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Dangers of The Female Athlete Triad

All serious athletes want to be more competitive in their chosen sports, and for many, that includes controlling their body weight. That can be a healthy thing, up to a point. Too often, however, young female athletes try to shed too many pounds and fall victim to a trio of health disorders commonly known as the female athlete triad.

The three parts of the female athlete triad are disordered eating, osteoporosis and amenorrhea, or cessation of menstruation.

Read the full SYS-CON Media article here.

Female Athlete Triad Educational Pamphlet

The Female Athlete Triad Coalition is a non-profit organization dedicated to preventing the Female Athlete Triad, which is syndrom in active females involving three interrelated conditions of low energy and disordered eating, bone loss and menstrual disturbances. 

The FATC provides an educational pamphlet on the issue that can be helpful for coaches and parents who can help prevent the triad in their athletes by becoming knowledgeable on the topic.

Click here to access the online pamphlet.

Check out the full Female Athlete Triad Coalition's website here.

Female Athletes Injured More than Male Athletes

This article adds to the growing body of research suggesting we need to revisit our methods for training and developing female athletes...

ScienceDaily (Jan. 28, 2010) — Female athletes experience dramatically higher rates of specific musculoskeletal injuries and medical conditions compared to male athletes, according to exercise physiologist Vicki Harber in the Faculty of Physical Education and Recreation at the University of Alberta.

According to her paper, depending on the sport, there can be a two- to sixfold difference in these types of injuries between male and female athletes. That's because many training programs developed for female athletes are built on research using young adult males and don't take the intrinsic biological differences between the sexes into account. 

Read on...

Promotion of Healthy Weight-Control Practices in Young Athletes

Source: American Academy of Pediatrics, Committee on Sports Medicine and Fitness

This detailed article by the American Academy of Pediatrics, Committee on Sports Medicine and Fitness describes common habits leading to unhealthy weight, and provides suggestions for healthy alternatives for weight control in young athletes. Some of the topics discussed are: dehydration, binging/purging behavior, and weight and body-composition measurement.

Click here to view full article at the American Academy of Pediatrics website.

More on 'female athlete triad' from the American Academy of Pediatrics

Source: American Academy of Pediatrics, Committee on Sports Medicine and Fitness

The Female Athlete Triad is a fairly new term explaining a serious combination of medical concerns associated with extreme training in female athletes. The Academy of Pediatrics explains the three main areas of this disfunction: disordered eating, menstrual dysfunction, and decreased bone mineral density. This committee has also formed an explanation of possible treatments and a list of recommendations. 

Click here to view full article at the American Academy of Pediatrics website.

Update on Female Athletic Triad

Source: American Academy of Orthopaedic Surgeons, Athletic Training and Sports Medicine

This article from the American Academy of Orthopaedic Surgeons is very descriptive of the new found term, "female athlete triad." We have covered this rising issue with previous articles, and feel that this is a very informative piece to add to the group. The AAOS does a nice job of getting to the point, and this would be a great article for anyone looking from an introductory standpoint or one looking for more detail. If you are an interested member of youth sports please help in spreading the word about this important issue for females in sport.

Click here to view full article at the American Academy of Orthopaedic Surgeons website.

Warrior Girls: Protecting Our Daughters Against the Injury Epidemic in Women's Sports (Book Review)

By Steve Horan

To those of us who parent or coach female athletes, there is nothing more inspiring than a group of young women competing in sports with passion and honor and joy.  The individual performances, team ideal, and bonding that can occur in girls' and women's sports are something to behold. 

On the other hand, there is nothing more ugly than the sudden thud and scream that tell us a serious injury has just occurred.  Even short of injury, there is something wrong about countless female athletes living their lives in chronic pain from punishing their bodies in sports.

Michael Sokolove aptly paints this contrast in his new book, Warrior Girls: Protecting Our Daughters Against the Injury Epidemic in Women's Sports. On the bright side, Mr. Sokolove presents an inspiring history of women's sports and the extraordinary expansion of athletic opportunities available to girls and women since the passage of Title IX.  On the dark side, he presents disturbing statistics about female injury rates which are many times higher than their male counterparts and reaching epidemic proportions. Here he is not talking about a few more bumps and bruises, but an epidemic of serious injuries (including ACL tears and concussions) which are not only ending athletic careers, but potentially affecting the athlete for the rest of her life.

What the Stopwatch Doesn't Tell: Revisiting Female Athlete Eating Disorders

This 2007 article from the Chronical of Higher Education paints a cautionary picture of eating disorders among female athletes.  This article was significant for its publication in the Chronical of Higher Education, perhaps the most influential news journal in the academic community.

