Women athletes who train hard and don’t consume enough calories are at risk for a syndrome called the female athlete triad. Women with female athlete triad lose so much body fat that their menstrual cycles become irregular or they stop menstruating entirely. They also lose bone density. Low bone density, menstrual irregularities, and inadequate calorie consumption are the three components that make up the female athlete triad. Some estimates are that over 50% of women athletes meet at least one criterion for this syndrome.
Why is Female Athlete Triad So Common?
There is enormous pressure for women to stay thin in sports such as gymnastics, figure skating, cross-country skiing and distance running. To keep their weight down, women who compete in these sports often practice unhealthy eating habits and restrict calories excessively. As a result, their body mass and body fat can drop to very low levels, low enough to cause their menstrual periods to stop or become irregular and estrogen levels to fall. Without adequate estrogen, they lose bone density and are at higher risk for stress fractures. Because they’re not menstruating, they also have fertility problems.
Even more disturbing is the fact that women with female athlete triad who lose bone density aren’t always able to recover it. Some loss of bone density may be permanent, which increases their risk of osteoporosis many years down the line.
What Causes the Female Athlete Triad?
No one knows exactly what causes female athlete triad, but a chronic energy imbalance seems to cause estrogen levels to drop and menstrual periods to stop. Female athletes with this syndrome usually train intensely without consuming enough calories, leading to a negative energy balance. This negative energy imbalance creates stress that affects hormones that control the menstrual cycle. Once menstrual periods stop, the ovaries don’t produce enough estrogen to keep bones healthy. To add to the problem, many women with female athlete triad don’t get enough calcium to prevent bone loss. Women with female athlete triad are at three times greater risk for stress fractures.
Other Problems Associated with the Female Athlete Triad
Many women with this syndrome suffer from psychological issues related to the pressure to train hard and stay thin. As a result, their suicide rate is higher than the average population. The chronic energy imbalance with this syndrome can lead to cold intolerance, weakness and fatigue, dehydration, depression, and intestinal issues. It’s a serious problem that can seriously impact a female athlete’s life and health.
Can It Be Treated?
The key is to help women with this syndrome get the calories and nutrition they need to correct their energy imbalance. The earlier an athlete gets treatment, the more likely it is that their bone mass will be preserved. Some doctors also give women with female athlete triad hormone therapy to help correct hormonal imbalances and restart their periods. A dietician can help athletes with this syndrome plan a diet to help them put on enough weight so that their health isn’t in jeopardy. The most important thing is for women with this condition to get treatment as soon as possible before they do permanent damage to their bones.
References:
Exercise Physiology. Theory and Application to Fitness and Performance. Seventh edition. 2009.
Medscape Family Medicine. “Female Athlete Triad”
