This chapter begins with a brief description of our current understanding of the condition referred to as the “Female Athlete Triad” (Triad). It explains what had been the three most widely held hypotheses about the cause of the Triad and then summarizes the prospective clinical experiments that identified low energy availability as the specific cause. Research supports that exercise has no suppressive effect on reproductive function in women beyond the impact of its energy cost on energy availability, and the suppression was found to occur abruptly below a threshold of 30 kcal/kg of fat-free mass per day. The chapter closes by identifying four distinct origins of low energy availability among female athletes and stresses the importance of identifying the particular origin in each case of the Triad before attempting to modify that athlete’s diet and exercise behavior. The chapter also discusses in more detail the means for controlling energy availability in the experiments, as well as the magnitude of errors that can occur in estimates of energy availability from estimates of body fatness, energy expenditure, and energy intake.
- Energy availability
- Female Athlete Triad
- LH pulsatility
- Menstrual cycle
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American College of Sports Medicine
Body mass index
Insulin-like growth factor-I
Lean body mass
Negative energy balance
Non-exercise energy expenditure
Total energy expended during exercise
Waking energy expenditure
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Anne Loucks is a founder and shareholder of AEIOU Scientific, LLC.
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Loucks, A.B. (2020). Exercise Training in the Normal Female: Effects of Low Energy Availability on Reproductive Function. In: Hackney, A., Constantini, N. (eds) Endocrinology of Physical Activity and Sport. Contemporary Endocrinology. Humana, Cham. https://doi.org/10.1007/978-3-030-33376-8_11
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