Female athlete Triad awareness among Multispecialty physicians
Open accessAbstract
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.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Less than half of coaches and physicians surveyed were able to identify the three components of the female athlete triad.
“For example, less than half of coaches and physicians surveyed were able to identify the three components of the female athlete triad 147 148 150 151”
From 2023 international olympic committee's (IOC) consensus statement on relative energy deficiency in sport (REDs) (2023) · cites this paper as [148]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
(2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318149f111 · Cited by 1,554 · see citing works
Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., Meyer, N., Sherman, R., Steffen, K., Budgett, R., et al. (2014) · British Journal of Sports Medicine · doi:10.1136/bjsports-2014-093502 · Cited by 1,469 · cited 2× · see citing works
“(RED-S)” [10].”
BackgroundMatkovic, V, Jelic, T., Wardlaw, G. M., Ilich, J. Z., Goel, P. K., Wright, J. K., Andon, M. B., Smith, K. T., & Heaney, R. P. (1994) · Journal of Clinical Investigation · doi:10.1172/jci117034 · Cited by 806 · cited 1× · see citing works
“This younger age group should be targeted for three main reasons: (1) the declining age of onset of eating disorders; (2) the opportunity to maximize bone accrual during adolescence (greater than 90 % of peak bone mass is attained by 18 years of age with the greatest rate bone mass accrual occurring between ages 11 an…”
BackgroundThe female athlete triad: disordered eating, amenorrhea, osteoporosis
YEAGER, K. K., AGOSTINI, R., NATTIV, A., & DRINKWATER, B. (1993) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199307000-00003 · Cited by 436 · see citing works
Flagged first, then by citations
Research works printed but not linked: 21
- [1]Foundation WsSM. Get your game on, girls! Celebrating the 40th Anniversary of Title IX. Zeno Group; 2011; Available at: http://www.womenssportsfoundation.org/home/media-center-2/press-releases/june-23-2011-press-release Accessed 2015.
- [3]Ducher G Turner AI Kukuljan S Pantano KJ Carlson JL Williams NI De Souza MJ Obstacles in the optimization of bone health outcomes in the female athlete triad Sports Med 2011 41 7 587 607 10.2165/11588770-000000000-00000 21688870 · DOI
- [4]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 2 137 142 10.1001/archpedi.160.2.137 16461868 · DOI
- [5]Hoch AZ Pajewski NM Moraski L Carrera GF Wilson CR Hoffmann RG Schimke JE Gutterman DD Prevalence of the female athlete triad in high school athletes and sedentary students Clin J Sport Med 2009 19 5 421 428 10.1097/JSM.0b013e3181b8c136 19741317 PMC2848387 · DOI
- [7]Matzkin E Paci G Mody E Matzkin E The female athlete triad Musculoskeletal health in women 2014 1 New York Springer 1 14
- [8]Gibbs JC Williams NI De Souza MJ Prevalence of individual and combined components of the female athlete triad Med Sci Sports Exerc 2013 45 5 985 996 10.1249/MSS.0b013e31827e1bdc 23247706 · DOI
- [9]Thein-Nissenbaum J Long term consequences of the female athlete triad Maturitas 2013 75 2 107 112 10.1016/j.maturitas.2013.02.010 23541905 · DOI
- [11]De Souza M Nattiv A Joy E 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 24569429
- [12]Mountjoy M Sundgot-Borgen J Burke L Carter S Constantini N Lebrun C Meyer N Sherman R Steffen K Budgett R Ljungqvist A Ackerman K RED-S CAT. Relative Energy Deficiency in Sport (RED-S) clinical assessment tool (CAT) Br J Sports Med 2015 49 7 421 423 10.1136/bjsports-2014-094371 25896450 · DOI
- [13]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 24 17163082
- [14]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 21522222 PMC2953355
- [15]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 4 272 279 10.1177/1059840514563760 25530174 · DOI
- [16]Rumball JS Lebrun CM Preparticipation physical examination: selected issues for the female athlete Clin J Sport Med 2004 14 3 153 160 10.1097/00042752-200405000-00008 15166904 · DOI
- [17]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 5 320 325 10.1097/01.jsm.0000179136.69598.37 16162990 · DOI
- [18]Ljungqvist A Jenoure P Engebretsen L Alonso JM Bahr R Clough A De Bondt G Dvorak J Maloley R Matheson G Meeuwisse W Meijboom E Mountjoy M Pelliccia A Schwellnus M Sprumont D Schamasch P Gauthier JB Dubi C Stupp H Thill C The International Olympic Committee (IOC) Consensus Statement on periodic health evaluation of elite athletes March 2009 Br J Sports Med 2009 43 9 631 643 10.1136/bjsm.2009.064394 19734496 · DOI
- [20]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 2 122 125 10.1097/JSM.0b013e3182425aee 22266742 · DOI
- [22]Misra M Long-term skeletal effects of eating disorders with onset in adolescence Ann N Y Acad Sci 2008 1135 212 218 10.1196/annals.1429.002 18574227 · DOI
- [23]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 6 634 639 10.1016/j.nut.2008.11.029 19230616 · DOI
- [24]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 16676700
- [25]Barrack MT Gibbs JC De Souza MJ Williams NI Nichols JF Rauh MJ Nattiv A 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 4 949 958 10.1177/0363546513520295 24567250 · DOI · Paper page
- [26]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 1586 10.1249/MSS.0000000000000574 25397605 PMC4430468 · DOI
Cited by
Sorted by citations
Mountjoy, M., Ackerman, K. E., Bailey, D. M., Burke, L. M., Constantini, N., Hackney, A. C., Heikura, I. A., Melin, A., Pensgaard, A. M., Stellingwerff, T., et al. (2023) · British Journal of Sports Medicine · doi:10.1136/bjsports-2023-106994 · Cited by 724 · see citing works
Self-citationMountjoy, M., Sundgot-Borgen, J., Burke, L., Ackerman, K. E., Blauwet, C., Constantini, N., Lebrun, C., Lundy, B., Melin, A., Meyer, N., et al. (2018) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2018-0136 · Cited by 447 · see citing works
Self-citationStellingwerff, T., Heikura, I. A., Meeusen, R., Bermon, S., Seiler, S., Mountjoy, M. L., & Burke, L. M. (2021) · Sports Medicine · doi:10.1007/s40279-021-01491-0 · Cited by 171 · see citing works
- Authors
- Curry, E. J., Logan, C., Ackerman, K., McInnis, K. C., & Matzkin, E. G.
- Affiliations
- Brigham and Women's Hospital (US)
- Boston Children's Hospital (US)
- Massachusetts General Hospital (US)
- Corresponding author
- Matzkin, Elizabeth G.
- Venue
- Sports Medicine - Open
- Published
- 2015-11-12
- Volume
- 1
- Issue
- 1
- Pages
- 38-38
- ISSN
- 2198-9761 (ISSN-L)
- 2199-1170
- PMC
- PMC4642583
- OpenAlex
- W2099701230
- Cited by
- 47
- References
- 4
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 3 · 2023: 12 · 2022: 8 · 2021: 3 · 2020: 4 · 2019: 1 · 2018: 7
- FWCI
- 2.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Sports Medicine - Open (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Keywords
- female athlete triad, physician awareness, diagnosis, referral, orthopedic surgery, obstetrics and gynecology, rehabilitation medicine
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
