Physical Medicine and Rehabilitation Clinics of North America
The Female Athlete Triad and Cardiovascular Dysfunction
Section snippets
Disordered eating
Women, including female athletes, are under intense pressure to be thin and have a low percentage of body fat, not only for aesthetic purposes but also because of the misperception that a thin physique will increase athletic performance. Hence, eating disorders are much more common in female athletes compared with nonathletes. Disordered eating refers to a spectrum of abnormal eating patterns ranging from a mild preoccupation with calories and body image to frank anorexia nervosa and bulimia
Menstrual dysfunction in athletes
Menarche refers to the age menses begins, which on average occurs at 12.5 years of age for nonathletic Caucasian American girls. Athletic females experience menarche at a later age, with retrospective studies varying between 14 and 15.4 years [27]. Warren and Perlroth [27] followed up pubertal progression for 4 years in 15 ballet dancers. The average age of menarche in 13 of the ballet dancers was 15.4 years; however, 2 still had primary amenorrhea at age 18. Primary amenorrhea has recently
Osteoporosis
The U.S. Department of Agriculture recently reported that only 13.5% of girls and 36.3% of boys aged 12 to 19 years in the United States get the recommended daily amount of calcium, placing them at serious risk for osteoporosis and other bone diseases. Furthermore, peak bone mineral acquisition seems to occur earlier in girls (aged 11–14) than boys (aged 13–17). The National Institute of Child Health and Human Development has stated that the nation's youth are in the midst of a calcium crisis
The female athlete triad and cardiovascular disease
Cardiovascular disease is the number one cause of death in women in the United States. Cardiovascular disease risk increases significantly after menopause, with one in four women ultimately dying of a cardiac event [43]. The key pathophysiologic event of menopause is suppression of hypothalamic pituitary reproductive axis and ultimately ovarian failure and decreased circulating estrogens. Epidemiologic observations suggest that estrogen may have a significant cardioprotective influence. This
Summary
The female athlete triad position stand was published by the ACSM in 1997 [7]. It described in detail three distinct, yet interrelated, medical conditions. In the past 10 years, a tremendous effort has focused on prevention, education, and treatment of this condition. Understanding the pathophysiology of athletic amenorrhea raises the additional question of whether these athletes also at risk for premature vascular dysfunction. If current ongoing studies prove that they are, a better name for
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Cited by (22)
Sports Medicine and Adaptive Sports
2020, Braddom's Physical Medicine and RehabilitationSports Medicine and Adaptive Sports
2018, Braddom's Rehabilitation Care: A Clinical HandbookExpanding the Female Athlete Triad concept to address a public health issue
2012, Performance Enhancement and HealthCitation Excerpt :This is because the key differentiating factor between AN sufferers with or without amenorrhea is the nutritional status, not psychological differences (Attia & Roberto, 2009). Concerningly, the association of amenorrhea with the menopause and the FAT via similar hormone profiles, led to suggestions that endothelial dysfunction is also a common characteristic (Hoch, Lal, Jurva & Gutterman, 2007; Hoch et al., 2007a; Zach et al., 2011a). In addition, research shows endothelial dysfunction is associated with energy deficiency induced amenorrhea (Hoch et al., 2007a; Hoch et al., 2003; Rickenlund, Eriksson, Schenck-Gustafsson & Hirschberg, 2005a; Zach et al., 2011a); low serum oestrogen and reduced bone density (Hoch, Papanek, Szabo, Widlansky, Schimke, & Gutterman, 2011).
The Female Athlete
2010, Radiologic Clinics of North AmericaCitation Excerpt :A study of women taking oral contraceptives had a lower BMD than their noncontraceptive counterparts.143 Hormonal imbalance also carries a theoretical risk of increased cardiovascular disease.144 Osteoporosis is a decreased bone mass and density with an increased incidence or risk of fracture in the postmenopausal woman, as stated by a National Institutes of Health Consensus Group in 2000.
Sports and Performing Arts Medicine: 5. Special Populations
2009, PM and RCitation Excerpt :Bone mineral density decreases due to a lack of estrogen [14]. Low estrogen also reduces endothelium-dependent vasodilation, leading to premature cardiovascular disease [15]. Ninety five percent of stress fractures occur in the lower extremities [16].
Risk of sports-related sudden cardiac death in women
2022, European Heart Journal