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The Female Athlete Triad Can Lead to Bone Health Problems


 

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Sports-related injuries among female athletes have soared and women with symptoms known as the female athlete triad are at greater risk of bone stress injuries and fractures, according to a study published in the July issue of the Journal of the American Academy of Orthopaedic Surgeons.

“The female athlete triad is a spectrum of symptoms that include low energy availability, menstrual cycle abnormalities, and low bone mineral density. Low energy availability can mean taking in inadequate calories or expending more energy than the body is designed to do. It can result from poor nutrition or eating habits or any type of eating disorder. Any combination of these conditions can lead to premature bone loss in females,” explained lead study author Elizabeth Matzkin, MD, Surgical Director of Women’s Musculoskeletal Health at Brigham and Women's Hospital and Assistant Professor at Harvard Medical School in Boston.

Elizabeth Matzkin, MD

Athletes and non-athletes participating in any sports and exercise can develop symptoms of the female athlete triad. However, the likelihood of female athletes sustaining a bone stress injury significantly increases as the number of symptoms they have increases—one symptom conferred a 15% to 21% increase in risk, two symptoms bumped the risk to 21% to 30%, and all three symptoms pushed the increase in risk to 29% to 50%.

The study authors also found that female athletes diagnosed with poor nutrition or low energy availability are 2 to 4 times more likely to sustain a sports-related injury. Female athletes who self-reported menstrual cycle abnormalities had a nearly 3 times greater risk of a bone and joint injury.

“Any athlete who falls under the ‘umbrella’ of the triad should be questioned by their physicians and educated regarding all of the components and potential health risks of this condition. By preventing premature bone loss in young female athletes, we can potentially prevent future fragility fractures,” said Dr. Matzkin.

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