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Published in: Sports Medicine - Open 1/2015

Open Access 01-12-2015 | Original Research Article

Female Athlete Triad Awareness Among Multispecialty Physicians

Authors: Emily J. Curry, Catherine Logan, Kathryn Ackerman, Kelly C. McInnis, Elizabeth G. Matzkin

Published in: Sports Medicine - Open | Issue 1/2015

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Abstract

Background

The female athlete triad (Triad) is a serious condition with lifelong consequences seen in physically active females. Prior studies assessing Triad knowledge among coaches/athletic trainers reported surprisingly low awareness results. Our aims were to (1) determine the percentage of physicians across multiple specialties who had heard of the phrase “female athlete triad” and (2) determine the percentage who can properly diagnose or have a high comfort level appropriately referring these patients.

Methods

Via electronic survey, we recruited medical staff, residents, and fellows at three large academic institutions across specialties to answer an eight-item test on Triad awareness and knowledge.

Results

A total of 931 physician participants were recorded. Of the total responders (40 % male and 60 % female), 23 % were residents, 12 % were fellows, and 65 % were attending physicians. Overall, 37 % had heard of the Triad. Of these respondents, an average of 2.1 ± 1.1 of the three components were properly identified with an overall average score on the Triad awareness test of 71 ± 18 % out of a possible 100 %. Fifty-one percent reported feeling either comfortable treating or referring a patient with the Triad.
When assessing awareness among specialties, the awareness rates were highest among orthopedic surgery (80 %), followed by obstetrics and gynecology (55 %) and physical medicine and rehabilitation/rheumatology (52 %). The three with the lowest awareness were anesthesia (9 %), radiology (10 %), and psychiatry (11 %).

