Female Athlete Triad: Past, Present, and Future

J Am Acad Orthop Surg. 2015 Jul;23(7):424-32. doi: 10.5435/JAAOS-D-14-00168.


After the passage of Title IX in 1972, female sports participation skyrocketed. In 1992, the female athlete triad was first defined; diagnosis required the presence of an eating disorder, amenorrhea, and osteoporosis. However, many athletes remained undiagnosed because they did not meet all three of these criteria. In 2007, the definition was modified to a spectrum disorder involving low energy availability (with or without disordered eating), menstrual dysfunction, and low bone mineral density. With the new definition, all three components need not be present for a diagnosis of female athlete triad. Studies using the 1992 definition of the disorder demonstrated a prevalence of 1% to 4% in athletes. However, in certain sports, many female athletes may meet at least one of these criteria. The actual prevalence of athletes who fall under the "umbrella" diagnosis of the female athlete triad remains unknown.

Keywords: eating disorder; female athlete; female athlete triad; low bone mineral density.

Publication types

  • Review

MeSH terms

  • Amenorrhea / etiology
  • Bone Density
  • Evidence-Based Medicine
  • Feeding and Eating Disorders / etiology
  • Female
  • Female Athlete Triad Syndrome / complications
  • Female Athlete Triad Syndrome / diagnosis*
  • Female Athlete Triad Syndrome / epidemiology*
  • Global Health
  • Guidelines as Topic
  • Humans
  • Osteoporosis / etiology
  • Prevalence
  • Sports*