Female Athlete Triad Differential Diagnoses

Updated: Nov 11, 2022
  • Author: Laura M Gottschlich, DO; Chief Editor: Craig C Young, MD  more...
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Diagnostic Considerations

Failure to diagnose the female athlete triad in a timely manner is probably the main medicolegal issue associated with this condition.

Because the diagnosis was formalized in the past decade or so, the direction the legal community has decided to take regarding the triad is still being established. Medical malpractice suits are likely to follow patterns established in the diagnosis of anorexia and bulimia. Although the diagnosis of the female athlete triad is relatively new, legal-civil penalties could be harsh because of the severity of the disease and the population it affects.

As with most diseases, timely diagnosis and initiation of treatment are paramount for avoiding lawsuits. Diagnosis of the female athlete triad can be delayed because in most cases, the stress fracture is diagnosed first, followed by the amenorrhea and finally by the eating disorder (the opposite of the order in which these components of the triad actually develop).

What may make civil litigation difficult are the secretive nature of the disease and the significant rate of patient noncompliance with treatment. Even with rapid diagnosis and treatment, bad outcomes are possible.

In addition to the conditions listed in the differential diagnosis, other problems to be considered include the following:

  • Drug interactions

  • Hypogonadotropic hypoestrogenism

  • Hypothalamic disorders

  • Hyperthyroidism

  • Luteal-phase inadequacy

  • Nutritional deficiencies

  • Ovarian defect (eg, gonadal dysgenesis)

  • Pituitary disorders

Differential Diagnoses