Health

Keeping young female athletes healthy, on and off the field

Experts warn to watch out for the triad of amenorrhea, anorexia and osteoporosis, as well as for parents who push to play through the pain.

By Victoria Stagg Elliott — Posted Nov. 15, 2004

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When a young female athlete, injured, came to see Michelle L. Look, MD, the physician was aggressive in her treatment. It seemed important to the patient to be well enough to take part in an upcoming competition.

But the injury still didn't get better. It was only when Dr. Look, a family physician in San Diego, spoke to the patient directly, without a parent in the room, that she learned that the athlete wasn't that interested in continuing to compete.

"Sometimes they don't have the power to say that they're hurting and they don't want to do it," said Dr. Look, speaking at an interactive session on caring for the young female athlete during the American Academy of Family Physicians annual scientific sessions in Orlando, Fla., last month. "By being the bad guy, you can give the patient an out."

In addition to making a higher priority of patient wellness than of athletic ambitions, Dr. Look suggested that doctors keep an eye out for other trouble signs when caring for young female athletes. These include symptoms of steroid use and eating disorders that can lead to osteoporosis, amenorrhea and various ill-health effects.

She pointed out, however, that physicians' line of questioning has to acknowledge that what is considered normal for the average teenager may not be so for the athlete.

"Instead of asking, 'Are your periods normal?' you really need to ask them, 'How many periods do you have a year?" she said. "They think amenorrhea is normal because none of their teammates have periods during the season, either."

Physicians in attendance agreed that dealing with some female athletes was a struggle but had life-long implications.

"You want to keep them healthy for their whole lives, because very few of our athletes are going to be college athletes or become professional," said Margaret Millar, MD, a family physician from Moline, Ill. "If they burn out, they won't be doing anything."

AMA policy says any pre-participation physical should be focused on ensuring the safety of the athlete, and the athlete should be assessed for special problems such as anemia, amenorrhea and eating disorders. If the athlete is injured, the decision about whether to return to the sport should be made by a qualified physician.

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External links

AAFP consensus statement on female athlete issues for team physicians (link)

AAFP consensus statements on sports medicine (link)

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