I was interviewed recently by Natsue Koikawa, Associate Professor of Sports Science at Juntendo University in Tokyo, Japan. She is also the Director of Women’s Track and Field at the university, along with the Deputy Directory of Japanese Center for Research on Women in Sport. After finding me online, she and her research assistant, Tomomi Hirao, came to Louisville to complete her research by interviewing about the female athlete triad. Ed Sato assisted in translating the conversation. 
The two women had questions regarding my treatment of the female athlete triad, and my treatment plans for these patients and we discussed our current research findings. The Female Athlete Triad is a huge problem in Japan. Over half of Dr. Koikawa’s track team, which would be the equivalent of a Division I NCAA team, has stress fractures and potentially the female athlete triad.
She asked me about education of this condition in the United States and any ideas I had on educating their coaches. I discussed with her that continuing education is always important among coaches and that this should be a topic in the high risk sports such as long-distance running and gymnastics.
Dr. Grossfeld’s Advice About the Female Athlete Triad
I offered my thoughts on that it is a multi-factorial problem in the sense that you have athletes that are anorexic versus athletes that are not taking in enough calories because they are going to class and they are working out all the time. I discussed with her that I treat these groups of athletes differently. The group that is anorexic needs to be addressed with a team approach including a psychiatrist, nutritionist, athletic trainer, the athletes, and the patient along with the coach.
For athletes that are nutrient deficient, I have them calculate basal metabolic rate, caloric intake and I ask the athlete to keep a food log. The athletic trainer then helps monitor their caloric intake.
After wrapping up our conversation and research findings that were only accessible via orthopedic surgeons, the two women were extremely gracious and appreciative. I asked them both to please email me if they have any further questions in the future and I am looking forward to more conversations with my new friends!
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