Female Athlete Triad

The Female Athlete Triad (the Triad), first coined in 1992 by the American College of Sports Medicine, is a potentially fatal condition and is composed of three interrelated pathologies; osteoporosis, amenorrhoea, and disordered eating (Bradley & Brzycki, 2004). It is important that female athletes are made aware of the Triad as it can affect athletes regardless of age or level of competition (Brunet, 2010).

Osteoporosis

Osteoporosis, a reduction in the bone mineral density (BMD), has severe consequences for athletes due to the greater risk of injuries. Injuries will result in being unable to complete a training program, compete in a race or match, and depending on the severity could be career or life threatening. Osteoporosis in female athletes usually occurs due to a combination of high training volume and inadequate food intake as, when body fat drops below 20% estrogen levels also drop significantly at this point (Insel et al., 2010). Reductions in estrogen can cause a menopause-like-state to occur early, with severe losses in BMD occurring.

To negate osteoporosis, athletes could supplement with calcium, and combine this with vitamin D, as vitamin D aids the uptake of calcium into the body. Although the main source of vitamin D is sunshine, athletes can acquire it from consuming fatty fishes’, and many cereals are now fortified with it as well.

Furthermore changes in the training schedule should be made. For example a reduction in running to prevent stress fractures should be made, and can be replaced with low impact cardiovascular exercise. This will help with the prevention of injury and ensure that aerobic adaptations to training are not lost.

Amenorrhea

Secondary amenorrhoea (the cessation of menstrual cycles) occurs in about 2-5% of America’s general population (Swedan, 2001) but occurs at a higher rate in athletes, and as a result of this athletes must be educated on the cause and effects of amenorrhoea and its knock on effects in the Female Athlete Triad. It is also important that menstruations are not missed as it has been shown that stress fractures are more common in athletes with past or current menstrual disturbances (Burke, 2007).

Increasing her calorie and fat intake will also help stimulate estrogen production, which in turn will help stimulate her menstruation cycle again and help an athlete recover from amenorrhoea. The birth control pill is also another possibility, as the estrogen contained in them can help induce periods (Women’s Health, 2010).

Disordered Eating

The influence of mainstream media upon perceptions of body image, and sports where regulation of body weight is vital for success (gymnastics), are factors that can increase the likelihood an athlete suffering from disordered eating.

Increasing the body weight of a female athlete will make them less likely to miss menstruations, a symptom of secondary amenorrhoea. It is important that sufficient quantities of dairy products are consumed, vital for providing an influx of calcium. Calcium will not only improve bone density and strength, which would prevent stress fractures, but it also aids muscular contractions and nerve transmissions. The UK recommended daily amount (RDA) of calcium is 700 mg (NHS) however athletes suffering from amenorrhoea can safely exceed this value, and can take around 1200 to 1500 mg/day (Burke, 2007).

It is also important that the diet sufficiently fuels all training demands, as if calories expended exceeds calorie intake a reduction of body mass will occur, and could lead to numerous problems. On this point, it is important that the training program is adapted if any of the symptoms of the Triad are suspected.

References

Bradley, M., Brzycki, M., Carlson, L., Harrison, C., Picone, R. & Wakeham, T. (2004). The Female Athlete: Train for Success. 1^st Edition. Wish Publishing.

Brunet, M. (2010). Unique considerations of the female athlete. Cengage Learning.

Burke, L. (2007). Practical Sports Nutrition. 1^st Edition. Human Kinetics.

Insel, P., Turner, R. E. and Ross, D. (2010). Discovering Nutrition. Jones and Bartlett.

Swedan, N. G. (2001). Women’s Sports Medicine and Rehabilitation.1^st Edition. Aspen Publishers Inc.

Womens Health. (2010). PCOS & Irregular Periods: Getting It Under Control. Online. Available at: http://www.womens-health.co.uk/pcos4.asp. Accessed on 14/3/2010.