Female Athletes Triad

Updated: Dec 10, 2019


The advantages of being active are obvious (i.e cardiovascular health, blood sugar regulation, muscle growth, increase metabolism, bone density, decreased abdominal weight, etc) but women know all too well that living an active lifestyle is difficult in more ways than one. If you’re an athlete participating in extreme and ongoing sports competition, you’ll face even more challenges. These unique hurdles relate not only to your performance on the field, but to maintaining your overall health in both the short and long-term.

It is essential that female athletes of all ages prioritize their well-being and take the necessary steps to ensure that they are protecting and supporting their health and wellness. Unfortunately, many are subjecting themselves to dangerous behaviours like extreme calorie restriction, over-exercising, and other “quick fixes” that are very harmful to the body. These things can lead to a condition known as Female Athlete Triad Syndrome.

What Is Female Athlete Triad Syndrome?

Female Athlete Triad Syndrome is actually a combination of three different conditions, all connected to over-exercising as a female athlete. These three conditions are:

  1. Amenorrhea: The abnormal absence of menstruation.

  2. Osteoporosis: A painless condition that causes decrease in bone density.

  3. Disordered eating: A condition characterized by abnormal and unhealthy eating patterns (often calorie, food or timing restriction)**

** Disordered eating does not have to be a diagnosed eating disorder such as bulimia or anorexia. Disordered eating are harmful eating behaviours engaged in attempt to modify body composition**

Over-exercising can lead to any one of these conditions, and it often leads to all three, resulting in a growing number of athlete triad syndrome cases in women.

Athlete triad syndrome doesn’t just affect females, although males don't suffer from amenorrhea for obvious reason (No uterus = No amenorrhea!) they can suffer from hormonal dysfunction. This being said, it seems to be having a much more substantial affect on women due to the extreme and often unrealistic expectations of the media and public regarding female athletes' figures and performance.

Who is At Risk?

Dance, gymnastics, figure skating and fitness competitors are examples of sports where female athletes are at a particularly higher risk of developing female athlete triad syndrome. With these sports judging competitors specifically for both their form and figure, women participating in such competitions are more likely to over-exercise and/or under eat in order to meet the standards assumed by their coach, team, and judges. In the recent years, Crossfit athletes have also been subject to increased risk of developing female athletes triad due to the high intensity of conditioning required to perform. Furthermore, marathon runners, triathlon athletes, obstacle course athletes and any high level sports increase risk of developing this syndrome.

As stated in a report by The Journal of the Canadian Chiropractic Association, “This cultural ideal places females at an increased risk of developing disordered eating patterns in an effort to conform to the ultra-thin ideal of Western society.”

Ultimately, statistics agree that female athletics have many advantages--like increased self-esteem and self-confidence amongst participants. It’s also linked to a reduction in “risky behaviours such as drug abuse and teen pregnancy.” Regardless, the threat of female athlete triad syndrome and eating disorders in general are a major area of concern for those in the industry.

How to Prevent Female Athlete Triad Syndrome

It has been well-established that it is the ideal set forth by Western culture in general that leads to most cases of eating disorders and over-exercising for female athletes aka social pressures to fit into the "beauty mold".

Therefore, the best course of action is to continue working towards setting more realistic standards for women’s figures and appearances. A critical example is using “average” women in advertising and media campaigns as these are the figures that influence the self-expectations of millions of females around the world in magazines and television.

Fortunately, many brands are already working towards this goal, with campaigns like that of Dove’s “Real Beauty” focusing on promoting self-love and acceptance for all body types. Of course, it cannot--and should not--end there.

For individual women right now, having a solid support system is a major component in keeping self-esteem high and self-expectations realistic. It’s important that female athletes also receive the right information and guidance from health professionals and their own team and coaches to help them realize what’s best for their body, both in the short and long term.

With this support and knowledge, every female athlete can be empowered to make smart, healthy choices that will ultimately benefit not only their overall well being, but also their performance in their sport. It is important to work with a registered dietitian who specializes in sports performance as well as disordered eating behavior. The key here is to fuel your body for high performance while keeping your mental health and mindset on the right track

Addressing Female Athlete Triad Syndrome

For women who are already suffering from female athlete triad syndrome, the best course of action is established on a case-by-case basis, dependent on the severity of the condition.

Disordered eating often requires routine intervention to address, especially if it has led to severe weight loss or if the patient is suffering from other conditions like bulimia or episodes of binge eating. This is a condition that needs to be treated by a health specialist in the field.

Amenorrhea is usually a result of disordered eating and may subside on its own with the return of a healthy eating pattern. Osteoporosis, on the other hand, requires on-going treatment to help prevent further bone loss and reduce the risk of fractures caused by brittle bones.

If you or someone you know is suffering from an eating disorder, disordered eating or female athlete triad syndrome, PLEASE reach out for help to a professional for advice and guidance. When it comes to such issues, prevention truly is the best medicine.

As a registered dietitian working with athletes and patients with eating disorder, I understand the importance of combining nutrition and psychology to fuel your body for performance, feel great in your body and mind.

Don't hesitate to reach out

Marie-Pier Pitre-D'Iorio, RD

Thank you Sydney for your contribution to this article!

#Athlete #eatingdisorder #sportperformance #nutrition

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The Balanced Dietitian