The Female Athlete Triad

Boy, what a day yesterday was….going back to work is no joke after having almost 2 weeks off (I’m a health coach for an insurance co). Yikes! Luckily I had good eats on handthank you stocked pantry/fridge!) But still, headache mania.
So I use the computer a lot (duh), thus, my head needs a major breather once evening hits–I try to be done with all my work (professional, personal, freelance) by about 6 p.m. so that I don’t need to stare at a screen in the evenings before bed.

And it helps me sleep better too, doing it this way (most research shows that the light from a screen-TV or computer-can mess with the sleep cycle and even the ability to fall asleep.)


On an even more personal note, I decided to tackle a very sensitive subject for many disordered eating persons, so if this is a trigger for you, be aware. We’re talking about the female athlete triad today…. (check out more posts on my disordered eating/exercise past)

I'm in the middle front with the creeper face --practically hidden (Dec, 05)

I first learned about this 3 interlocking component triangle in my first semester undergrad exercise sciences studies, and thought to myself, why would anyone want to do that to themselves?!

Oh the irony.

What IS the female athlete triad, you ask? Well, here it is:

The Female Athlete Triad

The triad is a syndrome of three interrelated conditions. These conditions may be less or more severe from case to case.

  • Energy deficit/disordered eating
  • Amenorrhea/menstrual changes or disturbances
  • Bone loss/Osteopenia/Osteoporosis

This condition is most often seen in athlete where leanness is preferred (gymnasts, ballerinas, cross country runners, figure skaters), but can affect any woman who restricts her eating and/or stresses the body in over exercising pursuits.

Unfortunately I was a victim of the female athlete triad beginning in late Summer/early Fall 2004. By early 2005 I had lost not only a lot of weight, but I had become so restricted in my eating I had lost hair, relationships, happiness(!!), bone mass, and my period.

I even had a DEXA scan completed in Fall 05′ and I had Osteopenia in my spine! (Osteopenia is the precursor to Osteoporosis; it is having a low bone mass density as based on a chart).  I was scared, unhappy, but so did not want to blame it on my restricted eating (hello dysfunctional thinking and denial!).

Irony, yet again. It was like I was fighting for something I really wanted (to be thin, gorgeous, etc.), but was scared along the way of what I was doing (hello, I was majoring in this stuff!)…..but did it anyway because I was stuck in a vicious cycle. (Note: NOW I know better.)

So I kept at my intense workouts, less-than- 1000 calories per-day eating schedule (wayyyy below what I eat now or what I should’ve eaten for my exercise amounts then), and continued on down that disordered road.

I knew I was ‘diagnosed’ with the female athlete triad, especially since my period was gone, gone, gone. Even though it was nice to not have to buy tampons for years, it’s a little scary when your ‘parts’ don’t all work the way they should!

{happy story: once I met my husband in Fall 2009 & after 2 months of dating, it came back for good-and regularly!}

Science shows that amenorrhea is usually caused by stress on the body : either because of too little nourishment, too much exercise, too little body fat, or even too much personal stress (I had all of the above–no wonder mine went bye-bye!), so if this is an issue for you (I have recovering readers), keep that in mind!

I will say it again, the above conditions that make up the female athlete triad are unhealthy, scary, and should be taken care of a.s.a.p. These conditions could be detrimental to the health and well-being of any one who suffers from this triad or even one of the conditions in the triad. If you need help, seek it! (or email me if you have further questions)

{Another happy story: after lifting weights for 1 year, in 2010 I had another DEXA-my bone density was in the normal range; my Osteopenia had disappeared! Though I still suffer from some lower back pain, the actual bone structure is strong again. Don’t let this detrimental condition happen to you! But if it has/does, PUMPing iron is one of the best ways to reverse the damage!}

Messing with the body’s normal cues (hunger, tiredness, menstrual periods, etc.) is NO joke. Trust me.

That is why it is vital to eat whole foods, avoid the crap that could mess with your hormones, exercise regularly, get enough sleep, develop and keep a positive body image, serve others, lift weights (!!!), and live life each day to its fullest. I can’t say it enough, listen to YOUR body and don’t compare to others! (A post is coming soon on that!)

whole, real foods --KEY!


On a similar note, I read the other day that less than 13% of women are lifting weights regularly (2 times per week). WHAT?!! I almost cried. I need to remedy this situation……look for more weights workouts in the future 😉

Have a LOVELY day!

When had YOU heard of the female athlete triad?? What ways do YOU take care of YOUR bones?? Ever had menstrual issues like me??

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  1. Thanks for addressing this!
    I have done a lot of damage to my body by over-exercising. I have never been “skinny” and at my lowest weight, was still well within the healthy range. I started actually gaining weight from too much exercise (2x a day of super intense cardio- sometimes logging 3 hours a day)- and also stopped getting my period. I have to take birth control now just to GET my monthly period, and have been battling my exercise addiction for quite a while- and have definitely slowed down to about 50% of the workouts that I used to do (I now do around an 80 min workout 4-5x a week and yoga on other days- and sometimes a full day off with nothing).
    What puts it into perspective for me is that I do want to get pregnant sometime in the near future, and I have to focus on being able to do that (which means getting a period!)
    How long did it take for you to start getting a normal period?

