Healthcare and Women

Female Athlete Triad Awareness for Women and Girls in Sports

Wed, 19 Feb 2025 17:35:23 +0000

Female Athlete Triad Awareness for Women and Girls in Sports

At the HHS Office on Women’s Health, we are committed to empowering women and girls to be active in sports and stay healthy throughout life. There are many sports-related conditions that are more common in women compared to men, including stress fractures, anterior cruciate ligament (ACL) tears, ankle sprains, and recovery time after concussions. This blog shares the steps women and girls can take to prevent complications associated with the female athlete triad, a condition that can impact their ability to participate in the sports and activities that keep them active.

The female athlete triad is made up of three underlying conditions, including low energy availability (with or without disordered eating), menstrual dysfunction, and impaired bone health:

Low energy availability means that there is less energy that is consumed from food than energy that is burnt from exercise. Low energy availability might be associated with disordered eating, such as restrictive eating, but women who develop the female athlete triad do not have to have an eating disorder to experience the impact of energy imbalance.
Menstrual dysfunction can vary from delayed menarche (start of your first period), no menstrual cycle (period) for three months or more (amenorrhea), or irregular menstrual cycles (period). Menstrual dysfunction might impact a woman’s fertility.
Impaired bone health means that you can have bone loss, weak bones, and bone stress injuries, such as stress fractures and other fractures.

Sports and activities that emphasize leanness (e.g., dancing, gymnastics, cheerleading, diving, running, and swimming) are often associated with the female athlete triad. The reality is that any woman or girl doing any sport or activity can develop the female athlete triad when the energy and nutrients from the food they eat does not match the energy they burn during exercise. The goal for women and girls who want to be active is to meet their energy needs based on how much they are exercising, have a regular menstrual cycle (period), and maintain strong bones so that they remain active throughout their lives. Balancing energy in and out of the body is important whether women and girls are playing sports or being active in grade school, high school, college, and beyond.

Many women and girls learn about the female athlete triad after they are sidelined with a stress fracture or another injury. Prevention is key when it comes to the female athlete triad. Here are the steps women and girls can take to prevent complications from the female athlete triad:

Keep track of your menstrual cycle (period). Many women and girls start seeing patterns when they keep track of their exercise in relation to their menstrual cycle (period). The menstrual cycle (period) is a vital sign for women and girls, and an irregular period is a sign that you need to investigate further. If your menstrual cycle (period) is more than 35 days apart or if you start missing having your period, see your health care provider to look for underlying causes.
If you notice that your energy output in the form of exercise exceeds your energy input in the form of food, re-evaluate your routine and consider talking with a nutritionist about how to balance your energy needs, especially if you are struggling with disordered eating. When the energy and nutrients from the food you eat does not match the energy you burn during exercise, you may feel like your energy levels are not where they should be, or you may notice that you are not performing at the level you have in the past. Your energy needs can change day to day depending on the level of exercise and whether you are growing in height.
If you develop symptoms of a stress fracture, such as pain and swelling, talk with your doctor about the next steps for evaluation and treatment. The bottom line is to treat your bones with care. Bones do so much more than provide structural support for your body. Women gain most of their peak bone mass during their adolescent years and continue to gain bone density after adolescence with peak bone mass occurring at 25–35 years. This means that during years of significant athletic activity, you are building up your bone stores. The stronger your bones, the less risk you have for fracture. Your bones become strong when your energy stores are in balance, meaning your energy in (food) and energy out (exercise) are in balance.

Understanding the female athlete triad can help women and girls learn the best ways to optimize their health and improve their ability to recover from injuries that come up in sports and exercise.

Remember that, for the female athlete triad, prevention is easier than cure. We don’t want you to take time away from your sport because of injury and want you to be active throughout your life.

