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This paper pairs with the\n                    <jats:italic>2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 1: State of the Science and Introduction of a New Adolescent Model<\/jats:italic>\n                    (Sports Medicine, 2025), to focus on evidence-based revisions for screening, diagnosis, treatment, and clearance and return to play. Revised recommendations for managing eating disorders (ED)\/disordered eating (DE) and non-pharmacological and pharmacological treatment of bone loss and abnormal menstrual cycles are included, as are the most recent clearance and return to play recommendations, inclusive of adolescent athletes. Recent research supports the adoption of revised criteria for defining and treating energy deficiency, moving away from the concept of an energy-availability threshold. Energy deficiency-induced menstrual disturbances can be reversed with a moderate increase in food intake and modest weight gain, but restoration of menses alone is not associated with high rates of ovulation or increased ovarian steroid levels until multiple consecutive normal length menstrual cycles are achieved. Revised guidelines for the diagnosis and treatment of functional hypothalamic oligo\/amenorrhea are included with guidance on the confounding effects of hyperandrogenemia. Gynecological age and psychological stress are factors impacting the individual susceptibility to the Triad. The bone health spectrum of the Triad now includes bone stress injuries. Routes of administration via epidermal patch versus oral for pharmacological treatment of low bone density are discussed. The diagnosis, treatment, and return to play approaches for adolescents with the Triad are unique compared with those employed for adults and require age-appropriate clinical guidelines. The strength of the evidence-based statements is graded using an accepted taxonomy in which randomized controlled trials and observational data are considered the highest level of evidence.\n                  <\/jats:p>","DOI":"10.1007\/s40279-025-02332-0","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T04:19:46Z","timestamp":1767154786000},"page":"375-427","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 2: Clinical Guidelines for Screening, Diagnosis, Treatment, and Return to Play for Adolescents and Adults"],"prefix":"10.1007","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3690-6691","authenticated-orcid":false,"given":"Nancy I.","family":"Williams","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5185-9710","authenticated-orcid":false,"given":"Mary Jane","family":"De Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9405-2981","authenticated-orcid":false,"given":"Madhusmita","family":"Misra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5999-7154","authenticated-orcid":false,"given":"Aurelia","family":"Nattiv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4473-1038","authenticated-orcid":false,"given":"Elizabeth","family":"Joy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0897-1832","authenticated-orcid":false,"given":"Michelle","family":"Barrack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7743-7786","authenticated-orcid":false,"given":"Emily A.","family":"Ricker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8861-8547","authenticated-orcid":false,"given":"Sasha","family":"Gorrell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3234-3190","authenticated-orcid":false,"given":"Kristen J.","family":"Koltun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4037-4213","authenticated-orcid":false,"given":"Emma","family":"O\u2019Donnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0377-8737","authenticated-orcid":false,"given":"Rebecca J.","family":"Mallinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7326-5320","authenticated-orcid":false,"given":"Ana Carla C.","family":"Salamunes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3603-2891","authenticated-orcid":false,"given":"Kary","family":"Woodruff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9826-2348","authenticated-orcid":false,"given":"Michael","family":"Fredericson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9721-7817","authenticated-orcid":false,"given":"Franziska","family":"Plessow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"2332_CR1","doi-asserted-by":"crossref","unstructured":"De Souza MJ, Williams NI, et al. 2025 Update to the female athlete triad coalition consensus statement and introduction of a new adolescent model part 1: state of the science. 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Dr. De Souza is a consultant for the California Prune Board, Regeneron Pharmaceuticals, and for the CocaCola Company. Dr. Gorrell is supported by the National Institutes of Mental Health (K23MH126201; R21MH131787) and the Brain & Behavior Research Foundation (NARSAD Young Investigator Award). Dr. Misra has served as a key opinion leader for Lumos Pharmaceuticals, consultant for Regeneron, receives study drug donation from Tonix Pharmaceuticals, and honoraria from UpToDate. Dr. Fredericson has several grants related to the subject matter of this article: (1) Co-Principal Investigator, Pac-12 Conference Student-Athlete Health & Well-Being Grant Award, \u201cImproving Bone Health and Reducing the Incidence of Bone Stress Injuries in Pac-12 Distance Runners: An Implementation Plan Focusing on Health Promotion, Optimal Fueling, and Changing Culture\u201d, and (2) Co-Investigator, United States Department of Defense, \u201cExtracorporeal Shockwave Therapy for the Management of Stress Fractures and High-Grade Bone Stress Injuries: A Randomized Double-Blind Controlled Trial\u201d. Dr. Fredericson is also an Advisory Board member of Hinge Health. Dr. Nattiv has received support as (1) Co-Principal Investigator, Department of Defense and Medical Technology Enterprise Consortium, \u201cExtracorporeal Shockwave Therapy for the Management of Stress Fractures and High-Grade Bone Stress Injuries: A Randomized Double-Blind Controlled Trial\u201d, and (2) Co-Principal Investigator, Pac-12 Conference Student-Athlete Health and Well-Being Grant Award, \u201cImproving Bone Health and Reducing the Incidence of Bone Stress Injuries in Pac-12 Distance Runners: An Implementation Plan Focusing on Health Promotion, Optimal Fueling, and Changing Culture\u201d, and (3) as a consultant for the National Football League Research and Innovation Committee. Dr. Salamunes is supported by Fulbright Brazil and Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de Ensino Superior (CAPES). The other authors declare that they have no conflicts of interest relevant to the content of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"NIW and MJD oversaw all final edits. The main writers were the section leaders and included, NIW, MJD, MM, AN, EJ, MB, EOD, and SG. All authors contributed to writing, editing consensus discussions, development and approval of evidence-based statements and their grading and approval of the final manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author contributions"}},{"value":"The opinions and assertions expressed herein are those of the author(s) and do not reflect the official policy or position of the Uniformed Services University or the Department of Defense. The contents of this publication are the sole responsibility of the author(s) and do not necessarily reflect the views, opinions or policies of The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclaimer"}}]}}