The female athlete triad is a disorder most common in adolescent female athletes. Although it is not exclusive to females or adolescents, this group is the most at risk. The triad is a potentially serious condition that will result in reduced athletic performance, as well as serious health concerns that may affect your health long after adolescence.

The Female athlete triad involves 3 conditions that are all interrelated;

1. Low energy availability

This can range from simply not eating enough food to provide your body with the energy it requires, to avoiding certain foods that are thought to be “bad” (such as carbohydrates), all the way through to serious eating disorders such as anorexia nervosa or bulimia nervosa.

2. Ammenorhea

Ammenorhea is a pause or interruption in your menstrual cycle. High levels of exercise, combined with not eating enough or the right types of foods, can interrupt the hormones that regulate your period. This can present as irregular periods, a skipped period, or never getting your period at all. Issues with your period are not solely due to the triad, but any irregularities should be monitored, and the female triad should be considered as a potential cause.

3. Decreased bone mineral density

In females who are suffering from the triad, the hormone oestrogen is lower, and when this is linked with poor nutrition, your bone density can start to suffer. Bone starts to weaken, and this can lead to a higher risk for bone related injuries such as stress fractures and traumatic fractures. Eventually, this can lead to osteopaenia (soft bones) and osteoporosis (weak bones).

Who is at risk?

Any adolescent female athlete is at risk of developing the triad, but at higher risk are those who;

  1. Have very high training loads or train at high intensities
  2. Athletes who compete in sports which have a focus on appearance or weight e.g. dancing, gymnastics, boxing
  3. Athletes who compete in distance/endurance events who think they need to lose some weight to improve their performance

How do you know whether you suffer from the Triad?

Some signs and symptoms of the disorder include (but are not limited to):

  • Weight loss
  • No periods or irregular periods
  • Fatigue
  • Low energy
  • Stress fractures
  • Multiple injuries
  • Fasting
  • Limiting food intake
  • Extreme exercise
  • Poor sporting performance

What do I do if I or someone I know is suffering from the Triad?

A medical professional must be consulted immediately to address the underlying causes of the triad. Your doctor may then decide to refer you to other health professionals such as dieticians, physiotherapists, exercise physiologists or psychologists to assist in your recovery. The most important thing is for diagnosis to be made early, and treatment to commence straight away.