Low energy availability, particularly when problematic (i.e., prolonged and/or severe), has numerous negative consequences for health and sports performance as characterized in relative energy deficiency in sport. These consequences may be driven by disturbances in endocrine function, although scientific evidence clearly linking endocrine dysfunction to decreased sports performance and blunted or diminished training adaptations is limited. We describe how low energy availability-induced changes in sex hormones manifest as menstrual dysfunction and accompanying hormonal dysfunction in other endocrine axes that lead to adverse health outcomes, including negative bone health, impaired metabolic activity, undesired outcomes for body composition, altered immune response, problematic cardiovascular outcomes, iron deficiency, as well as impaired endurance performance and force production, all of which ultimately may influence athlete health and performance. Where identifiable menstrual dysfunction indicates hypothalamic-pituitary-ovarian axis dysfunction, concomitant disturbances in other hormonal axes and their impact on the athlete’s health and sports performance must be recognized as well. Given that the margin between podium positions and “losing” in competitive sports can be very small, several important questions regarding low energy availability, endocrinology, and the mechanisms behind impaired training adaptations and sports performance have yet to be explored.

能量可用性低，特别是当出现问题时（即，长期和/或严重），会对健康和运动表现产生许多负面影响，其特征是运动中相对能量缺乏。这些后果可能是由内分泌功能紊乱引起的，尽管明确将内分泌功能障碍与运动表现下降和训练适应性减弱或减弱联系起来的科学证据有限。我们描述了低能量可用性引起的性激素变化如何表现为月经功能障碍以及其他内分泌轴中伴随的激素功能障碍，从而导致不良的健康结果，包括骨骼健康不良、代谢活动受损、身体成分不良结果、免疫反应改变、心血管问题、缺铁以及耐力表现和力量产生受损，所有这些最终都可能影响运动员的健康和表现。如果可识别的月经功能障碍表明下丘脑-垂体-卵巢轴功能障碍，则还必须认识到其他激素轴的伴随紊乱及其对运动员健康和运动表现的影响。鉴于竞技体育中领奖台位置与“失败”之间的差距可能非常小，有关低能量可用性、内分泌学以及训练适应和运动表现受损背后的机制等几个重要问题仍有待探索。