The Role of Energy Availability in Reproductive Function in the Female Athlete Triad and Extension of its Effects to Men: An Initial Working Model of a Similar Syndrome in Male Athletes.
Level 5 - mechanism / opinion, no new human data
Narrative review and conceptual working model without original empirical data or systematic review methodology
PubMed 31696452 · doi:10.1007/s40279-019-01217-3
What was done
The authors conducted a narrative review of the Female Athlete Triad literature regarding low energy availability, reproductive function, and bone health. Using existing evidence, they developed an initial working model of a comparable syndrome in male athletes (the Male Athlete Triad), focusing on physiological responses of the hypothalamic-pituitary-gonadal axis and bone health to energetic deficiency across sexes.
What was found
The review reported qualitative findings without quantitative meta-analytic data: (1) available evidence does not support a distinct energy availability cutoff below which menstrual dysfunction is triggered; (2) male reproductive, energetic, and skeletal systems appear more resilient to low energy availability than female systems, requiring more severe energy deficits before impairments occur; and (3) hypothalamic-pituitary-gonadal axis recovery appears faster in men than in women after low energy availability.
Why it matters
This review establishes a theoretical framework for recognizing and researching energy-deficiency syndromes in male athletes while challenging previous assumptions of a single, universal energy-availability threshold for reproductive impairment in females.
Limits
The abstract provides no quantitative effect sizes, sample sizes, or study counts. As a narrative review rather than a systematic review, it is prone to selection bias, and the proposed male athlete triad model represents an early working framework rather than a validated clinical diagnostic paradigm.
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- supports Chronic or prolonged fasting and severe calorie restriction can suppress ovulation and cause the cessation of the menstrual cycle in women.