As female athletic triad is defined the syndrome that manifests in physically active women and girls and consists of three interrelated conditions:
- reduced energy intake
- amenorrhea and
- reduced bone density (osteopenia/osteoporosis)
Female athletic triad is common among people who have high performance requirements, especially regarding sports that emphasize in body weight and appearance. Although low body weight in some sports may be necessary, however, attention should be given in order the individual to meet through diet energy needs. Restriction of energy intake can happen either unintentionally due to poor nutritional education either voluntarily because of psychopathological causes (anorexia and bulimia).
Energy restriction leads to great loss of fat mass resulting in impaired estrogen release and therefore menstrual cycle disruption. Estrogens are hormones responsible for the proper functioning of the menstrual cycle and woman fertility. Additionally, due to poor quality of diet, reduced intake of dietary calcium and because of low estrogen levels there is a significant reduction in bone density. As a result there are amenorrhea, increased risk of fractures, low athletic performance and often mental disorders. Many times an athlete can display subclinical signs of the aforementioned conditions or some components of the syndrome, such as dysmenorrhea or decreased bone density without having osteopenia or osteoporosis. Female athletic syndrome is hardly reversible, thus girls and women should be monitoring annually in order to early diagnose it.
The key components of treatment are the increase of energy intake with concomitant reduction of exercise in order to restore normal weight and improve the quality of diet. Most of the times it is quite necessary to obtain nutritional supplements with calcium and vitamin D until normal menstrual cycle is restored.