Way to Grow!

Excessive Exercise

By Joel S. Brenner, MD


New Program at CHKD - Adolescent Medicine

You and your pediatrician now have another ally when it comes to your teen’s health: CHKD’s new adolescent medicine program, providing care for issues related to reproductive health, nutritional concerns, acne, depression, substance abuse and less common conditions such as female athlete triad. A physician’s referral is required to make an appointment. Care is provided by Dr. Joel Brenner, who also offers a primary care sports medicine clinic.

Dr. Brenner, who completed his pediatric residency at CHKD, is board certified in pediatrics, adolescent medicine and sports medicine. For more information, call 668-7850.

Lack of regular exercise can lead to a number of health problems for children. But for a small percentage of young women, too much exercise can cause problems too.

Preteen and adolescent girls who train intensively can develop a condition called female athlete triad, which is a combination of three interrelated conditions:

  • disordered eating
  • amenorrhea (absence or loss of menstrual periods)
  • osteoporosis (weakening of the bones)

A female athlete can have one, two or all three parts of the triad. Girls who participate in sports such as running, gymnastics and dance, where a thin body is an advantage, are more likely to develop the disorder, but rigorous training in any sport can lead to female athlete triad.

Girls with female athlete triad may be very competitive, train excessively by adding extra workouts to their team practices and be overly concerned if they have to miss a day of practice or exercise. They are often very thin with very little body fat.

The “disordered eating” aspect of the syndrome may constitute a full-fledged eating disorder, with symptoms such as binging and purging, or teeter just on the edge of that, with strict dieting to maintain an ideal competition weight.

Low body weight, coupled with intensive exercise, may disrupt the function of the endocrine system, reducing the amount of estrogen and progesterone girls produce, thus leading to a delay or complete cessation of menstruation. But low estrogen levels also cause another big worry: osteoporosis, or weakening of the bones. In the short term, this may actually impair athletic performance and cause injuries such as stress fractures. The long-term consequences of estrogen loss during the peak bone-building years can be weak bones for the rest of a young woman’s life.

If your daughter shows signs of female athlete triad, consult your pediatrician. Treatments – which may include more moderate athletic training, nutritional counseling and hormones to regulate menstruation – can help prevent serious and lasting health concerns.

Dr. Brenner is a pediatric sports medicine and adolescent medicine specialist with Children’s Specialty Group PLLC at CHKD.