Female Athlete Triad

Female athletes, especially those competing, are under pressure to maintain their body weight; therefore, restricted diet and heavy training load are seen in these athletes, resulting in an increased risk of the so-called “Female athlete triad” Syndrome.

The American Academy of Family Physician (AAFP) also recognizes this triad as a devastating syndrome for female athletes.

The triad, as its name implies, is defined into three interrelated conditions and often presented with at least one of the following components:

• Eating Disorder or low energy availability
• Menstrual Dysfunction
• Osteoporosis

The National Athletic Trainers’ Association published a positioning statement that provides early screening and management recommendations. Recognizing physical signs and symptoms is essential to early detection and prevention.

Management

Nonpharmacologic therapy

The best strategy to restore the function of bone metabolism is to reduce load impact on the bone through reduced exercise load and weight gain, resumption of the menstrual cycle flow, and activation of the hypothalamic-pituitary-ovarian (HPO) axis, which is the tight control regulation for the female reproductive system.

Pharmacological therapy

Suppose female athletes do not resume their menses within 6-12 months; in that case, the increased risk of bone deterioration is high despite following a reasonable intervention with nutrition, exercise modification,…