Women in sport: Part 1

The issues for the sporting female are often not front and centre, but incredibly important to every sports practitioner.

So I thought it was time we had an update on what the latest is, we thought it was a Triad, but it may be a Tetrad!

I guess the most commonly discussed issue for women in sport is the "female athlete triad'. The Triad is well recognized as an interrelated syndrome wherein several clinical sequelae (i.e., menstrual dysfunction, disordered eating, low EA), ranging in severity, may predominate and have a negative effect on bone mineral density, BMD.

This of course has serious consequences interms of the potential for bone related stress injury. However, the current thoughts on the development and consequences of this condition are changing quite rapidly.

female athlete triad.jpg

In a recent study, the authors examined the cumulative effect of Triad risk factors associated with low BMD in adolescent and adult exercising women. To my knowledge, this is the first investigation that has reported a “dose response” or cumulative effect of Triad risk factors on BMD. The researchers demonstrated that exercising women presenting with multiple Triad risk factors were at a higher risk for low BMD than exercising women with no or individual Triad risk factors. In addition, they reported associations between combined Triad risk factors, particularly those related to menstrual dysfunction and low BMI/body weight BW, and higher risk for low BMD. Furthermore, their findings suggest that as the number of Triad risk factors increase from one to four factors in exercising women, there is an increase in the percentage of participants with low BMD (z-score < -1 and z-score <= -2), ranging from 21% to 62% and from 3% to 18%, respectively. So, in this study, the exercising women with greater exposure to Triad risk factors were more likely to demonstrate low BMD. Findings from the current study also reinforce prior associations between Triad risk factors and low BMD such as late menarche, current oligo/amenorrhea, low BMI/BW, participation in lean sport/activity, for example distance running and elevated dietary restraint.

Simon Bartold
Director of Bartold Clinical