Identifying Teens at Risk for Female Athletic Triad.

VAIL, COLO. -- The adolescent well-health exam provides what may well be a once-in-a-lifetime opportunity to identify patients at risk for the female athletic triad before permanent damage occurs, Dr. Stephen M. Scott said at a conference on obstetrics and gynecology sponsored by the University of Colorado.

"We may have a very narrow window of opportunity to prevent these girls from developing osteoporosis, the effects of which will linger for the rest of their lives," said Dr. Scott of the university in Denver.

The female athletic triad--menstrual dysfunction, disordered eating, and osteoporosis--results from intensive sports training coupled with reduced caloric intake. The emphasis needs to be on prevention, early, detection, and education about this condition, he said, because the results of treatment have been "somewhat discouraging--mixed at best."

Even if a physician can successfully convince the young athlete to cut back on her training and increase caloric intake, her bone mineral density often climbs only part way back to normal.

The same is true in response to exogenous hormone therapy.

"You're dealing at this point with a girl who: may never reach her peak bone mass, even with reversal of her training regimen," Dr. Scott said.

These athletes are young, strong, perfectionistic, and driven. They commonly have several misconceptions about their health and training that are worth focusing on. Many of them have become convinced by peers or coaches that if they're experiencing normal menses, they're not training hard enough to achieve peak performance. They also tend to view osteoporosis as an old woman's disease, figuring their own athletic career will be over long before they are at risk.