Symptom: Disordered Eating
One of the primary symptoms associated with the female athlete triad is disordered eating, which can occur either intentionally or unintentionally. Many females who experience this triad develop an eating disorder due to body dysmorphia related to their involvement in sports. As a result, they adopt various methods to expend more energy than they consume in an attempt to shed weight. Some of these methods include dieting and restricting food intake, purging, engaging in excessive training and exercise, or a combination of all three. While gymnasts are known to have a higher prevalence of eating disorders, athletes participating in other sports may also experience pressure to lose weight or intensify their training regimen. Consequently, they too are at risk of developing the female athlete triad, even if they do not have existing body image issues.
Symptom: Absence of Menstrual Periods
The second symptom associated with the triad is the absence of menstrual periods. In some cases, athletes who adopt unhealthy eating habits and engage in excessive training from a young age may never experience menstruation at all. In the past, it was mistakenly believed that this was a common occurrence among all female athletes. However, the American College of Sports Medicine (ACSM) has recently emphasized that regular menstruation should be experienced by all female athletes, regardless of their level of physical activity. This shift in perspective is a result of the recognition that the lack of menstrual periods is actually an indication of inadequate nutrition and an energy imbalance wherein energy expenditure surpasses energy intake, rather than solely being attributed to intense levels of physical activity.