Surreal illustration of a female athlete running on a fractured track, symbolizing the Female Athlete Triad.

The Female Athlete Triad: How to Protect Your Health and Performance

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Reese Marlowe in Health & Wellness November 2025 • 4 min read.

"Understanding and Managing Low Bone Mass, Menstrual Dysfunction, and Energy Availability in Active Women"


As more women participate in athletics, the benefits of exercise on health are clear. However, this increased activity also brings unique health challenges. The Female Athlete Triad is a set of interrelated conditions that can affect female athletes of all ages and in any sport. It includes low energy availability, menstrual dysfunction, and low bone mass. If left unaddressed, it can lead to serious health problems.

The Female Athlete Triad can have both short-term and long-term effects on an athlete’s well-being. Sustained low energy availability can affect various body systems, including the skeletal, endocrine, cardiovascular, reproductive, and central nervous systems. Given the rise in female athletic participation over the past decade, it's likely that the prevalence of this syndrome will continue to increase. Early recognition and appropriate management are essential to protect the health of female athletes.

This article provides an overview of the Female Athlete Triad, including its causes, risk factors, and strategies for prevention and treatment. It emphasizes the importance of a multidisciplinary approach involving healthcare providers, counselors, coaches, and parents to ensure the well-being of female athletes. By understanding this syndrome, we can help athletes maintain their health and achieve their full potential.

Understanding the Triad

Surreal illustration of a female athlete running on a fractured track, symbolizing the Female Athlete Triad.

The Female Athlete Triad is best understood as a continuum, ranging from optimal health to disease, in three key areas: energy availability, menstrual function, and bone mineral density. An athlete's condition can fall anywhere along this spectrum. Energy availability refers to the balance between energy intake (calories consumed) and energy expenditure (calories burned through exercise and daily activities).

Low energy availability occurs when an athlete doesn't consume enough calories to support their activity level. This can lead to menstrual irregularities, such as oligomenorrhea (infrequent periods) or amenorrhea (absence of periods). Over time, low energy availability and menstrual dysfunction can decrease bone mineral density (BMD), increasing the risk of stress fractures and osteoporosis.

  • Energy Availability: The balance between calorie intake and expenditure.
  • Menstrual Function: Regularity of menstrual cycles, ranging from regular to absent.
  • Bone Mineral Density: A measure of bone strength and density.
  • Risk Factors: Dieting, intense exercise, and psychological pressures.
Several factors can increase an athlete's risk of developing the Female Athlete Triad. These include restricting caloric intake, exercising for extended periods, having a vegetarian diet, and experiencing psychological stress. Athletes who participate in sports that emphasize leanness or weight categories, such as gymnastics, dance, and distance running, are also at higher risk. Early identification and intervention are crucial to preventing long-term health consequences.

Taking Action for Athlete Health

The Female Athlete Triad is a complex syndrome that requires a comprehensive approach to prevention and treatment. By understanding the risks, recognizing the signs, and implementing appropriate strategies, we can help female athletes maintain their health and achieve their athletic goals. Early screening, education, and a multidisciplinary team approach are essential to ensuring the well-being of female athletes for years to come. Emphasizing proper nutrition, addressing psychological factors, and promoting a healthy body image are all key components of a successful strategy.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.7180/kmj.2014.29.1.1, Alternate LINK

Title: Management Of Low Bone Mass In Female Athletes

Subject: General Medicine

Journal: Kosin Medical Journal

Publisher: Kosin University College of Medicine

Authors: Hoon Choi

Published: 2014-06-30

Everything You Need To Know

1

What exactly is the Female Athlete Triad, and whom does it affect?

The Female Athlete Triad is a combination of three interrelated conditions: low energy availability (often due to insufficient calorie intake relative to exercise), menstrual dysfunction (irregular or absent periods), and low bone mineral density. These conditions exist on a spectrum from optimal health to disease and can affect female athletes of all ages and sports.

2

Within the Female Athlete Triad, what does low energy availability really mean for an athlete's body?

Low energy availability in the context of the Female Athlete Triad refers to an imbalance where an athlete's calorie intake doesn't meet the demands of their exercise and daily activities. This deficit can disrupt various bodily functions, including the endocrine, skeletal, cardiovascular, reproductive, and central nervous systems. Addressing low energy availability is critical in managing the Triad.

3

What are the major risk factors that make a female athlete more susceptible to developing the Female Athlete Triad?

Risk factors for the Female Athlete Triad include restricting caloric intake, prolonged exercise, vegetarian diets lacking essential nutrients, and psychological stress. Athletes in sports emphasizing leanness or weight categories, like gymnastics, dance, and distance running, are particularly vulnerable. Identifying and addressing these risk factors early on is key to prevention.

4

How is the Female Athlete Triad typically managed or treated once it has been identified in an athlete?

The Female Athlete Triad is managed using a multidisciplinary approach. This typically involves healthcare providers, counselors, coaches, and parents. Interventions include optimizing nutrition to address low energy availability, restoring normal menstrual function, and improving bone mineral density through a combination of diet, exercise, and, in some cases, medication. Psychological support is also essential to address any underlying issues related to body image or eating disorders.

5

What are the potential long-term health implications if the Female Athlete Triad is left unaddressed or untreated?

Failure to address the Female Athlete Triad can lead to both short-term and long-term health problems. In the short term, athletes may experience fatigue, impaired performance, and increased risk of stress fractures. Long-term consequences include osteoporosis, cardiovascular issues, and reproductive problems. Early intervention is essential to prevent these complications and protect the athlete's overall well-being.

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