In the past 40 years, female sports participation, particularly at the high school level, has significantly increased. Physical activity in females has numerous positive benefits, including improved body image and overall health. Unfortunately, a select population of exercising females may experience symptoms related to the female athlete triad, which refers to the interrelatedness of energy availability, menstrual function, and bone mineral density. Clinically, these conditions can manifest as disordered eating behaviors, menstrual irregularity, and stress fractures. Triad symptoms are distributed along a spectrum between optimal health and disease; all of the components of the triad may not be affected simultaneously. The female athlete triad was first identified in 1992. Since that time, a vast amount of research related to the identification, management and prevention of this condition has been published. More recently, research related to the long term effects of triad components has come into light. Women who were diagnosed with female athlete triad syndrome as adolescents and young adults in the 1990s are now in their 30s and 40s; negative long term effects of the female athlete triad, such as low bone mineral density, are now starting to manifest. Women of all ages should be assessed for triad components during routine annual physical examinations; appropriate measures to treat any current triad components should be implemented. In addition, women in their 30s, 40s and early 50s should be screened for a history of the female athlete triad. Multidisciplinary management of these conditions is strongly recommended.
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