The Female Athlete Triad — American Academy of Pediatrics clinical report: the triad (menstrual function, bone health and energy availability, each ranging from optimal health to disease) arises when energy intake falls short of covering the energy spent in exercise, can appear as one component or any mix of them, and can weigh more on adolescents than adults since adolescence is the key window for building bone mass
A clinical report from the American Academy of Pediatrics on the female athlete triad in girls and adolescents. It points out that more girls now play sport and enjoy its social, educational and health benefits, yet sport brings risks, the triad among them, and it summarises current knowledge on the triad conditions' epidemiology, diagnosis and treatment. Abstract only was read; the publisher record states the report has since been reaffirmed.
Key Findings
The triad was originally recognised as the interrelationship of amenorrhea, osteoporosis and disordered eating; understanding has evolved to recognise that each component exists on a spectrum from optimal health to disease.
The triad develops when energy intake falls short of the energy spent in exercise, which harms reproductive, bone and cardiovascular health.
An athlete may show just one component, or several in any combination.
Adolescent athletes' health can be hit harder by the triad than adults', since adolescence is a critical window for accruing bone mass.
The report covers epidemiology, diagnosis and treatment; the abstract gives none of the figures, criteria or treatments.
Practical Application
"My teenage daughter's periods have stopped since she started racing — is that just training?" The American Academy of Pediatrics clinical report on the triad (Weiss Kelly 2016, A) says the triad occurs when food intake does not cover the energy cost of training, harms reproductive, bone and cardiovascular health, can show up as just one sign, and can matter more in a teenager than in an adult because adolescence is when bone mass is built. It is a reason to involve a parent and a clinician, never a training decision the assistant makes.
One sign is enough to take seriously: the report says an athlete can present with a single component, so missed or stopped periods alone, or disordered eating alone, is not reassurance that the others are fine.
The assistant does not diagnose the triad and does not suggest any treatment; the report's diagnosis and treatment content is not in the abstract and is not carried here.
Not from this paper; the base's own practice: for a teenage rider, missed periods, weight loss or a weight target go to a parent and a clinician, and the plan is never built around losing weight (SYNTH-81); the current all-sex framework with its health and performance consequences is the IOC REDs consensus (REF-341); the energy-availability threshold experiment behind the energy mechanism is REF-342.
Limitations
Clinical report written as a narrative summary; the abstract describes no systematic search or formal consensus method.
The abstract contains no prevalence data, screening criteria, diagnostic thresholds or treatment steps, so none are carried here.
Female athletes only; the male side of low energy availability is outside its scope (see REF-341).
The "triad" framing has since been broadened by the REDs concept (REF-341); this entry is kept for the adolescent bone point and the paediatric authority, not as the current framework.
Abstract only was read; nothing from the full text is used.
How this entry was checked and changed
Why this level
major governing-body clinical guidance (rubric: consensus / position statement = A, as for the ACOG committee opinion in this base); the abstract gives no data, so the entry carries the framing only