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The Female Teen Athlete Triad Syndrome – Part Two

The Female Teen Athlete Triad Syndrome – Part Two-Paradigm Malibu

The Female Athlete Triad, is a psycho-physiological disorder and the focus for this two part series. The first article reviewed the fundamentals of this illness, while this second article will get into the details of the disorder as well as examine why some professionals believe it is a myth.

Teen Athlete Triad Syndrome

First, it is important to point out that the teen athlete triad syndrome is a disorder females are  vulnerable to. Considering that the Triad includes disordered eating as one of three illnesses and that the age of onset for eating disorders is typically during adolescence. Female teen athletes need to assess their levels of energy expenditure compared to the levels of energy intake.

Essentially, a large gap between energy going out (physical activity in sports) and energy coming in (food intake) will cause the body to react. As a reminder, the Triad consists of three health challenges: disordered eating, amenorrhea (the absence of a menstrual period), and decreased bone mineral density (fragile bones that are more likely to fracture). When the body experiences too large a difference between outgoing and incoming energy, estrogen levels go down and causes menstrual periods to stop. Normal estrogen levels need to maintain calcium content in the bones. With low estrogen levels, bones can become progressively more porous leading to fragility and eventually osteoporosis.

Side Effects of Illness

Another reason to ensure that female teen athletes are aware of this illness is that during adolescence there is a high value placed on looks. Research indicates that those females who are particularly at risk are those who participate in endurance and aesthetic type sports. Such as gymnastics and ballet. Also at risk are those who participate in sports that require a formfitting suit, such as swimming, where the appearance of one’s body and weighing less might be link to a better performance.

Disordered eating, which is one of the three illness that make up this disorder, is  both the intentional and unintentional restriction of food intake. Of course, the restriction of food and a skewed vision of one’s body. Known as body dysmorphia – are significant contributors and indications of a teen eating disorder. Sadly, the rate of occurrence of eating disorders, such as Anorexia Nervosa and Bulimia Nervosa, is only increasing. This is partly because the conversations about these mental illnesses are happening more frequently. And partly because of the underlying social issues in Western culture.


Although it is true that increasing the levels of estrogen can help with restoring the body to health, it doesn’t help in all cases. When the bones of a female athlete are already too fragile, estrogen won’t be useful. Bone loss is not reversible. Furthermore, the underlying psychological concerns may need to be addressed in order to heal the unhealthy body image. As well as the  need to restrict food, and the need to uphold a certain image of oneself. Of course, societal and adolescent pressures do not make this an easy task. However, at root, a female teen’s self-esteem and her relationship with her body are calling for attention and healing. Healing this disorder warrants the attention of both a nutritionist to assess hormone levels. As well as a psychologist to assess and treat the disordered eating.

In 2006, the British Journal of Sports Medicine published an article expressing six allegations against the validity of the Triad and claimed that the disorder was myth. The article indicated, for example, that the data pointing to the presence of the disorder was being misinterpreted and that the essentially the Female Athlete Triad did not exist.

However, one year later, the same journal published a “refutation of the myth of the female athlete triad”. Indeed, the disorder does exist. And because of its effects on the psychology and biology of the female, particularly on teen female athletes, it can be fatal.


Providing psycho-education and precautionary measures to young teens is important. As well as ensuring that their energy levels balance can prevent the disorder from becoming a concern.  Furthermore, taking these steps can help prevent this disorder from becoming an obstacle to living a healthy, fulfilling, and meaningful life.



Loucks, A.B. (2007). Refutation of “the myth of the female athlete triad”. British Journal of Sports Medicine. Retrieved on April 1, 2014 from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2465124/

DiPietro, L. & Stachenfeld, N.S. (June 2006). The myth of the female athlete triad. British Journal of Sports Medicine. Retrieved on April 1, 2014 from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2465096/

Boston College Eating Awareness Team. The female athlete triad. Brown University Health Education. Retrieved on April 1, 2014 from: http://www.brown.edu/Student_Services/Health_Services/Health_Education/nutrition_&_eating_concerns/eating_concerns/female_athlete_triad.php


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