What is female athlete triad? Here's what to know about the often unrecognized, underdiagnosed condition

PHILADELPHIA (CBS) — A doctor and student at the Sidney Kimmel Medical College are trying to raise awareness about an often unrecognized and underdiagnosed condition that affects many young female athletes.

On the outside, athletes often look like the picture of health, but doctors say that can be deceiving.

In between classes at Sidney Kimmel Medical College, Hanna Blankmeier gets in workouts, but she's no longer a competitive swimmer.

"It's just very peaceful for me," Blankmeier said. "I love the rigor physically of it and really testing my body, pushing my body."

Blankmeier said that competitive edge led to a disorder that she didn't even know she had until she heard about it in medical school – the female athlete triad.

The female athlete triad happens when there's energy deficiency, impaired bone health and menstrual dysfunction.

"I suspect it's significantly underdiagnosed," said Dr. Swati Shroff, who specializes in women's health at Sidney Kimmel Medical College.

"When someone is burning more calories than they're consuming, it kind of signals to the brain, to a part of the brain called the hypothalamus, to stop releasing certain hormones, including estrogen," Shroff said. "When that happens, that's what leads to the menstrual dysfunction and affects bone health."

Blankmeier said she and many of her fellow swimmers stopped menstruating, and she didn't know it was a problem.

"It was expected if you were working really hard," she said.

The triad includes elements of an eating disorder, Blankmeier said. Her own eating disorder eventually became severe and she couldn't compete anymore.

With the disorder now under control Blankmeier said she and Shroff are working to raise awareness because left untreated, the female athlete triad can lead to serious conditions like osteoporosis and infertility.

One study found only 37% of physicians had heard of the female athlete triad.

Learn more at Kidhealth.org and femaleathletetriad.org .