What Is the Female Athlete Triad?

The female athlete triad (TRIAD) is a condition that affects female athletes. It includes the following 3 characteristics:

  • Low energy availability caused by not balancing calories burned during exercise with calories consumed
  • Amenorrhea (loss of menstrual periods or delay of first menstrual period) caused by low energy availability
  • Low bone density or osteoporosis (a decrease in bone density that causes weak, brittle bones that break easily)

How Does the Female Athlete Triad (TRIAD) Affect Bone Health?

TRIAD can cause low bone density for age and osteoporosis. Osteoporosis in children and teenagers is defined as low bone density associated with a significant fracture history, especially if the injury that caused the break is a low-impact injury.

When calories consumed during exercise are not balanced by a sufficient intake of calories, estrogen production may decrease. Estrogen is very important for optimal bone health, particularly in a growing teenager. Other hormones that affect bone are also adversely impacted by low energy availability. Further, TRIAD raises your child’s risk of breaking other bones in the future, which can affect their athletic performance.

Rev. 12/2018. MassGeneral Hospital for Children and Massachusetts General Hospital do not endorse any of the brands listed on this webpage. This webpage is intended to provide health information so that you can be better informed. It is not a substitute for medical advice and should not be used to treatment of any medical conditions.