Female athletes face ‘serious health implications’ of missed periods

Thirty-six per cent of female athletes have ignored missed periods thinking it was normal or in some cases beneficial for an active person, a survey has found. The Female Athlete Health Report from Project RED-S and Kyniska Advocacy focused on responses from 769 athletes in the UK assigned female sex at birth to questions concerning their menstrual cycle and body image.

It found 30% of respondents had been told by a medical professional that period abnormalities were “normal” given their activity level. The report stated this indicated GPs and other healthcare professionals “were not sufficiently informed about the potentially serious health implications of irregular/missed periods”.

Common reasons for menstrual dysfunction include low energy availability, polycystic ovary syndrome, an overactive thyroid or heart disease. The absence of menstruation is also a key symptom of Relative Energy Deficiency in Sport (RED-S). It is a condition that can affect elite and non-elite athletes and is characterised by low energy availability due to a calorie deficit.

Pippa Woolven is a former athlete and co-founder of Project RED-S, who helped to develop the Female Athlete Health Report. Woolven struggled with fatigue, injuries and low moods during her career but was consistently given the all-clear by medics to continue competing. She was finally diagnosed with RED-S in 2017 and retired in 2021.

She said: “RED-S carries widespread and often life-changing health and performance consequences to athletes of any age, gender, ability or activity. Historically, it has been misunderstood, undiagnosed and untreated. We’re here to help push for change across all levels of sport.”

RED-S can lead to irreparable damage, impairing almost every