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Risk Biotypes and the Female Athlete Triad

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Exercise and Human Reproduction

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Abstract

The number of women participating in sports has increased dramatically in the past few decades. This rise in sports participation promotes numerous mental and physical benefits to the female athlete. However, clinical experience and research reports provide evidence of a health sequela, the “Female Athlete Triad,” developing as a result of inadequate dietary intake relative to exercise expenditure among a subset of athletes. The Female Athlete Triad (Triad) is an interrelated disorder of low energy availability, menstrual dysfunction, and reduced bone mineral density, and has been studied in various populations of athletic girls and women. In addition, current evidence suggests that athletes with Triad can experience other detrimental effects, including musculoskeletal, cardiovascular, gastrointestinal, renal, and neuropsychiatric symptoms. Female athletes participating in sports emphasizing leanness are at increased risk of developing the Triad. Factors that may account for this increased risk include an increased pressure to meet specific weight or body shape requirements of sport, the perceived benefit of a low body weight or thin frame in optimizing performance, and an increased susceptibility to sociocultural demands. These factors can lead to harmful dieting and subsequent energy deficit with likely health repercussions. Alternatively, some leanness sport athletes, such as those in endurance sports, may also develop an energy deficit inadvertently as a result of a high training volume and lack of awareness of their energy and nutritional needs. The specific risk biotypes considered in this chapter include endurance sports (e.g., runners, triathletes, cyclists, and swimmers), aesthetic sports (e.g., figure skating and gymnastics), weight-class sports (e.g., lightweight rowing and wrestling), and others. The involvement of a multidisciplinary team including sport medicine physicians, athletic trainers, dietitians, sports psychologists, among others, is required for the treatment of the Triad. The management comprises non-pharmacological and pharmacological approaches in some cases. However, the most effective way to avoid long-term consequences is early detection and prevention of this condition, especially in higher risk populations.

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Authors and Affiliations

  1. Division of Sports Medicine, Boston Children’s Hospital, Sports Endocrine Research Lab, Neuroendocrine Unit, Massachusetts General Hospital Boston, 319 Longwood Avenue- 6th Floor, 02115, Boston, MA, USA

    Kathryn E. Ackerman MD, MPH

  2. Department of Pediatric and Adolescent Medicine, Mayo Clinic, 3040 Avalon Cove Ct NW, 55901, Rochester, MN, USA

    Maria de Lourdes Eguiguren MD

  3. Department of Family and Consumer Sciences, California State University, 1250 Bellflower Blvd, 90840, Long Beach, CA, USA

    Michelle Barrack PhD, RD

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  1. Kathryn E. Ackerman MD, MPH
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  2. Maria de Lourdes Eguiguren MD
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  3. Michelle Barrack PhD, RD
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Correspondence to Kathryn E. Ackerman MD, MPH .

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  1. Department of Morphological Sciences, University of Cordoba Department of Morphological Sciences, Cordoba, Spain

    Diana Vaamonde

  2. Division of Medical Physiology, Stellenbosch University , Tygerberg, South Africa

    Stefan S du Plessis

  3. Cleveland Clinic Foundation, American Centre for Reproductive Medicin Cleveland Clinic Foundation, Cleveland, Ohio, USA

    Ashok Agarwal

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Ackerman, K., Eguiguren, M., Barrack, M. (2016). Risk Biotypes and the Female Athlete Triad. In: Vaamonde, D., du Plessis, S., Agarwal, A. (eds) Exercise and Human Reproduction. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3402-7_13

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