Female Athlete Triad

synonyms: female athlete, female athlete triad

Female Athlete ICD-9

Female Athlete Etiology / Epidemiology / Natural History

• Female Athlete Triad = Osteoporosis, Amenorrhea, and Altered eating habits.
• Amenorrhea leads to osteoporosis and a predisposition to fractures.
• Amenorrhea in the female athlete is most commonly caused by insufficient caloric intake, either by a poor diet, or an eating disorder. (Constantini NW, Sports Med 1994;17:213).
• Women are prone to Patellofemoral Pain, and Anterior Cruciate Ligament tears.

Female Athlete Anatomy

• Female athletes with a higher increased dynamic valgus and high abduction loads were are at increased risk of ACL tear. (Hewett TE, AJSM 2005;33:492).
• Female athletes have a greater total valgus knee load when landing from a jump than men.

Female Athlete Clinical Evaluation

• Obtain menstraul history: age of menarche, history of amenorrhea, use of oral contraceptives
• Document hisoty of recurrent stress fractures, menstrual dysfunction, and/o poor nutrition/disordered eating.

Female Athlete Xray / Diagnositc Tests

• Bone densiometry typically shows low BMD for chronological age.

Female Athlete Classification / Treatment

• Education and prevention
• Decrease training intensity, increase calorie intake, consider calcium, vitamin D, hormone replacement therapy, nasal calcitonin.
• Bisphosphonates are contraindicated due to teratogenic effects.
• Best managed with multidisciplinary approach: PCP, coach, athlete, athletes family.

Female Athlete Associated Injuries / Differential Diagnosis

• Anorexia nervosa
• Bulimia nervosa
• Eating disorder not otherwise specified
• Stress Fracture

Female Athlete Complications

• Stress fracture

Female Athlete Follow-up Care

• Best managed with multidisciplinary approach: PCP, coach, athlete, athletes family.

Female Athlete Review References

• Bennell KL, AJSM 1996;24:810
• Barrow GW, AJSM 1988;16:209