Female Athlete Triad: Difference between revisions

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= Introduction  =
One of the major medical concerns for women in sports is that of the female athlete triad which was initially defined at the Traid Consensus Conference in 1992<ref>Yeager KK,Agostini R, Nattiv A, Drinkwater BL.The female athlete traid: disordered eating,amenorrhea,osteoporosis. [Commentary].Med. Sci Sports Exer 25:775-7,1993.</ref>.Also known simply as the Triad, this condition is seen in females participating in sports that emphasize leanness or low body weight<ref>Torstveit et al. 2005. ‘The Female Athlete Triad: Are Elite Athletes at Increased Risk?’ Medicine and Science in Sports and Exercise. vol. 37, no. 2. p. 184-93.</ref>.This behavious may lead to fatal consequences<ref>Hobart, Julie A. and Douglas R. Smucker. 2000. ‘The Female Athlete Triad.’ The American Academy of Family Physicians. &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; http://www.aafp.org/afp/20000601/3357.html&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; Retrieved on 2007-10-11</ref>. It is a syndrome which involve 3 distinct and interrelated conditions:<br>
#Disordered Eating (a range of poor nutritional behaviour)
#Amenorrhea (irregular or absent menstural periods)
#Osteoporosis (low bone mass and microarchitectural deterioration, which leads to weak bones and risk of fractures)
The problem of the&nbsp; of the female athlete traid collectively, as well as its indiviual components, have since been recognized as potentially serious problems for girls and women in sports worldwide.<ref>Nattive A,Agostini R,Drinkwater BL,Yeager KK; The female athlete traid: the inter-relatedness of disordered eating, amenorrhea and osteoporosis.Clin Sports Med 13:405-18,1994.</ref><ref>Otis CL,Drinkwater B, Johnson MD,et al:American College of Sports Medicine Position Stand on the Female Athlete Traid.Med Sci Sports Exer 29:i-ix,1997.</ref>A study by Burrows et al has suggested that the current triad components do not identify all at-risk women; rather, the authors suggest that criteria such as exercise-related menstrual alterations, disordered eating, and osteopenia may be more appropriate<ref>Burrows M, Shepherd H, Bird S, MacLeod K, Ward B. The components of the female athlete triad do not identify all physically active females at risk. J Sports Sci. Oct 2007;25(12):1289-97.</ref>.It is said to be interrelated as if an athlete is suffering from one element of the Triad, it is likely that they are suffering from the other two components of the triad as well<ref>"What is the Triad?". Female Athlete Triad Coalition. Retrieved 14 March 2012.</ref>. A Norwegian study of the prevalence of the triad found that fewer than 5% of elite female athletes met all the triad criteria and that this prevalence was comparable to that seen in normally active girls and young women<ref>Torstvcit MK, Sundgot-Borgen J. The female athlete traid exist in both elite athlets and controls;Med Sci Sports Exer.2005; 37(9) 1149 59.</ref>.When evaluating the presence of two of the components of the triad, prevalence ranged from 5.4% to 26.9% in the athletes. This implies that a Significant proportion of female athletes suffer from components of the triad rather than the triad itself and that this is not just confined to elite athletes, It has also been suggested that osteopenia is the likely effect of disordered eating on bone; osteoporosis is rare in this group of active women<ref>Khan KM,Liu-Ambrose T,Sran MM,Ashe MC,Donaldson MG,Wark JD.New criteria for 'female athlete traid'syndrome? Br J Sports Med 2002; 36; 10-13.</ref>.<br>
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<h1> <br /> </h1>
= Epidemiology  =
= Epidemiology  =



Revision as of 22:12, 2 April 2017

Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Definition/Description[edit | edit source]

Female Athlete Triad is a syndrome that evolves from the interrelationships among energy availability, bone mineral density, and menstrual function. The clinical manifestations include eating disorders, functional hypothalamic amenorrhea, and osteoporosis. Not all clinical signs must be present to diagnose Female Athlete Triad. (22)
Female Athlete Triad commonly occurs in adolescent or highly competitive female athletes. This syndrome is most common in Adolescent athletes largely due to their skeletal immaturity and naturally low Bone Mineral Density (BMD) being more susceptible to physical and metabolic stressors.
Energy Availability, Decreased Bone Density, and Amenorrhea.
All coaching staff members of high level and high school women’s sports teams should be highly aware of signs of this disease in order to manage the health of their players. (17) It is also recommended that all female athletes are screened for Female Athlete Triad on a yearly basis. (09)
Early signs of the Female Athlete Triad include weight changes, repeated fractures, and decreased energy.
Longterm effects of Female Athlete Triad include low peak BMD, Osteoporosis, Thoughts of suicide during longterm disease process, and kidney and liver dysfunction. (09)

