title: Energy availability, menstrual dysfunction and bone health in sports; an overview of the female athlete triad.
abstract: BACKGROUND
  The female athlete triad (FAT) is a serious health-related problem that threatens women who exercise. This condition is an interrelated multifactorial syndrome which includes low energy availability, menstrual cycle disturbances and decreased bone mineral density.
  
  
  OBJECTIVE
  To review the major components of the FAT and their relationships, as well as strategies for diagnosis and treatment.
  
  
  METHODS
  Articles related to the topic were reviewed through PubMed and SportDiscus databases.
  
  
  RESULTS
  Interrelationship between components of the FAT may result in clinical manifestations, including eating disorders, amenorrhea and osteoporosis. Clinical conditions are not always exhibited simultaneously. Prevention is important to minimize complications. Diagnosis and treatment is complicated and often must involve an interdisciplinary therapeutic approach.
  
  
  CONCLUSIONS
  Understanding of the disease may be facilitated by a unified framework focusing on energy deficiency. Preventive or early interventions require to increase energy availability through a higher total energy intake or a decrease in energy expenditure trough excessive physical exercise. A healthy lifestyle, and support by parents and coaches should be included. Psychotherapy may be necessary when eating disorders are present.
authors.affiliation: Institute of Biomedicine (IBIOMED), Department and Physical Education, University of León, León, Spain. smarr@unileon.es
authors.forename: Sara
authors.initials: S
authors.lastname: Márquez
authors.forename: Olga
authors.initials: O
authors.lastname: Molinero
mesh_terms: D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D056352:Athletes; D015519:Bone Density / Q000502:physiology; D001842:Bone and Bones / Q000502:physiology*; D004734:Energy Metabolism / Q000502:physiology*; D001068:Feeding and Eating Disorders / Q000150:complications / Q000523:psychology; D005260:Female; D053716:Female Athlete Triad Syndrome / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D008019:Life Style; D008297:Male; D008599:Menstruation Disturbances / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D010024:Osteoporosis / Q000209:etiology; D013177:Sports / Q000502:physiology*; D055815:Young Adult