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The 30-second answer
Yes, low energy availability can contribute to menstrual changes, weaker bones, and bone stress injuries, but a coach cannot determine the cause from the sideline. A missed period is not a training badge, and repeat bone pain or stress injury is not something to train through. Share the concern privately with the family and route the athlete for medical evaluation.
What to do next
- 1
Respond privately, document only observable participation or injury concerns through the school-approved channel, and involve the parent or guardian.
- 2
For missed or increasingly irregular periods, recommend timely evaluation by the athlete’s pediatrician, adolescent-medicine clinician, or sports-medicine clinician rather than waiting until the season ends.
- 3
For focal bone pain or a suspected stress injury, stop impact activity and follow the school’s athletic-training and medical-referral process before return.
- 4
Fix obvious access barriers to breakfast, lunch, snacks, recovery food, rest, and appropriate training load without diagnosing RED-S or writing an individual treatment plan.
Patterns a coach should notice, not diagnose
- An athlete privately reports a period gap of three months, increasingly irregular periods, or periods that stopped after training increased.
- The same athlete has focal bone pain, a previous stress reaction or stress fracture, declining performance, or slower recovery.
- Other observable concerns include repeated illness, fatigue, dizziness, poor growth, weight loss, extra unscheduled training, or anxiety and rigid rules around food.
What a coach can say
“Thank you for telling me. Missed periods and repeat bone pain are health information, not something I will discuss with the team. I cannot diagnose the cause, but this pattern deserves medical evaluation now. I will involve your parent or guardian and our athletic-training or school health process, and we will pause impact activity if a bone stress injury is suspected.”
What to avoid
- Do not call missed periods normal for serious athletes or praise the athlete for training through them.
- Do not collect team menstrual calendars, weight logs, food diaries, or private lab results.
- Do not recommend iron, calcium, vitamin D, hormonal treatment, or a calorie target from a coach conversation.
When general guidance stops
Missed or increasingly irregular periods, delayed puberty, focal bone pain, suspected or repeated stress injury, poor growth, weight loss, restrictive eating, or persistent fatigue needs family involvement and qualified medical evaluation. Diagnosis, lab interpretation, treatment, nutrition prescription, and return-to-play decisions stay with the appropriate clinical team and school process.
Urgent boundary
Inability to bear weight, a suspected acute fracture, collapse, fainting, confusion, chest symptoms, or severe weakness requires immediate school emergency-action-plan activation and urgent medical support.
Use the matching resource
These open the complete public handout or released tool. There is no email gate.
Sources
For the whole school season
Want this built into the week? See Program Access.
Open the week, review the parent message, send it through your school channel, give the two-minute team talk, and share the matching resource. Families join privately with your program code; Aspire never messages families for you.
Individualized assessment, diagnosis, and 1:1 treatment are separate from Program Access.
See exactly what the school gets