The Female Athlete Triad

John Furia, MD


Medscape General Medicine. 1999;1(1) 

In This Article


Once the diagnosis is established, an individualized, multidisciplinary approach to treatment is required. Usually this means referral to a primary care physician with some experience with disordered eating, a dietitian, and a mental health practitioner.

Approach the athlete with concern. Be direct and secure confidentiality.

Begin by reestablishing adequate food intake. Assess the weight loss. If more than 35% of body weight has been lost, hospitalization is recommended.[15] Impress upon the athlete that performance will suffer if normal eating habits are not re-established. The athlete must be educated about nutrition and the dangerous effects of inadequate food intake.

Seek out emotional difficulty and allow the athlete to express her feelings. Inquire about feelings of depression, self-doubt, and loss of self-esteem. Patients with the Triad often need to be shown that they are cared for by family, friends, and coaches.

Arrange for counseling services. Often, the very traits that make a woman an exceptional athlete (ie, competitiveness, motivation, and stubbornness) are the same traits that make her susceptible to the Triad.

Amenorrhea can be reversed by reducing exercise stress, gaining weight, or pharmacotherapy. Hormone therapy can benefit some athletes. Separate estrogen and progesterone pills or dermal patches are sometimes used to re-establish regular periods. In my experience with collegiate athletes, however, most women prefer combination oral contraceptive pills.