The Female Teen Athlete Triad Syndrome – Part One

Athletes, regardless of gender, face significant challenges to their physical and mental health. However, with excessive exercise, females are vulnerable to the Triad Syndrome, or simply the Triad. This article is the first of two and will provide an overview the syndrome including symptoms. The second article will go into more detail about what causes those symptoms and some doctors believe that the syndrome is a myth.

Triad Syndrome

There are three specific challenges that are common to female athletes. These health challenges are: disordered eating or an eating disorder, amenorrhea (the absence of a menstrual period), and decreased bone mineral density (fragile bones that are more likely to fracture). The psycho-physiological disorder is known as a triad because if a female experiences one of these challenges, she is likely to experience the other two.

Health Conditions 

These three health conditions connect to athletic training. But more commonly seen in women who participate in gymnastics, ballet, figure skating, and long distance running. The Triad Syndrome is frequently seen among teen athletes who participate in sports that emphasize low body weight and thinness. Risk factors include sports that pressure female athletes to perform at certain standards and who require periodic weight check-ins.

This condition is very serious because it has fatal consequences, particularly if disordered eating worsens. The neglect of balancing the needs of the body and the demands of the sports they are involved in can lead to female athletes experiencing significant consequences. The dangers from a mental health perspective include the presence of an eating disorder, such as Anorexia or Bulimia, as well as Body Dysmorphic Disorder, not to mention depression and anxiety. Furthermore, female teen athletes with a propensity for the Triad might also suffer from low self-esteem, perfectionism, and high levels of stress.

Triad Syndrome symptoms to look for include:

  • Constantly feeling fatigued or lethargic
  • Difficulty sleeping or insomnia
  • Irregular periods
  • Frequent restriction of food intake
  • Weight loss
  • Frequent injuries, such as strains in muscle and fractures
  • Sensitivity to cold
  • Preoccupation with food and weight

Because this syndrome can be fatal, identifying any of these symptoms should provoke seeking treatment. The athletic career of many female adolescents is a significant part of their lives. For this reason, the factors that contribute to optimal performance in that sport might lead to physical, emotional, and mental health challenges.


To prevent these challenges, it is best to have a treatment plan with a multidisciplinary approach. In other words, treatment for the Triad Syndrome should include nutritional counseling, medical care, medical management by a doctor, mental health treatment such as individual therapy, and participation in a support group. These interventions can facilitate the return of normal menstruation, prevent fatality from an eating disorder, address the underlying thoughts and emotions that contribute to the disordered eating, and promote a healthier relationship with the body. Coaches, parents, and mentors can also provide monitoring of their female teen athletes for any of these symptoms in order to prevent the syndrome go untreated.



Ekern, J. & Karges, C. (2013). Female Athlete Triad Syndrome Can Be A Dangerous Health Issue. Eating Disorder Hope. Retrieved on March 31, 2014 from:

Female Athlete Triad Syndrome. Wikipedia. Retrieved on March 31, 2014 from: