The Female Athlete Triad

Parkview Sports Medicine

The Female Athlete Triad

The pressure to reduce body fat and perform at elite levels may lead many young athletes to pair excessive exercise with calorie-poor diets. This can result in a variety of potential health concerns, including the Female Athlete Traid.

The Basics

The Triad is a health condition involving three distinct, yet interrelated, components:

  • A lack of energy availability is the strongest indictor of the Triad. You can think of energy availability as the calories you consume minus the calories you burn during sports or exercise. It is important for you to consume enough quality, nutritious calories to support your workout regimen and enhance your bone health.

  • Amenorrhea is the absence of a menstrual period for three or more consecutive months. When this happens, your hormone balance is disrupted, which could affect your bone health. A number of health concerns can cause amenorrhea, including a lack of energy availability paired with excessive exercise, physical and emotional stress or a low body-fat percentage.

  • Premature osteoporosis is a condition in which you have an exceptionally low bone density for your age. A lack of energy availability and amenorrhea can disrupt your body’s bone-building processes and weaken your skeleton, making your bones more likely to fracture.

Warning Signs and Symptoms

Common warning signs and symptoms of the Triad may include:

  • Irregular menstrual cycles or amenorrhea

  • Chronic fatigue

  • Difficulty sleeping

  • Stress fractures

  • Recurring injuries

  • Obsessive dieting or calorie restriction

  • Obsessive desire to become thinner

  • Cold sensation in hands and feet

High-Risk Sports

The Triad is most common in sports where the focus is on lean body mass for optimized performance or the appearance of the athlete, including:

  • Distance running

  • Cycling

  • Gymnastics

  • Figure skating

  • Ballet and dance

  • Martial arts

Ways to Prevent the Triad

You can take several steps toward preventing the Triad:

  • Give your body enough energy to fuel your performance. During sports and exercise, make sure you eat a healthy, balanced diet with enough calories to support your training. Your diet should include a proper balance of protein, carbohydrates, calcium, vitamin D and fat. Talk with a sports nutritionist about your diet.

  • Keep a menstrual calendar. A disruption in your menstrual cycle, or amenorrhea, is a sign that you may be at risk for the Triad. Talk with your physician if you miss three consecutive menstrual periods.

  • Don’t ignore your injuries. If you develop the same pain in your leg or foot when you run, or the same pain in your back whenever you practice your gymnastics routine, you may have a stress fracture. Be sure to get it checked out. This could prevent further injury.

Finding Help

If you experience symptoms associated with the Triad, schedule a visit with your physician as soon as possible. Parkview Sports Medicine offers a multidisciplinary team of sports medicine physicians, physical therapists, athletic trainers and sports nutritionists who can assist you.

Taking part in sports is a great way to stay active and improve your health and well-being. As long as you take care of yourself and talk to your physician when you have questions or concerns, sports will make you a stronger, healthier person.

Contact Us

For more information, call (260) 266-4007.

Parkview Sports Medicine

Services provided at AWP Sports Training –
Located within the SportONE Parkview Fieldhouse
3946 Ice Way, Fort Wayne, IN 46808
and on The Summit Campus
1025 W. Rudisill Blvd., Fort Wayne, IN 46807


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