Some
physically active women are at risk for a group of symptoms called
the Female Athlete Triad. This often unrecognized disorder is a
combination of three conditions:
Disordered
eating, whether manifested as restrictive eating behaviors, bingeing,
purging or excessive exercise, can lead to changes in normal body
hormones, such as estrogen. Normal estrogen levels are needed to
maintain calcium content in bone. Estrogen levels may be lowered
when amenorrhea occurs and as a result, calcium content can be lost
from bone. The result is osteoporosis, or porous bones.
Who's
at risk: are all athletes on this team?
If you are a physically active woman, you are at risk for the Triad.
The competitive nature and strong discipline that can help make
you a good athlete may also be part of the equation leading to this
disorder. Competitive athletes may be at a higher risk than the
more casual athlete due to a more rigorous training schedule and
the "play-to-win" nature of their sports. You are particularly
at risk if you participate in endurance sports, like cross-country
running; aesthetic sports, like gymnastics or ballet; and sports
which require formfitting uniforms, like swimming. The emphasis
on a certain "look" and the perception that carrying less
weight will universally improve performance lead to this risk.
How will the Triad affect my performance?
Each part of the Triad can impair health and sport performance.
Disordered
eating:
an underfueled athlete is a slowed and weakened athlete. No matter
what the sport, if your muscles lack sufficient and proper fuel,
performance is impaired. At first there might just be some early
fatigue. As the fuel deficit worsens, actual loss of strength and
muscle size can occur as the body
uses skeletal muscle in order to fuel essential body functions,
like heart function and breathing. Lack of fuel can also lead to
your inability to concentrate, not a quality befitting an athlete.
If you are an athlete with strength losses and poor concentration,
you can be more easily injured. Injuries then are slow to heal in
a poorly fueled body.
Amenorrhea: Loss of menstrual
periods may signal a change in your body's intricate and complicated
hormone system. Hormone imbalance from underfueling your body can
result in lowered estrogen production. There are also other causes
of lowered estrogen levels. A diminished estrogen level can have
many effects; the most immediately apparent one can be bone loss.
Amenorrhea can often go unreported to medical providers because
of the common belief it is "just part of the training effect."
We do know that the bone loss that occurs as a result of this is
NOT "just part of the training effect" and can start to
occur after just a few months with no period. Click for more information
on amenorrhea.
Osteoporosis:
Loss of bone, especially if you are an athlete, can be an
unfortunate setup for an injury. Stress fractures can sideline sports
activity and be slow to repair if you are underfueled. Repeated
stress fractures and unexplained injuries should be a red flag to
further evaluate your eating and exercise patterns. Bone loss that
occurs because of amenorrhea can be permanent; osteoporosis is not
just a disease grandmothers get!
What are the warning signs?
In addition to the clinical information presented, the following
could be red flags:
Frequent
or unexplained injuries, stress fractures
Excessive
or compulsive exercise (not being able to skip a day of exercise
or reduce time spent exercising)
Change
in performance -- loss of endurance, speed, strength
Impaired
concentration
Absent
or irregular menstrual periods
Restrictive
eating masked as a "performance enhancing" meal plan
Use
of weight loss products or supplements
Prevention of the Female Athlete Triad
Prevention of the Female Athlete Triad is the best way to stay healthy
so you can enjoy participating in your sport. Try these tips:
Choose
an activity that complements your natural body strengths and suits
you as an individual.
Realize
your health is more important than competitive success. Taking
health risks for a perceived competitive edge will make you lose
in the long run.
Be
wary of those who value your competitive success over your well
being.
Frequent
weigh-ins, weight comments and punitive consequences for weight
gain may increase an athlete's risk for the Triad.
Appreciate
your own healthy, active body. Don't compare yourself to others,
especially those portrayed in the media. Optimal weight for health
AND performance is different for everyone.
Realize
the thinnest athletes are not necessarily the fastest or the strongest.
Think
of fuel as the ultimate performance enhancer!
Don't
starve your bones. Part of your fuel mix should include several
servings a day of good calcium sources like milk, yogurt, cheese,
calcium-fortified juices and soy products. I f you are lactose-intolerant,
try some of the no-lactose dairy products available. Green leafy
vegetables, almonds and beans also have some calcium.
Be
a role model with both your words and actions. Speak up when you
hear others making negative comments about weight or body shape.
Compliment friends and teammates on their talents and personality,
not their looks. Take a positive attitude about fueling yourself
and enjoying foods.
Located on the third floor of Health Services.
Confidential information or care is available through individual
appointments or phone consultation with a Nutritionist to discuss
the many types of eating concerns you may have regarding yourself,
a friend, roommate or teammate. Health Education also offers workshops,
pamphlets, and reading materials covering these and related issues.
There are no fees for Health Education services.
Located at the corner of Brown and Charlesfield streets.
Confidential information and care is available on a walk-in, or
by scheduled appointment basis. Care is available for initial, current
or past disordered eating patients. There are no fees for medical
care at Health Services. However, there may be fees incurred if
laboratory tests, medications, specialist or emergency hospital
care is needed.
Located on the second floor of Rhode Island Hall.
Confidential appointments are available at Psychological Services
for students concerned about their eating issues. Guidance is also
available for those who are concerned about a friend, roommate,
or teammate's eating. Services include crisis intervention, short-term
psychotherapy and referrals. There are no fees for appointments
at Psychological Services.
Links
you can use
This site looks at ways we can feel good in the bodies we have.
One of their slogans: "Remember, your body hears everything
you think." Other topics on the web site: Size Acceptance;
What do you say when everyone around you is dieting? 200 Ways to
Love the Body You Have; Dieting Detox; Evaluating Weight Loss Programs:
What are the Red Flags? Free subscription to email newsletter "Body
Positive Pages."
Articles from the ADA on eating disorders, including The Female
Athlete, Compulsive Eating and Anorexia.
Highly recommended web site, offering support and programs for people
seeking a lifestyle without diets. You can take a self-profile quiz
that cues you to the many benefits of a non-diet life. Slogan: "You
Count, Calories Don't." Run by a registered dietitian. This
site includes a chat line, resources and links to other sites.
This site includes definitions, statistics, warning signs, causes
and frequently asked questions.
This site provides general information about eating disorders and
body image concerns, tips for helping a friend and referral sources.
Go to the Sports Science Center on this site for articles by experts
in exercise science and sports nutrition. Topics include supplements,
hydration and sports psychology.
The Personal Health section of this website has information on fitness,
nutrition, strengthening exercises, weight control and women's health.
Adapted from the Boston College Eating Awareness
Team
Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.
