Sports Medicine Group Updates Position on Female Athlete Triad

Female athletes can be susceptible to bone loss, menstrual problems, and low energy availability. Eric Gevaert / iStockphoto.com

The American College of Sports Medicine (ACSM) has updated its stance on the Female Athlete Triad, an idea that recognizes a relationship among bone mineral density, menstrual function, and energy availability. The Female Athlete Triad is most prominently affected in women participating in sports emphasizing leanness, such as gymnastics, swimming, rowing, and track and field. Exercise is very beneficial, but for some of these athletes, it is easy to take exercise to unhealthy extremes.

When any of these physical elements becomes abnormal, problems result:

1. Low bone mineral density becomes osteopenia and, eventually, osteoporosis.
2. Loss of menstrual function is called amenorrhea.
3. Low energy availability simply means a lack of available energy for the body to function. This normally comes about through disordered eating.

The ACSM notes that when the triad is affected negatively, the first order of business in correcting the problem is increasing energy availability. That means increasing intake of calories, decreasing energy expenditure (e.g., exercise), or both. Low energy availability leads to osteoporosis through metabolic hormone problems. It also leads to amenorrhea due the body having no spare energy to conduct a menstrual cycle. Amenorrhea, in turn, compounds the likelihood of osteporosis due to low estrogen levels.

Speaking of treatment, the ACSM also noted that a treatment team should include a medical provider, a dietitian, and, when an eating disorder is present, a mental health counselor.

• ACSM stand on Female Athlete Triad
• Finding treatment providers
• Risk factors in eating disorders