The Female Athlete Triad: Is Your Daughter at Risk?

By Semko, Laura 
March 21, 2017

October 2016

The Female Athlete Triad: Is Your Daughter at Risk?

Taking part in a sport is a good way for your daughter to stay active and healthy. But too much of a good activity can at times turn bad. The American Academy of Pediatrics recently issued a report on the female athlete triad. Knowing about this disorder can help you spot it in your child.

2 teen girls sitting on the ground, stretching their hamstrings

What is the female athlete triad?

Not eating enough and exercising too much on a routine basis can lead to the female athlete triad. This disorder stems from this energy-in, energy-out imbalance. It can happen by accident because of overtraining or on purpose. Choosing to eat less food is often the sign of an eating disorder.

Poor eating habits can limit your child’s growth. It can also lead to the other two parts of the triad. One of which is a problem with menstruation. Athletic girls and adolescents with an energy imbalance may have irregular or no periods. Their bodies may simply not make enough of the hormone estrogen.

A lack of estrogen and nutrients can also cause bone loss, the third health problem of the athlete triad. Your child’s body normally builds up bone strength during adolescence. Nutritional and hormonal problems can impair this process. That can weaken bones for a lifetime. Your child will have a higher risk for fractures and osteoporosis, a condition marked by brittle bones.

How to spot the triad in your child

The female athlete triad most often affects girls and young women who take part in sports that stress a certain look, weight, or level of performance. These include gymnastics, ballet, diving, and figure skating. Cross country runners are also at high risk.

In many cases, an athletic girl or young woman may have only one or two of the triad’s health problems. Talk with your daughter’s healthcare provider if you notice:

  • Excessive exercising

  • Weight loss

  • Irregular or no period

  • Fatigue

  • Stress fractures, which are small painful cracks in a bone that are often caused by repetitive movements, like running

Also watch for signs of an eating disorder. These include binge eating, self-induced vomiting, dieting, the use of laxatives or weight-loss pills, and yellowing of the skin. An eating disorder can lead to serious health problems, such as an irregular heartbeat or kidney damage. It may also raise your daughter’s risk for heart disease.

Treatment for the triad focuses on gradually changing eating and exercise habits. That may call for a team of healthcare providers, such as a nutritionist and a psychologist. Restoring bone loss is also vital. Your daughter may have to take bone-building medicines or calcium and vitamin D supplements.


Read more about eating disorders in young athletes.


Online resources

American Academy of Family Physicians

American Academy of Orthopaedic Surgeons


March 21, 2017


Current Perspectives on the Etiology and Manifestation of the ‘Silent’ Component of the Female Athlete Triad. R.J. Mallinson and M.J. De Souza. International Journal of Women’s Health. 2014;6:451-67., Health Considerations in Female Runners. B.Y. Kim and A. Nattiv. Physical Medicine and Rehabilitation Clinics of North America. 2016;27(1):151-78., The Female Athlete Triad. A. Weiss Kelly and S. Hecht. Pediatrics. 2016;138(2):e1-e10., Update on the Female Athlete Triad. M.T. Barrack, K.E. Ackerman, and J.C. Gibbs. Current Reviews on Musculoskeletal Medicine. 2013;6(2):195-204.

Reviewed By:  

Turley, Ray, BSN, MSN