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Athletic Secondary Amenorrhea (ASA)

The Female Athlete Triad was originally defined as the interrelationship between disordered eating, amenorrhea and osteoporosis in active women. In 2007, the American College of Sports Medicine broadened the criteria — it now includes low-energy availability (with or without eating disorders), disturbed menstruation (including amenorrhea) and bone mineral density (BMD) decline, an osteoporosis precursor. An estimated one to five percent of active females experience all three symptoms while twenty to twenty-five percent have at least one. The most easily recognizable component is perhaps athletic amenorrhea, which is reported in 60 – 66 percent of women, with the highest prevalence in runners.