Health conditions form triad of problems


Female athlete triad.

What is it, and who has it? Apparently, more people than you think.

“Fifteen to 62 percent (of female athletes), depending on the sport, have Female Athlete Triad,” said Susan Krueger, biology professor at UW-Eau Claire.

Female athlete triad contains three stages, Krueger said. It begins with disordered eating, which leads to amenorrhea (the absence of menstrual periods) and then osteoporosis if not medically addressed.

The first step

It all starts with the amount of nutrition that athletes are putting into their bodies.

Inadequate nutrition causes lower energy levels, which starts the triad. That, along with their excessive exercise, puts a young female athlete at risk, said Dr. Irfane Khatib, an obstetrician-gynecologist at the OBGYN Clinic of Eau Claire.

If an athlete is not getting the amount of nutrition their body requires, it could lead to disorders such as anorexia, he said.

However, coaches at UW-Eau Claire said they try to avoid this by making sure their athletes are getting enough of what they need.

“I think nutrition in college kids is really overlooked,” saidJerry Kollross, coach of men’s and women’s swimming and diving teams. That’s why, within the first two weeks of the season, he said he brings a nutritionist in from Marshfield Clinic to help the team plan their diet, which is composed of carbohydrates, protein, fat and proper hydration, among other things.

Dan Schwamberger, coach of the men’s and women’s cross country teams, follows the same game plan. He said he believes that female athlete triad is definitely something female athletes have to be aware of, and his team also follows a diet composed of similar components.

When you have a female athlete who is extremely physical taking in an insufficient amount of calories, she is at risk for amenorrhea, Krueger said.

What a relief … or is it?

Generally, if athletes balance adequate nutrition with their sport, they never suffer from this condition.

Danielle Lucia, a freshman on the UW-Eau Claire volleyball team, said she has never missed her period due to her athletic activities. While the team has no specific diet, they all try to eat well, Lucia said, which helps them avoid these problems.

At first, absence of your period might be seen as a perk, Krueger said. However, when a female athlete suffers from inadequate nutrition, or disordered eating, absence of her period might be a sign of the second part of Female Athlete Triad.

Amenorrhea is the absence of your period for more than three months, Krueger said.

“(It’s a) sign that estrogen is not being produced by the ovaries,” Krueger said, adding that is something to worry about for female athletes.

During lectures where she has taught about Female Athlete Triad, she’s encountered young female athletes who have dealt with the condition.

“Some of these girls would say, ‘I wouldn’t have my period for the whole (high school) season,'” Krueger said. Their high school coaches would attribute that to working hard, she said, and not to more serious conditions.

While Krueger said amenorrhea seems like a “good thing” on the surface, it leads to long-term problems, and essentially, to the third part of the triad.

Bone-deep problems

Lucia said the first thing that comes to her mind when she hears osteoporosis is “older women who have a hard time with their bones” for many reasons including inadequate nutrition.

However, osteoporosis is the third step of the triad, Krueger said. When an athlete suffers from amenorrhea, their body isn’t making any estrogen, which causes menopause.

Menopause sets off rapid bone loss, Krueger said, and no matter what a person does, the lost bone mass cannot be recovered.

This increases the possibility of bone fractures in the wrist, vertebrae, and hip, Krueger said.

Treatment and prevention

If female athlete triad does occur, Krueger said she recommends female athletes do a number of things. First of all, she said they should inform their coach of the problem and then go to health services to see a doctor or dietitian to get back on track and avoid more serious damage.

But most of all, she said they shouldn’t think lightly of the situation.

“Take it seriously,” she said.

Taking this disease seriously seems to be in the mindset of coaches at UW-Eau Claire.

Schwamberger said there should be an open relationship between the coach and the team to avoid this problem.

“Whether you’re a cross country runner or any other type of athlete, you’ve got to focus on recovery,” he said, adding if an athlete has female athlete triad, recovery is important to prevent future problems. That way, he said, it can be stopped early or avoided altogether.

“Be smart now,” Schwamberger said. “So that it isn’t a problem in the future.”