The female triad. Eating disorders, amenorrhea, and osteoporosis.

There are certainly challenges facing all of those involved in athletics in the years to come. Eating disorders and amenorrhea and their increased long-term risks of developing osteoporosis are concerns that face female athletes and are are areas where further research is needed. At this point in time, so little is known compared with what remains unknown, and for the most part, the situation remains somewhat dismal. It is unclear what the mechanisms are that explain the amenorrhea that occurs with intense exercise. It is also unclear what role estrogen therapy has in these individuals and whether it is reasonable to allow these athletes to continue to participate by using only estrogen therapy as a means to prevent further bone loss. It will certainly be necessary to devote further research into these issues so clear-cut guidelines can be established. What we do know is somewhat alarming, yet if recognition of these problems is made, early intervention and monitoring are possible, and it is hoped, irreversible bone loss can be prevented. Athletes, coaches, and parents need further education so these disorders can be identified quickly, and further therapy can be instituted if indicated.