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Knowledge, Attitudes and Behaviors Regarding the Female Athlete Triad in Australian Female Exercisers and Coaches


Board #196 June 2 3:30 PM - 5:00 PM

Ducher, Gaele1; Kyriazis, Stephanie M.1; Kukuljan, Sonja1; Turner, Anne I.1; Hill, Briony L.1; Van Der Pligt, Paige1; Pantano, Kathleen J.2; Williams, Nancy I., FACSM3; De Souza, Mary Jane, FACSM3

Medicine & Science in Sports & Exercise: May 2010 - Volume 42 - Issue 5 - p 389
doi: 10.1249/
B-33 Free Communication/Poster - Musculoskeletal I: JUNE 2, 2010 1:00 PM - 6:00 PM: ROOM: Hall C

1Deakin University, Burwood, Australia. 2Cleveland State University, Cleveland, OH. 3Pennsylvania State University, State College, PA.


(No disclosure reported)

PURPOSE: Prevention of the female athlete triad, which refers to the interrelationship between low energy availability, menstrual dysfunction and low bone mineral density, is essential to protect overall health of the athlete. The aim of the study was to investigate the knowledge, attitudes and behaviors of regularly exercising adult females and coaches regarding eating patterns, menstrual cycles and bone health.

METHODS: A total of 191 female exercisers, aged 18-40 years, who engaged in ≥2 hrs/wk of strenuous activity, and 48 coaches, who have been involved in coaching females, completed a survey about the triad.

RESULTS: 11 exercisers and 4 coaches were excluded (incomplete answers). The remaining 180 female exercisers (mean training volume: 9 hrs/week) and 44 coaches (50% males, mean duration of coaching: 15 years) were competing/coaching in lean-build sports (e.g. running, swimming, cycling, dancing: 82 exercisers, 28 coaches), non lean-build sports (e.g. basketball, soccer, hockey: 94 exercisers, 16 coaches) or gym/fitness (4 exercisers), from local up to international level. Only 10% of the exercisers and 18% of the coaches could name the three components of the triad. Forty-five percent of the exercisers believed that missing periods over a long duration did not affect health. When asked about what they would do if experiencing amenorrhea (no menses for ≥3 months), 88% of the exercisers would take action (89% would talk to their general practitioner), but those who reported a history of amenorrhea were less likely to take action than those who did not (66% vs. 98%, p<0.0005). Although 73% of the coaches believed missing periods over a long duration affected health, only 14% mentioned the risk of low bone density and 39% linked amenorrhea with an increased risk of stress fracture. Eighty percent of coaches did not require their athletes to have a pre-participation physical examination at the beginning of the season, including respondents who coached at the national (75%) and international level (86%).

CONCLUSIONS: A significant proportion of active Australian women and coaches are not aware of the detrimental effects of menstrual dysfunction on bone health. The use of the pre-participation physical examination as a screening tool was rare, even in participants coaching at the national and international levels.

© 2010 American College of Sports Medicine