ovarian steroid hormone exposure and functional hypothalamic oligo-amenorrhea are added to the reproductive function continuum. Bone stress injury is added to the bone health continuum. Rates of change are depicted for the induction and recovery of clinical outcomes within the adult model. Evidence-based statements are presented throughout the paper and supported by a high number of level A and B grades.

Sports MedicineVol. 56(2)
Henry M. Jackson Foundation (US), Pennsylvania State University (US), Loughborough University (GB), English Institute of Sport (GB), Uniformed Services University of the Health Sciences (US), Harrisburg University of Science and Technology (US), University of California, Los Angeles (US), University of Pittsburgh (US), University of California, San Francisco (US), University of Utah (US), Loughborough College (GB), Los Angeles Medical Center (US), Orthopaedic Hospital (US), Utah Department of Health (US), Stanford Medicine (US), University of Virginia (US), California State University, Long Beach (US), Stanford University (US)
Openalex Percentile: Top 12%
Bone health and osteoporosis research
1.72
DOIOpen Access PDFOpenAlex
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