Female Triad Flashcards
What are the 3 points of the triad
Low energy/disordered eating
Bone loss/osteoporosis
Menstrual disturbances/amenorrhea
Which female athletes are at risk of developing the triad?
Athletes participating in sports that emphasize low body weight or subjective judging of appearance
gymnasts, figure skaters, ballet, diving, dancing, wrestling, long distance running’s judo, talk won do
In addition to the pressure to maintain a low weight, why else do these sports increase risk for th triad
They are not team sports and are socially isolating, as a result of extreme focus on training
Why are the corners of the triad related to each other?
- PRESSURE to perform at optimal levels and a perceived requirement to maintain low body mass
- Results in lots of training and LOW food intake
- This plus psychological stress Leads to physiological disturbance in the endocrine control of the menstrual cycle
- This causes increased risk in developing amenorrhea
- This leads to decreased production of ovarian estrogen
- This leads to decreased bone mineral density/ risk of low BMD and osteoporosis
How does the triad get activated?
Athlete belief that low weight enhances performance + EMOTIONAL STRESSORS= begins to “diet”
What happens after the woman begins to “diet”?
Diet becomes increasingly restrictive and training becomes excessive —> caloric restriction —-> menstrual dysfunction and decreased bone mineral density
What are some ~emotional stressors~ that can trigger the initiation of the triad?
Death of a coach/family member
Growth spurt
Illness that prevents training
Moving to university
Pressure/difficult standards
What is the happy triad?
Optimal energy intake, optimal bone health, eumenorrhea
What’s the big deal with not eating enough
Body switches from reproduction/growth to SURVIVAL.
Reduced ATP for cell function, thermoregulation, growth and reproduction
Do most of the athletes in the triad have clinical mental disorders like anorexia or bulimia
NO!
What are the 2 mechanisms to explain the low energy availability?
- Exhibiting behaviors such as not taking in enough food to offset exercise, food restriction, laxatives, diuretics, enemas, binging and purging
- Clinical mental disorders- anorexia and bulimia
How does decreased energy intake lead to decreased estrogen production?
After 5 days of energy availability being reduced from 45 down to 30 kcal/kg FFM/day, the PULSATILITY of GnRH and LH/FSH release is disrupted
This leads to decreased E2 production, accelerating bone resorption and decreased bone mineral density
What is the NORMAL energy availability?
45 kcal/kg/FFM/day**
What happens to LH pulse profiles when EA drops to 30, 20, and 10?
30- amplitudes decrease
20 and 10- frequency low, amplitude way up
What is the threshold EA when things start to go wrong?
30 kcal/kg/FFM/day
