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Female Athlete Triad

The Female Athlete Triad is a condition found among women that consists of three interrelated irregularities: disordered eating habits, irregular menstruation, and premature bone loss or osteoporosis. The term Female Athlete Triad was coined in the early 1990's when researchers from the National Institutes of Health noticed unusual health patterns within female athletes. They observed an increase in both disordered eating within young female athletes. These researchers found that exercising intensely while receiving inadequate nutrition can lead to amenorrhea, or irregular menstrual cycles, which in turn can lead to osteoporosis.

Symptoms of the Female Athlete Triad

• abdominal pain and bloating
• anemia
• constipation
• chest pain
• cold and discolored hands and/or feet
• depression
• erosion of dental enamel (from frequent vomiting)
• fatigue
• intolerance to cold
• irregular or loss of menstrual period
• lanugo (fine, downy hair covering the body)
• lightheadedness
• sore throat
• stress fractures

Triad Factor #1: Disordered Eating

The first component of the Female Athlete Triad is disordered eating. Disordered eating habits include restriction of certain foods, binge eating and purging, often as a result of one's insecurity with one's bodily image. Other commonly used techniques to lose weight include laxatives, diuretics, self-induced vomiting, fasting, fad diets, and attempts to sweat off weight. Disordered eating is found to be most common in female athletics that emphasize lightness, quickness, agility, and speed. As a result, the youth sports in which eating disorders are most common are figure skating, gymnastics, running, dancing, swimming rowing, wrestling and horse racing.

Social Context of Disordered Eating

Female athletes face a difficult paradox: Western culture emphasizes a feminine ideal body and behavior that contrasts with the image of an athletic body and behavior. According to researchers, this paradox effects the body image, eating behaviors, self-presentation, and self-esteem of female athletes. In many cases, the environment of female athletics results in the development of unhealthy habits such as disordered eating, excessive exercising, and training through injuries. The prevalence of disordered eating habits within female athletes is largely a result of the social construction of the ideal feminine body as being thin and toned. Those female athletes that best fit the socially constructed definition of femininity are rewarded with positive media attention, fan adoration, and sponsorships. They become figureheads of female athletics and perpetuate socially constructed expectations for feminine behavior and appearance in athletics.

Long Term Effects

One of the more common eating disorders among youth athletes is Anorexia Nervosa, which can have severe lasting effects, such as:

• permanent damage to liver, intestines, heart, kidneys
• low blood pressure
• slowed heart rate
• cardiac arrest
• kidney failure
• osteoporosis
• infertility
• low sex drive
• lanugo growth (fine hair) all over the body
• hyperactivity

The lasting effects of another common eating disorder, Bulimia Nervosa, are:

• peptic ulcers
• damaged or torn oesophagus
• swollen salivary glands
• eroded enamel
• stomach cramps
• difficulty swallowing
• constipation
• cardiac abnormalities
• possible kidney failures
• bloating

One of the less common but still prominent and consequential eating disorders among youth athletes is Binge Eating. The long term effects are:

• diabetes
• heart attacks
• high blood pressure
• osteoarthritis
• long term damage to kidneys, liver, heart, muscles

Warning Signs of Eating Disorders

• constant drinking of no-calorie beverages
• compulsive exercises
• dental cavities and bad breath (from vomiting)
• depression and low self-esteem
• frequent trips to the bathroom during or after meals
• frequent criticism of one's body
• inflamed cheeks from swollen parotid gland
• often eating alone
• often feeling cold
• preoccupation with weight and food
• repeated concerns of being overweight
• rapid weight loss
• use of laxatives

Triad Factor #2: Amenorrhea

The second factor of the Female Athlete Triad is amenorrhea, a condition which can be broken down into two forms. Primary amenorrhea is when a female reaches 16 years of age without experiencing a regular menstrual cycle. Secondary amenorrhea is defined as a menstrual cycle that ceases for at least three consecutive periods as the athlete increases her training and changes her eating habits. The prevalence of amenorrhea within the general population of females is between 2% and 5%, while the prevalence within female athletes has been reported anywhere between 3% and 66%.

Triad Factor #3: Osteopenia or Osteoporosis

During amenorrhea, estrogen levels are typically low. Since estrogen is necessary in the development of bone density and skeletal construction, amenorrhea often leads to the third triad component, Osteoporosis, also known as Osteopenia in more mild cases. When female athletes' don't ingest enough calcium (approximately 1,500 mg per day) and experience low estrogen levels this results in weakened bones. The weakening of bones then leads to higher risk of injuries, such as stress fractures. Women form 30% of their bone density between the ages of 15 and 30, so if the condition is not corrected during youth it can prevent the bones from ever developing to full density, which leads to future irreversible problems.

External Links

• Georgetown Athletics
• Georgetown Hoyas men's basketball