Felicia.Chong@… February 19, 2025

Fitness and Nutrition

Eating Disorders

Healthcare and Women

Menstruation and Menopause

Pain

Safety

Improving Maternal Health Outcomes with a Focus on Physical Activity

Thu, 14 May 2020 04:00:00 +0000

Improving Maternal Health Outcomes with a Focus on Physical Activity

Cross-posted from health.gov

An increasing number of pregnant women in the United States have chronic health conditions — such as hypertension, diabetes, and heart disease — that may put them at higher risk of pregnancy complications. The Department of Health and Human Services (HHS) is working across its agencies to decrease these risks and improve the health of women across the country during pregnancy and the postpartum period.

Physical activity is one of many health behaviors that can impact chronic disease and the risk of negative health outcomes. Moderate-intensity physical activity by healthy women during pregnancy has many benefits, including reduced risk of gestational diabetes and excessive weight gain — as well as reduced symptoms of postpartum depression. In addition, physical activity during the postpartum period can benefit a woman’s overall health in many ways, such as improved mood and cardiorespiratory fitness.

Collaboration Paves the Way for New Resources

Over 3.5 million women give birth each year in the United States. Dorothy Fink, MD, Deputy Assistant Secretary for Women’s Health and Director of the Office on Women’s Health (OWH), is one of the health professionals leading the charge to improve maternal health nationwide. “The health of women during pregnancy and the postpartum period is a key priority — not only for the Office on Women’s Health, but for the Office of the Assistant Secretary for Health and the Department of Health and Human Services,” says Dr. Fink.

Understanding the importance of physical activity to maternal health, Dr. Fink approached ODPHP shortly after the release of the latest edition of the Physical Activity Guidelines for Americans and the Move Your Way campaign. From her experience as a physician, she noted that women are often more open to changes in health behavior during pregnancy and the postpartum period. So she proposed a collaboration to encourage physical activity in these populations. “Despite the many benefits of physical activity during these periods, the majority of women are not meeting the Physical Activity Guidelines,” says Dr. Fink. “Working alone, OWH or ODPHP would be able to create resources and communicate with at-risk groups. But working in collaboration, OWH and ODPHP have the opportunity to reach so many more women and really begin to move the needle.”

OWH and ODPHP are now combining resources and expertise to expand the Move Your Way campaign. The offices are working together to develop new resources specifically for women who are pregnant and postpartum and the health care providers who care for them. Once created, these resources will help get more women moving during this crucial period — supporting the health of mothers and babies.

Innovation Continues with Virtual Focus Groups

Earlier this year, ODPHP and OWH worked with colleagues at the National Institutes of Health’s (NIH) National Cancer Institute (NCI) and — with support from a health education and research contractor —finalized plans for conducting formative research with women who are pregnant and postpartum and their health care providers. Research into the attitudes, beliefs, and information needs of these groups will be crucial to the creation of new evidence-informed Move Your Way materials later this year.

The team initially planned to conduct 12 in-person focus groups in 3 locations. As coronavirus began to impact the United States and the need for social distancing grew, the team quickly developed and executed an alternative research protocol that included virtual focus groups. Conducting a series of 24 English and Spanish virtual focus groups allowed OWH and ODPHP to hear from a diverse group of more than 95 pregnant and postpartum women across the country while maintaining social distancing.

The team also conducted remote in-depth interviews with health care providers who specialize in maternal health. These interviews examined health care providers’ beliefs, attitudes, and perceptions around maternal health and physical activity. The team wanted to discover what providers know about the Physical Activity Guidelines for Americans and how they seek information related to physical activity during pregnancy and the postpartum period.

This research has already uncovered common barriers and facilitators to activity, key information sources, and common misconceptions about physical activity for these populations. For example, findings from the interviews with health care providers mirrored Dr. Fink’s experience that women are more open to healthy behavior changes during pregnancy. But preliminary findings from the focus groups suggest that concerns about whether certain types of physical activity are safe may be playing a role in the physical activity behavior of women who are pregnant and postpartum. These insights and others discovered as the team completes its research will be used to create Move Your Way campaign resources that educate health care providers on best practices and encourage women who are pregnant and postpartum to get active.

