Female Athlete Triad Medication

Updated: Aug 24, 2017
  • Author: Laura M Gottschlich, DO; Chief Editor: Craig C Young, MD  more...
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Medication

Medication Summary

Medical treatment is of secondary importance in the treatment of the female athlete triad, after changes in eating and exercise habits of the athletes affected with this condition. Some medicines can be used in conjunction with behavior modifications. The medications mainly consist of those used for hormone replacement (eg, oral contraceptives) and dietary supplementation.

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Vitamins, Fat-soluble

Cholecalciferol (Vitamin D3, Bio-D-Mulsion Forte, Delta D3)

Cholecalciferol stimulates the absorption of calcium and phosphate from the small intestine and promotes the release of calcium from bone into blood. It is use for the treatment of vitamin D deficiency or prophylaxis of vitamin D deficiency. Supplementation with 400-800 IU of vitamin D is suggested for young adults with menstrual dysfunction.

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Electrolytes

Class Summary

Calcium supplementation restores serum calcium levels. Supplementation may help minimize the osteoporosis that can occur with the triad, especially in athletes with strict or unusual dietary restrictions. Doses are 1200-1500 mg of elemental calcium.

Calcium carbonate (Oystercal, Caltrate, Oysco 500, Tums E-X, Children's Pepto)

Calcium carbonate is indicated to restore and maintain normocalcemia when hypocalcemia is not severe enough to warrant rapid replacement. It is used orally as supplementation to IV calcium therapy. Calcium carbonate moderates nerve and muscle performance by regulating the action potential excitation threshold. Amounts of elemental calcium in calcium carbonate tablets are as follows: Tums, 200 mg; Rolaids, 220 mg; Os-Cal, 500 mg.

Calcium citrate (Calcitrate, Cal-Citrate 225, Cal-Cee)

Calcium citrate is an oral formulation usually used as supplementation to IV calcium therapy. Calcium moderates nerve and muscle performance by regulating the action potential excitation threshold and facilitating normal cardiac function. Give the amount needed to supplement dietary intake, so as to reach recommended daily amounts. The amount of elemental calcium in 1000 mg of calcium citrate is 210 mg.

Potassium acid phosphate (K-Phos)

Potassium is essential for transmission of nerve impulses, contraction of cardiac muscle, maintenance of intracellular tonicity, skeletal and smooth muscles, and maintenance of normal renal function. Gradual potassium depletion occurs via renal excretion, through gastrointestinal loss, or because of low intake. Potassium depletion sufficient to cause a 1-mEq/L drop in serum potassium requires a loss of about 100-200 mEq of potassium from the total body store. Approximately 60-90 mg of potassium is recommended.

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Estrogen and Progestin Combination

Oral Contraceptives

Oral contraceptive agents can be used in athletes older than 16 years whose bone mineral density (BMD) continues to decline during treatment for the female athlete triad despite a normalized caloric intake and weight.

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Hormone, Parathyroid

Teriparatide

Recombinant human parathyroid hormone rhPTH(1-34), which has identical sequence to 34 N-terminal amino acids (biologically active region) of 84-amino acid human parathyroid hormone (PTH). Acts as endogenous PTH, thus regulating calcium and phosphate metabolism in bone and kidney. Works primarily to stimulate new bone by increasing number and activity of osteoblasts (bone-forming cells). Additional physiological actions include regulation of bone metabolism, renal tubular reabsorption of calcium and phosphate, and intestinal calcium absorption.

When administered with calcium and vitamin D, teriparatide increases bone mineral density and decreases risk of fractures in patients with osteoporosis.

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