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Wednesday, July 23, 2025

Silent struggles

by

Dr Chloe Thompson
30 days ago
20250622

Glob­al at­ten­tion has re­cent­ly grown around the chal­lenges faced by fe­male ath­letes, not just on the field but al­so in terms of their health and well-be­ing. Low En­er­gy Avail­abil­i­ty (LEA) is a press­ing is­sue be­ing stud­ied. This con­di­tion is of­ten hid­den but can have se­ri­ous con­se­quences for ath­let­ic per­for­mance, long-term health and qual­i­ty of life.

LEA oc­curs when the body lacks suf­fi­cient en­er­gy to sup­port ba­sic phys­i­o­log­i­cal func­tions, such as hor­mone pro­duc­tion, bone health, and men­tal well-be­ing, af­ter ex­er­cise. This en­er­gy short­fall of­ten oc­curs un­in­ten­tion­al­ly, es­pe­cial­ly when ath­letes are train­ing in­tense­ly and not con­sum­ing enough food to meet their en­er­gy needs. Over time, LEA can lead to con­di­tions such as the Fe­male Ath­lete Tri­ad, which in­cludes men­stru­al dys­func­tion, low bone min­er­al den­si­ty, and en­er­gy de­fi­cien­cy, as well as the broad­er con­di­tion known as Rel­a­tive En­er­gy De­fi­cien­cy in Sport (RED-S). RED-S af­fects not just fe­male ath­letes but al­so males and can im­pair car­dio­vas­cu­lar, gas­troin­testi­nal, meta­bol­ic and im­mune func­tion.

Al­though LEA and RED-S have been wide­ly stud­ied in North Amer­i­ca and Eu­rope, re­search in the Caribbean has been lim­it­ed un­til now. As a grad­u­ate stu­dent in the Fac­ul­ty of Sport, my re­search has been un­cov­er­ing im­por­tant in­sights in­to the knowl­edge, aware­ness and preva­lence of LEA among adult fe­male ath­letes in Bar­ba­dos. Twen­ty ath­letes have com­plet­ed a sur­vey ex­plor­ing their eat­ing habits, train­ing loads, men­stru­al cy­cles, fa­tigue, and over­all knowl­edge of en­er­gy avail­abil­i­ty. The find­ings were both re­veal­ing and con­cern­ing.

While all par­tic­i­pants had at least heard of the term “LEA,” on­ly 20% re­port­ed be­ing very fa­mil­iar with it, and 25% were not fa­mil­iar with it at all. This frag­ment­ed un­der­stand­ing of a ma­jor health risk high­lights a sig­nif­i­cant gap in ath­lete ed­u­ca­tion, par­tic­u­lar­ly giv­en that these women are com­pet­ing at some of the high­est lev­els in sport in the re­gion. Most par­tic­i­pants re­port­ed symp­toms con­sis­tent with LEA. These in­clud­ed chron­ic fa­tigue, low sta­mi­na, emo­tion­al ex­haus­tion, and dis­rup­tions to their men­stru­al cy­cle, which are all red flags for en­er­gy de­fi­cien­cy.

De­creased per­for­mance was the most recog­nised con­se­quence among the ath­letes, fol­lowed by an in­creased risk of in­jury. Few­er ath­letes iden­ti­fied the risks of hor­mon­al im­bal­ance or men­tal health is­sues, even though these are well-doc­u­ment­ed out­comes of LEA and RED-S in sci­en­tif­ic lit­er­a­ture.

These find­ings high­light a cru­cial dis­con­nect be­tween aware­ness and ap­pli­ca­tion. Many ath­letes may not re­alise that the symp­toms they are ex­pe­ri­enc­ing are linked to a more pro­found en­er­gy im­bal­ance. This un­der­scores the need for tar­get­ed ed­u­ca­tion that not on­ly rais­es aware­ness but al­so em­pow­ers ath­letes to act, whether by seek­ing med­ical ad­vice, ad­just­ing their train­ing rou­tines, or im­prov­ing their nu­tri­tion.

This re­search has sig­nif­i­cant im­pli­ca­tions not on­ly for in­di­vid­ual ath­letes but al­so for the fu­ture of sport in Bar­ba­dos and across the Caribbean. Fe­male ath­letes in the re­gion are gain­ing more op­por­tu­ni­ties and recog­ni­tion, but health sup­port sys­tems have not al­ways kept pace with their growth. There is a press­ing need for bet­ter ath­lete ed­u­ca­tion, more ac­ces­si­ble nu­tri­tion­al and psy­cho­log­i­cal sup­port, and poli­cies that recog­nise the unique health risks fe­male ath­letes face.

LEA is par­tic­u­lar­ly dan­ger­ous be­cause it of­ten goes un­no­ticed un­til se­ri­ous prob­lems emerge, like stress frac­tures, burnout, or long-term re­pro­duc­tive is­sues. By the time these symp­toms ap­pear, the dam­age may al­ready be done. Ear­ly de­tec­tion and pre­ven­tion are key. Ath­letes at every lev­el de­serve to un­der­stand how their bod­ies func­tion and what they need to main­tain op­ti­mal health. Aware­ness of LEA should be as fun­da­men­tal as know­ing how to warm up or re­cov­er af­ter a train­ing ses­sion.

The study al­so asked ath­letes how they would pre­fer to learn more about LEA. Work­shops, group dis­cus­sions, and short ed­u­ca­tion­al ar­ti­cles were the most pop­u­lar meth­ods, show­ing that ath­letes are ea­ger to learn but need the right tools and en­vi­ron­ment to do so. For sports fed­er­a­tions, coach­es and health pro­fes­sion­als, this is a call to ac­tion. There must be a co­or­di­nat­ed ef­fort to in­te­grate LEA and RED-S aware­ness in­to train­ing pro­grammes, coach­ing cer­ti­fi­ca­tion, and ath­lete well­ness strate­gies. Schools, clubs, and na­tion­al sport­ing bod­ies all play a cru­cial role in pro­tect­ing the well-be­ing of ath­letes.

This re­search is just the be­gin­ning, and it opens the door for larg­er, re­gion-wide stud­ies and in­ter­ven­tions. As the Caribbean con­tin­ues to build its pres­ence on the in­ter­na­tion­al sports stage, safe­guard­ing the health of its ath­letes must be a pri­or­i­ty. LEA is not just a med­ical is­sue; it is a mat­ter of eq­ui­ty, rep­re­sen­ta­tion, and long-term ath­lete de­vel­op­ment. By lis­ten­ing to the ex­pe­ri­ences of fe­male ath­letes and re­spond­ing with sci­ence-backed, cul­tur­al­ly rel­e­vant so­lu­tions, Bar­ba­dos and its neigh­bours can set a pow­er­ful ex­am­ple in sports health ed­u­ca­tion. For now, the mes­sage is clear: un­der­stand­ing LEA is not op­tion­al. It is es­sen­tial to the suc­cess and safe­ty of every fe­male ath­lete, on and off the field.

Dr Chloe Thomp­son is a med­ical doc­tor pur­su­ing the MSc Sports Med­i­cine in the Fac­ul­ty of Sport at The UWI


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