Table 7.

A description of specific treatment and prevention strategies used by a sample of college coaches in the United States for the female athlete triad.

Specific Strategies Used by a Sample of Coaches in the U.S. for the Prevention of the Female Athlete Triad
Direct Intervention by Coaches With athlete: Educate individual athlete and team on healthy living and healthy eating. Have open communication between the athlete and coach. Provide handouts on recent literature. Engage individual/team in preseason discussions about triad. Immediately address the emotional needs of the athlete. May need to determine if athlete is in appropriate weight class for the sport and restrict supervised weigh-ins to lightweight rowing only. Avoid “undersizing” uniforms; they encourage the athlete to lose weight. A food journal or a menstrual cycle journal are required. All athletes, men and women, are educated on the importance of nutrition. We provide packets of suggested meals and snacks that are easy to prepare on a college budget and talk openly about drug and alcohol abuse. Eliminate athlete from competition, if diagnosed as anorexic or bulimic. Weight lifting, impact sports are encouraged to increase bone mass. With other health care professionals: Nutritionists consult athlete on a regular basis to discuss calcium, vitamin D, and nutritional needs. Coaches, team physicians, athletic trainers, and nutritionists work together to discuss warning signs or symptoms that may be observed in the athlete and devise a comprehensive nutritional plan and training program for the athlete. Mandatory meetings are held with nutritionists and sports psychologists who specialize in eating disorders. Team physician monitors for the presence of amenorrhea during physicals. Intervention starts with the team physician. As coaches, we never try to solve the problem ourselves; we involve a multidisciplinary team of medical professionals. A comprehensive screening, assessment and educational program in place, which is supported by college staff and resources. Behavioral contacts are used to assure that the athlete is compliant in behavioral changes, for example, if athletes do not keep appointments with health professionals, they cannot practice or compete.
Referrals sources most Jrequenth used and rationale:
Nutritionist/Dietitian Educate individuals/team on healthy eating strategies Educate about the components of the triad Set realistic body image/goals for athlete
Athletic Trainer Educate individual/team; monitors athlete with signs and symptoms. Educate on triad and where to seek help (from other health professionals)
Team Physician/MD/Nurse Practitioner Prescribes bone density tests; prescribes birth control pills, if amenorrheric. Blood testing Calcium/Vitamin D supplements Medication or estrogen supplements; sometimes administer fosamax. Monitor athlete on a regular basis Use of physicals to screen athlete for triad; for example, questioning athletes about their menstrual cycle during preseason physical exams. Educate individual and/or team about the triad.
Health Centers Educate team on heath center services. Follow University protocol for treatment of athlete. Collaborate athlete's plan of care with athletic trainer, team physician, nutritionist