Prevalence of the Attributes of the Female Athlete Triad in Competitive Nigerian Female Athletes

Jane Sharon Akinyemi; Nancy Williams; Ana Carla Salamunes; Mary Jame De Souza; Grace Olapeju Otinwa

doi:doi:10.11648/j.ajss.20251304.11

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| Peer-Reviewed

Prevalence of the Attributes of the Female Athlete Triad in Competitive Nigerian Female Athletes

Jane Sharon Akinyemi^*

, Nancy Williams

, Ana Carla Salamunes

, Mary Jame De Souza

, Grace Olapeju Otinwa

Published in American Journal of Sports Science (Volume 13, Issue 4)

Received: 20 September 2025 Accepted: 9 October 2025 Published: 30 October 2025

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Abstract

The Female Athlete Triad syndrome describes three interrelated conditions: low energy availability with or without disordered eating, menstrual dysfunction, and poor bone health, inclusive of low bone density and bone stress injury. Sports participation for female athletes has risen exponentially; however, investigations into the health and wellbeing of female athletes from Africa are extremely limited because these groups are noticeably absent from the Triad literature. This research gap can have negative health implications, on the Female Athletes in Nigerian athletes. Purpose: To investigate the prevalence of Triad components in competitive Nigerian female university athletes as well as explore hematological markers. Methods: n=71, (21.8±0.3yrs) and BMI (22.5±0.6 kg/m²) female athletes from the University of Lagos, during the Nigeria University Games Competition, completed a Health, Exercise Nutritional Survey questionnaire to provide demographics, medical history, exercise, and dietary practices. Athletes consented to a complete blood count (CBC) assessment: white blood cell (WBC), hematocrit (HCT), red blood cell (RBC), hemoglobin (HGB) and platelets. Results: Exercise frequency was 4.6±0.3 days/wk., overtraining, 6.8%, age at menarche 12.8±0.1 yrs., and gynecological age 9.2 ±0.5 yrs. Factors reflecting energetic status include (20/71): 28% reported eating a low-fat diet, (27/71) 38% dieted to lose weight to change their body composition and to improve performance, (2/71) 3% reported a history of anorexia and Bulimia. Prevalence of oligomenorrhea was (11/71) 15% while amenorrhea was (14/71) 19%. Stress fracture was reported to be (9/71) 13% and (3/71) 4%, had a family history of osteoporosis. (24/71) 34% refrained from training due to injuries during the past year and (7/71) 9.8% reported illness due to exercise. CBC measures showed RBC (3.95±0.06 10¹²/L), HGB (10.64±0.11 g/dL), HCT (32.68±0.31%) WBC (5.20±0.14 10⁹/L) and platelets (245.17±8.2 *10⁹/L), demonstrating that RBC and WBC are within the normal range while HGB, HCT and platelets are abnormal. Athletes in endurance sports had a decreased hematocrit (HCT). Conclusion: A significant percentage of Nigerian female athletes participating in the NUGA Games demonstrated factors reflective of poor energy intake, menstrual dysfunction and bone health including a history of stress fractures and absence from sport due to injury. The prevalence of factors observed suggests the need to advance screening tools and education efforts to include randomized clinical trials, optimize health of athletes and provide information for future investigation into the Triad among Nigerian athletes.

Published in	American Journal of Sports Science (Volume 13, Issue 4)
DOI	10.11648/j.ajss.20251304.11
Page(s)	85-94
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Female Athlete, Energy Deficiency, Amenorrhea, Bone Health, Menstrual Irregularity

References

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APA Style

Akinyemi, J. S., Williams, N., Salamunes, A. C., Souza, M. J. D., Otinwa, G. O. (2025). Prevalence of the Attributes of the Female Athlete Triad in Competitive Nigerian Female Athletes. American Journal of Sports Science, 13(4), 85-94. https://doi.org/10.11648/j.ajss.20251304.11

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ACS Style

Akinyemi, J. S.; Williams, N.; Salamunes, A. C.; Souza, M. J. D.; Otinwa, G. O. Prevalence of the Attributes of the Female Athlete Triad in Competitive Nigerian Female Athletes. Am. J. Sports Sci. 2025, 13(4), 85-94. doi: 10.11648/j.ajss.20251304.11

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AMA Style

Akinyemi JS, Williams N, Salamunes AC, Souza MJD, Otinwa GO. Prevalence of the Attributes of the Female Athlete Triad in Competitive Nigerian Female Athletes. Am J Sports Sci. 2025;13(4):85-94. doi: 10.11648/j.ajss.20251304.11

