Female Athlete Triad
Female Athlete Triad (FAT) a condition of an energy imbalance in a female athlete that results in the loss of menstruation and decreased bone density, can be caused by purposeful or accidental actions. Restricting calorie intake because of pressure by coaches, teammates, or self-imposed ideals to become thinner or leaner can start disordered eating. Adding over-training, while eating fewer calories than expended, results in a sustained energy deficiency. This can lead to stress fractures due to bone density loss, and musculoskeletal injuries due to poor nutritional health.
Symptoms
The first symptom is typically a loss of menstruation. Other physical symptoms include gastrointestinal problems, cold intolerance, fatigue and weakness, dehydration, muscle cramps, body mass index lower than 17.5, and dental and gum problems. Psychological symptoms include anxiety, depression, avoiding food intake, use of diet pills or laxatives, frequent use of the bathroom, fixation on weight, and difficulty concentrating.
Prevention and Treatment
Prevention is key to assist the female athlete in achieving her sports goals and staying healthy in the long run. Parents, coaches, and the athletes themselves need to be educated that amenorrhea is not normal. The pre-season sports physical should include a gynecological component that screens for the signs and symptoms of FAT. Adding sports nutrition in the pre-season education session is essential for the athlete and parents to understand the nutritional needs to provide for peak performance without causing any harm to the athlete.
Coaches should not concentrate on weight as part of the female athlete’s performance, and along with parents, should be cognizant of the signs of female athlete triad. The athlete’s part is to eat healthily, get 8-hours of sleep nightly, and avoid weight loss supplements, drugs, and alcohol, as well as foster supportive relationships that encourage good body image and proper health habits.
Physical Therapy
Physical therapy is a valuable adjunct to the nutritional and psychological components of prevention and treatment. Our physical therapist has expertise in strength and conditioning, training, body composition assessments, and rest-recovery ratios, as well as, the evaluation and treatment of injuries.
I would add recreational athletes, as well as elite athletes and young athletes who fail to consume enough calories to maintain the body’s function and physical training, are affected and should also be aware of the long term effects of energy deficiency.
References:
American College of Obstetricians and Gynecologists (2019). Female athlete triad. Retrieved from https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Female-Athlete-Triad?IsMobileSet=false
American College of Sports Medicine (2019). Industry presented blog: The Female Athlete Triad and Sports Nutrition Strategies for Recovery Webinar Q&A. Retrieved from https://youtube.com/watch?v=VuDQ3zzhD10&feature=youtu.be
Mendelsohn, F.A., & Warren, M.P. (2010). Anorexia, bulimia, and the female athlete triad: Evaluation and management. Endocrinology & Metabolism Clinics of North America, 39(1), 155-x. https:/doi.org/10.1016/j.ecl.2009.11.002 Papanek, P. E. (2003) The female athlete triad: An emerging role for physical therapy. Journal of Orthopedic Sports Physical Therapy, 33(10), 594-614. Retrieved from www.jospt.org/doi/pdf/10.2519/jospt/2003.33.10.694