To stay up to date on the latest announcements from ODPHP and OWH and be the first to hear when new materials are ready, follow @HealthGov and @womenshealth on Twitter or sign up for the ODPHP physical activity listserv.

Anonymous (not verified) May 14, 2020

Fitness and Nutrition

Healthcare and Women

Pregnancy

OWH Director: How I Make My Health a Priority

Tue, 21 May 2019 04:00:00 +0000

OWH Director: How I Make My Health a Priority

The 20th annual National Women’s Health Week is here! I am thrilled to be part of the celebration this year as the new director of the Office on Women’s Health. As a practicing physician, I have been focused on women and girls’ health issues my entire career and am excited to bring my knowledge to this role and continue to help women and girls achieve the best possible health.

National Women’s Health Week is about taking steps to achieve better health, such as visiting a health care provider for a checkup and talking about what screenings and vaccines you may need, including the MMR vaccine to protect against measles, mumps, and rubella; getting plenty of physical activity; eating healthy foods; paying attention to your mental health; and practicing safe behaviors, like not texting and driving. Even though these steps are essential for good health, I think most of us can agree that it is not always easy to build them into our daily lives. Sure, we know these steps can help us feel our best and prevent serious diseases and conditions, like heart disease and diabetes, but sometimes it is hard to get motivated or stay on track, especially when we have so many other responsibilities.

Also, what works for one woman may not work for another. Each one of us is unique — we all have different goals, different motivations and reasons for getting or staying healthy, and different ways of achieving our health goals. The key to building healthy habits into our lives is to find what works for us as individuals. We want to help you do that during National Women’s Health Week! Here are some steps to uncover ways to be healthier every day.

Reflect on your health. Health is a lifelong journey, and it certainly is not a straight line. There are stops along the way, forks in the road, and sometimes, your destination changes as you evolve and change. With my new work schedule, I have been reflecting on my health journey — thinking about where I am right now and where I want to go. I have thought about questions like these: Why do I want to be healthy? What am I already doing to lead a healthy life? What do I want to improve?

What I realized is that I am motivated by my desire to have a strong and healthy body for life. One of the activities I want to work on is making strength training a bigger part of my daily routine because healthy muscles and strong bones are so important for all women and girls. They help us do important everyday tasks and maintain good posture. My patients truly inspire me when it comes to improving muscle strength. Yes, it is important to figure out a fitness routine that gets you moving — anything from dancing to walking to swimming to running — but muscle strength is just as important. I have taken care of too many patients with compression fractures of their spines who could have benefited from stronger back muscles. Think about adding some dumbbells to your fitness routine! Try committing to 10 minutes a day of physical activity. Small steps can make a big difference over time!

This National Women’s Health Week, I encourage you to try reflecting on your health, too! Take a pulse check on your health to see where you are and where you want to go from here.

Set manageable goals and take small steps. You have heard it before, but simple steps can make a big difference in your health. Drastic changes can be overwhelming and tough to maintain. That is why I opt to get creative when possible! I look for timesavers and small ways to work toward my goals throughout the day. For example, using a slow cooker can save time if you love the smell of food cooking when you arrive home. My goal is to try one new recipe a month, so by the end of the year that is 12 new recipes for my collection.

Another strategy is preparing meals on the weekends. I have had many patients make dramatic improvements to their health by preparing meals on the weekends for the week ahead. Additionally, having food ready to eat after a busy day can help prevent you from eating late at night, which can impact your blood glucose levels. Many of my patients living with diabetes would show me their blood glucose levels the morning after eating late at night, and their glucose levels were often higher compared to when they ate earlier in the evening. Our bodies need time to metabolize food. Going to bed on a full stomach makes it harder for our bodies to metabolize what we ate for dinner. Eating before 8 p.m. and walking after meals are small steps you can take to improve your health.

