ABSTRACT:
Female athlete TRIAD (FAT) consist of Disorders Eating (DE), Menstrual Dysfunction (MD), and Reduced bone mineral density (BMD) This study investigated the awareness, prevalence and impact of the FAT, DE, MD and reduced BMD and Osteoporosis among 100 national-level female athletes in India aged 16-30. Using a survey-based, self-structured questionnaire, the study assessed awareness, occurrence, and performance impacts of the TRIAD. Results revealed a high prevalence of DE was 76%, MD was 71%, and low BMD was 17%, with knowledge gaps. While 76% of athletes were aware of DE, understanding varied, and 64% engaged in self-directed, often harmful weight management. MD was common, but only 12% took medical evaluation. BMD awareness was low 37%, and 30% reported training-related fractures. 12% confirmed the presence of all three TRIAD components. Awareness of the TRIAD was limited 40%, and 55% were unaware of sport-specific risks. The study highlighted the interconnectedness of these conditions, with DE contributing to MD and increased fracture risk. Furthermore 12% of athletes diagnosed with TRIAD dropped out of sports due to decreased performance and low energy. The findings underscore the need for targeted educational programs, nutritional guidance, and improved access to specialized medical support to the health and performance of female athletes and reduce dropouts.
Cite this article:
Upasana Vishwakarma, Reeta Venugopal. The Female Athlete TRIAD among Indian Athletes. Research Journal of Humanities and Social Sciences. 2025;16(4):256-0. doi: 10.52711/2321-5828.2025.00042
Cite(Electronic):
Upasana Vishwakarma, Reeta Venugopal. The Female Athlete TRIAD among Indian Athletes. Research Journal of Humanities and Social Sciences. 2025;16(4):256-0. doi: 10.52711/2321-5828.2025.00042 Available on: https://rjhssonline.com/AbstractView.aspx?PID=2025-16-4-2
REFERENCES:
1. Willett, W.C., Colditz, G.A. Protein consumption and bone fractures in women. American Journal of Epidemiology. 1996; 143(5): 472-479.
2. Thirza IJ, Hillen, Shannon L et al. Primary Dysmenorrhoea in young Western Australian Women: Prevalence, Impact and Knowledge. J Adolesc Health. 1999; 25: 40-45.
3. Borgen, J.S., Torstveit, M. The female athlete triad- the role of nutrition. Schweizerische zeitschrift fur sportmedizin und Sporttraumatologie. 2003; 51(1): 47-52.
4. Redman, L.M., Loucks, A. Menstrual disorders in athletes. Sport Medicine. 2005; 35(9): 747-755
5. American Academy of Pediatrics Committee on Sport Medicine and Fitness Promotion of healthy weight- control practices in young athletes. Pediatrics. 2005; 116: 1557- 1564.
6. Nattiv, A., Loucks, A.B., Manore, M.M., Sanborn, C.F., Borgen, J.S., Warren, M.P. The female athlete triad. American College of Sports Medicine. 2007: 1867-1881.doi: 10.1249/mss.0b013e318149f111.
7. McGehee, T., M., T., Green, J.M., Leeper, J.D., Dunn, D.L., Richardson, M., Bishop, P.A. Body image, anthropometric measures and eating disorder prevalence in auxiliary unit members. Journal of Athletic Training. 2009; 44 (4): 418-426.
8. Okusanya, B. Menstrual pain and associated factors amongst undergraduates of ambrose alli university ekpoma, edo state, Nigera: Nigerian Journal of Medicine. 2009; 18(4): 409-452.
9. Nissenbaum, J.M.T., Rauh, M.J., Carr, K.E., Loud, K.J., McGuine, T.A. Associations between disordered eating, menstrual dysfunction and musculoskeletal injury among high school athletes. Journal of Orthopaedic and Sports Physical Therapy. 2011; 41(2): 60-69.
10. Nissenbaum, J.M.T., Rauh, M.J., Carr, K.E., Loud, K.J., McGuine, T.A. Menstrual irregularity and musculoskeletal injury in female high school athletes. Journal of Athletic Training. 2012; 47(1): 74-82.
11. Wright, H.H. The female athlete triad in student track and field athletes: South African journal of clinical nutrition. 2013; 26(2): 69-74.
