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Menstruation DisturbancesNCT05107804

Energy Restriction and Hormones in Premenopausal Women

A study testing Exercise+CR and Light Conditioning in people with Menstruation Disturbances and Luteal Phase Defect, run by Penn State University.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

A growing body of epidemiological and biological evidence strongly suggests that physical activity may reduce the risk of breast cancer. Although the mechanism remains unclear, possible links between reduced risk and exercise include favorable alterations in body composition and positive changes in the hormonal… Read more about this study

Who is it for?
Ages 25 to 40 years, women onlyHealthy volunteers can take part
What is being tested?
Exercise+CR and Light Conditioning
Could I receive a placebo?
No, everyone receives an active treatment
How many people
47 participants
Where
No sites listed yet
Study dates
Mar 2001to Nov 2006
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 25 to 40 years
  • Women only
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Weight 50-90 kg
  • BMI 18-35 kg/m2
  • Nonsmoking
  • <1 hour/week of purposeful aerobic exercise for the past 6 months
  • Gynecological age ≥10 years
  • Documentation of at least two ovulatory menstrual cycles during screening.

Who cannot join

  • History of serious medical conditions
  • Medication use that would alter metabolic hormone levels
  • Significant weight loss/gain (±2.3 kg) in the last year
  • Current evidence of disordered eating or history of an eating disorder
  • Taking exogenous hormonal contraceptives for the past 6 month
  • Smoking

About this study

Official title: Effects of Moderate Aerobic Exercise Combined With Caloric Restriction on Circulating Estrogens and IGF-I in Premenopausal Women

A growing body of epidemiological and biological evidence strongly suggests that physical activity may reduce the risk of breast cancer. Although the mechanism remains unclear, possible links between reduced risk and exercise include favorable alterations in body composition and positive changes in the hormonal milieu. One hormonal biomarker of breast cancer, circulating estrogen, is postulated to be reduced by chronic physical activity, presumably due to disruptive effects of exercise upon menstrual cyclicity, and the potential for loss of body fat with subsequent reductions in the peripheral biosynthesis of circulating estrogens. Although studies have shown that chronic exercise can reduce circulating estrogen, we know little about the magnitude and duration of exposure to an energy deficit required for these changes. Additionally, no studies have addressed the degree to which peripheral production of estrone, versus the ovarian production of estradiol, is altered with exercise that promotes weight/fat loss. A second biomarker of breast cancer, insulin-like growth factor-1 (IGF-1), is presumably increased with exercise but reduced with exercise if energy balance is negative. No prospective studies have addressed whether a moderate aerobic exercise program that results in weight loss will lead to significant changes in IGF-I levels, particularly in individuals of differing initial energy stores.

Metabolic energy availability is an important contributing factor in the development of reproductive cancers. However, current methods for assessing energy availability, which include anthropometric measures, calculations of energy balance, evaluation of various serum and urinary biomarkers are prone to measurement error, not sensitive to alterations in energy availability, and are sometimes affected by disease states. The current project includes the introduction of a novel approach to estimating energy status by measuring metabolic hormones in plasma: insulin, IGF-I, insulin-like growth factor binding protein-3 (IGFBP-3) and leptin.

This study tested whether a program of moderate aerobic exercise that is combined with a moderate level of dietary restriction would result in significant decreases in two biomarkers of breast cancer, circulating estrogens and IGF-I.

Read the detailed description

This study used a randomized prospective design (block; 3:1 allocation) to test the effects of a four month (four menstrual cycles) intervention of moderate aerobic exercise (4 times per week, 60 minutes/session) combined with caloric restriction designed to produce a weekly energy deficit of -20%. The aims of the study were: 1) To test the hypothesis that a moderate level of low energy availability created through a combination of exercise and caloric restriction will lower circulating estrogens and IGF-I; 2) To test the hypothesis that exercise-induced decreases in body fat will contribute substantially to the lowering of circulating estrogens changes with training; 3) To validate a novel method of assessing energy status that represents an improvement of existing.

Eumenorrheic, untrained women between 25-40 years (n=47) were randomly assigned to one of two treatments groups: exercise with caloric-restriction (EX+CR; n=36) or light conditioning reference (LC; n=11) groups. To determine treatment effects on circulating estrogens, reproductive function and IGF-I, both serum and urinary levels of hormones were monitored for a control period of 2 months (2 menstrual cycles), i.e., Screening and Baseline, followed the 4 month (4 menstrual cycles: intervention 1-4) experimental period. The exercise/diet intervention began on the first day of the third month (menstrual cycle) and continue for four menstrual cycles thereafter (intervention 1, 2, 3, and 4). A post-study measurement was taken during cycles days 1-7 of the seventh menstrual cycle.