Ask yourself about the different reasons why it might be hard for you to focus on a particular area of your health. Once you know what your challenges are, you can create a plan to overcome your obstacles step-by-step.

Think about what is most important to you. My family and friends are a key part of my health. One of my motivating factors for taking care of myself is that I need to maintain my health so that I can be there for my family.

Healthy relationships are integral to good health. It can be challenging when relatives are not in the same city as you, but it makes it all the more important to talk with them frequently and plan visits. Even during busy weeks, I try to call my grandma because talking with her always reminds me of what matters most in my life. One of my grandfather’s friends from World War II is 99 years old! Staying in contact with him over the years has reminded me to be active. (He continued to jog into his 90s and still does an occasional 5K race!) We are planning to visit him this summer and I cannot wait to listen to more stories about his time with my grandfather during WWII and the years since then. It is sad to talk about for sure, but in health care, we know how loneliness impacts health. Think about how you can put a smile on someone’s face by letting them know you care about them. You may very well find that your heart smiles in return.

Building healthy habits into your life takes practice, and all we can do is learn as we go. Hopefully, pausing to reflect on your health, finding simple tweaks you can make to your routine, and thinking about what is most important to you will help you take the next step on your health journey. If you are not sure where to start, we can help. Please use our online tool to explore where you are and where you want to go. Based on your responses, you will receive personalized tips so you can start working toward your next healthy destination today!

Anonymous (not verified) May 21, 2019

Fitness and Nutrition

Parents: 5 Things to Know About HPV and the Vaccine

Wed, 21 Feb 2018 05:00:00 +0000

Parents: 5 Things to Know About HPV and the Vaccine

Parents, you can help protect your child from getting certain HPV-related cancers. How? With a safe and effective vaccine! Here are the top five things you should know about HPV, or human papillomavirus, and the vaccine.

HPV infection is very common. HPV is the most common sexually transmitted infection in the United States. In fact, the Centers for Disease Control and Prevention (CDC) estimates that about 79 million Americans currently have HPV and that almost every person who is sexually active will get HPV at some point in their life, if they don’t get the vaccine. People with HPV tend to be in their late teens and early twenties, and most people with HPV don’t know they have it. There are many different types of HPV infections, and while some are minor and go away on their own, others can cause long-term problems, like genital warts and cancer. HPV infections are responsible for 90% of anal and cervical cancers, 70% of vaginal and vulvar cancers, 60% of penile cancers, most genital warts, and certain cancers of the throat and neck.
You can help protect your child from cancers caused by HPV. Fortunately, there are safe and effective vaccines that prevent infection with the types of HPV that cause cancer and genital warts. These vaccines were studied extensively in clinical trials before being licensed, and they continue to be monitored for safety. What’s more is that the vaccines work extremely well, and they offer long-lasting protection against HPV and HPV-related diseases.
Most side effects of the HPV vaccine are minor. The most common side effects of the HPV vaccine are similar to other vaccines and may include pain, swelling, and redness at the injection site. Other adverse effects that can occur include fever, headache, fatigue, nausea, muscle or joint pain, or fainting (at the time of injection or immediately after).
Both boys and girls can benefit from the HPV vaccine. The vaccine helps prevent infections that can cause cancer. Cervical cancer is the most common HPV-related cancer among women, and oropharyngeal (throat, tongue, tonsils) cancers are most common among men. The CDC estimates that HPV probably causes more than 10,000 new cervical cancer cases in women and more than 9,000 new oropharyngeal cancer cases in men each year in the United States.
Boys and girls need to finish the full vaccine series of two or three doses for the vaccine to be effective. The HPV vaccine is administered in multiple doses, but the number of doses depends on a child’s age. Children 9–14 years old need two doses, and they should get the second dose six to 12 months after their first dose. Teens and young adults 15–26 need three doses of the vaccine over six months. They should get the second dose one to two months after their first dose and the third dose six months after the first dose.

