The policy covers important health issues that impact female athletes, including disordered eating, menstrual dysfunction and decreased bone mineral density (osteoporosis). The original AAP statement on female athletes only addressed menstrual dysfunction, also called "amenorrhea".

Some female athletes may experience an energy deficit when calories they expend exceed calorie intake. This deficit may be unintentional, resulting from inadequate replacement of the caloric demands of training, or may be a conscious attempt to lose weight or body fat to improve appearance or performance. A study of young elite swimmers revealed that more than 60 percent of average-weight girls and nearly 18 percent of underweight girls were trying to lose weight. The methods for weight loss included decreased eating, vomiting, and the use of laxatives and diuretics. Girls participating in sports that emphasize leanness - ballet, gymnastics, long-distance running, diving and figure skating - are most at risk.

Menstrual disorders in the female athlete can include primary amenorrhea, or a delay in menses until age 16, fewer menstrual cycles, and menstrual periods occurring at intervals longer than 35 days. Menstrual dysfunction should not be considered a normal response to exercise and can result in decreased bone mineral density or osteoporosis.

The AAP recommends that education and counseling be provided to athletes, parents and coaches regarding health issues pertaining to female athletes. Also, coaches and athletes should refrain from defining an ideal level of weight and/or body fat for each sport or individual participant. Weight is not an accurate estimate of fitness or fatness, and when weight is lost, both muscle and fat are lost.