My 16-year-old daughter is very involved in a gymnastics club. She practices up to 20 hours a week. I've noticed she's lost a lot of weight, but I thought this was normal for her level of activity. Then she broke a bone in her foot. When they X-rayed her foot, there were signs of early osteoporosis. The doctor has diagnosed her with "female athlete triad." What is this?

Female athlete triad is a new term used to describe a combination of three things: (1) disordered eating, (2) menstrual problems, and (3) osteoporosis or loss of bone density. When girls are involved in sports such as ballet, figure skating, and gymnastics, there is a lot of pressure to be abnormally thin. Girls may stop eating or change their eating patterns to lose weight.  

This kind of diet and weight loss causes estrogen hormone levels to drop and menstrual cycles to stop. These two problems cause a third problem: bone loss. This puts girls at risk for fractures now and later in life, when more bone loss occurs during menopause.

It is very important for young athletes to receive adequate nutrition and emotional support to avoid these problems. Ask your doctor if there are any programs in your area that may help. Individual counseling may also be a good next step.

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