If you are an athlete and you stop getting your period, this is not good for your body. This can result in injuries now, and in serious health problems later in your life.
Female Athlete Triad is a medical condition with 3 (“triad”) medical problems that exist together in female athletes. The 3 parts of the Triad are:
- Low energy (from food) availability
- Abnormal or missing menstrual periods
- Low bone density
Let’s talk about why these 2 things are important.
Starting with bone health.
You already know your bones continue to grow as long as you are growing taller, but they are also becoming denser and stronger through your teen years. Healthy females reach almost 100% of their final bone density by 18 years old. Your bones stop increasing in strength shortly after that. It is important to maximize your bone strength during this time, since it is your skeleton and all your bones that will hold you up for the rest of your life. Later in life, for everyone, bone density decreases. When you shortchange this process and have less dense bones to begin with, older women have an even higher risk for hip fractures, broken wrists or vertebral fractures in your back. That results in this:
Now, about periods.
Periods stop in young women when there isn’t enough nutrition to sustain them. When low nutrition causes periods to stop, one of the big reasons is that malnutrition lowers estrogen (female hormone) levels. Low estrogen levels not only affect bones, but also can cause heart disease by increasing bad cholesterol and damaging blood vessels. When estrogen levels are low, your ovaries do not release an egg every month (more on that HERE if you have questions about how that works exactly). If, as a teen, you go a long time without ovulating, (or releasing an egg), you may actually not be able to get pregnant later in your life when you want to have a family. Whether or not your periods are normal is a good clue as to whether your nutrition and your body weight are healthy.
What about nutrition?
Now, not all low nutrition is caused by eating disorders. Some athletes simply do not have enough appetite to eat what they need. And many teens don’t really know what they SHOULD eat to stay healthy and fueled up for sports. Some sports value extreme thinness (such as lightweight rowing, figure skating, track, gymnastics, dance) and this can increase pressure on athletes to maintain very low body fat levels, which then also lowers estrogen. Sometimes, though, disordered eating is part of the problem. Attitudes towards food and nutrition may be unhealthy and treatment for eating disorders is part of the overall care of some female athletes with the Triad.
Are you worried you might have The Triad? These are screening questions that all female athletes should answer to see if you are at risk for Female Athlete Triad:
- Do you worry about your weight or body composition?
- Do you limit or carefully control the foods that you eat?
- Do you try to lose weight to meet weight or image/appearance requirements in your sport?
- Does your weight affect the way you feel about yourself?
- Do you worry that you have lost control over how much you eat?
- Do you make yourself vomit or use diuretics or laxatives after you eat?
- Do you currently or have you ever suffered from an eating disorder?
- Do you ever eat in secret?
- What age was your first menstrual period?
- Do you have monthly menstrual cycles?
- How many menstrual cycles have you had in the last year?
- Have you ever had a stress fracture?
What to do if you have The Triad?
First thing first, improving your nutrition and body weight is the best treatment of Athlete’s Triad. This means you do not necessarily have to train less, but you do need to provide your body with the fuel that it needs. A very small weight gain is usually all that is needed – on the order of 2-6 pounds. Each female is different, so this is something you will need to work with your Doctor on.
But what exactly to eat?
Great question – because not every calorie is created equal! You do want to consume calories that have a lot of nutrients in them. In addition, for proper bone health as a teen, you need to have about 1300 mg of calcium and 600 units of vitamin D. Many young women avoid milk or dairy, which is the best way to get these together. But calcium can also be found in dark leafy greens, certain types of beans, some fish and other foods. Egg yolks, certain fish and fortified foods including dairy are good sources of Vitamin D (as is exposure to sunlight).
Putting together a healthy athlete diet does not have to be hard or taste bad. To help you, I have a few great resources for you about nutrition here:
And, lastly, this is a great resource with lots of information and suggestions for athletes, parents, coaches and others interested in female athletes’ health: