A survey has found that 36% of female athletes dismissed missing periods as normal or, in certain situations, advantageous for an active individual. The Female Athlete Health Report from Project RED-S and Kyniska Advocacy examined responses from 769 athletes who were asked about their menstrual cycle and body image. 

The results showed that 30% of female athletes were told that period abnormalities were "normal" due to their different activity levels. Menstrual dysfunction is commonly caused by a lack of energy, polycystic ovarian syndrome, an overactive thyroid, or heart disease. Calorie shortage causes Relative Energy Deficiency in Sport (RED-S) causing poor energy availability. Before the survey, less than half of the respondents had heard of RED-S.

The investigation examined athlete body image, with 74% of those polled admitting they did not look like an athlete, 50% decreasing their food intake to boost their performance, and 52% doing so to fit in or look the part in their sport.91% were concerned about how many calories they consumed, with 19% saying they were concerned "all the time." 53% got remarks on their physique, and 49% searched for information and help on the Internet.

The report stated that it’s important and required to have a centralized thorough coach education on female health to be included in all coaching centers at all levels.

Furthermore, the report advocated for establishing an athlete-led female health, body image, eating disorder, and RED-S support network, as well as the widespread distribution of an online female athlete health toolkit for athletes and parents to be used by athletes first entry into the sport.   GPs should be given more resources to help them understand female athletes health problems in a better way.

(Source: https://www.theguardian.com/sport/2023/may/03/female-athletes-health-implications-missed-periods-red-s)