Baseline energy needs were assessed during the baseline cycle. Resting metabolic rate and non-exercise physical activity were added to determine a caloric need for the day. Caloric intake was supervised throughout the entire study, and meals were comprised of 55% carbohydrates, 30% fat, and 15% protein. Exercise training was supervised, and maximal aerobic capacity (VO2max) was calculated. Menstrual status was assessed through analysis of daily urinary metabolites of estrone-1-glucuronide (E1G), pregnanediol glucuronide (PdG), and midcycle luteinizing hormone (LH). Underwater weighing and a digital scale were used to assess body composition, and fasting blood samples were collected to assess metabolic hormones.

Being tested
Exercise+CR, Light Conditioning
Keywords
Energy Balance, Menstrual Cycle Disturbance, Luteal Phase Defect, Menstruation Disturbances, Pathologic Processes
Medical subject headings
Menstruation Disturbances, Pathologic Processes

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Exercise+CROther

    Exercise with caloric-restriction

  • Light ConditioningOther

    Light Conditioning Exercise

Study groups in NCT05107804
Study groupRoleWhat they receive
Exercise with caloric-restrictionExperimentalExercise: Participants engaged in supervised exercise training sessions (to expend ~20% of baseline energy needs) in Noll Laboratory; 4 times per week. Diet: Participants consumed meals in the General Clinical Research Center metabolic kitchen that reduced dietary intake 20-35% of baseline energy needs. Diet composition was 55% carbohydrates, 30% fat, and 15% protein.
Receives: Other: Exercise+CR
Light Conditioning (reference group)Active comparatorExercise: Participants engaged in supervised exercise training sessions (to expend ~10% of baseline energy needs) in Noll Laboratory; 1-2 times per week. Diet: Participants consumed meals in the General Clinical Research Center metabolic kitchen that had calories sufficient to maintain body weight and additional calories to remain in energy balance. Diet composition was 55% carbohydrates, 30% fat, and 15% protein.
Receives: Other: Light Conditioning

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in estrogen and IGF-1

    Change in urine estrone-1-glucuronide (E1G ng/mL) and serum IGF-1 (ng/mL)

    Measured: Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)

Secondary outcomes (9)
  1. Change in body composition

    Change in percent body fat (%)

    Measured: Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)

  2. Change in body composition

    fat mass (kg) and fat free mass (kg)

    Measured: Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)

  3. Change in reproductive hormones

    Change in reproductive hormones sex hormone binding globulin (SHBG nmol/L)

    Measured: Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)

  4. Change in reproductive hormones

    Change in reproductive hormones pregnanediol glucuronide (PdG ng/mL)

    Measured: Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)

  5. Change in metabolic hormones

    Change in metabolic hormones leptin (ng/mL) and insulin-like growth factor binding protein 3 (ng/mL)

    Measured: Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)

  6. Change in metabolic hormones

    Change in metabolic hormone insulin (μIU/mL)

    Measured: Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)

  7. Change in metabolic hormones

    Change in metabolic hormone sex hormone binding globulin (nmol/L)

    Measured: Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)

  8. Change in metabolic hormones

    Change in metabolic hormone total triiodothyronine (ng/dL)

    Measured: Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)

  9. Change in menstrual cycle phase length

    Change in follicular phase length (days) and luteal phase length (days)

    Measured: Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Nov 2021
  2. Study startMar 2001
  3. Primary completionNov 2006
  4. Study completionNov 2006

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
47 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05107804
Sponsor's protocol ID
01M0088
Other IDs
M01RR010732, DAMD 17-01-1-0361, DAMD 17-01-109360
Status last verified
Oct 2021
First submitted
6 Oct 2021
Last updated
4 Nov 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Williams NI, Reed JL, Leidy HJ, Legro RS, De Souza MJ. Estrogen and progesterone exposure is reduced in response to energy deficiency in women aged 25-40 years. Hum Reprod. 2010 Sep;25(9):2328-39. doi: 10.1093/humrep/deq172. Epub 2010 Jul 6.

    PubMed 20605898

Questions about this trial

What is this clinical trial studying?

A study testing Exercise+CR and Light Conditioning in people with Menstruation Disturbances and Luteal Phase Defect, run by Penn State University.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Nov 2021. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in estrogen and IGF-1 (time frame: Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05107804, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Nov 2021.

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