The female athlete triad

Regular exercise brings health benefits, but for some young women it can also bring disordered eating, amenorrhea and osteoporosis. The 'female athlete triad' consists of three separate, but interrelated medical entities: (i) disordered eating; (ii) amenorrhea (or absence of menses), and; (iii) premature osteoporosis (altered bone mineral density). Although coaches, athletes, parents, and to some extent team physicians, have been aware of these problems for some time, it is only relatively recently that concerns about short- and long-term health consequences have been voiced in the medical literature. Prevention of the Triad disorders starts with awareness and sensitivity to the pertinent issues. We now know that concerns about weight and dieting emerge in children between the ages of 9 to 11. Athletes and coaches must be thoroughly educated on nutrition and training principles, the development and maintenance of normal menstrual cycles, and the prevention of osteoporosis. By evaluating the female athlete triad, amenorrhea, medical complications, signs and symptoms, key signs at physical examination, and the management and prevention of the triad disorders, this article offers an important review of the female athlete triad.