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@article{10.11648/j.ajss.20251304.11,
  author = {Jane Sharon Akinyemi and Nancy Williams and Ana Carla Salamunes and Mary Jame De Souza and Grace Olapeju Otinwa},
  title = {Prevalence of the Attributes of the Female Athlete Triad in Competitive Nigerian Female Athletes
},
  journal = {American Journal of Sports Science},
  volume = {13},
  number = {4},
  pages = {85-94},
  doi = {10.11648/j.ajss.20251304.11},
  url = {https://doi.org/10.11648/j.ajss.20251304.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajss.20251304.11},
  abstract = {The Female Athlete Triad syndrome describes three interrelated conditions: low energy availability with or without disordered eating, menstrual dysfunction, and poor bone health, inclusive of low bone density and bone stress injury. Sports participation for female athletes has risen exponentially; however, investigations into the health and wellbeing of female athletes from Africa are extremely limited because these groups are noticeably absent from the Triad literature. This research gap can have negative health implications, on the Female Athletes in Nigerian athletes. Purpose: To investigate the prevalence of Triad components in competitive Nigerian female university athletes as well as explore hematological markers. Methods: n=71, (21.8±0.3yrs) and BMI (22.5±0.6 kg/m2) female athletes from the University of Lagos, during the Nigeria University Games Competition, completed a Health, Exercise Nutritional Survey questionnaire to provide demographics, medical history, exercise, and dietary practices. Athletes consented to a complete blood count (CBC) assessment: white blood cell (WBC), hematocrit (HCT), red blood cell (RBC), hemoglobin (HGB) and platelets. Results: Exercise frequency was 4.6±0.3 days/wk., overtraining, 6.8%, age at menarche 12.8±0.1 yrs., and gynecological age 9.2 ±0.5 yrs. Factors reflecting energetic status include (20/71): 28% reported eating a low-fat diet, (27/71) 38% dieted to lose weight to change their body composition and to improve performance, (2/71) 3% reported a history of anorexia and Bulimia. Prevalence of oligomenorrhea was (11/71) 15% while amenorrhea was (14/71) 19%. Stress fracture was reported to be (9/71) 13% and (3/71) 4%, had a family history of osteoporosis. (24/71) 34% refrained from training due to injuries during the past year and (7/71) 9.8% reported illness due to exercise. CBC measures showed RBC (3.95±0.06 1012/L), HGB (10.64±0.11 g/dL), HCT (32.68±0.31%) WBC (5.20±0.14 109/L) and platelets (245.17±8.2 *109/L), demonstrating that RBC and WBC are within the normal range while HGB, HCT and platelets are abnormal. Athletes in endurance sports had a decreased hematocrit (HCT). Conclusion: A significant percentage of Nigerian female athletes participating in the NUGA Games demonstrated factors reflective of poor energy intake, menstrual dysfunction and bone health including a history of stress fractures and absence from sport due to injury. The prevalence of factors observed suggests the need to advance screening tools and education efforts to include randomized clinical trials, optimize health of athletes and provide information for future investigation into the Triad among Nigerian athletes.
},
 year = {2025}
}

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TY  - JOUR
T1  - Prevalence of the Attributes of the Female Athlete Triad in Competitive Nigerian Female Athletes

AU  - Jane Sharon Akinyemi
AU  - Nancy Williams
AU  - Ana Carla Salamunes
AU  - Mary Jame De Souza
AU  - Grace Olapeju Otinwa
Y1  - 2025/10/30
PY  - 2025
N1  - https://doi.org/10.11648/j.ajss.20251304.11
DO  - 10.11648/j.ajss.20251304.11
T2  - American Journal of Sports Science
JF  - American Journal of Sports Science
JO  - American Journal of Sports Science
SP  - 85
EP  - 94
PB  - Science Publishing Group
SN  - 2330-8540
UR  - https://doi.org/10.11648/j.ajss.20251304.11
AB  - The Female Athlete Triad syndrome describes three interrelated conditions: low energy availability with or without disordered eating, menstrual dysfunction, and poor bone health, inclusive of low bone density and bone stress injury. Sports participation for female athletes has risen exponentially; however, investigations into the health and wellbeing of female athletes from Africa are extremely limited because these groups are noticeably absent from the Triad literature. This research gap can have negative health implications, on the Female Athletes in Nigerian athletes. Purpose: To investigate the prevalence of Triad components in competitive Nigerian female university athletes as well as explore hematological markers. Methods: n=71, (21.8±0.3yrs) and BMI (22.5±0.6 kg/m2) female athletes from the University of Lagos, during the Nigeria University Games Competition, completed a Health, Exercise Nutritional Survey questionnaire to provide demographics, medical history, exercise, and dietary practices. Athletes consented to a complete blood count (CBC) assessment: white blood cell (WBC), hematocrit (HCT), red blood cell (RBC), hemoglobin (HGB) and platelets. Results: Exercise frequency was 4.6±0.3 days/wk., overtraining, 6.8%, age at menarche 12.8±0.1 yrs., and gynecological age 9.2 ±0.5 yrs. Factors reflecting energetic status include (20/71): 28% reported eating a low-fat diet, (27/71) 38% dieted to lose weight to change their body composition and to improve performance, (2/71) 3% reported a history of anorexia and Bulimia. Prevalence of oligomenorrhea was (11/71) 15% while amenorrhea was (14/71) 19%. Stress fracture was reported to be (9/71) 13% and (3/71) 4%, had a family history of osteoporosis. (24/71) 34% refrained from training due to injuries during the past year and (7/71) 9.8% reported illness due to exercise. CBC measures showed RBC (3.95±0.06 1012/L), HGB (10.64±0.11 g/dL), HCT (32.68±0.31%) WBC (5.20±0.14 109/L) and platelets (245.17±8.2 *109/L), demonstrating that RBC and WBC are within the normal range while HGB, HCT and platelets are abnormal. Athletes in endurance sports had a decreased hematocrit (HCT). Conclusion: A significant percentage of Nigerian female athletes participating in the NUGA Games demonstrated factors reflective of poor energy intake, menstrual dysfunction and bone health including a history of stress fractures and absence from sport due to injury. The prevalence of factors observed suggests the need to advance screening tools and education efforts to include randomized clinical trials, optimize health of athletes and provide information for future investigation into the Triad among Nigerian athletes.

