Written by Shannon Lukez, ANP.
The Female Athlete Triad includes three conditions in teen or adult female athletes who are not meeting their energy requirements. This ultimately leaves them undernourished. The Triad consists of disordered eating, osteopenia (thinning of the bones) and amenorrhea (cessation of menstrual cycle). It is important to keep in mind that symptoms of the Triad are really on a continuum. For example, disordered eating can range from inappropriate nutritional choices to limiting the quantity of food consumed to bulimia.; amenorrhea can be experienced as irregular, very light or short menstrual cycles that if not corrected may lead to true amenorrhea; osteopenia can be experienced as increased injuries, stress fractures, real fractures and subsequent severe loss of bone density (osteoporosis).
When female athletes train excessively and do not get the proper nutrition, estrogen levels drop leading to a secondary amenorrhea. This predisposes their bones to lose density. As female athletes train for their sports, weight loss as an overall performance enhancement objective should be discouraged. Our bodies are like expensive cars. We need to fuel them with quality "gas" in the form of quality nutrition to keep them running smoothly.
The Female Athlete Triad may have long-term consequences. Bone health is dependent on the estrogen component which is diminished in the setting of irregularities of the menstrual cycle. This leads to a negative impact on bone density. Young females should be building up their bone "banks" for later in life. When osteopenia or osteoporosis is being seen in these young women, we do not know if it is correctable to prevent long-term bone depletion. Any female athlete diagnosed with a stress fracture should have a DEXA scan to evaluate overall bone density. This is a non-invasive test that measures the density of our bones. Results will help guide the treatment plan.
Supporting the female athlete using a comprehensive plan including nutrition, healthy weight maintenance, exercise, stretching, range of motion and strengthening is essential to her success.