The HPV vaccine is a powerful tool in preventing cancer. If you have questions, talk to your child’s doctor about HPV and the vaccine, or visit www.cdc.gov/hpv.

Anonymous (not verified) February 21, 2018

Cancer

Healthcare and Women

Healthy Aging

Reproductive and Sexual Health

Safety

An Interview About Thyroid Cancer

Tue, 16 Jan 2018 12:00:00 +0000

An Interview About Thyroid Cancer

Your thyroid is a small gland at the base of your neck. It makes a hormone that helps control your body's metabolism, including how fast you burn calories and how fast your heart beats. About three times as many women get thyroid cancer as men. One woman shares her story about finding out she had papillary thyroid cancer, the most common of type, when she was only 19. Read her story — from her diagnosis to treatment to being cancer-free.

Anonymous (not verified) January 16, 2018

Were you experiencing any symptoms?

No, I had not experienced any symptoms prior to my diagnosis.

How was it discovered?

The lump (tumor) on my thyroid was discovered by my very thorough nurse practitioner. Similar to the way a gynecologist typically checks your breasts for lumps, this nurse practitioner also routinely checked for lumps throughout my neck area. I am so glad she did! The lump was not large, but she still referred me to another doctor to have it checked out — just in case.

Do you remember how you felt when you got your diagnosis?

I was confused and shocked! Even though I had gone through several tests before the diagnosis, there was still a part of me that thought it wouldn’t be cancer. It didn’t make sense to me. I was young and healthy, and I had no symptoms. But sometimes that’s how thyroid cancer works.

What was your treatment like?

Treatment for the cancer involved a complete removal of my thyroid, along with the removal of several of my parathyroid glands and lymph nodes where the cancer had spread. After the surgery, I spent many months preparing for radioactive iodine treatment by eating a specialized diet that limited my iodine intake. (It’s in a lot of processed foods.) I had to do this so that my radioactive iodine treatment would be as effective as possible. I was fortunate to have excellent doctors who supported my wish to stay in school during this time, so I was able to work out a treatment plan with them that allowed me to continue my studies at my university and return home on a regular basis for checkups.

During my summer break, I checked into the hospital for several days for radioactive iodine treatment (radiation). This involved taking pills with radioactive iodine and then staying isolated in a hospital room until I had removed most of the radiation from my system. Any remaining thyroid cancer cells would have immediately taken up the radioactive iodine, effectively destroying those cells. I had to drink lots of water and take showers every couple of hours to move the remaining radioactive iodine out of my system as quickly as possible.

Do you need routine care now or special medications?

Since I no longer have a thyroid, I have to take thyroid medication daily in order to provide my body with the hormones it needs to survive. I also see an endocrinologist at least once a year to check my thyroid hormone levels and make adjustments to my medication as needed.

How many years have you been cancer-free, and how does it feel?

I have been officially cancer-free for five years now, and it feels great!

How has this experience, especially at such a young age, altered your life?

Having been diagnosed with thyroid cancer at a young age has made me extremely grateful for the excellent medical care I have access to. I’m also more diligent about seeing doctors.

What would you say to other women who may have recently learned they have thyroid cancer?

Find a highly rated medical team that you trust, do your own research so that you understand your diagnosis and treatment options, and surround yourself with supportive friends and family.

Cancer

Healthcare and Women

Interviews and Spotlights

Learn more about thyroid diseases and how they affect women.

Breast Reconstruction: Know Your Options

Thu, 26 Oct 2017 00:00:00 +0000

Breast Reconstruction: Know Your Options

Breast reconstruction after cancer isn’t for everyone, but federal law protects your right to make that choice. The 1998 Women’s Health and Cancer Rights Act requires that insurance plans cover reconstruction at any time after a medically necessary mastectomy. More women are choosing breast reconstruction, so it’s important to know about all of your options. Check out these common breast cancer reconstruction questions and answers to help you get the information you need.

When can I get my breasts reconstructed?

