scholarly journals The Female Athlete Triad

2012 ◽  
Vol 5 (2) ◽  
pp. 33-43
Author(s):  
Dana Brewington ◽  
Derrick Johnson ◽  
Mark Stovak ◽  
AT Harvey
Keyword(s):  
Effect Size ◽  
Primary Care Physicians ◽  
Female Athlete ◽  
Negative Energy ◽  
Comfort Level ◽  
Female Athlete Triad ◽  
Mineral Density ◽  
Retention Of Knowledge ◽  
Clinician Practice

Background. The Female Athlete Triad (Triad) is characterized by negative energy balance, disordered menstrual cycles, and low bone mineral density. The understanding and practices of primary care physicians (PCPs) regarding the Triad and the benefit of an educational intervention were assessed. Methods. PCPs attending a regional conference were surveyed prior to, immediately after, and three months following the plenary lecture on the Triad. Surveys included knowledge about the components, diagnostics, treatment, clinician practice, and comfort level with regard to the Triad. Results. The pre-test survey was completed by 84 of 126 (67%) attendees. The lecture increased from 53% to 98% the proportion of PCPs who identified the three domains of the Triad. Knowledge scores improved over the course of the lecture (from 3.4 to 5.1, p < 0.05), particularly regarding Triad components (effect size = 1.2) and treatment (effect size = 1.6) with only small gains in diagnostic knowledge (effect size = 0.1 to 0.3). The three-month follow-up survey, completed by only seven clinicians (8%), suggested good retention of knowledge though little practice changes. Conclusions. A 50-minute educational session improved knowledge about the Triad. Particular improvement was noted in understanding the underlying etiology and treatment.

scholarly journals Bone-Mineral Density and Other Features of the Female Athlete Triad in Elite Endurance Runners: A Longitudinal and Cross-Sectional Observational Study

2010 ◽  
Vol 20 (5) ◽  
pp. 418-426 ◽  
Author(s):  
Noel Pollock ◽  
Claire Grogan ◽  
Mark Perry ◽  
Charles Pedlar ◽  
Karl Cooke ◽  
...  
Keyword(s):  
Female Athlete ◽  
Negative Energy ◽  
Endurance Athletes ◽  
Female Athlete Triad ◽  
Training Volume ◽  
Mineral Density ◽  
Cross Sectional ◽  
Menstrual Dysfunction ◽  
Endurance Runners ◽  
And Training

Low bone-mineral density (BMD) is associated with menstrual dysfunction and negative energy balance in the female athlete triad. This study determines BMD in elite female endurance runners and the associations between BMD, menstrual status, disordered eating, and training volume. Forty-four elite endurance runners participated in the cross-sectional study, and 7 provided longitudinal data. Low BMD was noted in 34.2% of the athletes at the lumbar spine, and osteoporosis in 33% at the radius. In cross-sectional analysis, there were no significant relationships between BMD and the possible associations. Menstrual dysfunction, disordered eating, and low BMD were coexistent in 15.9% of athletes. Longitudinal analysis identified a positive association between the BMD reduction at the lumbar spine and training volume (p = .026). This study confirms the presence of aspects of the female athlete triad in elite female endurance athletes and notes a substantial prevalence of low BMD and osteoporosis. Normal menstrual status was not significantly associated with normal BMD, and it is the authors’ practice that all elite female endurance athletes undergo dual-X-ray absorptiometry screening. The association between increased training volume, trend for menstrual dysfunction, and increased loss of lumbar BMD may support the concept that negative energy balance contributes to bone loss in athletes.

scholarly journals FEMALE ATHLETE TRIAD - PROBABLE BUT DIFFICULT TO CONFIRM IN FEMALE ICE HOCKEY PLAYERS

2018 ◽  
Vol 8 (2) ◽  
pp. 69-92
Author(s):  
Patricia Katherine Doyle-Baker ◽  
Leanne P McLean ◽  
Tak Fung
Keyword(s):  
Female Athlete ◽  
High Energy ◽  
Negative Energy ◽  
Ice Hockey ◽  
Fat Free Mass ◽  
Group Differences ◽  
Female Athlete Triad ◽  
Mineral Density ◽  
Hockey Players ◽  
Composition Changes

