Reproductive Disorders among Female Athletes: Causes, Pathomechanism, and Treatment Approaches – A Literature Review
DOI:
https://doi.org/10.12775/QS.2026.68.74481Keywords
relative energy deficiency, low energy availability, functional hypothalamic amenorrhea, amenorrhea, female athlete triad, sport, physical activity, lifestyle, lifestyle modificationAbstract
Background. Female sport participation has grown rapidly, outpacing sex-specific clinical guidelines and leaving reproductive disorders under-recognised and often normalised as a marker of training success. The conceptual model has shifted from the narrow Female Athlete Triad to the broader Relative Energy Deficiency in Sport (RED-S) framework, yet diagnostic delay remains common.
Aim. To synthesise current literature on the spectrum of reproductive disorders in female athletes and provide a clinically actionable framework for aetiology, diagnosis, and management.
Material and methods. A narrative review of original studies, randomised controlled trials, systematic reviews, meta-analyses, and consensus statements from the International Olympic Committee, American College of Sports Medicine, Endocrine Society, and American Society for Reproductive Medicine.
Results. Low energy availability (LEA) was identified as the primary trigger of GnRH suppression, with effects on skeletal, cardiovascular, metabolic, and psychological health. Diagnosis requires a systematic algorithm; management is based on nutritional and psychological intervention, with transdermal hormonal replacement as a last resort. Widespread oral contraceptive prescription is a counterproductive practice masking the underlying energy deficit.
Conclusions. Reproductive dysfunction in female athletes reflects a systemic energy-conservation response, not an isolated gynaecological finding. Closing the diagnostic gap requires screening integration, education, and a cultural shift away from normalising amenorrhea in sport.
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Copyright (c) 2026 Anastasiya Aleshchyk, Michał Adamczak, Marcel Majewski, Bogumił Libura, Martyna Lazar, Łukasz Szkaradowski, Szymon Baranowski, Julia Lewańska, Krzysztof Bogdański, Zuzanna Kruszyńska
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