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Female Athlete Triad


What is the female athlete triad?

The female athlete triad is a combination of three health problems. These health problems include disordered eating, loss of monthly period, and low bone density. The condition occurs when a female athlete does intense training or exercise and has a strict diet.

What increases my risk for the female athlete triad?

  • You may not eat enough, not eat for long periods of time, or follow strict diets. You may have a serious eating disorder such as anorexia (eating little or nothing) or bulimia (bingeing and purging).
  • Your risk increases if you play a sport that requires a lean or thin appearance. Examples are ballet, figure skating, and gymnastics.
  • Pressure from coaches and parents to be thin or lose weight can increase your risk.
  • You may have a lack of social support because your training schedule keeps you from spending time with family and friends.
  • Anxiety, depression, or obsessive compulsive disorder can increase your risk.
  • You are more likely to develop this condition if a family member has an eating disorder.

What are the signs and symptoms of the female athlete triad?

  • Irregular or no monthly periods
  • Dry, cracked skin, and thinning hair or fine hair covering your body
  • Large amount of weight loss
  • Scars or callouses on your hands or knuckles caused by forcing yourself to vomit
  • Feeling more tired than usual
  • Frequent injuries such as stress fractures
  • Trouble concentrating or mood changes

How is the female athlete triad diagnosed?

Your healthcare provider will ask you questions about your eating behavior, weight changes, exercise habits, monthly periods, and injuries. He may ask how you feel about yourself and about the way you look. You may also need the following:

  • Blood and urine tests: Samples of your blood and urine are tested to measure the amount of hormones and other chemicals in your body. Weight loss decreases the amount of estrogen in your body. Your period may stop, become irregular, or never start at all if your estrogen level is too low.
  • Bone density scan: This test uses a type of x-ray to take pictures of your bones and measure your bone density. Poor nutrition, especially with a low calcium intake, and low estrogen levels may lead to osteopenia or osteoporosis. Osteopenia means you have weak or thinning bones. Osteoporosis means your bones are more likely to break because of bone loss.
  • EKG: This test records the electrical activity of your heart. It is used to check your heart rhythm.

How is the female athlete triad treated?

  • Nutrition counseling: You may need to see a dietitian who can help you plan and adjust the amount of food that you need. The best meal plan for you may depend on your weight, age, sport, and other factors. He can help you reach or stay at your ideal body weight with proper nutrition and healthy eating habits. Ask your healthcare provider for more information on the best nutrition plan and weight for you.
  • Medicines: Your healthcare provider may give you medicines that help prevent bone loss and increase bone mass. These medicines can decrease the risk of bone fractures. You may also be given medicines to relieve other symptoms, such as an abnormal heartbeat or depression.
  • Vitamins and minerals: You may need vitamins and minerals, such as vitamin D, calcium, and iron.
  • Cognitive behavioral therapy: This is also called CBT. You and a therapist will work together to learn the reasons you are unhappy with your body. The therapist will work with you to change your behaviors and decrease your negative feelings about food and your weight.
  • Psychotherapy: This is a type of counseling that is usually done in a series of meetings or talks. You, your family members, coaches, teammates, or people who are close to you may also attend.

How can I prevent the female athlete triad?

  • Do not be afraid to ask for help at any time: Talk to your coach, trainers, friends, or family if you have problems with your health. Talk with a dietitian if you need help with meal planning. Weight loss or gain should be guided by a healthcare provider.
  • Do not compare yourself to others: Focus on your own ideal body weight and sports performance. Try to choose friends or role models with healthy body images and eating habits. Coaches, trainers, teammates, and family members should not pressure you to diet and lose weight.
  • Eat healthy foods: Healthy foods may help you feel better and have more energy. Eat foods that are high in calcium, iron, and protein. Calcium is found in dairy products such as milk, cheese, and yogurt. Protein and iron are found in chicken, fish, meat, and beans. Include fruit, colorful vegetables, and whole grains. Do not skip meals and snacks.
  • Monitor your weight and monthly period: You or a healthcare provider may need to check your weight regularly. Keep track of your menstrual periods so that you can check the number of days between cycles.

What are the risks of the female athlete triad?

Even with treatment, your bone density may not recover completely. Without treatment, low bone density and exercise increase your risk of fractures. Low bone density can lead to osteoporosis. You may have trouble exercising and performing well in sports. You may develop heart rhythm problems, which can cause a slow, fast, or irregular heartbeat. You could develop low blood pressure or other health problems later in life. The female athlete triad can be a serious, life-threatening problem if it is not treated.

When should I contact my healthcare provider?

  • You feel you cannot cope at home, work, or school.
  • Your symptoms are getting worse.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You have a seizure.
  • You have trouble breathing, chest pain, or a fast heartbeat.
  • You feel like hurting yourself.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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