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Female Athlete Triad

NB: Don’t scroll past gentleman, this can also affect males, it is also referred to as “relative energy

As it states a triad (three) common in the female and consists of:

  • Low bone mineral density (BMD)
  • Mensural abnormalities (missed or scanty flow)
  • In the presence or absence of eating disorders (bulimia, anorexia nervosa)

These when they occur show an underlying physiologic disturbance in normal body processes and by
then already at hormonal level. Only occurrence of one of the above warrants evaluation for the female
athlete triad.

Common Sports: soccer, netball, gymnastics, swimming etc.

Abnormal weight management practices (making weight through abnormal eating habits) or low energy
intake compared to exercise expenditure.

The output is an energy deficiency or negative energy balance which impacts negatively on the
metabolic processes and the hormonal profile. The common organs that are initially affected are the
weight bearing bones (stress fractures and increased risk of sustaining a fracture from low BMD), female
reproductive system (amenorrhea or a scanty flow).

These when sustained progresses to affect various organs as there is no energy to adequately fuel the
body’s metabolic processes.

Athlete specific negative manifestations:
Anemia and reduced aerobic capacity (cardiovascular and Hematologic), frequent injuries and fractures,
muscle cramping and easy fatiqueability (energy production and musculoskeletal), underweight or low
BMI and chronic fatique syndrome (metabolic). All these will negatively affect your performance and
result in inability to reach your peak as an athlete.


  1. Full medical evaluation by a sports physician including blood tests to look at your hemoglobin and
    hormone profile (thyroid, estrogen, progesterone etc) and any indicated tests.
  2. Identifying cause (less intake or high expenditure) and correcting it
  3. Treatment is multi-disciplinary (nutrition, psychological support, iron supplements, oral
    contraceptives and bisphosphonates (NB: Bisphosphonates not to be consumed by women of child
    bearing age) and supplementing any deficiencies.

This is a correctable disorder and the key thing is prevention or early recognition and treatment with
good practices of managing the training load, nutrition and psychological assessment.
As the BFA medical we encourage all teams and in particular the women football teams to screen
athletes for this female athlete triad and refer for prompt treatment to aid improved athlete
performance and normal bodily function.



GABORONE, Botswana – Following the request by Senior National Team Coach, Adel Amrouche for leave of absence to attend to a personal matter, the Botswana Football Association (BFA) wishes to inform the public that he has been granted the leave with immediate effect.

Since the COSAFA tournament is the last competitive tournament for the Zebras in the immediate future, the BFA amicably resolved to release Amrouche. The affairs of the National team in preparation for the tournament, set to take place in Nelson Mandela Bay in South Africa from 7-18 July 2021 shall be handed over to Letang Kgengwenyane.

“The BFA understands and supports Mr. Amrouche’s situation and wishes him all the best in his future endeavours,” said BFA Chief Executive Officer (CEO), Goabaone G. Taylor.

Amrouche took over as the Zebras head coach in August 2019 on a two-year deal. After weeks of engaging with the coach over his future, an agreement was reached not to extend his contract.

Adel Amrouche

“Amrouche has been Zebras head coach since August 2019, and his leadership during that time was important to our successful development and international exposure of our players,” added Taylor.

“We appreciate all that Amrouche has done to build a disciplined team. He has always had a thorough understanding of what it takes to be a successful team and has done his best to mentor his players accordingly,” concluded Taylor.

Amrouche has since expressed gratitude towards the BFA for the opportunity.
“I’m eternally grateful for the opportunity to lead the Zebras over the last two years. I leave having picked up quite a number of valuable lessons that will be necessary in the journey ahead. I wish the Zebras success in future competitions,” Amrouche said in statement recently.

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