Female hockey players have high energy expenditure and may enter a negative energy balance (EB) without noticeable body composition changes. Menstrual cycle (MC) and luteal phase (LP) length, EB, and bone mineral density (BMD) were tracked over nine months (mean, SD, ±) in 12 ice hockey players (HP; age 21.1 ± 3.4 yrs; height (HT) 165.9 ± 4.6 cm; weight (WT) 64.7± 8.1 kg, body fat percent (BF%) 22.8 ± 3.8%) and 12 non-athlete controls (C; age 21.4 ± 2.8 yrs., HT 169.5 ± 5.5 cm; WT 65.4 ± 5.4 kg; BF% 20.0 ± 3.1%). HP MC (35.8 ± 11.2 days) was longer than C (29.8 ± 4.3 days) and HP LP (10.1 ± 2.1 days) was also longer than C (9.6 ± 2.8 days). Anovulation occurred in 50.0 % of HP versus 39.2 % of C. No group BMD differences were observed in lumbar spine (p = 0.9), hip (p = 0.5), and radial (p = 0.7) sites. A negative EB was identified (HP = -1026.52 ± 450.1; C = -780.00 ± 310.19 kcal / day), yet no significant within-group differences in WT (HP p = 0.7; C p = 0.8), BF % (HP p = 0.97; C p = 0.6), or fat free mass (HP p = 0.6; C p = 0.98) were found over the study duration. Rigorous hockey schedule likely contributed to 28 % completion of the Basal Body Temperature and MC recordings in HP compared to 70 % in C. Both groups entered a state of negative EB, but did not exhibit a BF % change associated with the Female Athlete Triad. 

Stress Fractures And The Reproductive System In The Female Athlete

2018 ◽  
Author(s):  
Irfan M Asif ◽  
Kimberly Harmon ◽  
Mallory Shasteen
Keyword(s):  
Femoral Neck ◽  
Disordered Eating ◽  
Reproductive System ◽  
Female Athlete ◽  
Female Athletes ◽  
Stress Fractures ◽  
Female Athlete Triad ◽  
Low Back ◽  
Mineral Density ◽  
Pubic Ramus

Stress fractures are more common in the female athlete. Stress fractures of the pubic ramus and femoral neck are particularly more common in females than in males. Rib stress fractures are an important injury to consider in the female rower, whereas spondylolysis is a common cause of low back pain in female athletes who hyperextend their spines. The higher incidence of stress fractures in females is mainly due to the higher prevalence of disordered eating and subsequent energy imbalance, which leads to detrimental effects on bone. This review discusses stress fractures and unique issues related to exercise and the female reproductive system. This review contains 6 figures, 5 tables and 49 references Key words: amenorrhea, bone mineral density, disordered eating, female athlete triad, femoral neck, pregnancy, pubic ramus, rib, spondylolysis, stress fracture

Stress Fractures And The Reproductive System In The Female Athlete

2018 ◽  
Author(s):  
Irfan M Asif ◽  
Kimberly Harmon ◽  
Mallory Shasteen
Keyword(s):  
Femoral Neck ◽  
Disordered Eating ◽  
Reproductive System ◽  
Female Athlete ◽  
Female Athletes ◽  
Stress Fractures ◽  
Female Athlete Triad ◽  
Low Back ◽  
Mineral Density ◽  
Pubic Ramus

Stress fractures are more common in the female athlete. Stress fractures of the pubic ramus and femoral neck are particularly more common in females than in males. Rib stress fractures are an important injury to consider in the female rower, whereas spondylolysis is a common cause of low back pain in female athletes who hyperextend their spines. The higher incidence of stress fractures in females is mainly due to the higher prevalence of disordered eating and subsequent energy imbalance, which leads to detrimental effects on bone. This review discusses stress fractures and unique issues related to exercise and the female reproductive system. This review contains 6 figures, 5 tables and 49 references Key words: amenorrhea, bone mineral density, disordered eating, female athlete triad, femoral neck, pregnancy, pubic ramus, rib, spondylolysis, stress fracture

scholarly journals Impact of a Professional Nutrition Program on a Female Cross Country Collegiate Athlete: A Case Report

