Research

Hormonal

Female physique competitors face significantly higher risks of Relative Energy Deficiency in Sport (RED-S), menstrual irregularities, and psychological distress compared to male competitors due to the biological demands of extreme leanness.

Female competitors should prioritize health over extreme leanness. Monitor menstrual function and bone health. Use slower weight loss strategies and maintain appropriate off-season body composition to reduce the risk of RED-S and hormonal disruption.

ModerateSupportsMEDIUM confidence
Generally, female athletes are at a risk for Relative Energy Deficiency in Sport (RED-S) that usually follows a low energy availability state, usually resulting in deteriorations of metabolic rate, menstrual functioning, and impaired bone and cardiovascular health [55].
Eric R. Helms et al. · Sports · 2019

Why this rating

Based on case studies and cross-sectional comparisons cited in a narrative review.

Source

Towards a Sustainable Nutrition Paradigm in Physique Sport: A Narrative Review

Eric R. Helms et al. · Sports · 2019

DOI 10.3390/sports7070172

narrative_reviewCited 36×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

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