Movaseghi S, Dadgostar H, Dahaghin S, Chimeh N, Alenabi T, Dadgostar E, Davatchi F.
Medicine & Science in Sports Exercise. 2011
Previously, no study had reported prevalence of the Female Athlete Triad in Asian or Islamic countries. The purpose of this study was to evaluate clinical manifestations of the Triad among elite female athletes in Iran. The study was conducted in three phases. Phase I included a total of 786 (94%) athletes with a mean age of 21.2 ± 4.5 years who completed a detailed questionnaire which contained questions relating to participants’ demographic characteristics, athletic history, history of injuries, and menstrual pattern. Athletes diagnosed with functional hypothalamic menstrual disorder or stress fracture in addition to those using weight-loss drugs participated in phases I and II. Bone-mineral density (BMD) was assessed using dual energy X-ray absorptiometry (DXA) during phase II of the study. Phase III consisted of clinical interviews to diagnose eating disorders. A total of 72(9.2%) athletes reported menstrual irregularities (MI) while 17(2%) reported stress fracture. Athletes participating in high-risk activities had significantly more stress fractures than those involved in low-risk sports. Only 3(0.4%) athletes manifested all three common clinical manifestations of the Triad which include eating disorder, menstrual irregularity, and low BMD. Since the design study was based on the 1997 ACSM position, the methods did not assess low-energy availability or sub-clinical menstrual disorders. For this reason, the study most likely underestimated the prevalence of the Triad among elite Iranian athletes. Future investigators should utilize objective methods to identify and evaluate cases of low energy availability and subclinical menstrual disorders.