Sports ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 82 ◽  
Author(s):  
Majid Syed-Abdul ◽  
Dhwani Soni ◽  
Jason Wagganer
Keyword(s):  
Case Report ◽  
Energy Balance ◽  
Energy Intake ◽  
Female Athlete ◽  
Negative Energy ◽  
Female Athlete Triad ◽  
Long Term Effects ◽  
Nutrition Program ◽  
Short And Long Term

Low caloric intake or excessive energy expenditure can lead to a negative energy balance, which, in female athletes, may result in a condition called the female athlete triad. While several guidelines identified proper nutrition as a first line of treatment, little research has been reported to show the effect of a professional nutrition program (PNP) on the female athlete triad. The purpose of this case report was to measure the short- and long-term effects of a PNP on a female athlete presenting triad characteristics. A 20-year-old female track-and-field athlete at a Division I university who was in negative energy balance and amenorrheic underwent a one-month PNP. Short- and long-term effects measured by a dual X-ray absorptiometry scan prior to and after attending a PNP showed increased total energy intake from 2188 kcals to 3187 kcals, which resulted in an increase in body fat percent (BF%) from 4.7% to 6.7%. However, by the end of four months, energy intake and BF% (5.7% and 6.0%) values were reduced, respectively. After the twelve-month follow-up, BF% was increased (10.5%), suggesting that increasing energy intake to meet energy demands, without compromising athletic training, can be an effective treatment for the female athlete triad.

scholarly journals Bone mineral density, rib pain and other features of the female athlete triad in elite lightweight rowers

BMJ Open ◽  
2014 ◽  
Vol 4 (2) ◽  
pp. e004369 ◽  
Author(s):  
Lygeri Dimitriou ◽  
Richard Weiler ◽  
Rebecca Lloyd-Smith ◽  
Antony Turner ◽  
Luke Heath ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Female Athlete ◽  
Female Athlete Triad ◽  
Mineral Density

Characterization of Risk Quantification Differences Using Female Athlete Triad Cumulative Risk Assessment and Relative Energy Deficiency in Sport Clinical Assessment Tool

2019 ◽  
Vol 29 (6) ◽  
pp. 569-575 ◽  
Author(s):  
Bryan Holtzman ◽  
Adam S. Tenforde ◽  
Allyson L. Parziale ◽  
Kathryn E. Ackerman
Keyword(s):  
Female Athlete ◽  
Assessment Tool ◽  
Cumulative Risk ◽  
Relative Energy ◽  
Risk Level ◽  
Energy Availability ◽  
Female Athlete Triad ◽  
Mineral Density ◽  
Energy Deficiency ◽  
Low Energy Availability

This study’s objective was to identify differences in risk for low energy availability and athletic clearance level by comparing scores on Female Athlete Triad Cumulative Risk Assessment (Triad CRA) and Relative Energy Deficiency in Sport Clinical Assessment Tool (RED-S CAT). A total of 1,000 female athletes aged 15–30 years participating in ≥4 hr of physical activity/week for the previous ≥6 months completed an extensive survey assessing health, athletic history, family disease history, and specific Triad/RED-S risk factors. Retrospective chart review ascertained laboratory and bone mineral density measures. Triad CRA and RED-S CAT were used to assign each athlete’s risk level (low, moderate, and high), and case-by-case comparison measured the level of agreement between the tools. We hypothesized that the tools would generally agree on low-risk athletes and that the tools would be less aligned in the specific elevated risk level (moderate or high). Most of the sample was assigned moderate or high risk for Triad CRA and RED-S CAT (Triad: 54.7% moderate and 7.9% high; RED-S: 63.2% moderate and 33.0% high). The tools agreed on risk for 55.5% of athletes. Agreement increased to 64.3% when only athletes with bone mineral density measurements were considered. In conclusion, Triad CRA and RED-S CAT provide consensus on the majority of athletes at elevated (moderate or high) risk for low energy availability, but have less agreement on the specific risk level assigned.

