The female athlete triad

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
• Amenorrhoea (lack of menstrual periods)
• Osteoporosis or low bone mass

Low-calorie diets 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 greater 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 amenorrhoea, 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.

2. Low body weight

Low body weight alone is not enough to explain the loss of menstrual periods. However, it seems that amenorrhea happens when you take in fewer calories, so you're getting too little nutrition for the amount of exercise you're doing.

Your weight influences your bone density. For example, a woman who weighs less than 57kg (9 stone) is 10 times more likely to have lower bone density than a woman who weighs 68kg (10 and a half stone) or more. Your risk of bone loss increases when you have a low percentage of body fat.

3. Irregular menstrual periods

Amenorrhea and other menstrual irregularities increase the risk of bone loss. With amenorrhoea, teenage girls experience significant reductions oestrogen.

A young female athlete who appears to be in top physical condition often has the highest risk of low bone density (osteoporosis) and fracture, especially if she experiences disordered eating and loss of menstrual periods.