In the athletic world, as in other parts of general society, there are certain sports (e.g., cheerleading, figure skating, and rowing) where a slim build is not only desirable but beneficial to an athlete’s performance or placement in a certain sporting category. Unfortunately, the attainment of a slim build often results in a trio of signs and symptoms known as the female athlete triad, comprised of disordered eating, menstrual dysfunction, and osteoporosis.

Disordered eating can take many forms, ranging from restricting food intake (e.g., anorexia) to binging or purging (e.g., bulimia) to taking medications to promote weight loss (e.g., laxatives, diuretics). Athletes will also partake in excessive exercising or wear rubber suits while exercising to increase their weight loss. All of these disordered eating practices can help contribute to the two remaining parts of the triad.

In general, menstrual dysfunction more commonly exists among female athletes, as opposed to nonathletic females. This menstrual dysfunction can take various forms, including amenorrhea, both primary and secondary; oligomenorrhea; and luteal phase deficiency. Primary amenorrhea is diagnosed when a female has had no menses by the age of 16 or has had no menses within 4.5 years of breast development. After having begun to menstruate, a female that has 3 to 6 consecutive months without a menses is said to have secondary amenorrhea. Oligomenorrhea denotes a cycle that exists >35 days in duration. Luteinizing hormone (LH) pulsatility is dependent on a female’s energy reserve. If a female has increased expenditure with decreased energy intake, the energy deficiency causes abnormal LH pulsatility suppression and, menstrual irregularity.