Female Athletic Triad Part TwoFrom Active.com - Register Online For Thousands of Events and Activities
How Heart and
Brain Function are Affected
Part one of my series on female athletic triad was
directed toward some of the issues that can affect women in athletic training.
You will recall that if a female athlete trains
hard and restricts food intake in an effort to loose weight, she may upset her
normal menstrual cycle. This can lead to reduced estrogen in her system.
Estrogen is very important to many body processes
beyond reproductive health. The list of systems influenced by estrogen is quite
lengthy: the obvious secondary sex characteristics of females, skin, heart,
blood vessels, bone, intestinal function, blood clotting, cholesterol
metabolism, the kidneys' filtering of sodium and water, uterine muscle mass,
and a multitude of other hormones.
(Guys, dont worry; we are not
short-changed. We produce plenty of estrogen for our needs as well.)
In the triad of factors for women (nutrition,
menstruation and bone health), the main concern is the effects on bone. A
decline in estrogen that comes with irregular or absent menstrual periods leads
to a reduction in bone density. The pounding that comes with training can lead
to stress fractures of bones in particular the tibia and foot bones.
But estrogen has more wide-ranging effects. Two
areas of the cardiovascular system also are affected by a reduction in
estrogen: the heart and the blood vessels of the brain.
Now this might sound like taking things to the
extreme. Anorexic patients are studied to learn how their body has adapted to
severe caloric restriction. Everyone knows they have lost weight, but much of
the weight loss is as muscle mass; its not only fat mass that has been
lost. So if the patient lost muscle that controls movement (skeletal muscle),
wouldnt it make sense that other muscle is also lost?
The muscle of the heart is very similar to
skeletal muscle and also is reduced, pretty much in proportion to the amount of
skeletal muscle loss. What appears to happen is that some of the tissue between
cardiac muscle cells becomes filled with what is called fibrous tissue, and
this fibrous tissue might be at the core of why some anorexics have heart
problems. Has this been proven in training females who have been diagnosed with
the triad? Not yet. But we've all seen some very lean and skinny distance
runners. It is possible that they may have some alterations in their heart
cells as well.
Believe it or not, there is an accepted clinical
method to produce a standard blow to the head of a rat. The procedure is quite
involved. When male and female rats are submitted to this impact, they respond
differently: Male rats are far more affected by the impact than female rats.
Researchers have taken a group of female rats that have had their ovaries
surgically removed (and all hormones but estrogen replaced) and performed this
same impact. Guess what? The results of the impact in these female rats are
almost the same as the results of the impact in male rats. Estrogen protects
the head from this method of impact. The area of the brain that has its
function altered by the loss of estrogen governs the circulation of blood
meaning the integrity of the blood vessels is influenced by
There is very little data on gender differences
in head injuries in athletes. One survey of about 140 national-class soccer
players showed that around half the men had a history of concussion while about
one-quarter of the women had a concussion history.
Much more research needs to be done on gender
differences in head injuries, but it is not much of a jump to see that a woman
who is under the effects of the triad may be placing more than her bones at
risk; her heart and brain may also be at risk.
As stated last time, never assume that a change
in menstrual function in a female athlete is due to training alone. A
physicians examination is necessary.