Br J Sports Med 48:289 doi:10.1136/bjsports-2013-093218
  • Consensus statement

2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013

Editor's Choice
  1. 1Department of Kinesiology, Penn State University, University Park, Pennsylvania, USA
  2. 2University of California Los Angeles, Los Angeles, California, USA
  3. 3Intermountain Healthcare, Salt Lake City, Utah, USA
  4. 4Harvard Medical School, Boston, Massachusetts, USA
  5. 5University of Waterloo, Waterloo, Ontario, Canada
  6. 6University of Toronto, Toronto, Ontario, Canada
  7. 7Hospital for Special Surgery, New York, New York, USA
  8. 8Stanford University, Stanford, California, USA
  1. Correspondence to Mary Jane De Souza, Department of Kinesiology, Women's Health and Exercise Laboratory, 104 Noll Laboratory, Penn State University, University Park, PA 16802, USA; mjd34{at}
  • Received 22 October 2013
  • Revised 4 December 2013
  • Accepted 6 December 2013


The Female Athlete Triad is a medical condition often observed in physically active girls and women, and involves three components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction and (3) low bone mineral density. Female athletes often present with one or more of the three Triad components, and an early intervention is essential to prevent its progression to serious endpoints that include clinical eating disorders, amenorrhoea and osteoporosis. This consensus statement represents a set of recommendations developed following the 1st (San Francisco, California, USA) and 2nd (Indianapolis, Indiana, USA) International Symposia on the Female Athlete Triad. It is intended to provide clinical guidelines for physicians, athletic trainers and other healthcare providers for the screening, diagnosis and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad expert panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision-making regarding sport participation, clearance and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team and implementation of treatment contracts. This consensus paper has been endorsed by the Female Athlete Triad Coalition, an International Consortium of leading Triad researchers, physicians and other healthcare professionals, the American College of Sports Medicine and the American Medical Society for Sports Medicine.