“Can women be given access to all Olympic events? There are not just tennis players and swimmers. There are also fencers, horsewomen, and in America there have also been rowers. Tomorrow, perhaps, there will be women runners or even soccer players. Would such sports practiced by women constitute an edifying sight before crowds assembled for an Olympiad? We do not think that such a claim can be made”

(Pierre de Coubertin, Founder of the Modern Olympics, 1912).

Thankfully, we can now laugh at such outdated comments! Women’s participation in sport (and the Olympics) has undergone radical change, particularly over the past four decades. Today, girls and women are embracing opportunities to participate in a wide array of sports ranging from running and soccer, to skateboarding and rugby, and their participation ranges from recreational to the highest professional levels. Increasingly, girls and women can imagine careers as athletes. They have female athletes as visible role models who are paid to travel the world and to compete on the international stage. More and more sports offer equal prize money (e.g. Australian Open, US Open), and some women’s leagues are gaining major corporate sponsorship (e.g. Sony Erikson and WTA). A few female athletes are gaining major corporate sponsorships and earning seven figure salaries. This progress has been made thanks to the strong determination of women from different countries of the world that persistently worked to be fully part of the sports movement and its development.

There is a large body of evidence confirming that exercise is not only beneficial but also necessary for maintaining and improving physical and mental health in women. Female athletes may capitalize on this as they devote huge time, blood, sweat and tears to maximize their training in an effort to optimize sport performance. Read more on womenssportsfoundation.org. As such, many female athletes have high energy expenditures which can place them at-risk for developing a chronic energy deficit and the serious repercussions to long-term reproductive, skeletal and cardiovascular health and possibly also exercise training and sport performance. For example, insufficient muscle and liver glycogen stores, iron deficiency, recurrent injuries including stress fractures are not conducive to successful sport performance!

It is common for female athletes to inadvertently develop low energy availability by failing to match energy intake with the demands of exercise training. It is important to keep in mind that hunger is not a reliable indicator of energy and macro-nutrient needs. Female athletes are also exposed to body weight, composition, and image-related pressures from their parents, peers, coaches and the broader society. For example, low body weight may confer a performance advantage in sports such as endurance running and cycling; rowers and boxers must meet specific competition body weight regulations; and gymnasts and ballet dancers are often judged on appearance.

These pressures are in addition to the westernized social emphasis that thinness, weight and shape is associated with success. Most female athletes are aware of the potential financial benefits when one has the ‘look’ desired by advertisers (just think of the financial rewards reaped by Maria Sharapova!). While it is great to see (some) female athletes finally getting paid their worth, the pressures to both perform on the sporting field and look a particular way can put additional stress on female athletes who typically struggle to earn equivalent incomes (prize monies and sponsorship deals) to their male counterparts. Striving to meet such narrow definitions of what is the ideal female ‘sporting body’ is leading increasing numbers of girls and women to experience body image concerns, with some engaging in (sometimes expensive, and/or harmful) body-management practices. Some also develop disordered eating behaviours, and even eating disorders, which also predispose them to the consequences of chronic energy deficiency.

Numerous other predisposing factors can increase the risk for female athletes to develop low energy availability. Casual comments or pressure from coaches, family, peers, the media and sponsors to conform to an expected body weight, shape or appearance, time away from training due to injury or illness, performance anxiety, low self-esteem, a perfectionist personality and other personal, work or family issues may prompt female athletes to restrict energy intake, use pathogenic weight control methods or exercise excessively to lose or maintain body weight or prevent weight gain.

Chronic energy deficiency in female athletes is common but largely ignored and often not discussed. Yet regardless of how low energy availability develops, the reproductive, skeletal and cardiovascular systems, and possibly also exercise training and performance, are compromised. Furthermore, many General Practitioners are not up-to-date on the latest research and do not refer or manage energy deficient female athletes appropriately. The dangerous cocktail of ongoing stigma and misinformation has lead to some confusion and questioning among female athletes: What happened to my period? Should I be concerned? Will it impact my chances of having children in the future? What will be the state of my bones in 20 years time? These are important questions for female athletes, as well as their coaches, family and friends, members of the exercise industry and health professionals. We hope the information provided on this website helps you answer some of your own private questions, and perhaps seek further advice from a health professional.