The Female Athlete Triad

John Furia, MD


Medscape General Medicine. 1999;1(1) 

In This Article

General Overview

The specific biochemical and hormonal pathways that become disrupted are quite complex, not fully understood, and beyond the scope of this article. An abbreviated description of the pathophysiology follows.

Usually the Triad begins with disordered eating. Poor nutrition combined with intense training results in an "energy deficit." In time, the energy deficit can cause the body to shut down the production of estrogen from the ovary[9,13,14,15,16] and the ovarian shutdown triggers amenorrhea.[9,13,15,16,17] Finally, the lack of estrogen combined with the lack of calcium and vitamin D from dietary deficiencies results in loss of bone density.[9,13,15,16,17] Osteoporosis with increased fracture risk can ensue.

My young patient sat with us during half-time.
"Yes, I know the thin girl. She's a dancer, very intense, and a straight-A student."