The female athlete triad is a problem marked by (1) an eating disorder, (2) cessation of menstruation and (3) bone loss. Females who participate in certain competitive sports may feel pressured to stay thin to improve athletic performance. Athletes may try to lose weight by severely restricting food intake, purging after meals (through vomiting or use of laxatives) or fasting. Researchers estimate as many as 62 percent of female athletes have some kind of eating disorder.

Intense exercise and weight loss cause a decline in the production of estrogen and can lead to irregular menstruation or amenorrhea (loss of menstrual periods for three months or longer). Younger girls who have not yet started their period may not begin menstruation.

Low estrogen levels and poor nutrition can also cause bone loss. This condition is especially critical because nearly 70 percent of peak bone mass is established by about 20. A female who doesn't establish strong bones during adolescence and young adulthood is at a higher risk for low bone mass and osteoporosis (weakening of the bones) during adulthood. In fact, girls who fail to establish strong bones may experience osteoporosis at a younger age.

Preventing the Female Athlete Triad

While exercise is promoted to build cardiovascular fitness, an overly aggressive program can be detrimental to health. Poor nutrition, estrogen decline and menstrual abnormalities are not only linked to osteoporosis, the behavior patterns may also increase the risk for heart disease. Researchers have found early signs of heart disease (marked by an inability of the blood vessels to properly dilate) in female college runners.

Investigators at the Medical College of Wisconsin studied the effects of estrogen replacement on heart disease risk factors for young women athletes. The researchers found those who took estrogen gained weight, resumed menstruation and showed a reversal of early signs of heart disease. The treatment also had an unexpected side effect - the runners improved their speed, taking about 45 seconds off their 5K race times.

Because of the negative publicity associated with estrogen replacement, doctors are now investigating folic acid as an alternative therapy for female athletes. Folic acid has similar effects on the blood vessels to estrogen. Women in the current University of Wisconsin study will take 10 mg of folic acid (the average multi-vitamin provides about 4 mg). Doctors are hopeful the high dose of folic acid will provide the same benefits as estrogen and reduce the risk of heart disease, osteoporosis and bone fractures among young female athletes.

SOURCES

Women's Sports Foundation, http://www.womenssportsfoundation.org