VL  - 13
IS  - 4
ER  -

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Author Information

Jane Sharon Akinyemi

Department of Sport and Movement Science, Salem State University, Salem, USA

Contact Email

http://orcid.org/0009-0004-4473-2315
Nancy Williams

Department of Kinesiology, Penn State University, University Park, USA

Contact Email

http://orcid.org/0000-0003-3690-6691
Ana Carla Salamunes

Department of Kinesiology, Penn State University, University Park, USA

Contact Email

http://orcid.org/0000-0002-7326-5320
Mary Jame De Souza

Department of Kinesiology, Penn State University, University Park, USA

Contact Email

http://orcid.org/0000-0001-5185-9710
Grace Olapeju Otinwa

Department of Human Kinetics and Health Education, University of Lagos, Lagos, Nigeria

Contact Email

http://orcid.org/0000-0002-8983-8103

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APA Style

Akinyemi, J. S., Williams, N., Salamunes, A. C., Souza, M. J. D., Otinwa, G. O. (2025). Prevalence of the Attributes of the Female Athlete Triad in Competitive Nigerian Female Athletes. American Journal of Sports Science, 13(4), 85-94. https://doi.org/10.11648/j.ajss.20251304.11

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ACS Style

Akinyemi, J. S.; Williams, N.; Salamunes, A. C.; Souza, M. J. D.; Otinwa, G. O. Prevalence of the Attributes of the Female Athlete Triad in Competitive Nigerian Female Athletes. Am. J. Sports Sci. 2025, 13(4), 85-94. doi: 10.11648/j.ajss.20251304.11

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AMA Style

Akinyemi JS, Williams N, Salamunes AC, Souza MJD, Otinwa GO. Prevalence of the Attributes of the Female Athlete Triad in Competitive Nigerian Female Athletes. Am J Sports Sci. 2025;13(4):85-94. doi: 10.11648/j.ajss.20251304.11

Copy | Download

@article{10.11648/j.ajss.20251304.11,
  author = {Jane Sharon Akinyemi and Nancy Williams and Ana Carla Salamunes and Mary Jame De Souza and Grace Olapeju Otinwa},
  title = {Prevalence of the Attributes of the Female Athlete Triad in Competitive Nigerian Female Athletes
},
  journal = {American Journal of Sports Science},
  volume = {13},
  number = {4},
  pages = {85-94},
  doi = {10.11648/j.ajss.20251304.11},
  url = {https://doi.org/10.11648/j.ajss.20251304.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajss.20251304.11},
  abstract = {The Female Athlete Triad syndrome describes three interrelated conditions: low energy availability with or without disordered eating, menstrual dysfunction, and poor bone health, inclusive of low bone density and bone stress injury. Sports participation for female athletes has risen exponentially; however, investigations into the health and wellbeing of female athletes from Africa are extremely limited because these groups are noticeably absent from the Triad literature. This research gap can have negative health implications, on the Female Athletes in Nigerian athletes. Purpose: To investigate the prevalence of Triad components in competitive Nigerian female university athletes as well as explore hematological markers. Methods: n=71, (21.8±0.3yrs) and BMI (22.5±0.6 kg/m2) female athletes from the University of Lagos, during the Nigeria University Games Competition, completed a Health, Exercise Nutritional Survey questionnaire to provide demographics, medical history, exercise, and dietary practices. Athletes consented to a complete blood count (CBC) assessment: white blood cell (WBC), hematocrit (HCT), red blood cell (RBC), hemoglobin (HGB) and platelets. Results: Exercise frequency was 4.6±0.3 days/wk., overtraining, 6.8%, age at menarche 12.8±0.1 yrs., and gynecological age 9.2 ±0.5 yrs. Factors reflecting energetic status include (20/71): 28% reported eating a low-fat diet, (27/71) 38% dieted to lose weight to change their body composition and to improve performance, (2/71) 3% reported a history of anorexia and Bulimia. Prevalence of oligomenorrhea was (11/71) 15% while amenorrhea was (14/71) 19%. Stress fracture was reported to be (9/71) 13% and (3/71) 4%, had a family history of osteoporosis. (24/71) 34% refrained from training due to injuries during the past year and (7/71) 9.8% reported illness due to exercise. CBC measures showed RBC (3.95±0.06 1012/L), HGB (10.64±0.11 g/dL), HCT (32.68±0.31%) WBC (5.20±0.14 109/L) and platelets (245.17±8.2 *109/L), demonstrating that RBC and WBC are within the normal range while HGB, HCT and platelets are abnormal. Athletes in endurance sports had a decreased hematocrit (HCT). Conclusion: A significant percentage of Nigerian female athletes participating in the NUGA Games demonstrated factors reflective of poor energy intake, menstrual dysfunction and bone health including a history of stress fractures and absence from sport due to injury. The prevalence of factors observed suggests the need to advance screening tools and education efforts to include randomized clinical trials, optimize health of athletes and provide information for future investigation into the Triad among Nigerian athletes.
},
 year = {2025}
}

