A Silent Crisis: Increasing Prevalence Of The Female Athlete Triad Over Time (1999 - Present)

Author: Mittie Grace Doyle A Silent Crisis: Increasing Prevalence of the Female Athlete Triad Over Time (1999 - Present) PURPOSE: Since the Female Athlete Triad (Triad) was first recognized in 1992, physicians and governing bodies have proposed policies aimed at preventing the condition’s occurrence. However, in recent years, a growing number of young athletes have stepped forward to share career-altering experiences with disordered eating, menstrual dysfunction and stress fractures. This questions the sufficiency of existing interventions and suggests that incidence of the Triad may be increasing. To the author’s knowledge, no systematic literature reviews assessing changes in prevalence of Triad clinical endpoints among collegiate female athletes over the last 25 years have been published. METHODS: Comprehensive review of publications (1999 - present) was conducted in PubMed and Google Scholar. Observational studies and randomized controlled trials in female collegiate athletes at institutions across the United States were included. Final searches were conducted on January 3, 2025. RESULTS: 51 of 64 relevant studies were identified for inclusion (n = 13,831). Prevalence of clinical eating disorders, disordered eating, menstrual irregularities, low bone mineral density and low energy availability ranged from 2% - 25.7%, 6.6% - 61%, 10% - 58.8%, 2% - 75% and 2.2% - 100%, respectively. Findings suggest increasing prevalence over time. CONCLUSION: Findings reveal a consistently high - and increasing - prevalence of Triad components in collegiate female athletes since the turn of the century. These data merit further investigation into the Triad’s etiology and demand evaluation of existing policy measures.