Elite Female Tennis Players at High Risk for Female Athlete Triad

Strategic Insights -

Research has found that elite female tennis players are among those at high risk for developing the Female Athlete Triad, characterized by energy deficiency, menstrual dysfunction, and low bone mineral density. The Women's Tennis Association (WTA) has developed a protocol to prevent and manage this condition, which includes screening for "red flags," targeted education, and a multidisciplinary treatment protocol. This article reviews the effectiveness of this protocol in preventing the development of the Triad.

Key Takeaways:

  • The Female Athlete Triad is a condition that affects elite female tennis players, characterized by energy deficiency, menstrual dysfunction, and low bone mineral density.
  • The WTA Triad protocol was developed in 2018 and utilized from 2018 to 2022 to prevent and manage the condition.
  • The protocol includes a multidisciplinary Performance Health Team that screens for "red flags" during annual physicals or upon clinical presentation of a menstrual problem, bone disorder, or nutritional concern.
  • The protocol also includes targeted education for players, coaches, and other support team members on nutrition and body image to prevent energy deficiency.
  • The WTA protocol is a multi-layered program that guides treatment and return-to-play decisions for female athletes at risk for the Triad.
  • Other sport governing bodies can adopt similar multi-layered programs and practices to educate, screen, manage, and prevent the development of the Triad.
  • Researchers have identified specific risk factors for the Triad, including energy deficiency, menstrual dysfunction, and low bone mineral density.
  • The study highlights the importance of prevention and early intervention in managing the Triad.
  • Authors of the study include Emily A. Ricker, Kristen J. Koltun, Carol L. Otis, Anna S. Peavler, and Mary Jane De Souza.

Statistics:

  • 1996: The initial year the WTA started developing the Triad protocol.
  • 2022: The final year the WTA utilized the protocol.
  • 26 years: The duration the WTA protocol was in place.
  • 2018: The year the WTA Triad protocol was developed.
  • 13(7): The issue and page number of the journal Sports where the research was published.
  • 205: The article number of the research in the journal Sports.

Sources:

  • The Women's Tennis Association (WTA) Multidisciplinary Education and Treatment Protocol for the Female Athlete Triad (1996-2022). Sports, 2025, 13(7):205. (Sports - http://www.mdpi.com/journal/sports).
  • NewsRx. Research from Uniformed Services University of the Health Sciences Provides New Data on Sports [The Women's Tennis Association (WTA) Multidisciplinary Education and Treatment Protocol for the Female Athlete Triad (1996-2022)]. Health & Medicine Week. August 15, 2025; p 5520.