The female athlete triad

A female athlete triad tale

When 16-year-old "Whitney" (her name has been changed to protect confidentiality) got into the university athletics team, she noticed that her best times were slower than the older girls, who were extremely thin. So she began eating less. Within two months, her weight had dropped 5 kilos (11 pounds) and reduced her body fat to less than 14%. Although her race times and endurance improved, Whitney’s menstrual period stopped.

While running, she tripped on a tiny rock, fracturing her ankle. Though Whitney was lean, muscular, and appeared to be the picture of health, her doctor became concerned about her excessive dieting, low body weight, and loss of her period -- key risk factors for low bone density (osteoporosis) and fractures. He immediately ordered a bone density test, which tests the strength of bones. The test results showed that Whitney had low bone density -- the bone strength of a much older woman.

Whitney couldn't believe she was at risk of bone loss. After all, she was a healthy athlete, but Whitney was wrong.

What is the female athlete triad?

The female athlete triad is made up of three medical conditions that are becoming increasingly common in active girls:

• Eating disorders
• Amenorrhea (lack of menstrual periods)
• Osteoporosis or low bone mass

Low-caloriediets are usually the first sign of eating disorders. Excessive exercise or exercise obsession can be another sign.

Teenagers who are thin and exercise excessively are at higher risk of amenorrhea. Plus amenorrhea is linked to decreased oestrogen levels, which may contribute to osteoporosis. A diet low in calcium and other bone-boosting nutrients can also contribute to low bone density.

Your doctor should evaluate and treat each of these three problems to ensure a healthy outcome.

Who's at risk of the female athlete triad?

Teenage girls who restrict their eating and have amenorrhea are at highest risk of female athlete triad. Female athletes who try to reach a low body weight for running or dancing are more likely to have amenorrhea, as are those who compete in scoring sports such as gymnastics and figure skating.

What are symptoms of the female athlete triad?

The female athlete triad is a combination of three conditions. Each condition has symptoms to alert you that a problem exists:

1. Eating disorders

Characterised by a morbid fear of weight gain, eating disorders lead to severe restriction of food intake. This results in extreme weight loss or even starvation. Most female athletes are concerned about their body weight and shape, and may follow a strict diet. Avoiding key nutrients could lead to inadequate amounts of protein, iron, calcium, and zinc in the diet.

Women who diet excessively often eliminate dairy products. Dairy products are a primary source of calcium, which is vital for bone strength. Some studies say that fewer than 25% of adolescent girls get the calcium necessary each day through foods or supplements. This deficit comes at a critical time in the teenager’s life -- when girls should be building their bone mass to the highest levels.