On April 1996, Doreen Chadwick Wiggins '88 M.D. ran the 100th Boston Marathon in four hours and fifteen minutes - eight weeks after giving birth to her fourth child. "My time wasn't that great," she says, "but it's good to know that you can, while breast-feeding, run a marathon two months post-partem and not have a problem."

Wiggins knows how easily that kind of drive can turn into a self-destructive obsession. A clinical assistant professor of obstetrics and gynecology at Brown's medical school, Wiggins and her husband, Michael - himself a triathlete and orthopedic surgeon - recently studied female athletes and cautioned doctors to be on the lookout for three problems that occur more frequently in these women. This "female athlete triad" - a term first coined by the American College of Sports Medicine in 1992 - consists of eating disorders, amenorrhea (absence of menstruation), and osteoporosis. Rates of all three, the Wigginses wrote in Clinics in Sports Medicine last fall, have increased dramatically since 1972, when Title IX, the federal law prohibiting gender bias in education, created more opportunities for girls and women to participate in sports.

The three elements of the triad, Doreen Wiggins says, aren't easily separable. By themselves, eating disorders can cause a variety of physical and psychological problems for young women. But when strenuous physical activity is combined with anorexia nervosa or bulimia nervosa - which together affect as many as 72 percent of female athletes - possible complications can include stress fractures, premature and irreversible bone loss, and a variety of cardiovascular and gastrointestinal problems.

Frequent strenuous exercise can lead to an estrogen deficiency, and, the Wigginses point out, women require estrogen to increase their bone mass. "Stress can be perceived by your body as too much exercise or not enough calories, or both," Doreen says. This stress can cause a breakdown in communication between hormone-secreting glands in the brain and the rest of a woman's body, she adds. The process also occurs in men, but it's more difficult to detect. "Men don't have a sign that you can catch," she explains. "Women do - they don't get a period."

Young women need to learn, she continues, that playing sports isn't about being thin; it's about being healthy and having fun. Wiggins, who has run seven marathons, emphasizes that athletics "can teach you a lot - [about] goal-directed behavior, discipline, focus, the sense of being able to control your own destiny." This fall she will launch Play Sports RI, a program at Women & Infants Hospital in Providence that will pair lower-income girls between the ages of eleven and fourteen with older volunteer female athletes. The program, she says, will help the younger girls appreciate the value of a healthy and active approach to life through organized sporting events; they will also learn the basics of nutrition, teen-pregnancy prevention, and CPR technique.

The girls may not all turn out to be marathoners, but Doreen Wiggins wants them to know such a goal is possible if they choose it. "It's basically an issue of control," she says. "Sports give you a sense that you can do something for yourself."