Energy balance

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

If you are a female athlete experiencing missed periods or low energy, your body is likely in 'survival mode' due to insufficient fuel relative to your activity. The most effective treatment is not medication, but increasing your food intake (specifically by 20-30% above your current baseline) and potentially reducing exercise volume. Aim for a daily energy availability of at least 45 kcal per kg of fat-free mass. This process takes time (often over a year) and requires working with a sports dietitian and physician to monitor weight gain and menstrual return safely.