Evidence map›Paper›PMID 41441437›Full record

ReviewSports (Basel, Switzerland)2025

Pharmacological vs. Non-Pharmacological Treatment in the Management of Relative Energy Deficiency in Sport (REDs): A Systematic Review and Meta-Analysis.

Aimee Nicole Wood, Andrew Soundy

Abstract readReview
In one paragraph

Review in Sports (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Aimee Nicole WoodDepartment of Physiotherapy, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TS, UK.ORCID 0009-0004-6911-0280
Andrew SoundyDepartment of Physiotherapy, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TS, UK.ORCID 0000-0002-5118-5872

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe purpose of the study was to conduct a systematic review assessing the impact of pharmacological and non-pharmacological interventions on Relative Energy Deficiency in Sport (REDs). The study design follows a systematic review and meta-analysis. The data sources are CINAHL, MEDLINE, SportDiscus, ERIC, and Embase from inception until July 2025. Eligibility criteria for selecting the studies include the experimental, quasi-experimental, and pre-experimental literature that investigated interventions designed to support the symptoms of REDs.

resultsA total of nineteen studies (fifteen non-pharmacological interventions, four pharmacological interventions), with a total of 759 females, were included in the review. Non-pharmacological interventions demonstrated positive benefits on menstrual function recovery, energy availability, fat mass, and body fat percentage. Meta-analyses quantified nutrition intervention benefits on an individual's fat mass (kg), 1.36 (95% CI 0.68, 2.04), and body percentage fat (%), 2.21 (95% CI 1.34, 3.08). It was also possible to identify the impact of non-pharmacological interventions on total triiodothyronine (T3) biomarkers (nmol/L), -2.37 (95% CI -5.57, 0.83). It should be noted, however, that non-pharmacological interventions were limited by quality and certainty assessment, identifying included evidence as low to moderate. Pharmacological interventions demonstrated some positive (at times very strong effect sizes) results for impact on bone mineral density, but conclusions are currently limited by well-powered experimental studies.

conclusionsThe current evidence base favors non-pharmacological management as an initial response for managing REDs. Initial pharmacological management appears to identify limited but potentially (depending on the drug) promising evidence for the impact on bone mineral density; further evidence is required to be more certain about the impact on hormonal profiling and menstrual recovery function. Further research is needed to help develop a greater understanding.

Indexed as

energy availabilityinterventionnon-pharmacologicalpharmacologicalRelative Energy Deficiency in Sport (REDs)

Identifiers

PMID41441437
PMCPMC12737033

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.