Sport & exercise is a great way for girls & women to stay fit, healthy, gain confidence and socialise with friends. Time & time again, research has proven that those who engage in regular physical activity are generally healthier, more confident and feel better physically & mentally than those who don’t.


Unfortunately, there is a serious medical condition that can effect females who train regularly. This condition is estimated to affect one in every four females involved in sport & regular training, and can cause stress fractures, iron-deficiency anaemia and weak bones.


Sadly, despite this condition effecting up to one quarter of girls and women in sport, it often goes unrecognised. It is not until it starts to impact upon a female’s sporting ability that something may be done. This condition is known as The Female Athlete Triad.


If you are a female involved sport and intense exercise, or if you are the coach or trainer of female athletes, or, if you have a daughter who plays sport, then you need to be aware of the ‘The Female Athlete Triad’. If you have a good knowledge of this condition and are able to recognise the signs, then it can either be prevented or managed successfully, allowing females to achieve their full athletic abilities.

What is the Female Athlete Triad?

The Female Athlete Triad is a combination of three medical conditions that are linked to each other:


  1. Low energy availability & disordered eating
  2. Menstrual problems
  3. Weak bones & stress fractures

A female does not need to exhibit all three components of The Female Athlete Triad at the same time to be at risk of health problems! If just one of these factors is present, then medical help should be sough to manage the condition.

Triad Factor #1: Low Energy Availability and Disordered Eating


The first factor of The Female Athlete Triad is low energy availability. Energy availability is the amount of energy from food (calories eaten) that is available for your body after exercise. Some females may try to lose weight as a way to improve their athletic performance or to achieve a certain look. Other times, girls simply may not realise how much energy they expend during workouts and they don’t eat enough to maintain a healthy weight.

Some girls with the Triad may also show disordered eating (including anorexia or bulimia), meaning they go to extremes and restrict or eliminate certain foods or food groups and skip meals. Basically they do not provide their body with sufficient energy.


In the short term, if you don’t fuel your body with enough energy from the food, you won’t be able to perform at your best. This will mean less power, muscle strength and stamina. However, in the long-term, if this energy deficit is too large, your body will not have enough energy to maintain normal bodily functioning, like developing healthy bones, regulating your body temperature or having a menstrual period every month.

Triad Factor #2: Menstrual Problems

The second factor of The Female Athlete Triad is menstrual problems. Exercising intensely and not eating enough food (i.e. low energy availability) can affect a female’s hormone levels. Decreases in estrogen, the hormone that helps to regulate the menstrual cycle, can occur. As a result, females with the triad may have irregular or missed periods, or they may stop altogether, which has serious reproductive health complications.

Triad Factor #3: Weak Bones and Stress Fractures

Bone problems resulting from The Female Athlete Triad include stress fractures and reduced bone density for your age. When you are in a negative energy balance, your body is not able to replace old bone cells with new healthy cells. This can lead to stress fractures and low bone mass. Usually, the teen years are a time when girls should be building up their bone mass to their highest levels — called peak bone mass. However, minimal energy intake will affect hormones, leading to stress fractures and other bone problems like osteoporosis, which are detrimental to athletic performance.

What Are the Signs and Symptoms?

Are you a female in sport or train regularly? Have you experienced any of the following:

  • weight loss
  • irregular periods or loss of periods
  • fatigue & decreased ability to concentrate
  • stress fractures
  • muscle injuries
  • brittle hair or nails
  • dental cavities
  • sensitivity to cold
  • low heart rate and blood pressure
  • heart irregularities & chest pain
  • preoccupation or obsession with weight, appearance, food & exercise


If you have experienced any of these signs or symptoms, it is important to talk to someone about it. Remember, with proper help, you can manage this condition, stay healthy, prevent serious health complications and keep performing at your best.

What Coaches and Parents Should Look For

If you are a coach or a parent of a female athlete, it is important to be aware of the signs and symptoms above. Frequent or deliberate attempts of female athletes to lose weight or decrease body fat quickly can be clear signs. Chaotic eating patterns, stress around eating and deliberate under-fuelling are also possible indicators. Talking about the triad may be a touchy subject for some female athletes but is important and should be always be evaluated by a sports-minded health professional.

So now that you know what The Female Athlete Triad is, and some of the signs and symptoms to look out for, stay tuned for Part 2 for prevention and treatment strategies. There are many nutrition-related options to help prevent and manage this condition, and allow female athletes to compete and excel in their sports in a healthy and happy way.

And in the mean time, if you are a female who is experiencing some of these symptoms, or are a parent, coach or friend, please consider seeking help from a health care professional, or at least talk to someone about it.

A big thank you to Lifestyle Photographer Fiona Peters for taking these images of me 🙂