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care of the young athlete patient education handouts the female athlete ta emale athlete triad refers to the combination of peatat ee the emale athlete 3 medical conditions eating problems ...

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               Care of the Young Athlete Patient Education Handouts
               The Female Athlete Ta
                            emale athlete triad refers to the combination of                                                             PeatŠat  €Šee ‹  the ‹emale athlete
                            3 medical conditions—eating problems, menstrual 
               F
                            problems, and weak bones—seen in competitive                                                           ’uring a sports preparticipation eamination female 
               female athletes. Prevention of the female athlete triad is                                                          athletes are asked ­uestions related to the female 
               important because it can interfere with normal growth and                                                           athlete triad €see below‚.  f components of the female 
               development, cause injury, and result in loss of strength                                                           athlete triad are suspected, the doctor may perform an 
               and endurance.                                                                                                      epanded physical eamination.
                  The following is information from the merican                                                                   • t what age did you begin menstrual periods“
               cademy of Pediatrics about the 3 conditions and                                                                    • ”ow often do you have a menstrual period“
               general guidance for prevention and treatment.                                                                      • ”ow long do your periods last“
                  Eat  ­lem€                                                                                                  • ‘hen was your last menstrual period“
               ating problems occur when an athlete eats fewer calories                                                           • ”ave you ever taken birth control pills, and when“
               than her body needs for growth, development, and                                                                    • ”ow many meals and snacks do you average 
               eercise. ome athletes choose to limit their calories to                                                              each day“
               improve performance or appearance. ther athletes are                                                               • –ist the foods and drinks you had yesterday.
               unaware that they aren’t eating enough calories to meet the                                                         • –ist the foods and drinks you try to avoid.
               energy demands of their sport. The athlete may be eating 
               enough for a nonathlete, but not enough for an athlete.                                                             • ’o you eat or drink milk, calcium‰fortified orange 
                   nade­uate food intake is called disordered eating and                                                              juice, yogurt, or cheese“ ”ow much each day“
               can result in low energy availability €not having enough                                                            • ‘hat has been your highest weight, and when“
               energy to fuel the body‚. ƒor eample, if an athlete only                                                           • ‘hat has been your lowest weight in the past 
               eats „,……… calories per day but uses 3,„…… calories, then                                                              „ years“
               she is eating †,„…… calories less than her body needs.  n                                                           • re you happy with your current weight“
               this case, the athlete will not have enough energy. This 
               can hurt performance, slow growth and development,                                                                  • ‘hat do you feel your ideal weight would be“
               and increase the risk of injury and illness. This can also                                                          • ”ave you ever tried to control your weight by 
               lead to an eating disorder, like anoreia or bulimia.                                                                  dieting“ —omiting“ –aative use“ ’iuretics“ ercise“
                  thletes of any sport may develop disordered eating, but                                                         • ‘hat sports do you participate in“
               some sports place athletes at higher risk. These include                                                            • ”ow much time do you spend training for your sport 
               sports that emphasi‡e leanness, such as gymnastics, dance,                                                             each week“
               diving, figure skating, long‰distance running, and cross‰                                                           • ”ow much time do you spend eercising in 
               country skiing, or sports that use weight classifications, 
               such as wrestling, martial arts, and rowing.                                                                           addition to your sports workout €ie, etra running, 
                  ‚e€tƒal  ­lem€                                                                                                  calisthenics, stair climbing machine‚“
                                                                                                                                   • ”ave you ever had a stress fracture“ ‘hen“
               Šot eating enough calories can cause menstrual periods to 
               become irregular (oligomenorrhea) or stop (amenorrhea).                                                         can be caused by not eating enough calories for energy 
                n the young athlete who isn’t eating enough calories,                                                          ependedŽ they are not caused by low body fat or the 
               menstrual periods may not start when they should.                                                               stress of eercise.
               Primary amenorrhea occurs when menstrual periods don’t                                                             „ea… ­ e€
               start before †‹ years of age. Secondary amenorrhea occurs 
               when regular menstrual periods stop for 3 months or more.                                                       ‘hen a young athlete doesn’t eat as many calories as her 
               Oligomenorrhea occurs when the time between menstrual                                                           body needs, and has menstrual problems, her bones do 
               periods is longer than 3Œ days. ll types of amenorrhea                                                         not develop the normal strength. ‘hen this happens, 
                                                                                                                     PA†E ‡ ˆF ‰
               Care of the Young Athlete Patient Education Handouts—The Female Athlete Triad
               a †‹‰year‰old girl can have bones as weak as those of a                                                             f a lack of enough calories is the cause of the menstrual 
               ‹…‰year‰old woman. he may more easily develop stress                                                           problem, it will be important that the athlete increase 
               fractures or, if severe, even compression fractures of the                                                      her food intake. he will need to eat all of the nutrients 
               spine. This decrease in bone strength will continue until                                                       her body needs, which includes carbohydrates, fats, 
               she has normal periods again but, even though she can                                                           and protein.  t may be helpful for her to see a registered 
               regain some bone strength, she may never catch up to                                                            dietitian for nutrition counseling. The athlete should 
               where she should be normally.                                                                                   gradually increase her food intake until her menstrual 
                  Pe’et                                                                                                    periods return. 
                                                                                                                                   f it is difficult for the athlete to increase her food intake, 
               The female athlete triad can be prevented by eating enough                                                      she may need to decrease her eercise™sports activity 
               calories, including fat, protein, and carbohydrates. ›ost                                                       instead. nce menstrual periods return, the athlete can 
               female athletes need a minimum of „,……… to „,œ…… calories                                                       slowly increase her activity again while increasing her 
               per day. Šot only will this prevent menstrual problems                                                          food intake to maintain menstrual periods. 
               and weak bones, it will help the athlete perform betterž  f                                                         f an athlete is not having regular menstrual periods, she 
               an athlete develops menstrual problems, she needs to see                                                        needs to eat Œ servings of calcium per day.  serving would 
               a doctor.  t is not normal to skip periods or stop having                                                       be † cup €š ounces‚ of milk, yogurt, or calcium‰fortified 
               periods.  f an athlete cuts out the fats in her diet, decreases                                                 orange juice, or † ounce of cheese. 
               the amount of food she eats, loses weight, or skips periods,                                                        f an athlete struggles with increasing her food intake, it 
               she should tell her doctor. ƒinally, if an athlete feels she                                                    may be helpful to have her see a counselor to work on why 
               needs to lose weight, she should consult her doctor first.                                                      eating enough is difficult for her.
                  Teatmet
                   f an athlete is not having regular menstrual periods, she 
               needs to see a doctor. The doctor needs to make sure there 
               are no other reasons for menstrual problems €for eample, 
               thyroid disease‚. 
                 “otes
               The information contained in this publication should not be used as a substitute for the medical 
               care and advice of your health care professional. There may be variations in treatment that your 
               health care professional may recommend based on individual facts and circumstances.
               Ÿopyright © „…†„ merican cademy of Pediatrics
               ll rights reserved.
                                                                                                                     PA†E ‰ ˆF ‰
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