The purpose of the present study was to assess the effectiveness of the triad components (amenorrhoea, disordered eating, and osteoporosis) in identifying physically active women at risk of long-term health problems. Eighty-two females (mean age 31.1 years, s = 6.7; body mass 58.4 kg, s = 6.6; stature 1.65 m, s = 0.06) completed training, menstrual, and dietary questionnaires. Bone mineral density and size-adjusted bone mineral density were assessed at the femoral neck and lumbar spine using dual energy X-ray absorptiometry. Seventy-eight percent of participants were eumenorrhoeic, 20% were oligomenorrhoeic, and 2% were amenorrhoeic. Thirty-six percent and 55% reported disordered eating practices in the present and past respectively. Eighty-one percent, 17%, and 2% were classified as normal, osteopaenic, and osteoporotic at the femoral neck respectively; 92% were normal, 7% osteopaenic, and 1% osteoporotic at the lumbar spine. No significant differences in femoral neck size-adjusted bone mineral density were observed between eumenorrhoeic and oligo/amenorrhoeic participants (F2,80 = 0.119, P = 0.73); eumenorrhoeic participants had significantly greater lumbar spine size-adjusted bone mineral density (F2,80 = 9.79, P = 0.003). Disordered eating participants had significantly lower femoral neck size-adjusted bone mineral density than those reporting no disordered eating (F2,80 = 13.816, P = 0.000). Twenty-two percent of participants fulfilled triad criteria, while 55% were "at risk" of long-term health problems. An accumulation of conditions resulted in lower lumbar spine size-adjusted bone mineral density (F1,80 = 6.074, P = 0.004). The current triad components do not identify all women "at risk" and more appropriate criteria such as exercise-related menstrual alterations, disordered eating, and osteopaenia are suggested.
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