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Refutation of the myth of the female athlete triad
  1. L Di Pietro,
  2. N Stachenfeld
  1. The John B Pierce Laboratory, Yale University, New Haven, Connecticut, USA
  1. Correspondence to:
 Dr L Di Pietro
 The John B Pierce Laboratory, Yale University, 290 Congress Avenue, New Haven, Connecticut 06511, USA;ldipietro{at}

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We are pleased to respond to Refutation of “the myth of the female athlete triad” by Loucks; however, to respond in a point-by-point manner to each and every issue of contention would prove quite tiresome, and, more than likely, futile. Therefore, our response will focus on the more general issues of science and language, with particular attention to the translation (ie, application) of laboratory findings into practice and then into policy intended to affect collective behaviours. In doing so, we wish to remind the reader that there are guidelines governing the delicate balance between science and practice. We have described these guidelines previously with regard to the triad,1 and wish to reiterate that they were developed to prevent practitioners, policy makers and regulators from reacting either too hastily to incomplete science or too slowly to sound science. We continue to maintain that the science pertaining to the female athlete triad is less than complete. Therefore, any attempt to influence practice or policy with regard to the triad should be made with extreme caution, as these efforts may be misguided at this time.

Loucks et al2–5 have made a landmark contribution to women’s health by identifying a mechanism (low energy availability, independent of exercise stress) by which exercise disrupts leutinising hormone pulsatility. That this mechanism was identified using the …

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    L DiPietro N S Stachenfeld