Copy | Download

TY  - JOUR
T1  - Prevalence of the Attributes of the Female Athlete Triad in Competitive Nigerian Female Athletes

AU  - Jane Sharon Akinyemi
AU  - Nancy Williams
AU  - Ana Carla Salamunes
AU  - Mary Jame De Souza
AU  - Grace Olapeju Otinwa
Y1  - 2025/10/30
PY  - 2025
N1  - https://doi.org/10.11648/j.ajss.20251304.11
DO  - 10.11648/j.ajss.20251304.11
T2  - American Journal of Sports Science
JF  - American Journal of Sports Science
JO  - American Journal of Sports Science
SP  - 85
EP  - 94
PB  - Science Publishing Group
SN  - 2330-8540
UR  - https://doi.org/10.11648/j.ajss.20251304.11
AB  - The Female Athlete Triad syndrome describes three interrelated conditions: low energy availability with or without disordered eating, menstrual dysfunction, and poor bone health, inclusive of low bone density and bone stress injury. Sports participation for female athletes has risen exponentially; however, investigations into the health and wellbeing of female athletes from Africa are extremely limited because these groups are noticeably absent from the Triad literature. This research gap can have negative health implications, on the Female Athletes in Nigerian athletes. Purpose: To investigate the prevalence of Triad components in competitive Nigerian female university athletes as well as explore hematological markers. Methods: n=71, (21.8±0.3yrs) and BMI (22.5±0.6 kg/m2) female athletes from the University of Lagos, during the Nigeria University Games Competition, completed a Health, Exercise Nutritional Survey questionnaire to provide demographics, medical history, exercise, and dietary practices. Athletes consented to a complete blood count (CBC) assessment: white blood cell (WBC), hematocrit (HCT), red blood cell (RBC), hemoglobin (HGB) and platelets. Results: Exercise frequency was 4.6±0.3 days/wk., overtraining, 6.8%, age at menarche 12.8±0.1 yrs., and gynecological age 9.2 ±0.5 yrs. Factors reflecting energetic status include (20/71): 28% reported eating a low-fat diet, (27/71) 38% dieted to lose weight to change their body composition and to improve performance, (2/71) 3% reported a history of anorexia and Bulimia. Prevalence of oligomenorrhea was (11/71) 15% while amenorrhea was (14/71) 19%. Stress fracture was reported to be (9/71) 13% and (3/71) 4%, had a family history of osteoporosis. (24/71) 34% refrained from training due to injuries during the past year and (7/71) 9.8% reported illness due to exercise. CBC measures showed RBC (3.95±0.06 1012/L), HGB (10.64±0.11 g/dL), HCT (32.68±0.31%) WBC (5.20±0.14 109/L) and platelets (245.17±8.2 *109/L), demonstrating that RBC and WBC are within the normal range while HGB, HCT and platelets are abnormal. Athletes in endurance sports had a decreased hematocrit (HCT). Conclusion: A significant percentage of Nigerian female athletes participating in the NUGA Games demonstrated factors reflective of poor energy intake, menstrual dysfunction and bone health including a history of stress fractures and absence from sport due to injury. The prevalence of factors observed suggests the need to advance screening tools and education efforts to include randomized clinical trials, optimize health of athletes and provide information for future investigation into the Triad among Nigerian athletes.

VL  - 13
IS  - 4
ER  -

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