Stories about: female athlete triad

Ask the expert: What is the female athlete triad and how can it be prevented?

Female athlete triad

The spring athletics season is in full swing and for those at the high school and college level, practices and game schedules can be intense. When you blend this physical commitment with the demands of a hectic academic schedule, sometimes maintaining healthy eating habits and positive energy balance can be challenging.

Dr. Kathryn Ackerman, medical director of Boston Children’s Female Athlete Program, shares important information about a condition called the female athlete triad and offers tools to keep young athletes healthy, energized and at the top of their game.

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Overcoming female athlete triad

shutterstock_246365317After dealing with an eating disorder during high school, Alicia* seemed to find her stride as a college student. She started running as a college freshman and competed with both the cross-country and track teams. “I was in a better place as part of the team. It was helpful to know that I had to eat to run.” Alicia realized that she needed to fuel her body to maintain a rigorous exercise regimen that included running 60 miles a week.

Then, a series of injuries struck Alicia. During her sophomore year, she tripped on some ice and broke her femur. After she recovered from the fracture and returned to running, Alicia began experiencing thigh pain that she thought was caused by a strained hamstring muscle.

However, Alicia’s pain was caused by a stress fracture in her pelvis. (A stress fracture is an incomplete break in the bone caused by overuse.) Alicia’s stress fracture worsened and later turned into a solid break.

“There were other injuries, including repeat muscle pulls, and I developed bradycardia (a slower-than- normal heart rate). I didn’t understand what was going on with my body and felt like I was overreacting.”

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The race against the female athlete triad

Laura on the track

It’s a common belief among female runners: The lighter you are, the faster you are. It’s also believed that menstrual irregularities, or loss of periods, are a healthy part of competitive training. Neither is true.

That’s precisely what Laura Duff, a senior at Colby College and an avid runner, wishes she knew when she was in high school.

It was during the summer before Laura’s senior year of high school that she became more aware of how she looked. “I don’t know what switched,” she says, “I just became very aware, and started to restrict my eating and be more controlling.”

“I wish I could tell my high school self that worrying about your body isn’t worth it”

While part of her diet was intentional, another part was simply due to the structure of high school. Long days of classes and cross-country practice with little scheduled time for snacks and lunch made it hard to focus on getting enough calories. Soon, her weight started to drop.

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Want to run the Boston Marathon one day? Play it safe with your health, ladies

If running a marathon were easy, we’d all be doing it. In reality, it takes incredible mental endurance and physical dedication paired with a strong desire to succeed. But if you really want to go the distance, don’t put your body at risk by overtraining.

Female athletes, especially those who participate in sports that emphasize being lean—like running—can be susceptible to the female athlete triad, an interrelationship of bone health, menstrual cycle and energy availability (caloric balance and nourishment).

Most of the time, female athletes get enough quality calories to maintain healthy energy availability, normal monthly menstrual cycles and healthy bone density. However, some runners, who might feel pressure to be as lean as possible, take in fewer calories than their body requires. This can result in irregular (or loss of) periods and changes in hormones, which can lead to low bone density and an increase in fractures and osteoporosis.

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