Reconstruction can be performed at the same time as the mastectomy (“immediate reconstruction”) or any time after (“delayed reconstruction”). Generally speaking, immediate reconstruction provides the best cosmetic results with less scarring. Some reasons to consider delaying reconstruction include personal preference, a diagnosis of advanced breast cancer (stage III or IV) or inflammatory breast cancer, radiation treatment, or if you do not have a reconstructive plastic surgeon in your area.

Is it possible to save my nipples?

Maybe. Ask your doctor if you are a candidate for a nipple-sparing mastectomy (NSM), which preserves the nipple and areola as well as all the breast skin. NSM is an option for patients with smaller cancers located away from the nipple-areola. When combined with immediate breast reconstruction, NSM provides superior cosmetic results without compromising cancer treatment.

What should I know about implants?

Implant reconstruction is the most common method and can provide excellent results in patients with good-quality mastectomies. However, some women find implants make their breasts feel cooler to the touch. Implant reconstruction is usually performed as a multiple-step procedure, starting with tissue expanders. In certain cases, it can be performed as a single stage (“direct to implant”). Implant reconstruction usually entails an overnight stay in the hospital, and recovery can take three to four weeks.

Over time, common side effects include hardening around the implant due to scar tissue (capsular contracture) or rippling (visible “waves” through the skin). Implants can also become infected, rupture, or become exposed through the skin, especially in patients who undergo radiation therapy. The FDA also recommends replacing implants every 10 years. Talk to your plastic surgeon about the possible side effects of implant reconstruction during your consultation.

Do I have other options besides implants?

Yes. You may also be a candidate for a flap procedure, which involves removing tissue from one part of your body (back, abdomen, buttock, or thigh) and transferring it to the chest. These surgeries recreate “natural,” warm, soft breasts, but they also leave scars on the area of the body from where the tissue was taken. The most common types of flaps use the patient’s abdominal tissue.

What should I know about flaps?

Flaps that sacrifice muscle are associated with some loss of strength, but most patients find this does not impact everyday activities. Abdominal flaps can create an abdominal bulge (“pooch”) or hernia, but these are rare after muscle-preserving procedures like the Deep Inferior Epigastric Perforator (DIEP) flap and the Superficial Inferior Epigastric Artery (SIEA) flap. The DIEP and SIEA procedures also allow for reconstruction of the nerves that can help restore some feeling in your breast after a mastectomy.

Flaps require longer surgery than implants, a longer stay in the hospital, and a longer recovery time (four to six weeks). Unlike implants, flaps do not rupture, leak, or need to be replaced. Flap breast reconstruction has a very high success rate in experienced hands, over 99% at some high-volume centers, but not all plastic surgeons offer these more complex procedures.

I need radiation treatment. What should I know?

Most plastic surgeons recommend delayed reconstruction if you need to have radiation treatment after the mastectomy. Studies show that flaps have fewer complications than implants in patients receiving radiation after mastectomy and immediate reconstruction. When radiation is planned, delayed reconstruction with flaps yields higher patient satisfaction and fewer complications than immediate reconstruction with implants or flaps.

Will I need more than one surgery?

Regardless of the reconstructive procedure, you will likely require more than one surgery for the best cosmetic results. A second procedure is often performed to “fine-tune” the reconstruction. The exact details of this revision surgery will depend on the type of reconstruction initially performed by your plastic surgeon, but it can include fat grafting, scar revision, and nipple reconstruction.

What’s the “best” option?

While you may be better suited for some options, there is no “best technique.” The best option is the one that suits your preferences, situation, and overall medical health. If you are interested in breast reconstruction, consult a board-certified plastic surgeon, preferably one specializing in breast reconstruction. If possible, talk to your plastic surgeon soon after the diagnosis, before any cancer surgery is scheduled so that immediate reconstruction can be considered.

Anonymous (not verified) October 25, 2017

Cancer

Healthcare and Women