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Female Athletes Have Special Needs
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Q. I've heard that women athletes are at risk for a serious condition known as the Female Athlete Triad. What is it, and what are the signs?

A. The Female Athlete Triad is a condition that often includes three related health problems: lack of energy, menstrual dysfunction and loss of bone density. If the condition progresses, it can manifest itself in the form of: eating disorders, loss of periods and osteoporosis.

Each of these problems are serious conditions by themselves, and if left untreated, they can cause significant and lasting damage to the body. Because young women and girls in school athletics are key populations affected by the Female Athlete Triad, their normal development is also compromised, as well as their immediate health.

The root of these problems seems to lie within low energy reserves, though the Female Athlete Triad is a complex condition that may have a number of contributing factors.

Impact of Low Energy Reserves

While we make deliberate decisions to spend a portion of our energy reserves each day (working out, doing chores, grocery shopping), we also use energy at a subconscious level as our body performs various tasks such as maintaining cells, generating warmth, fighting illness, growing, and maintaining various systems (i.e. reproductive).

Food equals energy, and when an athlete is not getting enough energy to fuel their active lifestyle, a deficit occurs. Having insufficient energy reserves goes beyond temporarily feeling tired or worn out. An ongoing energy deficit can force the body to adjust its normal functions, since it simply cannot keep up with the athlete's activity level as well as its regular biological duties.

It can be healthy for people to burn more energy than they consume (within reason), if they are overweight and as a result, have a surplus of energy reserves in the form of excess fatty tissue. However, people at a healthy weight should seek to balance their energy intake and output. Unfortunately, female athletes often struggle when it comes to regularly eating the amount of food they require to compensate for their high activity level, and their energy availability becomes inconsistent and inadequate.

Eating Disorders

Since inadequate food energy is a central factor in the Female Athlete Triad, it is understandable why this condition often begins with disordered eating. Many athletes perceive a low body weight and a strict diet as positive tools in their quest to improve their fitness level and enhance their performance. When taken to the extreme, this becomes a dangerous tactic that will instead decrease their athletic performance and put their overall health at serious risk.

Common practices observed in those who suffer from disordered eating include: severely limiting food intake, constantly weighing and/or measuring foods, refusing to eat in front of others, and abusing laxatives. Aside from the obvious physical risks of malnutrition, dehydration and low body weight, eating disorders are also linked to serious psychological problems, including depression, anxiety, and an unhealthy self image.

The Implications of Menstrual Dysfunction

Some female athletes have the misconception that an irregular or absent menstrual cycle is an acceptable part of an active lifestyle. The fact is exercise does not cause menstrual dysfunction. Inadequate energy levels do. Exercise only becomes a problem if the individual does not have the needed energy to fuel the activity output. When the body can't keep up, it may select to discontinue its normal reproductive functions.

If a woman's period stops, her body is trying to warn her that something is not right. In girls and young women, menstrual dysfunction can also delay or disrupt healthy development and puberty.