The Female Athlete Triad

By now, you all know that I love So You Think You Can Dance. Last weeks show highlighted a young girl who had to give up dance for 2 years because of an eating disorder. She was able to heal, and now has a healthy body view and outlook and has been able to resume dancing. She is a beautiful dancer! So, today I wanted to highlight a common problem that is unique to female athletes and it is called the Female Athlete Triad. Watch the video and then read further to discover what this problem is, and why it is important to address this at an early age with our daughters.

So what is the Female Athlete TriadThis is the balance of nutrition and hormones that effect a female athlete that can lead to serious injury and health risk. Specifically it refers to disordered eating, amenorrhea, and osteoporosis. A female athlete can have one or all three of the parts of the triad. 

Disordered Eating: Most female athletes with this aspect of the triad are trying to lose weight to improve their athletic performance. Dancers, gymnasts, cheerleaders, martial artists, rowers and swimmers are often effected by this because of the stereotyped body profile of these sports or needing to make a certain weight class. It includes severe eating disorders such as anorexia and bulimia nervosa, but can be just not eating enough calories to keep up with demand, or avoiding certain foods considered to be “bad” such as fats. This can also include just poor nutritional awareness and poor food choices leading to a lack of appropriate nutrients to repair the body.

Amenorrhea: This is the absence of a regular menstrual cycle or very irregular cycles. Exercising intensely and not eating enough calories leads to decreases in the normal hormones that regulate this cycle. A missed period does not automatically mean that your female athlete is experiencing this condition. Missed periods are normal for teens, especially in the first year of beginning menses. But frequent missed periods could signal pregnancy or another medical condition and should be discussed with your doctor.  Some girls may never get their first period because of the intensity of training for their sport. 

Osteoporosis: When an athlete is intensely training for a sport and is experiencing amenorrhea there is a decrease in the estrogen she is producing. Poor nutrition, including decreased calcium intake, combined with low estrogen can lead to osteoporosis. This is a weakening of the bones due to improper bone formation and loss of bone density. Most people think this is a disease of old age. But in the female athlete it can lead to stress fractures and other injuries. The teenage years are when bone density should be peaking in order to have strong bones into later adulthood. Poor nutrition now in the athlete can limit her career through injury as well as cause pain and deformity later in life. 

What are the signs and symptoms to look out for?

Weight loss
No periods or irregular periods
Fatigue and decreased ability to concentrate
Stress fractures
Other injuries
Continued dieting despite weight loss
Preoccupation with food and weight
Using laxatives
Brittle hair and nails
Dental cavities (especially in cases of bulimia as frequent vomiting erodes tooth enamel.)
Sensitivity to cold
Low heart rate and blood pressure
Heart irregularities and chest pain

What to do if you or someone you know has one or more of the above signs or symptoms. Contact your doctor. Your doctor will be able to provide resources and information on where to get more help. Try looking for a sports medicine doctor or one that specializes in the treatment of female athletes. Even if you aren’t experiencing the above, if you are a female athlete, or the parent of one, it will benefit you to know what signs and symptoms to look for. 

Talk to a sports nutritionist. They can help you develop a diet that is balanced and provides the nutrients you need while helping you to “ make weight” or to drop a few pounds if necessary.

Talk to you physical therapist. Your PT can help design a training program that provides a balanced approach to your sport and eliminates muscle imbalances and strength deficits that can lead to injury. 

Talk to a Sports psychologist. Mental health of the athlete is just as important as physical health. Many teens are pressured by their parents, coaches, and peers. Being a teen isn’t easy to begin with and having someone to talk to about self-esteem, positive body image, perfectionism, and the sporting mentality can help take your athlete to the next level while helping to eliminate stress. This is especially important for female athletes experiencing one or all parts of the female athlete triad. 

All teen female athletes should keep track of the following things to stay on top of their physical condition. Parents should ask their children about these topics and keep open dialogue’s with their athlete:

Keep track of your periods. When it starts and stops and if it is heavy or light. This will help you to understand what your normal cycle is and if there is a change.

Don’t skip meals or snacks. The calorie demands of the athlete are extremely high. You need the energy that meals and snacks provide to compete at a high level. But the content of your meals and snacks should provide you high quality nutrition. Sugar and processed foods won’t help you perform better. Go for whole foods like fruits and vegetables and nuts or seeds. Whole grains are better than refined carbohydrates. 

Be an athlete for you, not for anyone else. Pressure from parents, coaches, and friends can help you to achieve success in your sport, but only if you really want to be doing it. Otherwise, it is just added stress that can lead to other health issues. 

Visit a nutritionist or dietician for a healthy diet plan that is customized to your needs based on your height, weight, and sport requirements.

If you have questions, please contact me at, or through the Contact Us! page at

Kelley PenroseComment