Energy balance

Restoration of energy availability through increased caloric intake and/or reduced exercise expenditure is the primary non-pharmacological intervention required to reverse menstrual dysfunction and support bone health recovery in female athletes with the Female Athlete Triad.

If you are an athlete experiencing missed periods or low bone density, the most critical step is to eat more and/or train less to fix your energy deficit. Do not rely on your weight staying the same as a sign of health; you can be 'weight stable' but still be starving your body physiologically. Aim to increase your daily calories by 20-30% gradually (adding 200-600 calories) and consider reducing training volume if necessary. Expect menstrual cycles to return within months, but understand that bone density improvements may take years. Work with a sports dietitian and physician.