Stress Fractures And The Reproductive System In The Female Athlete

2018 ◽  
Author(s):  
Irfan M Asif ◽  
Kimberly Harmon ◽  
Mallory Shasteen
Keyword(s):  
Femoral Neck ◽  
Disordered Eating ◽  
Reproductive System ◽  
Female Athlete ◽  
Female Athletes ◽  
Stress Fractures ◽  
Female Athlete Triad ◽  
Low Back ◽  
Mineral Density ◽  
Pubic Ramus

Stress fractures are more common in the female athlete. Stress fractures of the pubic ramus and femoral neck are particularly more common in females than in males. Rib stress fractures are an important injury to consider in the female rower, whereas spondylolysis is a common cause of low back pain in female athletes who hyperextend their spines. The higher incidence of stress fractures in females is mainly due to the higher prevalence of disordered eating and subsequent energy imbalance, which leads to detrimental effects on bone. This review discusses stress fractures and unique issues related to exercise and the female reproductive system. This review contains 6 figures, 5 tables and 49 references Key words: amenorrhea, bone mineral density, disordered eating, female athlete triad, femoral neck, pregnancy, pubic ramus, rib, spondylolysis, stress fracture

Detection and Management of the Female Athlete Triad

2020 ◽  
pp. 36-40
Author(s):  
Craig Coleman ◽  
Brett Spain Spain
Keyword(s):  
Female Athlete ◽  
Multidisciplinary Approach ◽  
Athletic Trainer ◽  
Health Practitioner ◽  
Net Energy ◽  
Female Athlete Triad ◽  
Mental Health Practitioner ◽  
Mineral Density ◽  
Physically Active ◽  
Exercise Physiologist

The female athlete triad is a disorder seen in physically active females that manifests as three interrelated syndromes that may or may not occur simultaneously.1,2,3 It is a multi-component disease initiated by an energy-deficient state (possibly from an eating disorder), bone mineral density abnormalities and menstrual changes.1,2,3 Prevention and early intervention are important in averting permanent debilitating damage. The cornerstone of treatment is creating a positive net energy availability, which requires a multidisciplinary approach comprised of a licensed physician, nutritionist, exercise physiologist, mental health practitioner, athletic trainer, coaches, the athlete and their parents.

Does Supplemental Estrogen Improve Bone-Related Symptoms of Female Athlete Triad in Female Athletes? A Critically Appraised Topic

2021 ◽  
pp. 1-5
Author(s):  
Elizabeth Hollenczer ◽  
Angelica Esposito ◽  
Erin M. Moore
Keyword(s):  
Oral Contraceptive ◽  
Bone Health ◽  
Female Athlete ◽  
Female Athletes ◽  
Energy Levels ◽  
Female Athlete Triad ◽  
Mineral Density ◽  
Bottom Line ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills

Clinical Scenario: Due to the Female Athlete Triad (Triad) being a 3-pronged syndrome, treatments can vary depending on the symptoms that clinicians focus on. With reproductive and bone health compromised, assessment and recovery methods include monitoring menstrual regularity and dual-energy X-ray absorptiometry scans. Low levels of estrogen have demonstrated negative effects on bone mineral density (BMD). Clinical Question: Does supplemental estrogen improve BMD in athletes with Female Athlete Triad symptoms? Summary of Key Findings: Supplemental estrogen does improve BMD with estrogen patches demonstrating increased improvement compared with oral contraceptive pills. Clinical Bottom Line: Restoration of regular menstruation, improvement of BMD, and ensuring optimal energy levels is the best approach for treating Triad symptoms. Transdermal patches are a new treatment option that address both menstrual function and BMD but still require further research. Strength of Recommendation: Available studies demonstrated a level 2 evidence for supplemental estrogen (oral contraceptive pills and estrogen patches) providing improvements for bone health related to the Triad.

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