Sport is healthy and promotes physical fitness—but there are risks that are often overlooked. One example is Female Athlete Triad, a condition that primarily affects women who engage in intensive sports. Although many are unaware of it, this is a serious health issue.
What is Female Athlete Triad?
Female Athlete Triad refers to a hormonal imbalance caused by sustained intensive training. It leads to decreased levels of sex and bone hormones, which negatively impacts hormone metabolism. The combination of extreme physical exertion, a high metabolic rate, and a low-calorie diet reduces body fat. Consequently, cholesterol levels also drop, a key component for producing hormones such as sex hormones and vitamin D, essential for bone health.
Female Athlete Triad is characterized by three main components: eating disorders, menstrual irregularities, and osteoporosis. These can result in severe health issues.
What symptoms occur?
Women affected by this condition often report pain in the feet, lower legs, or hips. In some cases, this may lead to bone edema or, in the worst-case scenario, a stress fracture. This is particularly common among ballet dancers, who often maintain a low-calorie diet and a low BMI while subjecting their bones to intense stress through frequent jumps. Similar issues are observed in marathon runners and triathletes, especially when hormonal imbalances affect bone health.
Why does this condition occur even in health-conscious athletes?
Athletes with this condition often follow sophisticated nutrition plans, covering essential nutrients. However, insufficient vitamin D intake is often underestimated. Vitamin D can only be metabolized in conjunction with fat, and a low-fat diet may lead to deficiencies. When high athletic demands meet a reduced-calorie diet, Female Athlete Triad can affect not only professional but also recreational athletes.
How is Female Athlete Triad treated?
Treatment starts with a thorough analysis of the individual’s health status. For endurance athletes with a low BMI, hormone and vitamin D levels are assessed. If needed, supplements like high-dose vitamin D, calcium, and other orthomolecular substances are used to optimize bone metabolism, improve performance, and prevent injuries. Additionally, bone density is measured, and adjustments are made to nutrition and hormonal balance.
How long does the treatment take?
The duration of therapy depends on the patient’s baseline condition. Improvements are fastest when there is only a vitamin D deficiency without significant bone loss. However, if bone mass has already been lost, the treatment may take longer. Women achieve their highest bone density in their mid-twenties, and this density benefits them into old age. Therefore, it is crucial to address vitamin D deficiencies and hormonal imbalances early on.
“Female Athlete Triad is highly treatable,” says Prof. Dr. med. Philip Catalá-Lehnen, Medical Director of Lans Medicum Hamburg. “If women address their nutritional deficiencies and vitamin D shortages, there’s no reason to stop exercising.” Early diagnosis and targeted therapy can help prevent long-term health issues and maintain athletic performance.”
