teen girl breathing hard after running

Triple Threat

Young female athletes who don’t adequately replace the calories they burn during workouts, meets and games risk developing a collection of conditions that can have significant health consequences.

Disordered eating, irregular menstruation and bone weakening are a series of related conditions known as female athlete triad. This trend has become more common in the last couple of decades as young women’s participation in sports has skyrocketed.

Connections and Consequences

“Female athletes who wish to lose weight may change their diet and start taking in insufficient calories,” says Damond Blueitt, M.D., sports medicine physician at Orthopedic Specialty Associates, a Texas Health Physicians Group practice, and on the medical staff at Texas Health Harris Methodist Hospital Fort Worth. “By doing so, they don’t get the minerals, nutrients and electrolytes they need, and these deficiencies can cause a hormonal imbalance over time that alters their menstrual cycles and causes them to miss periods. These issues with menstruation may hinder fertility later in life.”

Poor nutrition — particularly meager calcium intake — and abnormal menstruation can reduce bone density just as young women are acquiring most of their bone mass. By age 18, most women have formed as much as 90 percent of their peak bone mass, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. With weaker bones, young female athletes may be more susceptible to fractures.

“Some of these athletes in their teens or 20s have bone density comparable to that of women in their 60s or 70s,” Dr. Blueitt says. “These women will find themselves behind the bone-density curve when natural bone-density loss begins in their 30s, meaning it will be tough for them to prevent osteoporosis.”

Look Closely

Watch out for these symptoms of female athlete triad:

  • Cosmetic changes. Poor nutrition can cause hair to thin, nails to become brittle and skin to change in texture and appearance.
  • Infrequent periods. If your daughter mentions menstrual irregularities, treat this as a red flag.
  • Rapid weight loss. Does your daughter suddenly look thinner, even though her workout regimen has stayed the same? Is she eating much less but maintaining her normal level of exercise?
  • Shifts in mood or energy level. Irritability, lack of interest in activities and fatigue can be signs of female athlete triad.
  • Telltale signs of purging. These can include numerous trips to the bathroom at mealtimes and cavities caused by vomiting.

By knowing the subtle signs of female athlete triad, you can recognize them in your daughter, speak with her about the triad’s dangers and support her in seeking the help she needs to have a healthy present and future.

If you think your daughter has female athlete triad, a sports medicine physician at Texas Health Ben Hogan Sports Medicine can diagnose her by conducting a physical exam and a variety of tests. If the triad is present, he or she will recommend a treatment plan that may involve several specialists, including a nutritionist and a mental health provider.

Physicians employed by Texas Health Physicians Group practice independently and are not employees of the hospital or Texas Health Resources.

Physicians on the medical staff practice independently and are not employees or agents of the hospital or Texas Health Resources.

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