Introduction: This study made use of a direct testing method to investigate the impact and severity on female athletes` energy availability caused by the "triad". The results will provide a theoretical foundation for the mechanism of athletic menstrual disturbance. Methods A cohort of 26 elite female athletes from Shanghai were selected, with ages ranging from 18 to 23 years. All subjects had menstruated for a period of no less than 3 years. The monitoring process of athletes` energy expenditure commenced on the third (±1) day after the beginning of their menstrual cycle (bleeding) using the apparatus, armband human monitoring system, made by USA Bodymedia. The monitoring process lasted 24 hours per day for five days (Loucks, 2006). In terms of evaluating the athletes` energy intake, the weight of the athlete`s three meals per day were measured and recorded. A self-report method was used to collect data on snacks consumed by the athletes. Starting on the 12th day after the start of menstrual bleeding, we collected a urine sample every morning until the commencement of the next menstrual bleed. The LH levels of the samples were evaluated to identify menstrual status, including ovulation and length of luteal phase. Athletes were grouped into either a normal menstrual group or irregular group based on the measured LH level. Results Athletes of the normal menstrual group had more available energy than those of irregularity group (p < 0.05). The ratios of the energy intake from three sources were not ideal. The energy from carbohydrate was lower than the expected value, and the energy intake from fat was high. Among these female athletes, the occurrence of amenorrhea, anovular, and luteal phase deficiency (LDP) were 7%, 34%, and 16% respectively. Conclusions The present study used an innovative method to evaluate athletes` menstrual period by measuring the LH level in urine. Athletes` available (spared) energy was 256.7kcal/d. The fat consumed by athletes was higher than the dietary goal. There was a strong correlation between menstrual status and energy availability. Athletes with irregular menstrual status should be treated with "therapy of food intake" (Loucks & Stanchenfeld, 2006).
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