Ladies, from the perspective of girl's and women's athletics in America, it's a great time to be alive. Since the historic passage of Title IX in that mandated equal sports participation of the sexes, the number of high school girls involved in organized athletics has skyrocketed over one thousand percent since 1971. Today, over 3 million girls ages 14-18 proudly call themselves female athletes, and the trend has extended in the grade schools and with adults. Evidence abounds on the benefits of girls playing sports - from lower rates of smoking, obesity, drug and alcohol use to better grades and self-confidence, improved math skills and a lower risk of breast cancer. It hardly comes as a surprise that, in one report, 80% of female executives at Fortune 500 companies reported playing sports while growing up. Athletics, when properly taught, teach invaluable life lessons to young women.

Along with all the good that sports can do for girls and women of all ages, however, there are health issues unique to female athletes that need to be considered, and current research, as well as personal experience, shows that this information is not getting out to people. Because of anatomical differences between the genders, for example, female high school and college soccer players are four to six times more likely than their male counterparts to tear their anterior cruciate ligament (ACL). Females who exercise regularly may be at risk for and develop the Female Athlete Triad, an inter-related series of conditions that begins with disordered eating (i.e. inadequate calorie intake for the amount of energy used with exercise and everyday functioning). This can lead to amenorrhea, or missing three or more consecutive menstrual periods; both of these factors can result in the frightening outcome of osteoporosis, or low bone mass and increased risk of fractures. There may even be a cardiovascular component, where 'Triad' females' arteries ability to dilate in response to exercise is decreased. Since current knowledge indicates that girls put on most of their bone mass from ages 11-14, and stop adding bone at around 20-21, it is essential that, as parents, coaches, health care providers - anyone, in short, committed to the well being of our young women - we can provide them with the information and support they need to strengthen their bones at this crucial time to last them for a lifetime.

A study at a large Midwestern university hospital that I was lucky to be involved in, showed that less than half of all physicians (and less than 40% of athletic trainers and 8% of coaches) that were polled knew what the Female Athlete Triad was. When these same doctors were asked how comfortable they felt treating the 'Triad,' the average score among specialties, including Orthopedics, OB-GYN, Pediatrics, PM&R (Rehab Medicine) and Family Medicine was nine percent. As one person put it, pediatric warning signs, left unchecked, lead to geriatric problems. For the sake of our female athletes, it is essential that they understand how their bodies work, and what their bodies are telling them. Be sure your female athlete is well informed about the best conditioning programs to prevent injury, her food intake and calcium needs, in both the athletic and off season, her menstrual history and her bone health. With some help from a physician knowledgeable in women's sports, a dietician and some testing, such as a DEXA scan to assess bone mineral density (strength), this is all feasible nowadays. As I said before, it's a great time to be alive!