ISSA SN Chapter 20: Special Concerns of Athletic Females
ISSA SN Chapter 20: Special Concerns of Athletic Females

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Chapter Goals:

  • Describe and define the terms that are relating to the female athlete triad.
  • Know the symptoms that exist for the female athlete triad.
  • Know which diseases that relate to nutrients are of concern for the female athlete and how they can be reduced with adequate intake of food/supplements. 

Female Athlete Triad

This is a set of symptoms that all come together to make this triad. There will be three of them, hence the word triad. They have devastating effects for those that are victim to it. It is not just relevant for athletes, as all adults can benefit from knowing this, but it is more commonly seen in the athletic population. 

Health professional should be well aware of the symptoms of these disorders, and athletes should be too, so that they can work with health professionals to overcome them or prevent them. 

The symptoms of the female athlete triad are:

  • Disordered eating: this is any abnormal or dysfunctional patterns of eating that exist and result in the improper intake of calories and nutrients. This can be present with or without an actual eating disorder. 
  • Amenorrhea: this is the loss of the menstrual cycle, or just very irregular ones. 
  • Osteoporosis: this is a well-known bone disease that causes the bones to become porous, fragile, and very prone to breaking. 

These terms for the symptoms are evolving with research and they may exist in similar but not completely the same meaning definitions.

The early diagnosis of the female athlete triad symptoms is key for the prevention of the health risks that are associated. The first and most often easiest, is the irregularity of the menstrual cycles. Some other first things to notice would be stuff like the loss of weight coming out of nowhere, low percentages of body fat, and some physical problems. And it is important to know that these three symptoms of the triad are all independent problems that may need to be treated alone, due to not having any meaning toward the whole triad of problems. 

Who is at risk?

Those that have poor nutrition and the athletes that train very strenuously are thought to be a the most risk, as those are the root causes. Not having the appropriate nutrition, as we know, is a known creator for deficiencies in many areas. The loss of weight can be from reductions in body fat, lean mass, and just water weight potentially. These conditions might cause the problems with the menstrual cycle and would show that there is evidence for overtraining and poor nutrition. If the problem continues, then we see the osteoporosis and other health problems start to come along. So, catching it early on in and always having an eye out for it, is crucial. 

The sports that ae known to have some nutrient deficiencies caused from participation are the most often found with this triad. These are the long distance running sports, cycling, swimming, figure skating, martial arts, and other sports where the control of your weight is demanded. But, it is not crazy to see it in any other sport either. 

Menstrual irregularities, an Early Warning Sign

Amenorrhea is seen in very few nonathletic females, and a much higher frequency in the athletic population. We see two forms of this:

Primary amenorrhea is the first, and it is when there is an absence of the menstrual cycle by the age of 15 or 16 in the females that already have their developed secondary sex characteristics. This is of dire importance, as teenage female athletes are still growing and maturing, so we should do our best to give it serious attention and prompt treatment medically. 

Secondary amenorrhea is when there is a loss of the menstrual cycle for 3 or 4 months that is not caused by a pregnancy. More than a 35 day interval between periods is also known as an irregularity. This is the first warning sign.

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I thought that exercise helps to prevent osteoporosis; can you elaborate on that point?

Osteoporosis is what we use to describe decreases in the mass of the bones. This causes the bone mineral density to lower, and the overall strength of the bones to be compromised. Being on a proper diet and exercising is known to treat osteoporosis, but there are connection to the amenorrhea and osteoporosis occurring. 

It should be noted that males are also at risk for developing osteoporosis due to improper nutrition, it is just less common to see. 

Measure that can be taken to prevent the female athlete triad

Adequate sports nutrition programming is the first thing to prevent this. There should be supervision by a physician and other health professionals like the nutritionists and the fitness trainers. Some people might even require some form of behavioral therapy, especially with any incidences of eating disorders. 

Dietary supplements have been discussed well throughout the book as ways that we can use to meet the gaps that exist in nutrition. A focus could be put on those vitamins and minerals that help to combat the symptoms of female athlete triad. These are seen as vitamin D, Calcium, and Folic Acid. 

Corrective treatments exist and may require reductions in the exercise and training volume that is received, a restoration of the lean body mass, and maybe increases in the body fat composition if it has dropped to one of the lower levels for the gender and age group the athlete is in. 

A last useful habit to get into is the use of a training journal to log the athlete’s life.

Adequate Calcium and Vitamin D intake and the Reduction of Osteoporosis 

Proper nutrition and especially the proper intake of these two important nutrients can counter osteoporosis. 

Adequate Folic Acid Intake and Reduction of Neural Tube Birth Defects

Medically supervised folic acid supplementation or even higher dosages of these supplements is quite effective in reducing this risk. It is less than a 100 percent sure reduction in the risk, but still very significant.

ISSA SN Chapter 20: Special Concerns of Athletic Females 1
ISSA SN Chapter 20: Special Concerns of Athletic Females 2
ISSA SN Chapter 20: Special Concerns of Athletic Females 3

Tyler Read

Tyler Read, BSc, CPT. Tyler holds a B.S. in Kinesiology from Sonoma State University and is a certified personal trainer (CPT) with NASM (National Academy of sports medicine), and has over 15 years of experience working as a personal trainer. He is a published author of running start, and a frequent contributing author on Healthline and Eat this, not that.

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