Parents of girls who play sports have been teaming up to ask me about something called the “female athlete triad.” Let me see if I can put some points on the educational scoreboard in helping everyone learn about this topic.

The female athlete triad occurs in teen girls who play sports or exercise intensely. The triad is a combination of three conditions: having an eating disorder, experiencing menstrual irregularities, and demonstrating osteoporosis or weakening of the bones.

The eating disorder may begin with an intent to lose weight for a sport, but when this becomes excessive, it can develop into anorexia nervosa or other eating disorders.

If and when the weight goes down, so do estrogen or hormone levels, resulting in irregular periods or no periods. While there are other reasons why a teenager can miss a period, if it is in conjunction with weight loss and athletics, the athlete’s triad needs to be considered.

Finally, low estrogen and poor nutrition mean low calcium intake and absorption, which can result in weakening of the bones, loss of bone density and improper bone formation. All of this can lead to stress fractures and the end of an athlete’s career.

If you think your daughter is experiencing signs or symptoms consistent with the female athlete triad, please talk to your daughter’s health care professional, who will want to help diagnose and treat this problem. The provider should be able to take a team approach to this problem, involving coaches, physical therapists, nutritionists, mental health specialists, and, of course, you and your daughter.

The best way to deal with the female athlete triad is to prevent it from happening. You can ask your daughter to keep track of periods, not miss meals or snacks, and even work with a dietician or nutritionist to insure that the right nutrients are taken in from a diet of at least 2000 to 2400 calories per day. All of this can improve sports performance without the complications that are associated with the triad in adolescent women who play sports or exercise intensely.

Hopefully tips like this will allow your daughter to win big when it comes to not developing the female athlete triad.

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Robert Larner, M.D. College of Medicine at the University of Vermont. You can also catch “First with Kids” weekly on WOKO 98.9FM and MyNBC 5, or visit the “First with Kids” video archives at www.UVMHealth.org/MedCenterFirstWithKids.

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Robert Larner, M.D. College of Medicine at the University of Vermont.

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