When 16-year-old "Whitney" made the varsity track team, she noticed that her best times were slower than the older girls, who were extremely thin. So Whitney began eating less. Within two months, she had dropped 11 pounds and reduced her body fat to less than 14%. Although her race times and endurance improved, Whitney's menstrual periods stopped.
Then, in her senior year, Whitney was predicted to qualify for the state track team. While running the day before the meet, she tripped on a tiny rock, fracturing her ankle. Though Whitney was lean, muscular, and appeared to be the picture of health, her doctor became concerned about her excessive dieting, low body weight, and loss of her period. These are all key risk factors for low bone density (osteoporosis) and fractures. He immediately ordered a bone density test, which tests the strength of bones. The test results showed that Whitney had low bone density and that she had the bone strength of a much older woman.
The female athlete triad is made up of three medical conditions that are becoming increasingly common in active teen girls:
Energy imbalance with or without an eating disorder
Decreased bone mineral density with or without osteoporosis
Low-calorie diets are usually the first sign of eating disorders. Excessive exercise or exercise obsession can be another sign.
Teens that are thin and exercise excessively are at higher risk of amenorrhea. And amenorrhea is linked to decreased estrogen levels, which may be the cause of osteoporosis. A diet low in calcium and vitamin D can also contribute to low bone density.
Your doctor should evaluate and treat each of these three problems to ensure a healthy outcome.
Who's at Risk for the Female Athlete Triad?
Teen girls who restrict their eating and have amenorrhea are at highest risk for female athlete triad. Female athletes who try to reach a low body weight for running or dancing are more likely to have amenorrhea, as are those who compete in scoring sports such as gymnastics and figure skating.
What Are Symptoms of the Female Athlete Triad?
The female athlete triad is a combination of three conditions. Each condition has symptoms to alert you that a problem exists:
1. Energy Imbalance
Characterized by morbid fear of weight gain, certain eating disorders lead to severe restriction of food intake. This results in extreme weight loss or even starvation. Most female athletes are concerned about their body weight and shape, and may follow a strict diet. Avoiding key nutrients could lead to inadequate amounts of protein, iron, calcium, and zinc in the diet.
Women who diet excessively often eliminate dairy products. Dairy products are a primary source of calcium, which is vital for bone strength. Some studies say that less than 25% of adolescent girls get the calcium necessary each day through foods or supplements. This deficit comes at a critical time in the teen's life -- when girls should be building their bone mass to the highest levels.