Female Athlete Triad has a higher incidence rate in sports where a lean physique is desired for performance or more aesthetically pleasing. Leads to a caloric deficit from women training more and consuming less.
Hypothalamus releases a surge of gonadotropin-releasing hormone (GnRH) every hour. Timing and control of this hourly rush of GnRH will be the major factor in maintaining a normal menstrual cycle. Around puberty, the pituitary gland secrets more follicle stimulating hormone (FSH) and luteinizing hormone (LH) which will start the monthly menarche in young girls. Any abnormality within these processes will have an effect the monthly menstrual cycle. Martin
Although there is no critical level of body fat required for maintenance of menstruation, the level of body fat stores cannot be ignored. Adipose cells produce and release a hormone called leptin. Leptin plays a role in many of the bodys processes including regulating metabolism as well as reproduction.
Leptin sends a signal to the brain telling it to release GnRH and activate the hypothalamic- pituitary-gonadal axis. When energy deficit is low so are leptin stores. The body will sacrifice non-essential functions (reproduction) in order to conserve essential functions (metabolism).
Amenorrheic athletes have reduced levels of: Estradiol Progesterone Leptin The positive effects of exercise can not compensate for the negative effects of these deficiencies. Low bone mass in athletes primarily from Low energy intake Low bone building nutrients
Increase caloric intake Gradual increase energy intake to accommodate total energy expenditure and to improve weight gain. Educate the athlete on using food as fuel for the body For menstruation and bone health Decrease energy expenditure This can be decreasing the duration or frequency of exercise sessions, or both.