Article Title



Samantha J. Goldenstein, Lenka H. Shriver, Laurie Wideman, FACSM. University of North Carolina-Greensboro, Greensboro, NC.

BACKGROUND: The Female Athlete Triad (low energy availability, low bone density, and menstrual disturbance) is a well-established phenomenon that can lead to severe health consequences not only among elite female athletes, but also among recreationally active females. Despite decades of research in this area, very few studies have assessed knowledge related to the Triad among physically active premenopausal females regardless of their athletic/competitive status. METHODS: 804 premenopausal females (26±7.8 yrs) completed an electronic survey to assess their knowledge of the Triad. Participants self-selected as collegiate/professional athletes (CP) (n=33), competitive amateur athletes (CA) (n=122), or recreationally active athletes (RA) (n=649). The inclusion criteria were based on performing a minimum of either 75 min of vigorous aerobic activity, 150 min of moderate aerobic activity, or two days of resistance training per week. RESULTS: Overall, 79% were not familiar with the Triad term, with RA (83%) and CP (73%) being the least familiar, followed by CA (60%). Only 11% could list all three Triad components and 5% answered two components correctly. CA demonstrated the most knowledge of the three components (23%) compared to CP (9%) and RA (9%). Amenorrhea was the most commonly recalled component (17%), followed by low energy availability (15%), then bone mineral density (14%). Less than 40% of participants recognized that cessation of menstruation with heavy training was abnormal, with the majority being unsure (34%) or unaware of this being a problem (27%). CA displayed the most knowledge about this issue (53%) with CP (39%) and RA (36%) displaying similar knowledge. After being presented with the three components of the Triad, 10% felt they were at risk for the Triad and 15% thought they might be at risk. The perception of being at risk was the highest among CP (36%) compared to RA (25%) and CA (18%). CONCLUSIONS: Although CA demonstrated higher knowledge about the Triad over collegiate/professional and recreationally active athletes, all three groups displayed low awareness and knowledge about the Triad. Our findings indicate that there is an urgent need for more targeted education to ensure physically active females understand the signs, symptoms, and risks of the Triad in order to prevent and/or minimize serious health risks in this population.

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