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Female Athlete Triad

Last Updated November 2023 | This article was created by familydoctor.org editorial staff and reviewed by Leisa Bailey, MD

What is female athlete triad?

The female athlete triad is a disorder that women can develop. The disorder affects three body functions that are connected to each other. These are:

  • Energy levels
  • Menstrual cycles
  • Bone mass

Symptoms

Signs and symptoms of the female athlete triad include:

What causes female athlete triad?

The main cause of the female athlete triad is an energy imbalance. This imbalance causes you to use more energy than you consume. Females who are very active may have this problem. It may be on purpose or by accident. The female athlete triad also may be due to an eating disorder, such as anorexia.

Girls and women may be at risk for the female athlete triad if they:

  • Are a competitive athlete
  • Play sports that require them to maintain a certain weight or to check their weight often
  • Exercise more than what is healthy
  • Are obsessed with being thin
  • Have body image issues
  • Are depressed
  • Are pushed by their coach or parents to win at all costs

How is female athlete triad diagnosed?

Contact a doctor if you or someone you know may have the female athlete triad. The doctor will ask questions about your periods, eating habits, and exercise routine. They also will do a physical exam. Your doctor may ask you if you take certain medicines, such as diet pills, laxatives, or birth control pills.

Your doctor may order blood tests to check vitamin D levels. They also may order a bone density study.

Can female athlete triad be prevented or avoided?

There are things you can do to prevent the female athlete triad, especially if you are at risk:

  • Eat a nutrient-rich, well-balanced diet.
  • Exercise in moderate amounts.
  • Get plenty of rest.
  • Find ways to reduce stress.
  • Talk to a doctor or counselor to get help.

Treatment

The female athlete triad is a disorder that should be taken seriously. Most cases require treatment. A doctor will talk to you about healthy eating habits and lifestyle choices. You may need to change your diet. A nutritionist can help create an eating plan that provides enough vitamins and nutrients. You also may need to change your exercise routine. Your doctor may recommend taking at least one day off each week from athletic training.

If your periods do not return to normal, you may need more treatment. Your doctor may prescribe birth control pills to help regulate your cycle. Hormone medicines that include estrogen or progesterone may help as well. These can balance your energy and improve bone strength.

Living with female athlete triad

Women who have the female athlete triad can develop other health problems. Amenorrhea is a condition that occurs when you miss a period for 3 months or more in a row. Osteoporosis is a disease that makes your bones thin and weak. It can occur when your body doesn’t get the nutrients it needs to help bones grow. It can increase your risk of fractures, breaks, and other injuries. Your organs also can sustain damage due to a lack of nutrients.

Without treatment, the female athlete triad can cause long-term health problems. When combined with a low body weight, it can even lead to death.

Questions to ask your doctor

  • How do I know if I have a problem?
  • Could there be another reason for low energy or irregular periods?
  • How do I strike a balance between my desire to win and my need to be healthy?
  • What lifestyle changes should I make?
  • Do I need medicine? Counseling?
  • Where can I get help for an eating disorder?
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