Female Athlete Triad

                                                          INTRODUCTION

The female athlete triad is a medical condition observed in physically active females. There are 3 components in FAT:-

                   💧Osteoporosis

                  💧 Amenorrhea

                  💧 Eating disorder

It is important to note that all the components of the triad are NOT needed to triad to be present.

Timely prevention, recognition and treatment can delay the progression.

In this diagram, red triangle shows the triad conditions and green triangle shows normal parameters.

                                   1. OSTEOPOROSIS

It is a major health problem. It can be defined as low BMD (Bone Mass Density). This lead to bone fragility and recurrent bone fractures.

CAUSES:-      1. Reduced Ca²+ absorption from intestine

                                          ￬

                     Parathyroid gland activated

                                        ￬

               Parathyroid hormone is released

                                      ￬

        increases resorption of calcium from the bones

                                     ￬

                        decreased BMD

    2nd reason can be Postmenopausal oestrogen deficiency ( which will lead to decreased calcium absorption)

COMPLICATIONS:-  frequent fracture (most commonly hip and wrist)

                                  :-  fall risk increases

                      2. AMENORRHEA

Menstrual function ranges from enumenorrhea (menstrual cycle 28 +7/-7 days) to amenorrhea ( absence of menstrual cycle for >90 days). It may be primary ( 1st menustral cycle is delayed) and secondary ( when menstral cycle has begun).

CAUSES:-  It can be due to weight loss, stress, excessive or wrong exercises.

                   3. EATING DISORDERS

 There has been a relationship between eating disorder and athletic activity. There are some sports in which the emphasis on thinness and reduction in body fat like gymnastics, ballet dancing, etc. Pressure from coaches, parents or competitors regarding body shape may lead to abnormal eating pattern. Other psychological risk factors like low self esteem, anxiety and OCD. 

Eating disorder can be: i) restrictive eating pattern                                                                                                                          ii) classic eating disorder like anorexia nervosa (fear of being overweight) and   bulimia nervosa (binging followed by avoid weight gain.

                 SYMPTOMS OF FAT

Absent or abnormal periods, acne, bone loss, excessive facial hair, fatigue, hair loss, headache, pelvic pain, vision changes, weight loss.

                TREATMENT OF FAT

Female athlete triad is a serious disorder and requires treatment. The main goal of the treatment is to normalise the menstrual cycles and to improve bone density.

Diet and Exercises:

The doctor would discuss the patient’s eating habits and suggest changes to improve nutrition in order to meet body requirements. The patient exercise routine is also revised to maintain healthy body weight.

Medications:

• The doctor would prescribe hormonal therapy to treat amenorrhea. Usually oestrogen and progesterone are prescribed to treat the altered menstrual periods. These hormonal medications also help to improve bone health.
• After evaluating the patient, the doctor would prescribe calcium and vitamin-D supplements to prevent bone weakness.
• However, the patient requires support from doctor, coaches and other family members for successful treatment of this condition.

Psychological Management:

It is one of the most important yet underutilized management strategies for this condition Patients with female athlete triad are often very competitive people and changing their mentality is not very easy. Psychological counselling is required for managing patient behavior. Mental health intervention is more important in patients with established eating disorders such as anorexia nervosa or bulimia nervosa.