TEAM MANAGEMENT OF THE FEMALE ATHLETE TRIAD .1. WHAT TO LOOK FOR, WHAT TO ASK

The female athlete triad of disordered eating, amenorrhea, and osteopo rosis affects many active women and girls, especially those in sports that emphasize appearance or leanness. Because of the athlete's psycho logical defense mechanisms and the stigma surrounding disordered eatin g, physicians may need to ask targeted questions about nutrition habit s when assessing a patient who has a stress fracture or amenorrhea, or during preparticipation exams. Carefully worded questions can help. P hysical signs and symptoms include unexplained recurrent or stress fra cture, dry hair, low body temperature, lanugo, and fatigue. Targeted l ab tests to assess nutritional and hormonal status are essential in ma king a diagnosis that will steer treatment, as are optimal radiologic tests like dual-energy x-ray absorptiometry for assessing bone density .