Female athlete triad is a mix of:
It is found in physically active girls and women.
Female athlete triad occurs when the amount of calories taken in is much lower than the amount of calories used. It is the result of:
The body responds to this energy deficit by dropping levels of a hormone called estrogen. Estrogen normally stimulates menstrual cycles and maintains the calcium levels in bones, keeping them strong. Low levels of estrogen can lead to irregular menstrual periods and decreased bone mineral density.
Factors that may increase the chance of female athlete triad include:
Symptoms may include:
The doctor may make the diagnosis based on symptoms and medical history including information about menstrual cycle, eating habits, and exercise routine. Information about regular medications or supplements is also important to know in case they are causing or worsening symptoms.
Additional testing may be done to rule out other conditions before a diagnosis is made.
Treatment plans will depend on the individual but often involves a blend of treatments. Many healthcare professionals may be involved in care, such as a gynecologist, dietitian, endocrinologist, and mental health specialists.
Treatment options include:
There are several different types of therapy. Options include individual or group, cognitive behavioral therapy, or sports psychology. Therapy can help:
Work with your care team to find which works best for you.
A dietitian can develop a nutrition plan that will provide enough calories to maintain a healthy weight and provide fuel for activities.
The doctor, coach, or trainer may review the exercise routines and advise changes. Changes may include reducing or alternating the length or intensity of workouts. It may also include strength training to help build muscle and bone density.
To help reduce your chance of getting female athlete triad:
Family Doctor—American Academy of Family Physicians
Ortho Info—American Academy of Orthopaedic Surgeons
When it Hurts to Move—Canadian Orthopaedic Foundation
Amenorrhea. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116009/Amenorrhea. Updated March 14, 2016. Accessed December 7, 2017.
Female athlete triad. Brown University website. Available at: https://www.brown.edu/campus-life/health/services/promotion/nutrition-eating-concerns-eating-concerns-and-body-image/female-athlete-triad. Accessed December 7, 2017.
Female athlete triad. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/female-athlete-triad.html. Updated October 2017. Accessed December 7, 2017.
Female athlete triad. Kid's Health—Nemours Foundation website. Available at: http://kidshealth.org/teen/food_fitness/sports/triad.html. Updated January 2014. Accessed December 7, 2017.
Female athlete triad: problems caused by extreme exercise and dieting. Ortho Info—American Academy of Orthopaedic Surgeons website. Updated October 2009. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00342. Updated June 2016. Accessed December 7, 2017.
Javed A, Tebben PJ, Fischer PR, Lteif AN. Female athlete triad and its components: toward improved screening and management. Mayo Clinic Proc. 2013;88(9):996-1009.
Last reviewed December 2017 by Beverly Siegal, MD, FACOG
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.