Energy deficiency in exercising women can lead to physiological consequences. No gold standard exists to accurately estimate energy deficiency, but measured-to-predicted resting metabolic rate (RMR) ratio has been used to categorize women as energy deficient. The purpose of the study was to (a) evaluate the accuracy of RMR prediction methods, (b) determine the relationships with physiological consequences of energy deficiency, and (c) evaluate ratio thresholds in a cross-sectional comparison of ovulatory, amenorrheic, or subclinical menstrual disturbances in exercising women (n = 217). Dual-energy X-ray absorptiometry (DXA) and indirect calorimetry provided data on anthropometrics and energy expenditure. Harris-Benedict, DXA, andCunningham (1980 and equations were used to estimate RMR and RMR ratio. Group differences were assessed (analysis of variance and Kruskal-Wallis tests); logistic regression and Spearman correlations related ratios with consequences of energy deficiency (i.e., low total triiodothyronine; TT 3 ). Sensitivity and specificity calculations evaluated ratio thresholds. Amenorrheic women had lower RMR (p < .05), DXA ratio (p < .01), Cunningham 1980 (p < .05) and Cunningham 1991 (p < .05) ratio, and TT 3 (p < .01) compared with the ovulatory group. Each prediction equation overestimated measured RMR (p < .001), but predicted (p < .001) and positively correlated with TT 3 (r = .329-.453). A 0.90 ratio threshold yielded highest sensitivity for Cunningham 1980 (0.90) and Harris-Benedict (0.87) methods, but a higher ratio threshold was best for DXA (0.94) and Cunningham 1991 (0.92) methods to yield a sensitivity of 0.80. In conclusion, each ratio predicted and correlated with TT 3 , supporting the use of RMR ratio as an alternative assessment of energetic status in exercising women. However, a 0.90 ratio cutoff is not universal across RMR estimation methods.Keywords: female athlete triad, menstrual disturbances, metabolic suppression Energy deficiency in exercising women is associated with severe consequences including reproductive dysfunction (De Souza et al., 2007b;Williams et al., 2015) and impaired bone health , a condition referred to as the Female Athlete Triad (Triad) Nattiv et al., 2007). When energy intake fails to meet metabolic demands, metabolizable fuels are repartitioned toward the physiological processes necessary for survival (i.e., locomotion, cellular maintenance, and thermoregulation) and away from those energetic processes deemed unnecessary for survival (i.e., growth and reproduction). This results in suppression of metabolism, energy expenditure, and thyroid hormones (Wade et al., 1996), contributing to the development The authors are with the Women'