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 Taken together, the health issues - disordered eating, a halt in
monthly menstrual cycles known as amenorrhea and a bone-thinning
disease known as osteoporosis - are known as the female athlete
triad. Girls may have just one of these problems or a combination,
in varying degrees, according to the authors of a recent clinical
guidance report in Pediatrics.
“There are physicians that are unaware of the triad and it’s
long-reaching consequences,” said Dr. Margot Putukian, director of
athletic medicine at Princeton University in New Jersey, who was not
involved in the report.
While sports can have tremendous benefits like improved self-esteem
and better physical and mental health, doctors, coaches and parents
need to be aware that some teens can take training to extremes,
Putukian said.
“When overtraining occurs, and elements of the triad surface, the
concern is that it can be associated with disordered eating,
menstrual dysfunction, with subsequent bone health issues, and then
certainly there can be dangerous consequences,” Putukian said by
email.
Girls with female athlete triad may be trying to lose weight to
improve their performance in sports, doctors from the Council on
Sports Medicine and Fitness argue in the paper.
Disordered eating might range from failing to consume enough
calories to support intense workouts to avoiding certain foods in an
effort to restrict fat or shed pounds, the authors note.
While this can lead to serious eating disorders like anorexia or
bulimia, not eating enough calories can also decrease hormones that
regulate menstruation and lead to irregular periods or a halt in
monthly menstrual cycles. Athletes may be more likely to have
menstrual irregularities than teen girls who don’t participate in
sports.
Hormonal irregularities and poor nutrition can also lead to
osteoporosis. This weakening of the bones can increase the risk of
stress fractures and other injuries, and is much more common in
athletes than in teens who don’t play sports, the authors note.
“Female athlete triad is the female health consequence of low energy
availability,” said Sharon Chirban, a sports psychologist at Boston
Children’s Hospital and Harvard Medical School who wasn’t involved
in the report.
“The personality most apt to get into trouble is often a high
commitment athlete who is willing to do whatever it takes to
succeed,” Chirban added by email.
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Making sure athletes understand the importance of getting enough
calories for intense exercise and the risks of irregular periods are
crucial for preventing female athlete triad, the report authors
argue.
Well-child visits should include questions about menstruation,
exercise and eating habits to help assess whether teen girls may be
at risk for developing female athlete triad. Doctors, parents and
coaches should also understand that when girls show symptoms of one
aspect of the triad, they are also at increased risk for developing
other the problems.
“It has been my experience that coaches, parents, pediatricians and
family practice physicians are not experienced in caring for
athletes, and athletes themselves are not aware of the health risks
unique to the triad for female athletes,” said Timothy Neal, a
researcher with the athletic training program at Concordia
University in Ann Arbor, Michigan, who was not involved in the
report.
Paying attention to mental health is critical for preventing and
addressing female athlete triad, Neal added by email.
“Parents, athletes, pediatricians, coaches and certified athletic
trainers should be aware of signs and symptoms of eating disorders,
including those athletes who display signs and symptoms of anxiety,
depression, anger, isolation, and other behaviors that may indicate
a mental health disorder,” Neal said.
SOURCE: http://bit.ly/29Uw4V0 Pediatrics, online July 14, 2016.
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