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The Female Athlete Triad

2. Irregular Menstrual Periods

Amenorrhea (the absence of a period) and other menstrual irregularities increase the risk of bone fractures. With amenorrhea, teenaged girls experience significant reductions in estradiol, the primary form of the female hormone estrogen.

A young female athlete who appears to be in top physical condition often has the highest risk of low bone density (osteoporosis) and fracture, especially if she experiences disordered eating and loss of menstrual periods.

Low body weight alone is not enough to explain the loss of menstrual periods. But it seems that amenorrhea happens when you take in fewer calories, so you're getting too little nutrition for the amount of exercise you're doing.

Your weight influences your bone density. For example, a woman who weighs less than 127 pounds is 10 times more likely to have lower bone density than a woman who weighs 150 pounds or more. Your risk of bone loss increases when you have a low percentage of body fat.

3. Osteoporosis and Risk of Broken Bones

Teen girls with female athlete triad are at risk for early broken bones. In fact, a broken bone may be the sign that first alerts the doctor there is a problem. Up to 30% of ballet dancers suffer from repeated stress fractures, which points to problems with not getting enough bone minerals and low body weight.

How Is Female Athlete Triad Treated?

If you are a female athlete, it's important to minimize your risks as much as you can. For instance, be vigilant of training's effects on the body. Take action if you lose menstrual periods or if your body fat decreases significantly.

Athletes with menstrual disorders have lower estrogen levels, which often leads to lower bone mass. Findings show that a young woman who hasn't menstruated in four years may have the bone density of a 50-year-old woman.

Be sure to increase calcium in your diet (or through supplements), and eat enough calories to keep your body fat or weight from dropping too low. People who are too lean – with a body fat below 12% for the teenaged female athlete -- will not maintain strong bones.

When Should I Call My Doctor About the Female Athlete Triad?

Talk to your doctor about your risk factors for the female athlete triad. If you have had a broken bone without an associated major injury, consider a bone density test.

Also, check with your gynecologist about ways to correct very irregular periods. Some teens see their menstrual periods start again once they increase calories or reduce exercise.

Because bone loss is a serious result of female athlete triad, consume about 1,300 milligrams of calcium per day from calcium-rich or calcium-fortified foods. If this is not possible, add calcium and vitamin D through supplements. Also avoid carbonated beverages, which can also contribute to decreased bone density.

If you have a fracture, a sports medicine specialist can help you find other exercises (such as swimming) that will allow you to maintain aerobic fitness while it heals.

Also keep in mind that there are some forms of birth control that are not appropriate for women with calcium loss. If you use birth control, ask your doctor about the potential risks.

WebMD Medical Reference

Reviewed by Roy Benaroch, MD on February 06, 2014

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