The Female Athlete Triad: Prevention and Implications for Coaching

In our first and second series of The Female Athlete Triad, we discussed the etiology of the triad spectrum and screening and treatment strategies.

In our first article of the female athlete triad series we discussed the etiology of the triad spectrum and in the second segment screening and treatment strategies. In this third part of this series we will discuss prevention and implications for coaching athletes with this condition.


The first step in prevention the female athlete triad is educating athletes, coaches, trainers, and parents. Athletes should be educated about basic nutrition concepts, burn out and over training, rest and recovery, healthy weight management, energy levels, and bone health. Female athletes, regardless of sport, should have a solid understanding of the importance of a healthy menstrual cycle.

It is also recommended that females keep a record of their monthly period, and consult a physician if they have menstrual dysfunction. Athletes should be encourages to seek counseling and consultation from a nutritionist to formulate an appropriate nutrition plan that is specific to their sport and energy needs. Open communication between athletes and their coaches, trainers, parents and medical professionals should be always available if they sense a problem or need to ask a question.

Implications for Coaching

Coaches should advise athletes on basic nutrition concepts, emphasizing that nutrition is an essential element of sports training and performance. Coaches should focus on cultivating a positive body image and a holistic perspective on training, nutrition, rest, and recovery. The NCAA, recommends de-emphasizing weight loss as a factor in performance, and frequent weigh-ins or punitive consequences for weight gain are not recommended. Coaches, trainers, and teammates should avoid pressuring athletes to diet and lose weight quickly. Coaches should have referrals for athletes in need of additional care including; nutritionists, counselors, and medical personnel.

Athletes should be encouraged to seek consultation and treatment immediately, when any symptomology might be present to prevent further complications. The best time to educate and screen for triad related symptoms is during sports participation physicals and yearly wellness check ups. Parents, coaches, medicine professionals, and athletes should be aware that even moderate dieting or poor nutrition combined with any menstrual cycle changes can be early indicators of the spectrum of the triad.

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