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The Female Athlete Triad

This week is National Body Image and Eating Disorders Awareness Week so today’s post focuses on a critical but little known trilogy of problems known as the “Female Athlete Triad”.

In a recent study of ‘exercising women’ in Australia, only 10% of participants could identify the 3 elements of the Female Athlete Triad.

Have you heard of it?  …Most dancers haven’t. Yet, with our very active dance schedules, perfectionist tendencies and desire to fit into the industry’s slender mould, dancers are all at risk of this serious combination of problems, and need to be aware of it.

OK, enough suspense: What is the Female Athlete Triad? The Female Athlete Triad involves 3 inter-related issues:

1) Low Energy Availability  / Disordered Eating

Bodies that are energy deficient due to a heavy physical workload without enough food intake to cover the body’s energy needs. While this can occur without changing food intake, e.g. when first starting full-time training, disordered or restrictive eating is almost always the cause.

There is often a strong fear of putting on weight and an unrealistic perception of being “fat”. Disordered eating leads to unhealthy weight loss, decreased muscular strength and endurance, and can also affect heart & brain function.

2) Irregular Period  / Amenorrhea

Disturbances to the menstrual cycle from irregular cycles to complete loss of monthly periods (known as Amenorrhea). Basically, the body is not getting enough nutrition to support menstruation, so the menstrual system shuts down. For some girls who train intensively from a young age, periods may never even start.

Consequences can include difficulty or inability to conceive when the time comes to start a family. If you have stopped getting your period for 3 months or more, or you are 16 yrs old or over and have not yet started to menstruate, please see your doctor.

3) Low Bone Density  / Osteoporosis

Low bone density and inadequate bone formation. Oestrogen, the hormone that regulates menstruation, also prevents bone decay. Without adequate diet or regular periods the bones weaken, resulting in an increased risk of stress fractures (2-4x more likely) and the debilitating effects of early onset osteoporosis.

Unfortunately, there are many ballet dancers and students who do not get regular periods (up to 44%!). Many think it’s great – no periods, no pain, no PMS – without realizing that this is the body’s way of signaling that something is going wrong: your body has gone into famine-mode.

This doesn’t happen just because you are training hard, it happens because your body is not getting enough fuel (food) to maintain its normal functions and your bones pay the price.

The teenage years are when bones are doing the bulk of their strengthening, with peak bone mass achieved in the 20’s. When bones are weakened during this time, the results may be irreversible. So this is an issue to be dealt with sooner rather than later, if you believe you are at risk.

So what can dancers do?

I always like to be practical, so here’s a few ideas:

1)   Get rid of your weighing scales: forget your dieting for awhile and focus on your strengths and artistry instead.

2)   Get enough food: Eat well, get enough Calcium, Vitamin D and Protein to protect your bones. You need to eat enough to match your body’s energy requirements. Nutrition is the best way to resolve the Female Athlete Triad – see a sports dietitian for support and advice.

3)   Get the joy back: often when the focus is solely on your appearance through controlling your eating habits, you get pretty miserable and isolated. Do what you can to enjoy dancing, even trying a different type of dancing can remind you that it’s supposed to be fun!

4)   Get social: hang out with friends and family and let yourself have fun, its about finding a balance again.

5)   Get help: See your doctor, counsellor or dietitian if you have signs of any of the 3 elements of Female Athlete Triad.



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