Prevalence[edit | edit source]

Due to inconsistencies and limitations in criteria defining Female Athlete Triad, study methodology, and experimental design there is an evident discrepancy in the literature when determining the prevalence of the triad. The chances of all three conditions of the triad presenting simultaneously are low, ranging from 0% to 16%. The odds of two conditions presenting at the same time range from 3% to 27%. Generally, most common to just have one of the conditions present with the odds ranging from 16% to 60%. (12)

SInce a diagnosis for Female Athlete Triad is possible without having all three components of the triad, it is possible for sedentary and normally active females to be diagnosed with the syndrome at rates that are only slightly less than competitive female athletes. (19)(23)

Characteristics/Clinical Presentation[edit | edit source]

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Associated Co-morbidities[edit | edit source]

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Medications[edit | edit source]

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Etiology/Causes[edit | edit source]

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Systemic Involvement[edit | edit source]

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Recent Related Research (from Pubmed)[edit | edit source]

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Original Editor <a href="User:Aarti Sareen">Aarti Sareen</a>

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Epidemiology[edit | edit source]

The female athlete triad, though more common in the athletic population, can also occur in the nonathletic population.All female athletes are at risk for the female athlete triad or any of its components, sports that have an aesthetic component e.g.in ballet, figure skating, or gymnastics or are tied to a weight class (eg, tae kwon do, judo, or wrestling) have a higher prevalence of affected female athletes[1][2][3].Weight class sports associated with disordered eating, in athlets including males are,wresting,rowing.

Pathophysiology[edit | edit source]

The pathophysiology behind every triad is as follows:

Disordered eating[edit | edit source]

Eating disorders are characterized by a serious disturbance in eating, such as restriction of intake or bingeing, as well as excessive concern about body shape or weight. The term disordered eating itself was coined to include pathologic eating behaviors that do not meet the strict Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) requirements for anorexia or bulimia; thus, it includes, but is not limited to, anorexia nervosa and bulimia nervosa.These eating behaviours lead to negative energy balance and reduce energy avalibility. For more information on Anorexia nervosa <a href="http://www.physio-pedia.com/Anorexia_Nervosa">click here</a> and for Bulimia Nervosa<a href="http://www.physio-pedia.com/Bulimia_Nervosa">click here</a>

Menstrual Dysfunction
[edit | edit source]

This includes includes luteal suppression, anovulation, oligomenorrhea, secondary amenorrhea and delayed menarche.

In luteal suppression have luteal phase and a prolonged follicular phase in which estradiol levels decrease. The cycle length usually does not change; the athlete will continue to ovulate—although it may be later in the cycle—and usually has regular menstruation.Anovulation is marked by low levels of estradiol and progesterone, which deter follicular development, as well as by an absence of ovulation.Amenorrhea usually refers to secondary amenorrhea, though delayed menarche/primary amenorrhea can occur in young athletes. By consensus, secondary amenorrhea is defined as the “absence of menstrual cycles lasting more than 3 months after menarche has occurred.”Oligomenorrhea is defined as “greater than 35 days between cycles.”


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Signs & Symptoms[edit | edit source]

If a girl has risk factors for female athlete triad, she may already be experiencing some symptoms and signs of the disorder, such as:

  • weight loss
  • no periods or irregular periods
  • fatigue and decreased ability to concentrate
  • stress fractures (fractures that occur even if a person hasn't had a significant injury)
  • other injuries

Girls with female athlete triad often have signs and symptoms of eating disorders, such as:

  • continued dieting in spite of weight loss
  • preoccupation with food and weight
  • frequent trips to the bathroom during and after meals
  • using laxatives
  • brittle hair or nails
  • dental cavities because in girls with bulimia tooth enamel is worn away by frequent vomiting
  • sensitivity to cold
  • low heart rate and blood pressure
  • heart irregularities and chest pain


[edit | edit source]

http://www.femaleathletetriad.org/

Recent Related Research (from Pubmed)[edit | edit source]

References[edit | edit source]

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<a _fcknotitle="true" href="Category:Womens_Health">Womens_Health</a> <a _fcknotitle="true" href="Category:Sports_Medicine">Sports_Medicine</a>

  1. Nattiv A, Loucks AB, Manore MM, et al. American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc. Oct 2007;39(10):1867-82.
  2. Rosen LW, Hough DO. Pathogenic weight-control behavior of female college gymnasts. Phys Sportsmed. 1988;16(9):141-6.
  3. Kiernan M, Rodin J, Brownell KD, Wilmore JH, Crandall C. Relation of level of exercise, age, and weight-cycling history to weight and eating concerns in male and female runners. Health Psychol. 1992;11(6):418-21.