EXCESS EXERCISE AND DISORDERED EATING
Decreased bone density Absent or infrequent menstruation has the bone density of a woman in her sixties. Women with osteoporosis have fragile, easily fractured bones. Some researchers have found that even a few missed menstrual periods can decrease bone density.
All physically active women and girls have the potential to develop one or more components of the female athlete triad. For example, it is estimated that 5-20% of women who exercise regularly and vigorously may develop amenorrhea.
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But the triad is most prevalent among athletes who participate in certain sports: those in which appearance is highly important, those that emphasize a prepubertal body shape, those that require contour-revealing clothing for competition, those that require endurance, and those that use weight categories for participation. Such sports include gymnastics, figure skating, swimming, distance running, cycling, cross-country skiing, track, volleyball, rowing, horse racing, and cheerleading.
The female athlete triad can be life-threatening. Typical signs of the eating disorders that trigger the condition are extreme weight loss, dry skin, loss of hair, brittle fingernails, cold hands and feet, low blood pressure and heart rate, swelling around the ankles and hands, and weakening of the bones. Female athletes who have repeated stress fractures may be suffering from the condition.
Early intervention is the key to stopping this series of interrelated conditions. Unfortunately, once the condition has progressed, long-term consequences, especially bone loss, are unavoidable. Teenagers may need only to learn about good eating habits; college-age women with a long-standing problem may require psychological counseling.
The female athlete triad. Clinics in Sports Medicine 31(2): 247-254; Mencias, T., et al. 2012. Female athlete triad screening in National Collegiate Athletic Association Division I athletes: is the preparticipation evaluation form effective? Clinical Journal Sports Medicine 22(2): 122-125; Nazem,