A female athlete’s health in her teen years can set up lifelong habits and support her future health. However, some female athletes may focus on aesthetics and performance goals while neglecting aspects of their health. Social media, peer pressure and body-focused comments from coaches can be strong contributing factors.
Sports medicine specialist, Jennifer Gaitley, MD, wants to help female athletes find a balance where they feel and play well – now and for years to come.
“I encourage female athletes to focus less on what they look like and more on how they perform. And their performance is about fueling well,” said Dr. Gaitley.
When an athlete is not fueling enough to support their growth and level of activity, they may notice changes in their menstrual cycle, their level of energy or they may develop injuries such as stress fractures. This condition is known as relative energy deficiency in sports (REDs).
Since high school and collegiate athletes train frequently for their competitive sports, REDs can be seen during these years, although it can affect athletes at any age or level of play. These habits and notions can put athletes at increased risk:
- Joining a sport that emphasizes a lean physique, such as distance running, gymnastics and dance
- Lacking knowledge about the nutritional needs for athletes
- Hearing critical comments about eating or weight by coaches, parents or teammates
Closing the energy gap of REDs: Fueling for athletic performance
Whether accidental or intentional, some female athletes simply don’t eat enough. They may start training harder and don’t realize they have to eat more to meet their new energy needs.
“Most female athletes would be surprised at how much energy they need each day,” said Dr. Gaitley. “They need energy to grow and develop, and they need even more calories when they’re in sports.”
Signs that a female athlete might not be eating enough to support their activity level include:
- Fatigue and lightheadedness: Without enough calories, athletes feel tired even when they’ve had enough sleep.
- Period problems: Irregular or absent menstrual cycles could be the body’s response to not getting enough food while training hard.
- Recurring injuries and illnesses: An under-fueled athlete may have a difficult time fully healing from injuries and may be more likely to get viruses, like the common cold.
- Stress fractures: Poor nutrition can lead to poor bone health, which contributes to injuries like stress fractures.
- Weight loss: Weight loss occurs when the output of energy is more than the input of calories. The desire by some athletes to restrict their intake – either to change their physique or improve their performance – can backfire and cause problems.
- Declining athletic performance: Athletes without proper nutrition may struggle to reach their performance goals.
If a young athlete is having any of these symptoms, it may be time to talk to a pediatrician or sports medicine specialist to get to the root of the issue and start treatment right away. Oftentimes, an athlete will see a sports medicine specialist for an injury, and at that point, the possibility of REDs may be discussed.
Missed periods in female athletes
Missed periods shouldn’t be ignored. “Just because their teammates don’t get their periods regularly doesn’t mean it’s normal,” said Dr. Gaitley. “We need to figure out the reason for these changes.”
A period is a sign of a female’s overall health. When the body is under a lot of stress or isn’t getting enough food, it may stop having a period. Missing periods can be a sign that there may be something wrong.
Talk to a provider if your female athlete:
- Has irregular periods (more than 35 days apart or less than 21 days apart)
- Has stopped having a period
- Hasn’t had their period yet by age 15 or 16
Bodyweight doesn’t tell the full story
Weight alone doesn’t indicate whether an athlete is getting enough energy. Each athlete’s needs are different, so their treatment plans are individualized. Dr. Gaitley’s goal is to get athletes healthy so they can return to their desired sport and activities.
Healthy habits to support female athlete health and performance
Positive practices for eating and sports performance start early. “We want female athletes to be active and healthy for their whole lives, and sometimes that means adjusting something in their teen years,” said Dr. Gaitley.
Here are some healthy habits all athletes and their families should consider:
- Get breakfast. When kids wake up late or feel tired in the morning, they might have a low appetite. Or, when they are rushing out the door, breakfast might get put on the back burner. Find ways to make breakfast happen for your young athlete, even if it’s something on the go.
- Pack snacks. Make sure your athlete has snacks readily available throughout the day, especially before and after sports practice.
- Get the right shoes. Sport-appropriate shoes can help prevent injuries such as stress fractures. Most shoes need to be replaced each season, if not more often. Runners usually need new shoes every six months or 300 to 500 miles. Cleats can be made more comfortable with inserts.
- Increase activity levels gradually. A general rule of thumb is to increase running volume slowly over multiple weeks to avoid injury.
- Have frequent conversations. Check in with your kids. Simple conversations can uncover opportunities to improve how they fuel for sports.
A personal approach to caring for female athletes
Dr. Gaitley’s goal is to identify the root causes of an athlete’s symptoms, such as stress fractures, and create a plan to better health and performance. It’s extremely important to identify athletes who are at risk of REDs because early detection and treatment can help stop progression to osteoporosis, menstrual dysfunction and clinical eating disorders like anorexia or bulimia.
Dr. Gaitley thoroughly assesses female patients who are showing signs of REDs and discusses their sports goals, dietary habits, menstrual patterns, injury history and more. Imaging and blood tests may also be ordered. She uses all this information to get to know the athlete and develop a recommended care plan. Dr. Gaitley can also connect her patients to other providers at Phoenix Children’s, as needed.
To learn more or make an appointment, call 602-933-3033 or visit Phoenix Children’s Sports Medicine Program.