ACL Graft Choice Risk Factors ACL-RSI Calculator (Return to Sport Readiness)AHA Pre-Participation Screening AOFAS Ankle-Hindfoot Scale ASES Elbow Score ASES Shoulder Score Acute:Chronic Workload Ratio (ACWR)Altitude Gain Guidelines Ankle Syndesmosis (High Ankle Sprain)Athlete's Heart vs HCM Beighton Score (Joint Hypermobility)Borg CR-10 Scale Borg RPE Scale (6–20)Brighton Criteria (BJHS)Buffalo Concussion Treadmill Test (BCTT)Child SCAT6 (Age 8–12)Commotio Cordis Protocol Cumberland Ankle Instability Tool (CAIT)DASH (UE Disability Index)Doha Groin Agreement ESC HCM SCD Risk Score ESC Pre-Participation Screening Energy Availability Calculator FAI Syndrome (Warwick)FAOS (Foot and Ankle Outcome Score)Fear-Avoidance Beliefs Questionnaire (FABQ)Female Athlete Triad Risk Foot Posture Index (FPI-6)Foot and Ankle Ability Measure (FAAM)Functional Movement Screen (FMS)Graduated Return-to-Play (GRTP) Protocol HAGOS (Hip and Groin Outcome Score)Hamstring Asymmetry Index Heat Index (Apparent Temp)Hip Outcome Score (HOS)Hooper Index (Athlete Wellness)I-PRRS (Psychological Readiness)IKDC (Objective Examination)IKDC (Subjective Knee Evaluation)Injury Severity KJOC Shoulder & Elbow Score KOOS (Knee Outcome Score)KOOS-PS (Physical Function Short Form)Kujala (Anterior Knee Pain Scale)LEAF-Q (LEA Screening)Lake Louise AMS Score Limb Symmetry Index (LSI)Little League Elbow Grading Lysholm Knee Score Marx Activity Rating Scale (MARS)Mayo Elbow Performance Score (MEPS)Modified Schober Test NEXUS C-Spine Criteria Neck Disability Index (NDI)One-Rep Max Estimator Osgood-Schlatter Severity Oswestry Disability Index (ODI)Ottawa Knee Rules Oxford Elbow Score Oxford Shoulder Score PAR-Q+ Readiness Questionnaire PARS-3 Youth Readiness Patellar Instability Severity Score Pitch Smart Guidelines (USA Baseball)Pittsburgh Knee Rules Post-Concussion Symptom Scale (PCSS)QuickDASH (Shoulder & UE)RED-S CAT (Clinical Assessment)Re-injury Anxiety Inventory (RIAI)Relative Age Effect (RAE)Return-to-Play Battery SANE Score (Single Assessment)SCAT6 (Sport Concussion Assessment Tool 6)SCOAT6 (Sub-acute and Office Follow-up)SEAQ-I Appetite Questionnaire STarT Back Screening Tool Session RPE (Internal Load)Sever's Disease Activity Single-Leg Hop Test Battery Standardized Assessment of Concussion (SAC)Steroid Equivalence Calculator Stinger / Burner Grading Sweat Rate and Rehydration TSK-11 (Tampa Scale for Kinesiophobia)TUE Criteria Checklist Tanner Stage Assessment Tegner Activity Scale (TAS)Training Monotony and Strain UCL Injury Risk (Medial Elbow)VISA-A (Achilles Tendinopathy)VISA-P Scale (Patellar Tendinopathy)VO2 Max VOMS (Vestibular/Ocular-Motor Screening)WADA Prohibited List Checker WBGT (Wet Bulb Globe Temp)WORC (Rotator Cuff Index)WOSI (Shoulder Instability Index)Wilks Score (Relative Strength)Wind Chill Index hEDS Diagnostic Criteria (2017)iHOT-33 (International Hip Outcome Tool)

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Female Athlete Triad Risk

Low Risk

0 Points • Full clearance

Energy Availability

Menstrual Status

Bone Mineral Density (Z-score)

High point totals should prompt multi-disciplinary intervention involving sports medicine, nutrition, and psychology.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Pre-participation physical evaluation (PPE) for female athletes, especially in endurance sports, aesthetic sports (gymnastics, figure skating, dance), and weight-class sports (rowing, martial arts).

Annual screening for adolescent and young adult female athletes presenting with stress fractures, recurrent injuries, or unexplained decline in performance.

Evaluation of athletes with disordered eating behaviors, restrictive dieting, or rapid weight loss.

Assessment of athletes with menstrual irregularities, including primary or secondary amenorrhea, oligomenorrhea, or delayed menarche.

Surveillance in female athletes with low energy availability (LEA) identified via dietary logs or validated questionnaires (e.g., LEAF-Q).

Follow-up monitoring for athletes diagnosed with any component of the Triad (low energy availability with or without disordered eating, menstrual dysfunction, low bone mineral density).

Screening for bone stress injuries (BSI) in female runners, military recruits, and dancers.

Key Indication - Diagnostic Alert for Low Energy Availability

The Female Athlete Triad is a clinical syndrome encompassing three interrelated components: low energy availability (with or without disordered eating), menstrual dysfunction, and low bone mineral density (BMD). The primary clinical utility is to identify athletes at risk for the Triad, as early detection and intervention can prevent irreversible bone loss and long-term health consequences. The American College of Sports Medicine (ACSM) and International Olympic Committee (IOC) recommend screening all female athletes for Triad components, especially those with a history of stress fractures, amenorrhea ≥3 months, or BMI <18.5 kg/m². A cumulative risk assessment using the Triad Cumulative Risk Assessment (CRA) tool stratifies athletes into low, moderate, or high risk, guiding further evaluation and management.

When Not to Use / Contraindications

Do not use as a standalone diagnostic tool for eating disorders; refer to DSM-5 criteria and specialized psychological evaluation.

Not applicable to male athletes; the Triad is specific to females due to menstrual function and estrogen-related bone health.

Avoid use in postmenopausal women or those with known primary ovarian insufficiency unrelated to energy availability.

Not suitable for acute injury assessment; it is a screening and monitoring tool for chronic conditions.

Do not rely solely on self-reported menstrual history; confirm with objective measures (e.g., serum estradiol, progesterone) if indicated.

Contraindicated in athletes with known pregnancy, as menstrual dysfunction is expected.

Last Comprehensive Review: 2026