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3 Symptoms to Watch Out For in Young Athletes

For young women athletes, striving for a lean look and high achievement can be dangerous

In many sports, being a "triple threat" makes you invincible. But some young women athletes face a different triple threat - female athlete triad.

Female athlete triad refers to a cycle some young women athletes fall into by consuming fewer calories than they burn, and simultaneously overtraining. That constant depletion of energy doesn't just lead to weight loss, it also can lead to hormonal imbalances.

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Chelsea M. Evans, DO
Sports medicine

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Hallmarks of female athlete triad

  • Energy deficiency (consuming fewer calories than training demands)
  • Loss of a monthly period (amenorrhea)
  • Low bone density

Achievement and appearance factors

"There's so much pressure to be successful. The focus on getting scholarships and playing at a higher level can lead to athletes making drastic changes in diet and exercise," says Chelsea Evans, DO, with LVPG Orthopedics and Sports Medicine. Appearance also comes into play, especially with bodyimage-focused sports such as dance, diving, gymnastics and cross-country running. "Striving for a lean look coupled with high achievement can be dangerous," Evans says.

Female athlete triad can cause hormonal disturbances that can lead to stress fractures, low bone mass and premature osteoporosis. It can impact mental health too. "Athletes with the disorder can suffer from anxiety, sports burnout and life-threatening eating disorders," says Richard Canlas, MD, with LVPG Primary Care Sports Medicine at the Health & Wellness Center in Hazle Township.


Multidisciplinary treatment

To help young female athletes get on a healthier track, Lehigh Valley Health Network (LVHN) offers a multidisciplinary team treatment approach, including sports physiologists, nutritionists, endocrinologists, sports medicine physicians and psychologists. Although treatment varies, it may include a hormonal evaluation, a DEXA scan - a test that measures bone mineral density to assess risk for osteoporosis or fracture - plus meetings with a nutritionist.

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Eric Wilson, MD
Sports medicine

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Athlete awareness

Athletes may not realize they have the disorder. To help spot female athlete triad (or RED-S in young male athletes), LVHN distributes screening questionnaires to local high schools. Athletic trainers and pre-participation sports physicals can help identify it too.

You also can play a part. If you suspect your high schooler may be at risk, don't wait to seek help.

"The best time to identify female athlete triad or RED-S and intervene is in high school, while parents still have close involvement in their child's health care," Evans says.

More about RED-S 

Male athletes who overtrain and undernourish are at risk for relative energy deficiency in sport (RED-S).

Like female athlete triad, RED-S puts male athletes at risk for bone density depletion, bone fracture, eating disorders and burnout.