How is RED-D managed?

If you think you might have RED-D then the best way to manage this is to talk to someone you trust, who can direct you to a specialist sports medicine physician. Your sports physician will discuss your symptoms, order necessary tests, and do a comprehensive clinical review which may lead to the diagnosis of REDs. As a syndrome, it involves an complex interplay of symptoms, making diagnosis a process of exclusion. A joint monitored plan from relevant, specialist members of a multidisciplinary team is best practice, the plan can then be implemented and reviewed together.

Some key factors that may be considered are:

• Screening tests

  which may include; Questionnaires (LEAF/LEAM/DEAQ), discussion around hormonal health/symptoms including menstrual history and libido, discussion around injury (parotuccary bony injuries) and illness’, and sleep quality/quantity, and mood, looking at growth and development charts and strength & conditioning profiling results over time where possible (to identify if any reduced muscle strength or reduced endurance performance).

• Diagnostic tests

  which may include; gynaecological ultrasound, bloods (especially looking at bone biochemistry, endocrine markers, cardiac tests such as blood pressure (sitting and standing), heart rate and an ECG test, Vitamin D and full blood count markers), DXA to look at bone mineral density.

• Nutritional assessment

  . Where possible it is highly important to get input from a specialist nutritionist to help assess and support dietary intake, supplements, recovery and meal plans where this may be helpful.

• Psychological assessment

  and then support as may be needed to support recovery. Psychological problems can be both the cause and result of REDs so it is very important to address.

• Evaluating

  dance work/training load. Where necessary, modifying these loads in the short term, to support energy balance may be recommended.

• A structured physical training program to include resistance training to promote good bone health

• Check blood Vitamin D levels and supplementation as advised where necessary

• The possibility of hormone therapy, if clinically indicated, such as transdermal oestradiol therapy with cyclic oral micronised progesterone in females, may be prescribed to support bone health.