The Female Athlete Archive

side image The Female Athlete Triad 

Women's involvement in sports competition has exploded since the implementation of Title IX in the mid 1970's. Female athletes of all ages and skill levels benefit from sports participation in many physiological and psychological ways. This includes improved health and quality of life for athletes. As opportunities for participation and competition continue to grow, some athletes may try to gain a competitive edge by training longer and more intensely than their competitors. If the athlete is not taking in the extra energy required to replace the vitamins and nutrients expended during this intense training, it could set some of these females up for one or more components of what is known as The Female Athlete Triad.

The Female Athlete, Triad has three components: energy availability-the amount or energy (calories) left after exercise training to support all other body functions, menstrual function- normal menstrual function at one end of the spectrum and amenorrhea (absent menstruation for longer than 3 months) at the other end, and bone mineral density (BMD) or bone strength.

In the case of the female athlete, when low energy availability (from increased training intensity) is severe enough, altered reproductive function may occur due to inhibition of hormonal release. Symptoms can include amenorrhea and/or anovulation. If left untreated infertility as an adult may occur. Estrogen deficiency also occurs as a result of inhibited hormonal release, affecting BMD by decreasing the rate of bone formation in premenopausal females. This may cause a failure of the young female athlete to reach peak bone mass during puberty, lowering BMD and possibly increasing the risk of osteoporotic fracture as an adult. Estrogen deficiency, due to low energy availability and abnormal reproductive function, can also increase the risk of cardiovascular disease in women, as lowered estrogen levels result in less protection against atherosclerotic plaque build-up in vessel walls.

Research suggests that the rate at which menstruation returns is directly related to the number of calories consumed daily, not the reduction of training intensity. By increasing caloric intake and thereby, energy availability, normal reproductive function will be restored and low BMD will be reversed for optimal bone health.

Optimizing sports performance and remaining injury free should be the goal of all female athletes. Physical therapists can support female athletes by restoring muscle imbalances and correct faulty biomechanics. We can also help educate them on the benefits of healthy training, nutrition and healing so that sports participation for females continues to be a positive and rewarding experience.