The spectrums of the Female Athlete Triad have been useful for identifying some of the key concerns for female athletes and exercising women. However, recent research has shown that the Triad actually over simplifies the situation, and ignores some other important considerations for girls and women engaged in sport and exercise. In particular, the effects on cardiovascular health are not represented in the Triad.
Cardiovascular consequences of low energy availability and amenorrhea in female athletes and exercising women include impaired endothelial dependent arterial vasodilation (i.e. poor expansion of blood vessels in response to increased blood flow) and an unfavourable lipid (i.e. cholesterol) profile. Not only do these findings suggest an increased risk for cardiovascular disease, but optimal cardiovascular function is also important for maximising training adaptations and sport performance (e.g. blood flow and perfusion of oxygen to working muscle).