Introduction: In physically active women, both professional and recreational, proper nutrition is fundamental for maintaining health, performance, and hormonal balance. Adequate energy intake supports bone metabolism, menstrual regularity, and overall physiological function. When energy balance is disrupted-due to restrictive diets, caloric deficits, or intense training-the body activates energy-saving mechanisms that suppress reproductive and skeletal functions. This condition may lead to Relative Energy Deficiency in Sport (RED-S), a multifactorial syndrome involving hormonal, metabolic, skeletal, cardiovascular, and immune disturbances. Despite its serious consequences, the prevalence of RED-S is often underestimated, and awareness among athletes and professionals remains limited. State of knowledge: The syndrome occurs in both elite and recreationally active women, often remaining undiagnosed. Despite growing scientific interest and expert recommendations, standardized diagnostic criteria and effective screening tools are still lacking, making early recognition and treatment of RED-S challenging. Aim: The aim of this study was to review current data on RED-S in women, with particular emphasis on its pathophysiology, clinical consequences, diagnostic challenges, and therapeutic strategies. Materials and Methods: A critical literature review was conducted for the years 2005-2025, including clinical and observational studies, systematic reviews, and expert consensus statements. Conclusion: RED-S represents a serious threat to women’s health and performance, with potential long-term consequences. Early diagnosis and non-pharmacological management-adequate nutrition, training modification, and psychological suport-are essential. Pharmacological treatment should be reserved for selected cases. Increasing awareness among healthcare professionals, athletes, and their support teams is crucial for effective prevention, early detection, and management of RED- S.
Białowąs et al. (Wed,) studied this question.