Female Athlete Triad

by Jennie

Dear Blog Readers,

This is an article I wrote for the most recent edition of The MasterSkier Journal. The journal is a great source of articles and opinion papers regarding training and many other ski related topics. It can be found mostly in ski shops this time of year, however I wanted to post this article to my site as well.  I think it’s a very important topic for all athletes and coaches to be knowledgeable about, and there is little talk regarding the issue. My experience stems through the eyes of an observer, a teammate, a veteran ski racer, and an Exercise Physiology student. As I hope you find it helpful and interesting, feel free to comment with your thoughts.




Female Athlete Triad

What is it, and why you should know

– Written by Jennie Bender


HEY MEN, do you have an active female in your life you care about? Does she get injured a lot, or have a poor diet? Read this, and learn something very important about both your health, and the health and future of the women in your life!


HEY WOMEN, have you ever had a stress fracture or easily broken bones? Are you trying to lose weight? Do you restrict what you eat? Do you have a period that is infrequent or non-existent? Are you trying to find where the line is between a healthy performing physique and an unhealthy one? Time to do some research and to connect the dots.


The Female Athlete Triad is the frequent relation between Disordered Eating, Amenorrhea, and Osteoporosis. Disordered eating doesn’t have to be a full-blown eating disorder, but it evolves when you’re ingesting significantly less calories than you need for daily living and activities. Amenorrhea is when females lose their menstrual cycle for longer than three months. It can happen when the body is not given enough calories to go through its menstruation process, commonly due to either a high activity level that’s burning more calories than the athlete is aware of, or an overall low caloric intake, such as when dieting. When periods are less frequent, the body makes less estrogen, which is essential for bone growth, especially for women ages of 13-25. This hormone imbalance and lack of nutrients can cause Osteoporosis, which is when your bones become weak and brittle, causing a life full of various injuries.


Athletes Role:


How does The Female Athlete Triad affect performance?

How do I lose weight and be healthy?


There is a sensitive line many athletes ride when experimenting with finding their more stable and resilient body weight that can handle a hard training cycle, versus their healthiest and lightest peak performance weight, which is also known as their racing weight. Some athletes start to “lean down” a few months before their season starts, while others try to hold a low weight all year around. Unfortunately, at the beginning stages of an athlete losing a lot of weight, the body can spike in efficiency. This is because if fat percentage is drastically lowered, it can cause a higher strength to weight ratio for that individual. However if this weight lost is muscle, the athlete can suffer from weakness. Never gauge an ideal athletic body weight purely from a number on a scale, because it does not take into account your physical composition. I said unfortunately, because most athletes don’t know when to stop leaning down. The mental and physical game of, “If a little is good, more is better” is exactly what causes the Female Athlete Triad, as well as many other unhealthy life choices.


Here is where I overstep my boundaries, and speak not just from research but from years of personal experience. Most of my career, people have either avoided talking about body weight, casually thrown around random suggestions without knowing me nor their own advice, or given me the classic “talk to a professional.” Yes, I agree, please do talk to a professional. Especially if you think you already have the Triad, are trying to lose weight, are concerned about your health, or just plain have a lot of questions. However, I want to share some tools that I have learned along the way, as well as basic guidelines as a start to being in control of your health and performance.


  • After reading thus far, do you have the Female Athlete Triad? The number one cure for fixing the Triad symptoms is increasing your intake of quality calories. AKA eat more food! Be realistic about your health, because you want to live long, and your body is your machine to bring you through that journey.
  • Look at your goals. For example, it’s okay to want to lose weight. It also seems to be something ingrained into the female psyche. However, acknowledge why this is driving you, what are the external factors in your life, and what is your ideal timeline.
  • Do not rush the process and plan you are about to make. If it’s to be injury free, then work backwards from now, and be realistic about your life choices. It takes patience and time.
  • Avoid fad diets. Some random endurance runner may only eat fruit. Good for him. Maybe that works for you too, but that certainly does not work for most.
  • Speaking of which, what works for someone else may not work for you. If your friend cut sugar completely out of her diet, good for her, but you don’t have to do that. Instead, perhaps don’t snack late at night (after 9pm), don’t drink a lot of sugary beverages, and pay attention to how many foods you eat that are man-made versus %100 naturally grown. I don’t mean they have to be organic; I am referring to if it was created in a factory. It probably tastes good, but is not that good for you. Don’t be fooled by labels that claim something is healthy. Focus on eating protein and greens.
  • Your weight is your business. Be open talking to someone you trust about your concerns, and be an ear for someone else, but if it’s only negative junk feedback, then find a better source. Body weight is like talking about sex. Everyone has an option, but not everyone wants to talk about it, and you have to find what works for you.
  • If you really want to dial things in, try to get body fat percentage professionally tested. Also, keep track of what your highest weight has ever been, as well as the lowest (in the past two years if you are under the age of 20.) How did you feel emotionally and physically at those weights?
  • Keeping in mind that until you are in your mid-20s, you aren’t supposed to know what your ideal body weight should be, because you are still developing. Even through college. What external factors are impacting your life? What are your eating habits? Do you stress eat? Do you not eat all day then binge at night? Are you eating around a bunch of boys or a bunch of girls? Do those people pay attention to what they eat?
  • Performance to body weight ratio. Facts and myths. Know them.
  • Get help if this is causing you a lot of stress. Weight control is a process almost every human being on this planet has to go through.


Coaches Role:


How should I be a part of this?


The Female Athlete Triad is comprised of three different health issues proven to be interrelated, however, it starts with having just one of the three. Seen frequently in athletes whose sport benefits and/or encourages a lean body for performance, the Triad should be taught to every coach out there who wants to see a successful healthy athlete. However, it does not mean you need to be the one addressing, fine-tuning, or guiding this athlete through their medical or physical issues. Does seeing one of these factors in an athlete mean an emergent cry for help? Not necessarily. However it calls for a private talk with the individual, asking how they are doing. Show concern for their health; not authority over their body.

Each sport varies with what intensity this issue is addressed. Sometimes it’s never addressed, and the fact that the athlete looks suddenly skinnier, or has an anxious behavior paired with odd injuries, is overlooked due to their increase in performance. Talking about weight with women tends to be a social faux pas, and especially at a young age of innocence and confusion this topic can be extra sensitive. Because of this, some professionals suggest that coaches should not be involved with discussing body image at all. It’s ok if you feel like you don’t have sufficient experience or knowledge to assist the athlete. After privately checking in with them on how they are doing, asking if they have concerns, and bringing up your concerns; give them information to educate themselves, and guide them to people who can help.

Gently monitor whether or not they seem to have energy at practice, if they are re-fueling after, and focus on positive body image, not weight loss. Be careful, because eating disorders can be psychologically contagious. Group weigh-ins? Please just don’t do them. Bring in guest speakers to talk about body image and nutrition. Find and use other resources, such as nutritionists, parents, athletic trainers, counselors, physicians, psychologist, or physiologist.


If you don’t feel comfortable talking about it, and it’s your role to, then have them read this article, and direct them to someone who knows how to make a proper plan. To quote the very informational website, femaleathletetriad.org: “Luckily, the key to avoiding menstrual problems and building strong bones is simple — eat enough calories to fuel your body during exercise and at rest.”


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