Female Athlete Triad

3 Ways to Prevent the Female Athlete Triad

The female athlete triad is the combination of low energy availability, menstrual dysfunction, and low bone density.

What is the Female Athlete Triad?

The female athlete triad is a syndrome that includes low energy availability, low bone density, and menstrual dysfunction. Energy availability is the delicate balance between calories in and calories out. When athletes do not eat enough calories to sustain the level of energy that they expend, they are in a state of low energy availability. Low energy, or a calorie deficit, is only sustainable for short periods of time. Prolonged states of low energy has a series of harmful effects including decreased bone density, irregular periods, and brain fog. It is important to note that “athlete” defines any physically active person, not just those competing at a high level. Keep reading for our tips on how to prevent the female athlete triad.

Why Does the Female Athlete Triad Occur?

Nutrition, Exercise, or Both

First we must begin with why the female athlete triad occurs in an athlete. The triad is often the result of the combination of undereating and over-exercising. Whether you are participating in recreational activity or competitive sport, your body requires nourishment to properly recover from the event. Under-eating may be intentional for athletes that are concerned about their body composition, or it can be unintentional. Regardless, it is important for athletes to be mindful of this balance to prevent the female athlete triad.

Who is the Most at Risk for the Female Athlete Triad?

Next, let’s discuss risk. Athletes participating in body conscious sports such as dance, figure skating, gymnastics, cheerleading, rowing, and distance running are most at risk for the female athlete triad. Athletes that restrict food groups or have multiple nutrient deficiencies are also at a higher risk. While athletes do not have to be diagnosed with an eating disorder to qualify for the triad, those that do may be at a higher risk.

Signs and Symptoms of the Female Athlete Triad

The female athlete triad has several short and long term consequences. The short term consequences include, but are not limited to, fatigue, frequent illness and/or injury, missing a period, irritability, impaired judgment, and brain fog. If not treated, these symptoms can spiral into long term consequences such as stomach distress, fertility issues, early osteoporosis, impaired growth and development, anxiety, and depression. Depending on the severity of symptoms, athletes may be suspended from competing in their sport, which can be devastating.

female athlete triad prevention
The female athlete triad presents itself with a variety of symptoms that have both short and long term consequences. A few of the consequences are listed above.

How to Prevent the Female Athlete Triad


Energy balance is important in preventing the female athlete triad. This means we have to consume nearly the same amount of calories that we are using each day to support our daily functioning. This can be difficult, especially for athletes that are unintentionally undereating. Luckily, we have some tips to help you reach energy balance, without counting calories. First, eat a balanced meal every three to four hours. Balanced meals incorporate the three key nutrients; carbohydrates, healthy fats, and protein.

Next, avoid restricting foods in your daily diet. If you are restricting due to allergies or personal preference, meet with a dietitian to ensure you are filling any nutrient gaps with safe alternatives. Lastly, fuel your activity with a pre-workout snack that is high in carbohydrates. One of our favorites is linked here. (Do you have any? I was thinking something as simple as rice cakes with sunflower butter, sliced banana, and drizzle of honey…. If you don’t have a recipe I can just write it out)


Exercise is an added stressor to our bodies. Although we typically view exercise as a good stress, it may not be in the context of the female athlete triad. Avoiding over-exercising can help prevent negative stressors from building in our bodies. Over-exercising can present in many different ways, all of which do not leave enough time for rest and recovery. If you are a recreational athlete, we recommend creating a training schedule that incorporates two to three days for low intensity training like yoga or walking. If you are a higher level athlete, it can be difficult to control your training plan. In this case, it is important to identify periods of time, or even days, that you have off from training. During this time, allow your body and mind to rest with some meditation, and make sure you are fueling with balanced meals.

Stress Management

Athletes at all levels experience stress from both internal and external sources. When over stimulated by stressors, our healthy habits tend to suffer first. Internal stress can be managed by practicing mindfulness through yoga, meditation, or journaling. Allowing these to be your outlet for stress may decrease your internal stress load, allowing your mind to focus on what is important. External stressors come in a variety of forms, such as diet, pressure from coaches, academic work, family life, social media, and more. When experiencing these stressors, it is important to disconnect from social media and to connect with your community in safe places. Take the time for yourself to unwind, talk to others, and prioritize your own mental and physical health.

female athlete triad prevention
The combination of a balanced diet, low intensity movement, and stress management can help prevent the female athlete triad from occurring

What should you do if you know someone who might have the female athlete triad?

It is advised to seek out help if you are suffering from one or more of these symptoms. I can help you! Please email me at info.valeriedlnutrition.com for a complimentaty consultation.

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