Female Triad 🔺 Flashcards
As the diet becomes more restrictive, energy availability is too low, mechanisms reduce the amount of ATP for cell function, thermoregulation, growth, and reproduction. THIS LEADS TO:
survival mode to conserve energy
but impairs health😷
What T-score would indicated “low bone mass”
1-2.5 SD below the mean
What is the normal energy availability from dietary intake
45 kcal/kg FFM/day
decreased levels of ovarian estrogen from amenorrhea can lead to
decreased bone mineral density
osteoporosis
what affect does chronic increased cortisol have on bones
increased resorption
WEAK ASS BONES
What is the threshold of energy availability from dietary intake where things begin to go wrong?
30 kcal/kg FFM/day
Oligomenorrhea is a period of ____ days or more between cycles
35
Amenorrhea is the absence of menstrual cycle lasting more than
90 days
Menstrual dysfunction can predict for future:
low BMD
At what energy availability from dietary intake do amplitudes of LH decrease but frequency does not change
30 kcal/kg FFM/day
Reducing energy intake is associated with ____ LH amplitude but _____ pulse frequency
⬆️increased LH amplitude
⬇️reduced pulse frequency
Increased risk in developing amenorrhea can lead to increased production of
ovarian estrogen
Does menstruation occur in anovulation?
Yes but no ovulation
impaired follicular development
What Z-score is considered below the expected range for age
2 SD below the mean
What causes the physiological disturbance in the endocrine control of the menstrual cycle
high training volume + low energy intake
When energy availability decreases:
glucose (increase/decrease)
ketone body formation (increase/decrease)
⬇️glucose decreases
⬆️ketone body formation increases
What are the BEHAVIORS associated with low energy availability with or without an eating disorder
eating too little to offset exercise cost
food restriction, laxatives💩, diuretics, enemas, skipping meals
binge eating and purging🤮
low energy availability impairs bone health _______
INDIRECTLY
by inducing amenorrhea and removing estrogen’s effect on bone formation
The pathophysiological basis of the triad is a __________ issue, NOT ______
NUTRITIONAL 🥗🌽🥦🥕🥒🥬🥑
not mental health
When energy availability decreases:
Cortisol (increase/decrease)
insulin (increase/decrease)
⬆️cortisol increases
⬇️insulin decreases
How quickly is LH/FSH pulsatility decreased when energy availability falls from 45 kcal/kg FFM/day to 30 kcal/kg FFM/day
5 days
Athletes that are more at risk for the triad are
individual sport athletes or team sport athletes?
individual sport
socially isolated
What T-score would indicate osteoporosis
2.5 SD below the mean
When energy availability decreases:
Growth hormone (increase/decrease) IGF-1 (increase/decrease)
⬆️GH increases (not for growth reasons! metabolic!)
⬇️IGF-1 decreases
T-score is based on:
Z-score is based on:
T score = compared to a healthy 30-year-old of the same sex and ethnicity
Z score = age-matched same sex and ethnicity
At what energy availability from dietary intake do amplitudes increase and frequency decreases
What does this mean?
10-20 kcal/kg FFM/day
less estrogen production
Progression from Eumenorrhea to amenorrhea
luteal phase defect (LPD) ➡️
Anovulation ➡️
Oligomenorrhea ➡️
Amenorrhea ➡️
The pressure to perform at optimal levels and perceived requirement to maintain a low body mass leads to
high training volume + low energy intake
What is the initiation of the triad
emotional stressors 🤯
(death of a coach/family member, growth spurt, illness that prevents training, moving to a university setting, pressure, difficult standards)
Luteal Phase Defect (LPD) is a menstrual cucle with a luteal phase less than _____ days or with low _____
10 days
low progesterone
When energy availability decreases:
Thyroid hormone (increase/decrease) Leptin (increase/decrease)
⬇️Thyroid hormone decreases
⬇️Leptin decreases
female athletes most at risk for the triad are those that participates in sports with what two components
aesthetic (gymnastics🤸🏼♀️ figure skating ⛸ ballet 👯♂️ diving🏊🏼♀️ dancing💃🏼)
weight (tae kwon do🥋 judo🥊 wrestling 🤼♀️ long distance running🏃🏼♀️)
How does disrupted pulsatility of LH/FSH lead to a decrease in bone mineral density
decreased E2 production, accelerating bone resorption