    • I am sorry to hear you’ve gone through a lot of this too!

      It took me just a month or two, actually! Crazy how the body knows when you’re no longer stressed 😉 I attribute all my amazing changes (inner and outer) to meeting and marrying my husband. He is amazing!

  2. caroline says:

    I take care of my bones by eating healthy and taking bodypump classes when I go to stl! =)

  3. i’ve never heard of the female athlete triad – very very interesting!! i’ve heard of those things happening, but never the “technical” name of it. to take care of my bones, i try to get the recommended amount of calcium each day and lift weights 3x/week. LOVE lifting! that statistic on women lifting is a huge bummer! sheesh. i’ve also dealt with menstrual issues over the years. my doc put me on birth control to help keep it regular for quite awhile, and i just recently decided to go off of it because i didn’t know if i necessarily agreed with it. that’s a whole ‘nother issue though! 😉 i’m hoping my period will continue to stay “normal”…

    • Yep-it is something that is rarely talked about, but “seen” easily from the public eye (but then again, not. There are thousands suffering from this! So sad).

      Yes, lifting rocks! And hope yours stays ‘normal’ too! 😉

  4. Great post! People don’t realize the damage they can do by exercising too much or eating too little.

  5. I heard of the female athlete triad a few years ago in college when I was taking my nutrition course! I try to take care of my bones by getting in enough calcium and doing weight bearing exercise :D. I used to have problems with my menstrual cycle…it stopped for a couple of months when I was going through my disordered eating period and then after that I had it twice a month…yuck!

  6. I never realized that lifting weights was so great for bone health! One more reason to love it!

  7. I was also diagnosed with the female athlete triad AND Osteopenia about two years ago.. it’s not something I’d wish on my worst enemy. But congrats on reversing your osteopenia! I haven’t gotten there yet but I hope to.

    • You will be there too :) Keep on moving towards it–you’re stronger than you think! And as you keep lifting the weights the fight for strong bones will be won!

    • Annie says:

      Hey Jessica! I was reading through this blog again as I was diagnosed with this 2 years ago. I won’t have a repeat DEXA until later this year but I am hoping its in the normal range. How are you doing with it? What kind of things are your doing to help? I do not see a specialist, just my primary care because we do not have them where I live (middle of nowhere!) haha Its so scary and stressful to have this condition and its nice to know other girls are going through it! Thanks Annette for this blog

  8. what an inspiring story! Thanks Annette!

  9. Yup I can relate! Thanks for sharing Annette :) I was never officially diagnosed with female athlete triad, but I think it became pretty clear when I was training intensely for ballet. I’ve never had a ‘normal’ period, it was only until they put me on BC when I was 18 that things started happening! Still trying to reverse the osteopenia, bones are still in the ‘too low’ range, but I’m working on it – great tip on the weight lifting! And disordered eating.. yep definitely had that one too! I hate to think of any long term damage that has been done, particularly with abnormal menstrual cycles and the effect on bones. It’s difficult when you’re so young, I had no idea what I was doing to myself! But you inspire me more every day girl, thanks ALWAYS 😉

  10. I am sorry to hear about the Osteopenia :( That’s tough–but it IS reversible, as I said above.

    It DEFINITELY takes time. Eating right (enough calcium, good protein, etc.) and lifting weights are CRUCIAL in the time process and in helping it move forward.

    Have a GREAT day, Annie!

  11. Sarah says:

    Hi I just found your blog. I have been researching the Triad and treatments just recently as I think I might have a stress fracture from running. (Can’t exercise at all right now) I haven’t had a period in three years or so. I never considered myself to have an eating disorder but I have been on the thin side. My doc wants me to take the pill to gain estrogen and get my period back. However after reading reviews I’m seriously freaked out about the side effects. Did you take hormones? I am gaining weight and eating more I’m just not sure if that’s enough to reverse any possible bone loss and get my period back on my own

    • I never did take hormonal birth control because of what I did to my body. I opted for the IUD (paraguard) instead & loved it!

      As for getting the period back, I tried to do it without hormones–mostly by taking care of myself, reducing stress, got help to stop worrying about food all the time, lifting weights (super key!!) and found peace with my mind & body. That isn’t the answer for everyone, but it was for me since gaining weight did nothing to bring my period back.

      Best to ya!

  12. How did u get it back by gaining fat or what? How much cal eating now

    • I gained it back by eating more calories, more healthy fats, and lifting weights! Also, reducing stress was a HUGE part for me.

      I have no idea how many calories I eat–but it is more than I had been!

  13. Crystal says:

    Did you have GI issues? After nearly 2 years of low cal diet and over hour long runs combined with lifting and HIIT workouts they diagnosed me with fem athlete triad due to horrible constipation (totally opposite of my usual!) and distention way beyond just plain bloating. Don’t know about osteoporosis or loss of menses d/t type of birth control that I’m on. I’ve adjusted my diet with a nutritionist about 3 months ago and am seeing slight improvement, but not much, with constipation. Anyone else have this particular problem and if so how long did it take to resolve??? Help, I’m desperate!

    • I never did have GI issues, I’m sorry I can’t help in that area! I do know that sometimes birth control type stuff can mess with that, so maybe continue tweaking your diet or trying other forms of bc?

      best of luck & happy new year!
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