Title: What the Stopwatch Doesn't Tell

Author: Strout, Erin

Source: Chronicle of Higher Education, v53 n24pA44 Feb 2007

ERIC Abstract:

Lurking behind the championships, trophies, and academic achievements of many top female athletes is a devastating battle with eating disorders--not a new problem, but one that has changed the way coaches talk to their teams about weight and nutrition. The illnesses, which are often difficult to detect, can throw an entire team into a tailspin. Increasing numbers of college coaches are dealing with athletes' eating disorders, and the problem is particularly acute in sports like running, where a lean physique and unusually small frame can enhance performance. This article discusses the negative effects of eating disorders to the health of female athletes. It also provides tips on how coaches can identify eating disorders. Moreover, this article presents how Michael Whittlesey, North Carolina's cross-country and assistant track-and-field coach, detected the eating disorder symptoms of his female runner Victoria Jackson. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Go to ERIC

Looking Out for Female Athlete Triad

By Steve Horan

Every coach of serious female athletes should be aware of the female athlete triad.  The female athlete triad is comprised of three linked conditions that occur in sequence: disordered eating, menstrual irregularities and premature osteoporosis. 

Any one of these conditions is a cause for concern.  Together, they can do serious damage to the health of a female athlete - including increased risk of infertility, stress fractures, and myriad additional health problems related to disordered eating.

1. How it happens

The female athlete triad works in a sequential fashion.   Disordered eating - often caused by psychological pressure to perform to a standard or look a certain way -- leads to inadequate nutrition and low energy intake.  Poor nutrition coupled with psychological stress may lead to physiological alterations, which in turn may cause menstrual irregularities (including loss of menstrual cycle - amenorrhea).  This can lead to decreased production of estrogen, which is important for maintaining adequate bone mineral density.  The result can be osteoporosis and increased risk of bone fracture.

2. The impact

There are no hard and fast numbers of the prevalence of female athlete triad.  Estimates of the prevalence of the first two legs of the triad (disordered eating, menstrual irregularity) range from 15 percent to more than 50 percent depending on the sport and age of the female athletes.  Figures on premature osteoporosis are harder to come by, in part  because this condition is harder to observe.  

As the triad receives increasing attention, more researchers are investigating the full scope of its physical effects.  Recent research from the Medical College of Wisconsin links the triad to increased risk for heart disease.  Researcher Anne Z. Hoch, D.O. draws the link.  "Women and girls with the Triad," she says, "have the same steroid and hormonal profile as postmenopausal women, and we know that postmenopausal women start to develop cardiovascular disease. So, our big question is whether the 20-year-old woman that comes into our clinic with the Triad also has early cardiovascular disease."

From a prevention and treatment viewpoint, it is worth noting that the triad is observed most often in girls who participate in sports in which performance is scored subjectively, a low bodyweight is emphasized, body contour-revealing clothing is required for competition, weight categories are used for participation and a prepubescent body is considered optimal for performance.

(Women's Sports Foundation).  But, the triad - or one of its component parts - can occur in any sport.

3. The coach's role

Most experienced coaches of  female athletes can point to young women who have experienced eating disorders, menstrual irregularity, or both.  It is instructive to know that these conditions, serious enough by themselves, can also lead to lifelong health problems including osteoporosis and perhaps even cardiovascular disease. 

Education is always a good starting point for prevention.  The emphasis of this education should be on good health and nutrition rather than the athlete's body weight.  Treatment requires intervention by a trained health professional.  The NCAA provides a helpful coaches' guide with sound advice on prevention, detection, and treatment.  Also see additional resources in the Learn More box

Coaching Points

1. The Female Athlete Triad is a serious health condition comprised of disordered eating, menstrual irregularities, and premature osteoporosis.  Recent research shows cardiovascular disease may also be associated with the triad.

2. Coaches can help prevent the female athlete triad (and its component parts) by: a) educating our athletes about this condition, b) emphasizing good health and nutrition; and c) deemphasizing body weight in communications with our athletes.

3. Coaches should be vigilant to look for signs of the Female Athlete Triad and facilitate treatment by a trained health professional for athletes who show signs of the triad.  See the NCAA resources in the Learn More box for details on how to detect and treat the Female Athlete Triad.

Learn More

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1. NCAA Coaches Handbook: Managing the Female Athlete Triad  National Collegiate Athletic Association

2. MWC Researchers Link Female Athlete Triad to Cardiac Risk Healthlink, Medical College of Wisconsin

3. The Female Athlete Triad: Quick Facts

The Women's Sports Foundation

4. Prevalence of the Female Athlete Triad Syndrome Among High School Athletes Archives of Pediatric and Adolescent Medicine

5. Female AthleteTriad

The Nemours Foundation

6. The Female Athlete Triad

MomsTeam.com