Dr. Jane Chung talks with a teenage girl in her clinic.

Jun 14, 2016 / Sports Medicine

Female Athlete Triad – What You Need to Know

The name, female athlete triad, suggests that there are three separate components to this condition. However, further research and studies have led experts at the Female Athlete Triad Coalition* to change their approach in making this diagnosis. Now, the three components are each considered on a spectrum and are thought to be interrelated.

  • Normal eating > Disordered eating > Eating disorder
  • Normal menses or period > Abnormal menses > Absent menses
  • Bone health > Mild bone changes > Osteoporosis

All of these concerning signs are a result of some imbalance in energy intake and expenditure, affecting the energy availability. This is particularly apparent in athletes competing:

  • In endurance sports.
  • At elite levels.
  • In sports where figure or weight is emphasized.
  • Under performance pressure from coaches/parents.

What Jane S. Chung, M.D. wants parents of young athletes to know is that athletes 11-17 years old are in an important phase of growth and optimizing bone health. It is during this window that bones will achieve more than 90 percent of their peak bone mass, and a well-balanced diet including sufficient calcium and vitamin D intake is important. Athletes with high energy expenditure are at the greatest risk of developing the signs and symptoms of the female athlete triad because they may unintentionally fail to meet their bodies’ energy needs.

To this point, research has focused mainly on female athletes and cannot be applied directly to male athletes; however, males may present similar signs and symptoms. The Female Athlete Triad Coalition has agreed upon a list of concerning signs and symptoms in female athletes. If you notice these in your young athlete or her teammates, please speak up.

  • Extreme weight loss or excessive worry about weight
  • Absent, delayed or irregular menses
  • Recurrent stress injuries such as stress reaction or stress fractures
  • Restrictive or unusual eating behaviors

Learn more about pediatric sports medicine.

*Dr. Chung is an active member of the Female Athlete Triad Coalition, an international multidisciplinary organization aimed to promote healthy behaviors in female athletes through collaboration, education, research and policy change. Read more about the coalition on the Female Athlete Triad website.


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