Female Athlete Triad Syndrome: Protect Your Teenage Daughter

“My daughter, Stacey, was a dynamic dancer. Toward the middle of her freshman year she started not wanting to eat the dinners that I made for our family. I began to notice her clothes sagging on her, and she was falling asleep while trying to keep up with homework. I thought it was normal since she was so involved in school and sports. When I approached her about not eating with us and the idea of cutting a couple school activities, she got upset and told me she was fine.”

But she wasn’t. This mother was noticing the tell-tale signs of Female Athlete Triad Syndrome.

Female Athlete Triad Syndrome, What Is It?

Female Athlete Triad Syndrome is a combination of three symptoms that include:

• Disordered eating
• Amenorrhea or abnormal/absent menstruation
• Osteoporosis or brittle bones due to hormonal changes or deficiencies

Javed et al. (2013) states, “the original definition of the triad as disordered eating, amenorrhea, and osteoporosis was updated by the ACSM in 2007 to include a spectrum of dysfunction related to energy availability, menstrual function, and bone mineral density.”

The female triad is common in high school and college level athletes. Your child may only be exhibiting one or two of the symptoms, but without intervention, your daughter could end up developing the full triad.

The percentages of young athletes who exhibit all three symptoms are low. However, Javed et al found that “23.5% have menstrual dysfunction, 18.2% exhibit disordered patterns of eating (with or without a diagnosed eating disorder such as anorexia), and 4.1% have a low body mass index.” The different components of the triad can have lasting, long-term effects if they are not properly addressed by medical professionals.

Does This Mean My Daughter Has An Eating Disorder?

Some teens do develop an eating disorder that accompanies female athlete triad. All eating disorders need to be addressed by a doctor.

Other athletes simply do not know how many calories they should be consuming for the amount of rigorous exercise they complete each day. Some female athletes need up to 3,500 calories per day to stay healthy. That seems excessive, but it’s necessary.

Your general practitioner, a registered dietician, or a specialized sports physician can help you determine a healthy diet for your daughter. It would be beneficial for both of you to be educated regarding diet. Then you, as a parent, will know what to prepare for dinner, and you will be able to watch your child eat to make sure they are consuming enough calories. You child should also be aware of their dietary needs.

Diet and exercise go hand in hand.

READ Macronutrients: What Do You Need To Keep Your Body Healthy?

What Are the Long Term Consequences?

The first cases of female athlete triad syndrome were diagnosed in adolescents in the 90s. Thein-Nissenbaum (2013) states these women are now in their 30s and 40s and “negative long term effects of the female athlete triad, such as low bone mineral density, are now starting to manifest.”

Low bone mineral density can lead to osteopenia or even osteoporosis. In an advanced state, both of these bone disorders can cause body disfigurement or lead to loss of movement. Imagine being an athlete as a young woman and then not being to move as an older woman. That would be disheartening.

Female athlete triad can be prevented with a proper diet and training schedule. Medical treatment can reverse the side-effects if your daughter already has full-blown female triad syndrome or just certain components of it.

How Could Your Daughter Fall Victim To Female Athlete Triad?

Sometimes it happens very unintentionally, maybe just a lack of proper nutrition.

For Stacey, it was different.

Stacey was a very observant young woman and an over-achiever. As a dancer, she wanted to be the best. She wanted to be on a college dance team and maybe get a scholarship so her parents would not have as much financial burden.

Stacey listened to the varsity dancers talking about their diets, what they did and didn’t eat. She felt their bodies looked better than hers, so she started her own extreme dieting based on things she heard other girls say.

Her dance coach even told the team that losing a couple of pounds could benefit their performance and better their chances for dancing in the future. This further prompted her.

Stacey started to reduce her calorie intake and practiced dancing for hours, sometimes with the team and sometimes on her own. She even started jogging at home to burn additional calories. She became obsessed with diet and exercise. It was all she could talk about – working out and diet.

Behaviors like these should be a red flag for parents.

Red Flags for Female Athlete Triad Syndrome:

Here are some of the other signs and symptoms that parents should look for:

• Low body weight
• Excessive dieting
• Lethargy, lack of energy
• Obsessed with exercise
• Abnormal or absent menstrual cycle
• Easily fractures bones (stress fractures) or easily breaks bones

The female athlete triad is most common in sports which have weight requirements including, but not limited to:

• Distance running
• Track
• Gymnastics
• Dance, ballet, cheerleading
• Bodybuilding
• Figure Skating

How Can You Screen for Female Triad Syndrome?

If you think your daughter might be going through this, make an appointment with your family’s general practitioner. Talk to the doctor in advance and express your concerns, maybe not in front of your daughter. You might even want your child’s coach to give input on their observations.

READ Nutrient Dense Foods: An Overlooked Approach To Weight Loss

Your primary care physician should be able to conduct a special screening during a routine physical to assess for disordered eating, menstrual irregularity, and low bone density. Thein-Nissenbaum et al. (2011) suggest that high school athletes should be assessed for the triad components at pre-participation physicals. Make sure you ask for it.

Treatment

Depending on what components of the triad your daughter experiences determines the type of treatment she will require. It may include a whole team of different types of specialists including, but not limited to a team physician, a sports dietician, a mental health professional, an athletic trainer, an exercise physiologist and medical consultants according to Gottschlich et al. (2014). Your doctor or doctors will guide you through the recovery process.

Conclusion

It’s important to pay attention to the small details when it comes to observing your athletic teenage daughter. Talk with her about the importance of staying healthy and monitor her health. If you have seen changes in her eating patterns, have concerns about her health due to changes in menstruation or recurring stress fractures, or think she already has other symptoms of female athlete triad, contact your family doctor. Don’t wait, the consequences could last a life-time.