12. Pentyala, S., Mysore, P., Pentyala, S., Rahman, Urbanczyk, K., Tumillo, T., Khan, S. Osteoporosis in female athletes. International Journal of Clinical Therapeutics and Diagnosis. 2013; 1(1): 5-11.
13. Souza, M.J.D., Nattiv, A., Joy, E., Misra, M., Williams, N.I., Mallinson, J.R., Gibbs, J.C., Olmsted, M., Goolsby, M., Matheson, G. Female athlete triad coalition consensus statement on treatment and return to play of the female athlete triad. Br J Sports Med. 2014; 48: 289.
14. Lagowska K., Kapczuk K., Friebe Z., Bajerska J. Effects of dietary intervention in young female athletes with menstrual disorders: Journal of the International Society of Sports Nutrition. 2014; 11: 1,21, DOI: 10.1186/1550-2783-11-21.
15. Melin, A., Tornberg, A.B., Skouby, S., Sjodin, A. The leaf Questionnaire: A screening tool for the identification of female athletes at risk for the female triad: British Journal of Sports Medicine. 2014; 48: 540-545.
16. Coelno, G.M.d.O., Riberio, B.G., Soares, E.d.A. Prevention of eating disorders in female athletes: Open Access Journal of Sports Medicine. 2014; 5: 105-113.
17. Matzkin, E., Curry, E.J., Whitlock, K. Female athlete triad: past, present and future: Journal of the American of Orthopaedic Surgeons. 2015; 23: 424-432.
18. Safarzadeh et al. The relationship between exercise and premenstrual syndrome: International Journal of Medical Research and Health Sciences. 2016; 5(9): 183-189.
19. Ezechi, O.C. Female Athlete Triad. Amenorrhea Chapter 2016; 15.
20. Srivastava, P., Varoda, A., Venugopal, R. Menstrual cycle pattern among adolescent school girls in Chhattisgarh. The International Journal of Indian Psychology. 2016; 3(10): 91-98.
21. Tenforde, A.S., Barrack, M.T., Nattiv, A., Fredericson, M. Parallels with the female athlete triad in male athletes. Sports Medicine. 2016 Doi 10.1007/s40279-015-0411-y.
22. Stefani, L., Giorgio, G., Lorini, S., Beni, G., Dei, M., Maffuli, N. Female athletes and menstrual disorders: a pilot study. Muscle. Ligaments and Tendons Journal. 2016; 6(2): 183-187.
23. Sharma, P., Singh, N., Tempe, A., Sharma, S. Knowledge, practices and restrictions related to menstruation in young girls: a study from north India. International Journal of Community Medicine and Public Health. 2018; 5(8): 3340-3344.
24. Yoshino, O., Dohi, M., Kigawa, M., Hiraike, O. Risk factors of stress fractures due to the female athlete triad: Differences in teens and twenties. Scandinavian Journal of Medicine and Sciences in Sports. 2019:1-10.
25. Venugopal, R., Varoda, A., Srivastava, P. Comparative study of pre menstrual syndrome in sports women and non-sports women of different age group. International Journal of Scientific Research and Reviews. 2019; 8(2): 40-46.
26. Findlay, R.J., Macrae, E.H.R., Whyte, I. Y., Easton, C., Forrest, L.J. How the menstrual cycle and menstruation affect sporting performance: experience and perceptions of elite female rugby players. Br J Sports Med. 2020; 54: 1108-1113.
27. Bishop, M.E., Ahmen, A., Rosendorf, J., Erickson, B.J., Cohen, S. Bone stresss injuries in female athletes: Annals of joint. 2020: 1-10.doi: 10.21037/aoj.2020.04.04.
28. Willmer, M., Jacobson, J.W., Lindberg, M. An exploratory analysis of work engagement among women with and without disordered eating. BMC Women’s Health. 2021; 21: 1-6.
29. Edama, M., Inaba, H., Hoshino, F., Omori, G. The relationship between the female athlete triad and injury rates in collegiate female athletes. Peer J. 2021. doi 10.7717/peerj.11092.
30. Daniel, K., Fischer, A., Welty, M., Valasek, A.E. Improving the diagnosis of menstrual dysfunction through quality improvement. Pediatric Quality and Safety. 2022; 7(1); e505, 1-7.