Female Athletic Triad
and exercise are healthy activities for girls and
women of all ages. But a female athlete who focuses
on being thin or lightweight may eat too little
and/or exercise too much. Doing this can cause
long-term damage to your health or even death. It
can also hurt your athletic performance and/or make
it necessary to limit or stop exercise. Three
interrelated illnesses may develop when a girl or
young woman goes to extremes in dieting or exercise.
Together these conditions are known as the
"female athletic triad":
1. Disordered eating:
Abnormal eating habits (i.e., crash diets, binge
eating) or excessive exercise keeps your body from
getting enough nutrition.
dysfunction: Poor nutrition, low calorie intake,
high energy demands, physical and emotional stress
or low percentage of body fat can lead to hormonal
changes that stop your menstrual periods (amenorrhea).
3. Osteoporosis: Lack
of periods disrupts your body's bone-building
processes and weakens the skeleton, making your
bones more likely to break.
Females at risk
Females in any sport
can develop one or more parts of the triad. At
greatest risk are those in sports that reward being
thin for appearance (i.e., figure skating,
gymnastics) or improved performance (i.e., distance
running, rowing). Fashion trends and advertising
often encourage women to try to reach unhealthy
weight levels. Some female athletes suffer low
self-esteem or depression, and may focus on weight
loss because they think they are heavier than they
actually are. Others feel pressure to lose weight
from athletic coaches or parents. Female athletes
should consider these questions:
you dissatisfied with your body?
you strive to be thin?
you continuously focus on your weight?
If the answers are
yes, you may be at risk for developing abnormal
patterns of eating food (disordered eating), which
can lead to menstrual dysfunction and early
Although they usually don't realize or admit that
they are ill, people with disordered eating have
serious and complex disturbances in eating
behaviors. They are preoccupied with body shape and
weight and have poor nutritional habits. Females are
10 times more likely to have disordered eating
compared with males, and the problem is especially
common in females who are athletic. The illness
takes many forms. Some people starve themselves
(anorexia nervosa) or engage in cycles of overeating
and purging (bulimia). Others severely restrict the
amount of food they eat, fast for prolonged periods
of time or misuse diet pills, diuretics or
laxatives. People with disordered eating may also
exercise excessively to keep their weight down.
Disordered eating can
cause many problems including dehydration, muscle
fatigue and weakness, an erratic heartbeat, kidney
damage and other serious conditions. You may not get
enough calcium, which can lead to bone loss. It's
especially bad to lose bone when you are a child or
teenager because that's when your body should be
building bone. You may also get hormone imbalances
that lead to more bone loss through menstrual
dysfunction: Missing three or more periods in a
row is cause for concern. With normal menstruation,
your body has estrogen, a hormone that helps to keep
bones strong. With amenorrhea, you may not get the
estrogen you need and may lose bone density and
strength (premature osteoporosis). If this happens
during youth, you may also get serious problems
later in life when the natural process of bone
mineral loss begins after menopause. Amenorrhea may
also cause stress fractures and make it difficult to
get pregnant if you ever want to have a baby.
Bone tissue wears away, making your skeleton
fragile. Low bone mass puts you at increased risk
female athletic triad is the first step toward
treating it. See your doctor right away if you think
you might have disordered eating, miss several
menstrual periods or get a stress fracture in
sports. Give the doctor your complete medical
you do for physical activity and what you eat
old you were when you began to menstruate and
whether you usually have regular periods.
you are sexually active, use birth control pills
or have ever been pregnant.
you have ever had stress fractures or other
changes (up or down) in your weight.
medications you are taking or symptoms of other
history of diseases (i.e., thyroid disease,
that cause stress in your life.
doctor will give you complete physical and pelvic
examinations and may use laboratory tests to check
for pregnancy, thyroid disease and other medical
conditions. In some cases you may also get a bone
density test. Treatment for the female athletic
triad often requires help from a team of medical
professionals including your doctor, a nutritionist
and a psychological counselor.