Female Athlete Triad Recognition and Knowledge of Collegiate Cross-country Coaches

The Female Athlete Triad (Triad) refers to the triad of low energy availability, impaired menstrual function and low bone density. However each component of the Triad is, in fact, a spectrum with energy availability ranging from normal to low, menstrual function ranging from normal to luteal phase defects and anovulatory cycles to frank functional hypothalamic amenorrhea (FHA, absence of menses) and bone density ranging from normal to low. There is obviously a need to engage coaches in education efforts so they know about the Triad and its components, can pass on this information to their teams, be comfortable discussing dietetic and menstrual issues with female athletes, and recognize Triad symptoms early and bring these to medical attention in a timely fashion. Coaches are in a unique position to educate athletes and prevent the Triad from developing or worsening over time, and to advocate for optimal resources including for the services of a sports dietician and psychologist.