Risk factors | Magnitude of risk | |||
Low risk (0 points each) | Moderate risk (1 points each) | High risk (2 points each) | ||
Low EA with or without DE/ED | No dietary restriction | Some dietary restriction*; current or past history of DE | Meets DSM-V criteria for ED¶ | |
Low BMI | BMI ≥18.5 or ≥90% EWΔ or weight stable | BMI 17.5 to <18.5 or <90% but ≥85% EW or 5 to <10% weight loss per month | BMI <17.5 or <85% EW or ≥10% weight loss per month | |
Delayed menarche | Menarche <15 years | Menarche 15 to <16 years | Menarche ≥16 years | |
Oligomenorrhea and/or amenorrhea | >9 menses in 12 months¶ | 6 to 9 menses in 12 months¶ | <6 menses in 12 months¶ | |
Low BMD | Z-score >–1.0 | Z-score –1.0◊ to –2.0 | Z-score <–2.0 | |
Stress reaction/fracture | None | 1 | ≥2 sites; ≥1 high risk or trabecular bone site§ | |
Cumulative risk (total each column, then add for total score) | ||||
Total score: | = | + | + | |
Scoring of risk factors is as follows: | ||||
| Low risk | The athlete is cleared for full participation in practice and competition. | ||
| Moderate risk | The athlete may participate to a modified extent, but may not participate fully in practice or competition, and must be monitored closely to be certain their condition is improving. | ||
| High risk | The athlete may not participate in practice or competition. | ||
For guidance about clinical improvement and clearance for participation, please refer to the UpToDate topic discussing the female athlete triad. |
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