UNDERSTANDING THE MALE ATHLETE TRIAD
Updated: May 31
In the world of sports, the physical demands of athletes are very high. Striving for peak performance can sometimes lead to neglecting important aspects of health, especially among male athlete. While the Female Athlete Triad has received considerable attention in recent years, the Male Athlete Triad should also be highlighted. In this blog, we will delve into the Male Athlete Triad, its symptoms, causes, and provide guidance on prevention and treatment.
Understanding the Male Athlete Triad:
The Male Athlete Triad is a syndrome of three interrelated components:
1) low energy availability, 2) low bone mineral density, and 3) hormonal disturbances. These three factors often occur together and can have severe implications on an athlete's overall health and performance most commonly seen in adolescent and young adult male.
1)Low Energy Availability: Low energy availability refers to a mismatch between an athlete's energy intake and the energy expended during exercise. This imbalance can result from restrictive eating habits, intense training regimens, or a combination of both. Insufficient calorie intake leads to inadequate fuel for the body. A subset of male athletes, especially those participating in sports emphasizing leanness, may exhibit deficits in nutrition
2) Low Bone Mineral Density: Intense exercise combined with low energy availability can contribute to decreased bone mineral density, making athletes susceptible to stress fractures and osteoporosis. Particularly distance runners are at high risk for having low energy availability are also reported to have low BMD scores and a high prevalence of bone stress injuries
3)Hormonal Disturbances: Measurable changes in hormones influence the metabolism and reproduction, such as those of the hypothalamic-pituitary-gonadal (HPG) axis. Low energy availability can disrupt the hormonal balance within the body, leading to a decrease in testosterone levels and an increase in cortisol, the stress hormone. Hormonal imbalances can affect muscle strength, recovery, and overall well-being.
Signs and Symptoms:
Recognizing the signs and symptoms of the Male Athlete Triad is crucial for early detection and intervention. Some common indicators include:
1.Unintentional weight loss or difficulty maintaining weight.
2.Fatigue and low energy levels.
3.Decreased libido and sexual dysfunction.
4.Frequent stress fractures or delayed healing of injuries.
5.Depression, anxiety, or mood disturbances.
Prevention and Treatment:
Preventing and treating the Male Athlete Triad requires a comprehensive approach that addresses both physical and psychological aspects. Here are some key strategies:
1.Education and Awareness: Athletes, coaches, and support staff should be educated about the Male Athlete Triad and its potential consequences. Understanding the importance of balanced nutrition, adequate rest, and recovery can help to reduce the risks.
2.Balanced Nutrition: Athletes should work with qualified sports dietitians to develop individualized nutrition plans that meet their energy needs by emphasizing a variety of nutrient-dense foods, including carbohydrates, proteins, and healthy fats, is essential.
3.Periodization and Rest: Training programs should incorporate proper periodization, allowing for adequate rest and recovery periods to repair and rebuild, reducing the risk of overtraining and associated health issues.
4.Psychological Support: The psychological well-being of athletes should be prioritized. Encouraging a healthy body image, promoting positive self-talk, and addressing any underlying mental health concerns can play a crucial role in preventing and managing the Male Athlete Triad.
5.Medical Intervention: A healthcare professional experienced in sports medicine can conduct a thorough evaluation, order relevant tests, and provide appropriate treatment recommendations.
Determining methods to encourage healthy behaviour in male athletes is a challenge. The Male Athlete Triad is a serious condition that can have long-lasting implications for male athletes. By understanding its components, recognizing the signs and symptoms, and implementing preventive measures, we can strive to create a healthier and more supportive environment for athletes.
1. van Erp-Baart AM, Saris WH, Binkhorst RA, Vos JA, Elvers JW. Nationwide survey on nutritional habits in elite athletes. Part I. Energy, carbohydrate, protein, and fat intake. Int J Sports Med. 1989;10(Suppl 1):S3–10.
2. 5. Burge MR, Lanzi RA, Skarda ST, Eaton RP. Idiopathic hypogonadotropic hypogonadism in a male runner is reversed by clomiphene citrate. Fert Steril. 1997;67(4):783–5.
3. . Loucks AB. Low energy availability in the marathon and other endurance sports. Sports Med. 2007;37(4–5):348–52.
4. Tenforde AS, Barrack MT, Nattiv A, Fredericson M.Parallels with the Female Athlete Triad in Male Athletes. Journal of Sports Medicine. Review Article 10.1007/s40279-015-0411-y.
5. Murray SB, Nagata JM, Griffiths S, Calzo JP, Brown TA, Mitchison D, Blashill AJ, Mond JM. The enigma of male eating disorders: A critical review and synthesis. Clinical Psychology Review. 2017 Nov 1;57:1-1.
6. De Souza MJ, Miller BE. The effect of endurance training on reproductive function in male runners. Sports Medicine. 1997 Jun 1;23(6):357-74.
7. Fredericson, M., Kussman, A., Misra, M., Barrack, M. T., De Souza, M. J., Kraus, E., Koltun, K. J., Williams, N. I., Joy, E., & Nattiv, A. (2021). The Male Athlete Triad-A Consensus Statement From the Female and Male Athlete Triad Coalition Part II: Diagnosis, Treatment, and Return-To-Play. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 31(4), 349–366. https://doi.org/10.1097/JSM.0000000000000948