Conclusions

Our findings suggest that approximately one third of the physicians surveyed have heard of the Triad. Approximately one half of physicians were comfortable treating or referring a patient with the Triad. Increased awareness through education to properly identify and manage the Triad is essential for all physicians.
Literature
2.
go back to reference Yeager KK, Agostini R, Nattiv A, Drinkwater B. The female athlete triad: disordered eating, amenorrhea, osteoporosis. Med Sci Sports Exerc. 1993;25(7):775–7.CrossRefPubMed Yeager KK, Agostini R, Nattiv A, Drinkwater B. The female athlete triad: disordered eating, amenorrhea, osteoporosis. Med Sci Sports Exerc. 1993;25(7):775–7.CrossRefPubMed
3.
go back to reference Ducher G, Turner AI, Kukuljan S, Pantano KJ, Carlson JL, Williams NI, et al. Obstacles in the optimization of bone health outcomes in the female athlete triad. Sports Med. 2011;41(7):587–607.CrossRefPubMed Ducher G, Turner AI, Kukuljan S, Pantano KJ, Carlson JL, Williams NI, et al. Obstacles in the optimization of bone health outcomes in the female athlete triad. Sports Med. 2011;41(7):587–607.CrossRefPubMed
4.
go back to reference Nichols JF, Rauh MJ, Lawson MJ, Ji M, Barkai HS. Prevalence of the female athlete triad syndrome among high school athletes. Arch Pediatr Adolesc Med. 2006;160(2):137–42.CrossRefPubMed Nichols JF, Rauh MJ, Lawson MJ, Ji M, Barkai HS. Prevalence of the female athlete triad syndrome among high school athletes. Arch Pediatr Adolesc Med. 2006;160(2):137–42.CrossRefPubMed
5.
go back to reference Hoch AZ, Pajewski NM, Moraski L, Carrera GF, Wilson CR, Hoffmann RG, et al. Prevalence of the female athlete triad in high school athletes and sedentary students. Clin J Sport Med. 2009;19(5):421–8.PubMedCentralCrossRefPubMed Hoch AZ, Pajewski NM, Moraski L, Carrera GF, Wilson CR, Hoffmann RG, et al. Prevalence of the female athlete triad in high school athletes and sedentary students. Clin J Sport Med. 2009;19(5):421–8.PubMedCentralCrossRefPubMed
6.
go back to reference Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP, et al. American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc. 2007;39(10):1867–82.CrossRefPubMed Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP, et al. American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc. 2007;39(10):1867–82.CrossRefPubMed
7.
go back to reference Matzkin E, Paci G. The female athlete triad. In: Mody E, Matzkin E, editors. Musculoskeletal health in women. 1st ed. New York: Springer; 2014. p. 1–14.CrossRef Matzkin E, Paci G. The female athlete triad. In: Mody E, Matzkin E, editors. Musculoskeletal health in women. 1st ed. New York: Springer; 2014. p. 1–14.CrossRef
8.
go back to reference Gibbs JC, Williams NI, De Souza MJ. Prevalence of individual and combined components of the female athlete triad. Med Sci Sports Exerc. 2013;45(5):985–96.CrossRefPubMed Gibbs JC, Williams NI, De Souza MJ. Prevalence of individual and combined components of the female athlete triad. Med Sci Sports Exerc. 2013;45(5):985–96.CrossRefPubMed
9.
go back to reference Thein-Nissenbaum J. Long term consequences of the female athlete triad. Maturitas. 2013;75(2):107–12.CrossRefPubMed Thein-Nissenbaum J. Long term consequences of the female athlete triad. Maturitas. 2013;75(2):107–12.CrossRefPubMed
10.
go back to reference Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, et al. The IOC consensus statement: beyond the female athlete triad—Relative Energy Deficiency in Sport (RED-S). Br J Sports Med. 2014;48(7):491–7.CrossRefPubMed Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, et al. The IOC consensus statement: beyond the female athlete triad—Relative Energy Deficiency in Sport (RED-S). Br J Sports Med. 2014;48(7):491–7.CrossRefPubMed
11.
go back to reference De Souza M, Nattiv A, Joy E, et al. Female athlete triad coalition consensus statement on the treatment and return to play of the female athlete triad. Clin J Sport Med. 2014;24(3):96–119.PubMed De Souza M, Nattiv A, Joy E, et al. Female athlete triad coalition consensus statement on the treatment and return to play of the female athlete triad. Clin J Sport Med. 2014;24(3):96–119.PubMed
12.
go back to reference Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, et al. RED-S CAT. Relative Energy Deficiency in Sport (RED-S) clinical assessment tool (CAT). Br J Sports Med. 2015;49(7):421–3.CrossRefPubMed Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, et al. RED-S CAT. Relative Energy Deficiency in Sport (RED-S) clinical assessment tool (CAT). Br J Sports Med. 2015;49(7):421–3.CrossRefPubMed
13.
go back to reference Troy K, Hoch AZ, Stavrakos JE. Awareness and comfort in treating the female athlete triad: are we failing our athletes? WMJ. 2006;105(7):21–4.PubMed Troy K, Hoch AZ, Stavrakos JE. Awareness and comfort in treating the female athlete triad: are we failing our athletes? WMJ. 2006;105(7):21–4.PubMed
14.
go back to reference Pantano KJ. Current knowledge, perceptions, and interventions used by collegiate coaches in the U.S. regarding the prevention and treatment of the female athlete triad. N Am J Sports Phys Ther. 2006;1(4):195–207.PubMedCentralPubMed Pantano KJ. Current knowledge, perceptions, and interventions used by collegiate coaches in the U.S. regarding the prevention and treatment of the female athlete triad. N Am J Sports Phys Ther. 2006;1(4):195–207.PubMedCentralPubMed
15.
go back to reference Kroshus E, Fischer AN, Nichols JF. Assessing the awareness and behaviors of U.S. high school nurses with respect to the female athlete triad. J Sch Nurs. 2015;31(4):272–9.CrossRefPubMed Kroshus E, Fischer AN, Nichols JF. Assessing the awareness and behaviors of U.S. high school nurses with respect to the female athlete triad. J Sch Nurs. 2015;31(4):272–9.CrossRefPubMed
