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. Diagnosis and treatment of this potentially serious condition is complicated and often requires an interdisciplinary team.Articles from 1981 to present found on PubMed were selected for review of major components of the female athlete triad as well as strategies for diagnosis and treatment of the conditions.The main goal in treatment of young female athletes with the triad is a natural return of menses as well as enhancement of bone mineral density. While no specific drug intervention has been shown to consistently improve bone mineral density in this patient population, maximizing energy availability and optimizing vitamin D and calcium intake are recommended.Treatment requires a multidisciplinary approach involving health care professionals as well as coaches and family members. Prevention of this condition is important to minimize complications of the female athlete triad.

In the early 1900s females were excluded from sport, specifically the Olympic games, because it was thought that sport might be too stressful for the female body, particularly the reproductive organs. Fortunately, the landscape of female athletics has changed dramatically in the past three decades. The change in female athletics is largely due to the induction of Title IX in the United States of America in 1972. Since the passage of Title IX female athletic participation has drastically increased worldwide. The passage of Title IX mandated equal access for sport participation in schools for males and females alike.Since the induction of Title IX in 1972 there has been a one thousand percent increase in the number of female athletes participating in sport. Female athletics have shown to increase self-esteem and self-confidence and reduce risky behaviours such as drug abuse and teen pregnancy in females. However, females face a unique set of psychological pressures in sport. Western society has placed a strong emphasis on ultra-thinness as the ideal body shape and size for females. This cultural ideal places females at an increased risk of developing disordered eating patterns in an effort to conform to the ultra-thin ideal of Western society.The female athlete is not immune to societal pressures of ultra-thinness. A desire to improve performance, a win at all cost mentality, combined with an overly controlling parent or coach, may increase the athlete’s risk for developing disordered eating patterns, ultimately leading to the female athlete triad.In 1992, the American College of Sports Medicine (ACSM) task force on women’s issues provided the first definition of the female athlete triad.Initially, the female athlete triad was recognized as three separate but interrelated entities; eating/low energy availability, menstrual disturbance/amenorrhea, and bone loss/osteoporosis.The ACSM position stand states that females that are at risk for developing the female athlete triad are those that are required to have frequent weigh-ins, consequences for weight gain in sport, pressure to win at all costs, and societal pressures to look a particular way. The female athlete triad most commonly presents in sports that have subjective scoring of the female’s performance, endurance sports, sports that emphasize low body weight, sports that have multiple weight categories and prepubertal athletic participation, and finally, sports that require the athlete to wear revealing or tight clothing.