Back to Journals » International Journal of Women's Health » Volume 10

Risk of female athlete triad development in Japanese collegiate athletes is related to sport type and competitive level

Authors Sawai A, Mathis BJ, Natsui H, Zaboronok A, Mitsuhashi R, Warashina Y, Mesaki N, Shiraki H, Watanabe K

Received 27 May 2018

Accepted for publication 27 September 2018

Published 30 October 2018 Volume 2018:10 Pages 671—687


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Elie Al-Chaer

Akemi Sawai,1,* Bryan J Mathis,2,* Hiroaki Natsui,3 Alexander Zaboronok,2 Risa Mitsuhashi,1 Yuki Warashina,4 Noboru Mesaki,4 Hitoshi Shiraki,4 Koichi Watanabe4

1Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; 2Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; 3Faculty of Sports and Health Sciences, Japan Women’s College of Physical Education, Setagaya-ku, Tokyo, Japan; 4Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan

*These authors contributed equally to this work

Introduction: Menstrual dysfunction, musculoskeletal injury, and poor nutrition combine to form the female athlete triad (FAT), which results in serious health consequences for affected athletes. To this point, the risk factors of this phenomenon have not been fully explored in Japanese female college athletes. Additionally, the effect of competitive level on FAT risk factors has also not been reported. Therefore, we aimed to examine FAT risk factors in Japanese female athletes of various sports as well as examine the impact of competitive level on FAT.
Methods: A Japanese-language survey was completed by 531 athletes and 20 nonathletes at two Japanese universities and answers with regard to menstrual status, musculoskeletal injury, nutrition, and other variables were analyzed based on classification of the sports into nine distinct groups based on activity type. Sport intensity, training volume, and competitive levels were used to further classify each sport. One-way ANOVA and the Bonferroni post hoc test using SPSS were carried out to analyze significance for relationships between sport intensity and FAT risk factors. Additionally, the relationship between competitive level and FAT risk factors was analyzed by ANOVA and Bonferroni post hoc tests.
Results: Sport intensity was positively correlated with a delay in menarche as well as dysmenorrhea and poor nutrition while musculoskeletal injury was correlated with repetitive, high-training volume sports. Lower competitive levels increased dysmenorrhea but did not impact injury status or nutrition.
Conclusion: Sport intensity and training volume, but not competitive level, are the critical factors affecting FAT risk in Japanese female college athletes.

Keywords: athletes, dysmenorrhea, FAT, female, Japanese, triad

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]