Consumer Information

Female Athlete Triad

WHAT YOU SHOULD KNOW:

The female athlete triad is a condition that may affect women who exercise too much or play sports. It is a combination of one or more health problems. These health problems include disordered eating, amenorrhea, and low bone density. Disordered eating happens when someone has abnormal eating patterns or behaviors. Amenorrhea is a condition where menstrual (monthly) periods stop or become irregular. Low bone density leads to osteopenia or osteoporosis where the bones become weak and thin. The female athlete triad occurs when a female athlete does intense training and has a strict diet. She may focus too much on being thin or lightweight to help her performance.
Signs and symptoms of the female triad begin with having abnormal eating habits. You may also have fractures (breaks in the bone), fatigue (tiring easily), too much weight loss, and trouble thinking. Different tests, such as blood and urine tests, bone density scan, or ultrasound may be used to help diagnose the female athlete triad. Treatment aims to manage all three health problems of the female athlete triad. These include medicines, proper diet and exercise, and counseling or therapies. The success of treating the female athlete triad is best when it is found and treated as soon as possible.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

RISKS:

The female athlete triad can be a serious, life-threatening problem, and treatment should be given as soon as possible. Some medicines may cause you to have sleeping problems, headache, abdominal (stomach) pain or convulsions. Other side effects include loss of appetite, vomiting (throwing up), irritability, and unusual changes in behavior.
If left untreated, your condition may get worse and you may also develop other serious problems. These may include depression and problems with your mood, friendships, and relationships. You may have a poor image of yourself, making it hard to go to school, work, and to get along with others. You may have problems with exercising and with sports performance. The female athlete triad may result in long-term damage to a woman's health that may lead to an early death. Ask your caregivers if you are worried or have questions about your condition, medicine, or care.

WHILE YOU ARE HERE:

Informed consent: You have the right to understand your health condition in words that you know. You should be told what tests, treatments, or procedures may be done to treat your condition. Your doctor should also tell you about the risks and benefits of each treatment. You may be asked to sign a consent form that gives caregivers permission to do certain tests, treatments, or procedures. If you are unable to give your consent, someone who has permission can sign this form for you. A consent form is a legal piece of paper that tells exactly what will be done to you. Before giving your consent, make sure all your questions have been answered so that you understand what may happen.

Activity: You may need to rest in bed and get plenty of sleep at first. If you have trouble breathing or chest pain, call your caregiver right away.

Diet and nutrition: You may need a diet that is high in calcium, iron, and protein. Calcium is found in dairy products such as milk, cheese, and yogurt. Iron is found in red meat and certain vegetables. Protein is found in chicken, fish, meats, and beans. Fruit, colorful vegetables, pasta, rice and bread may also be included in your eating plan.

Intravenous fluid: Caregivers may increase the fluids and nutrients in your body by giving solutions in your IV. An IV is a tube placed in your vein for giving medicine or liquids. These liquid solutions contain water, mineral salts, sugars, and proteins. IV fluids may help treat dehydration (losing too much fluid).

Medicines: You may need any of the following:

Medicines for disordered eating: Your caregiver may give you medicines to treat your eating disorder and relieve its symptoms. These include medicines to control your depression, mood changes, nausea (upset stomach), vomiting (throwing up), or seizures (convulsions).
Medicines for low bone density:
- Calcitonin: This medicine helps to move calcium into your bones.
- Hormone replacement therapy: This is also called HRT. You may be given a hormone called estrogen. Caregivers will monitor you closely while you use this medicine.
Others:
- Vitamins and minerals: Vitamins and minerals, especially vitamin D, calcium or iron, may be needed to improve your health.

Tests: You may have any of the following:

12-lead ECG: This test, also called an EKG, helps caregivers look for damage or problems in different areas of the heart. Caregivers may need to prepare your skin by shaving off some hair, or cleaning it with a gritty lotion. Sticky pads are placed on your chest, arms, and legs. Each sticky pad has a wire that is hooked to a machine or TV-type screen. A short period of electrical activity in your heart muscle is recorded. Caregivers will look closely for certain problems or changes in how your heart is working. This test takes about 5 to 10 minutes. It is important that you lie as still as possible during the test. You may need this test more than once.
Abdominal ultrasound: An abdominal ultrasound is a test that is done to see inside your abdomen. Sound waves are used to show pictures of your abdomen on a TV-like screen.
Blood and urine tests: Samples of your blood and urine are sent to a lab for tests. These tests measure the amount of hormones and other chemicals in your body.
Bone density scan: This test is also called dual-energy x-ray absorptiometry (DXA or DEXA) or bone densitometry. It uses a special x-ray to take pictures of your bones and measure the amount of bone density.

Treatment options: Treatment options for the female athlete triad depend on your signs, symptoms, and condition. You may need any of the following types of counseling or therapy with a special caregiver:

Cognitive therapy: With a therapist, you will learn how to control your actions and improve your behavior. This is done by teaching you how to change your behavior by looking at the results of your actions. You may also need to know how to cope with situations that may trigger eating problems.
Nutrition counseling: A caregiver, called a dietitian or nutritionist, may talk to you and your coach or family members about nutrition. The best diet for you may depend on your weight, age, sport activities, and other factors. Your dietitian plans and adjusts the amount of food that you need. He may teach you the right nutrition your body needs. He may also help you have and keep an ideal body weight. Ask your caregiver for more information on the best diet and weight for you. .
Psychotherapy: This is also called talk therapy. Meetings or talks may be held for you and your family. Your coaches, teammates, or people who are close to you may also be asked to attend these meetings. These meetings can help everyone better understand the female athlete triad.

Vital signs: This includes taking your temperature, blood pressure, pulse (counting your heartbeat), and respirations (counting your breaths). To take your blood pressure, a cuff is put on your arm and tightened. The cuff is attached to a machine which gives your blood pressure reading. Caregivers may listen to your heart and lungs by using a stethoscope. Your vital signs are taken so caregivers can see how you are doing.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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