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Published on March 30, 2017

young female athlete running

A Threat to Young Female Athletes

Too much intense exercise, hectic schedules and too few calories can put teen girls and young women at risk for what’s known as female athlete triad.

While well-known to physicians, especially those in orthopedic, sports medicine, as well as doctors with teen patients, it’s mostly unrecognized outside of those circles.

The triad includes under-eating, interruptions in menstruation and losses of bone density.

Jesse Barondeau, MD, Avera Medical Group Pediatrics Mitchell, specializes in health care for adolescents, and he said sometimes parents and even some coaches may not know of it.

“Very competitive athletes may not be eating enough calories to keep up with their hectic schedules, between practices and games. That’s when we see this issue,” he said. “Symptoms include changes to the menstrual cycle, and it can cause short-term injuries as well as bone development issues.”

Those problems can include poor bone health, leading to earlier onset osteoporosis or other bone-density problems. Barondeau said in some cases, the female athlete is in fact starving her body of nutrients, and the body compensates by slowing menstruation and draining calcium from bones to help the heart do its work.

“While it does have lasting impacts, it can also lead to a greater risk for stress fractures, which are not only painful but can lead to a season- or career-ending injury,” said Barondeau. “Rest and recovery, and a careful consideration of caloric intake, are steps that can help girls and young women.”

Samuel Schimelpfenig, MD, Avera Medial Group McGreevy 7th Avenue, a sports medicine and pediatric specialist, said compromised nutrition can cause additional problems.

“Without the nutrients necessary, the body cannot do its normal maintenance and repair functions during rest. That’s another aspect of this condition,” he said. “Aggressive athletes need enough rest between games or seasons. Early specialization in one sport, no matter what it is, can be a contributing factor.”

Schimelpfenig said it can happen to girls in any sport.

“I’d encourage all parents to avoid early specialization into a sport,” he said. “Children and adolescents need plenty of calories and nutrition and plenty of rest. A full day off each week, and a period where intense training isn’t the daily routine will help.”

Both physicians agree that the problem is one where your body craves energy but it’s not getting enough.

“It can be challenging, but appropriate nutrition can really help, and that could be through supplements with iron, or it could include nutritionist support as well,” Barondeau said. “Athletes plan their workouts and they need to plan their meals as well, so it all comes together to keep them full of energy and less apt to suffer from the triad or injuries that come with it.”

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