Female College Athletes Need Better Screening for Health Problems, Researchers Report

Female athletes, particularly those involved in high level college sports at the NCAA Division I level, are particularly prone to a trio of medical issues called the “female athlete triad.” A new study conducted by sports medicine researchers at the Medical College of Wisconsin found there are some possible shortfalls in the methods used to screen these athletes for the triad, and that could put athletes at risk for lifelong health problems.

The findings are published in the Clinical Journal of Sports Medicine, published online April 14, 2012. Anne Z. Hoch, D.O., professor of orthopedic surgery at the Medical College of Wisconsin and director of the women’s sports medicine program at Froedtert & The Medical College of Wisconsin, is the corresponding author. Tara Mencias, M.D., a medical resident in physical medicine and rehabilitation, and Megan Noon, M.D., assistant professor of orthopedic surgery at the Medical College, are co-authors of the study.

The researchers surveyed 257 NCAA Division I universities to determine when and how often athletes had health histories and physical examinations performed, and to evaluate the content of a pre-participation examination form used to further assess athletes’ health.

Of particular interest to the research team was whether the exams and forms comprehensively screen for the female athlete triad. The triad is an interrelationship between energy availability, menstrual function, and bone mineral density; researchers have found that in many sports, women do not take in enough nutrition (some have eating disorders), which leads to amenorrhea (absence of menstrual periods), and loss of bone density and strength.

The researchers found that 63 percent of the university athletic programs surveyed only completed a full history and exam on freshmen and transfer athletes, rather than every year or every other year.

Furthermore, only 25 universities (9 percent) had 9 or more of the 12 Female Athlete Triad Coalition screening recommendations included on their pre-participation examination forms.

“For an accurate picture, these forms really need to include a 72 hour food record to measure energy intake,” said Dr. Hoch. “An exercise history or an accelerometer, which is an inexpensive way to measure energy expenditure, is also helpful. These screening tools may result in early identification of athletes at risk for the triad.”

The researchers suggest further research to explore the most sensitive and specific items to include on a screening tool for the Female Athlete Triad.