16.
go back to reference Rumball JS, Lebrun CM. Preparticipation physical examination: selected issues for the female athlete. Clin J Sport Med. 2004;14(3):153–60.CrossRefPubMed Rumball JS, Lebrun CM. Preparticipation physical examination: selected issues for the female athlete. Clin J Sport Med. 2004;14(3):153–60.CrossRefPubMed
17.
go back to reference Rumball JS, Lebrun CM. Use of the preparticipation physical examination form to screen for the female athlete triad in Canadian interuniversity sport universities. Clin J Sport Med. 2005;15(5):320–5.CrossRefPubMed Rumball JS, Lebrun CM. Use of the preparticipation physical examination form to screen for the female athlete triad in Canadian interuniversity sport universities. Clin J Sport Med. 2005;15(5):320–5.CrossRefPubMed
18.
go back to reference Ljungqvist A, Jenoure P, Engebretsen L, Alonso JM, Bahr R, Clough A, et al. The International Olympic Committee (IOC) Consensus Statement on periodic health evaluation of elite athletes March 2009. Br J Sports Med. 2009;43(9):631–43.CrossRefPubMed Ljungqvist A, Jenoure P, Engebretsen L, Alonso JM, Bahr R, Clough A, et al. The International Olympic Committee (IOC) Consensus Statement on periodic health evaluation of elite athletes March 2009. Br J Sports Med. 2009;43(9):631–43.CrossRefPubMed
19.
go back to reference American Academy of Family Physicians AAoP, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, American Osteopathic Academy of Sports Medicine. In: WO BDR, editor. Pre-participation physical evaluation. Elk Grove, IL: American Academy of Pediatrics; 2010. American Academy of Family Physicians AAoP, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, American Osteopathic Academy of Sports Medicine. In: WO BDR, editor. Pre-participation physical evaluation. Elk Grove, IL: American Academy of Pediatrics; 2010.
20.
go back to reference Mencias T, Noon M, Hoch AZ. Female athlete triad screening in National Collegiate Athletic Association Division I athletes: is the preparticipation evaluation form effective? Clin J Sport Med. 2012;22(2):122–5.CrossRefPubMed Mencias T, Noon M, Hoch AZ. Female athlete triad screening in National Collegiate Athletic Association Division I athletes: is the preparticipation evaluation form effective? Clin J Sport Med. 2012;22(2):122–5.CrossRefPubMed
21.
go back to reference Matkovic V, Jelic T, Wardlaw GM, Ilich JZ, Goel PK, Wright JK, et al. Timing of peak bone mass in Caucasian females and its implication for the prevention of osteoporosis. Inference from a cross-sectional model. J Clin Invest. 1994;93(2):799–808.PubMedCentralCrossRefPubMed Matkovic V, Jelic T, Wardlaw GM, Ilich JZ, Goel PK, Wright JK, et al. Timing of peak bone mass in Caucasian females and its implication for the prevention of osteoporosis. Inference from a cross-sectional model. J Clin Invest. 1994;93(2):799–808.PubMedCentralCrossRefPubMed
22.
go back to reference Misra M. Long-term skeletal effects of eating disorders with onset in adolescence. Ann N Y Acad Sci. 2008;1135:212–8.CrossRefPubMed Misra M. Long-term skeletal effects of eating disorders with onset in adolescence. Ann N Y Acad Sci. 2008;1135:212–8.CrossRefPubMed
23.
go back to reference Schtscherbyna A, Soares EA, de Oliveira FP, Ribeiro BG. Female athlete triad in elite swimmers of the city of Rio de Janeiro. Brazil Nutrition. 2009;25(6):634–9.CrossRefPubMed Schtscherbyna A, Soares EA, de Oliveira FP, Ribeiro BG. Female athlete triad in elite swimmers of the city of Rio de Janeiro. Brazil Nutrition. 2009;25(6):634–9.CrossRefPubMed
24.
go back to reference Beals KA, Hill AK. The prevalence of disordered eating, menstrual dysfunction, and low bone mineral density among US collegiate athletes. Int J Sport Nutr Exerc Metab. 2006;16(1):1–23.PubMed Beals KA, Hill AK. The prevalence of disordered eating, menstrual dysfunction, and low bone mineral density among US collegiate athletes. Int J Sport Nutr Exerc Metab. 2006;16(1):1–23.PubMed
25.
go back to reference Barrack MT, Gibbs JC, De Souza MJ, Williams NI, Nichols JF, Rauh MJ, et al. Higher incidence of bone stress injuries with increasing female athlete triad-related risk factors: a prospective multisite study of exercising girls and women. Am J Sports Med. 2014;42(4):949–58.CrossRefPubMed Barrack MT, Gibbs JC, De Souza MJ, Williams NI, Nichols JF, Rauh MJ, et al. Higher incidence of bone stress injuries with increasing female athlete triad-related risk factors: a prospective multisite study of exercising girls and women. Am J Sports Med. 2014;42(4):949–58.CrossRefPubMed
26.
go back to reference Ackerman KE, Cano Sokoloff N, Denm G, Clarke HM, Lee H, Misra M. Fractures in relation to menstrual status and bone parameters in young athletes. Med Sci Sports Exerc. 2015;47(8):1577–86.CrossRefPubMed Ackerman KE, Cano Sokoloff N, Denm G, Clarke HM, Lee H, Misra M. Fractures in relation to menstrual status and bone parameters in young athletes. Med Sci Sports Exerc. 2015;47(8):1577–86.CrossRefPubMed
Metadata
Title
Female Athlete Triad Awareness Among Multispecialty Physicians
Authors
Emily J. Curry
Catherine Logan
Kathryn Ackerman
Kelly C. McInnis
Elizabeth G. Matzkin
Publication date
01-12-2015
Publisher
Springer International Publishing
Published in
Sports Medicine - Open / Issue 1/2015
Print ISSN: 2199-1170
Electronic ISSN: 2198-9761
DOI
https://doi.org/10.1186/s40798-015-0037-5

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