Have you ever wished that your period would just stop for a while? That you wouldn't have to deal with those annoying cramps and bloating? I am sure that many of us have felt this way at some time or another. You may even know someone- your sister, a friend or a classmate- who has had this happen. You may think to yourself "she is so lucky." You may want to rethink this though. The female athlete triad is a serious condition with some potentially serious long term consequences. It can also often be overlooked, so it is important for us to be aware of the signs and symptoms.

The female athlete triad consists of 3 parts: disordered eating, amenorrhea and bone loss.

Our adolescent years are tough. Many of us are awkward, we are getting pimples, and our bodies are changing. Yet we are bombarded with images of beautiful women in Teen Magazine and Cosmo with flawless figures and beautiful skin, and many of us strive to emulate them. With sports, we can also feel pressure to look a certain way, especially with ballet, ice skating and gymnastics, but even soccer players and track athletes can feel this pressure too. This pressure can lead us to restrict what we eat or to exercise excessively to burn calories after eating a meal in order to maintain a certain weight. Not taking in enough calories and nutrition can affect our energy levels and our performance with sports. These dysfunctional habits can also potentially lead to more serious eating disorders such as anorexia nervosa or bulimia nervosa.

Amenorrhea is defined as the absence of menstruation, and in this case it is no menstruation for 3 months or longer. When a female is not receiving adequate nutrition, is exercising intensely, and has a low body fat percentage; then she can experience a drop in her hormone levels that regulate her menstrual cycle, which can result in a complete cessation of menses.

The decrease in the hormone Estrogen, associated with amenorrhea, coupled with poor nutrition can lead to a loss of bone density. This is especially important, as it is during the adolescent years that we build up our bone mass for life, and not building up enough bone mass can lead to injuries, stress fractures, and even osteoporosis when we are older.

It is common for girls to feel self-conscious during their teen years. There are a lot of changes going on and some girls change faster than others. However, we need to be aware of what is normal and what is not. Pay attention to signs such as: excessive exercise, weight loss, decreased energy levels, injuries/stress fractures, and irregular or complete cessation of menses. Talk to your physician if you notice any of these changes in yourself, a loved one or a friend. They can guide in providing the nutritional, physical and mental assistance to address the issues of the female athlete triad.

Toni Flynn, DPT

Last month, Elizabeth and Crystal talked about making goals for the coming year. They discussed making small changes to your regular routine even if it's only 5 minutes of change. Crystal also talked about doing activities you haven't done in the past to strengthen your body in a new ways. You may be thinking it's too difficult to make new habits or change up your schedule at the gym since it took you months to even get a regular schedule at the gym. I can understand that. I too work out doing the same things on certain days of the week. However, when I go outside my box of regular fitness I do notice I challenge myself more.

In an attempt to correct this problem, last year I took up rock climbing and hiking. It started out as a way to strengthen my shoulders and enjoy the outdoors, but it became so much more than that. By the end of the year I had visited 12 different national parks, rock climbed outdoors four times, and I completed many of San Diego's day hikes. I've included a few of the pictures from my National Parks adventures.

Rocky Mountain National Park Death Valley National Park The Grand Canyon

During my monthly challenge to see a different park, I had the opportunity to work on keeping goals even when things didn't pan out. Things almost never went according to plans; hiking partners got sick, keys were locked in the car, kayaks were only rented until 2 pm and it was 2:15pm, knees started throbbing at 5 miles away from the car, a Mamma Grizzly bear and her cubs crossed our path and we didn't have bear spray (always listen to the Rangers, they know what they are talking about!), and so on. The amazing thing about each one of those experiences was I became better able to handle the challenge each time. I was able to stay calm, breathe through the situation, and keep moving forward. (Even the Grizzly bear being feet away from my nephews and I). Also, those aren't the memories I really remember the most. I remember coming around a curve on the trail and staring Mt. Rainier right in the face with no one else around. Biking with my best friend in the middle of Ohio and laughing hysterically. Losing count of how many alligators I saw in the Everglades. And most importantly, our family reunion hiking and looking at wildflowers in Yellowstone and the Grand Tetons has been one of my favorite memories with my family in many years.

Now I know these experiences sound like big adventures and we're talking about taking little steps towards small adventures, but really it's about our mind set. If you had asked me in January 2015 if I would be planning to hike Mt. Whitney in August 2016 along with hiking Half Dome hopefully in July 2016, I would have told you I didn't have enough time, or enough vacation, or I wasn't in good enough shape. However, as we work towards making and achieving small goals, we are able to imagine achieving big goals. It's not that the challenges get smaller, we simply are able to handle them better as we improve with practice.

My request for 2016 is this, challenge yourself!

For some that will be walking two blocks without pain, for others that will be returning to the gym after a 5 year hiatus. For most of us, it will mean letting go of fear and anxiety and pressing forward in the direction of our dreams despite not having a clear path in view. Each time you get discouraged say the phrase, "What doesn't challenge me doesn't change me." As you do, I promise you will see yourself and your life change for the better.

Kira Shurtz, DPT

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