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Wellness > Health

The Female Athlete Triad: A Systemic Health Crisis in Women’s Pro-Sports

This article is written by a student writer from the Her Campus at SJSU chapter.

*TW* Eating Disorders

Being a professional athlete can be physically and mentally exhausting. Pro-athletes are expected to be at the top of their game. They are required to spend a significant amount of time training and conditioning in order to strengthen their bodies and build endurance. Of course, years of training and physical conditioning can lead to greatness in the pro-sports industry but at what cost?

Female athletes face systemic health issues and sexism within the pro-sports industry due to rigorous training and the pressure to maintain a certain body image. Exhaustive training combined with economic anxieties and career stress can put female athletes at risk of developing unhealthy eating habits, menstrual dysfunction, and poor bone health.

The Female Athlete Triad

“The female athlete triad (the triad) is an interrelationship of menstrual dysfunction, low energy availability (with or without an eating disorder), and decreased bone mineral density; it is relatively common among young women participating in sports”, according to a 2012 study by the National Center for Biotechnology Information health journal.

The triad commonly affects young female athletes but it can later cause long-term effects that follow them into adulthood and their professional careers. It is caused by an “imbalance of energy intake and energy expenditure”, says Neville H. Golden in a 2002 study by the International Journal of Adolescent Medicine and Health. At a young age, athletes are more susceptible to advice from their trainers and mentors, which can negatively affect their health. 

Disordered Eating 

Eating disorders are very serious mental and physical illnesses that involve unhealthy relationships with diet. Risk factors include “biological, psychological, and sociocultural issues”, according to  the National Eating Disorders Association. According to the DSM-5, there are about eight types of eating disorders. Common eating disorders include Anorexia Nervosa, Bulimia Nervosa, Pica, and Binge Eating Disorder (BED). 

U.S. Gymnastics Olympians Laurie Hernandez, 21, and Shawn Johnson, 29, spoke out about their battles with their eating disorders. In an Oct. 2021 US Weekly article, the athletes shared stories recounting their experiences with unhealthy eating and how it negatively affected their nutritional health and self-confidence.  

Amenorrhea and Low Bone Density

Amenorrhea is the absence of menstruation or when you don’t get your monthly period. It results from a complex set of hormonal problems that occur in women, especially active women. Energy intake and expenditure play prominent roles in the triad, thus the type of amenorrhea athletes experience would be characterized as functional hypothalamic amenorrhea (FHA). “This type of amenorrhea, commonly associated with exercising and stress, is most relevant to the female athlete.”, according to Taraneh Gharib Nazem and Kathryn E. Ackerman in a 2012 study by Sports Health.

In 2019, Nike was hit with a doping scandal with elite running coach Alberto Salazar at its center. The USADA banned Salazar from track and field for four years because of doping or illegally administering drugs to athletes part of the former Nike Oregon Project. 

The Nike Oregon Project was a group established by Nike to cultivate progress and competition in track and field. They were shut down due to their toxic culture and improper training methods. 

Mary Cain, a former Nike Oregon Project athlete, spoke out about the abuse she suffered at the hands of Salazar and other male coaches.  “And if you’re not getting your period, you are not able to have the necessary levels of estrogen to maintain strong bone health. And in my case, I broke five different bones.”, says Cain in The New York Times. Athletes suffered from amenorrhea for three years and extreme weight loss due to Salazar unnecessarily giving her birth control pills and diuretics or “water pills, help rid your body of salt (sodium) and water”, according to Mayo Clinic’s 2021 Health Information page

There is a serious systemic health crisis in women’s sports. Young female athletes need physical and emotional support in order to excel in their careers and live healthy lives. To eradicate this oppressive and abusive system, reform is needed. 

The athletic industry needs to appoint health professionals and new company officials that prioritize the wellbeing of their athletes. More women should be put in power in these pro-sports organizations. The pro-sports industry created a system designed for men by men. To be better, we need to protect young female athletes and listen to their stories.

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Wila Mae was a Style Intern at Her Campus for the Spring 2023 semester. She's a passionate storyteller and loves creating short-form video content highlighting secondhand shopping and Bay Area small businesses on her socials. Keep up with Wila Mae and her work @wilamae.navarro on Instagram and @wilamae2 on TikTok.