FHA: Effects of Physical and Psychosocial Stress on Functional Hypothalamic Amenorrhea in Exercising Women

Sponsor
University of Colorado, Colorado Springs (Other)
Overall Status
Recruiting
CT.gov ID
NCT05967819
Collaborator
(none)
54
1
4
25
2.2

Study Details

Study Description

Brief Summary

The goal of this clinical trial is to determine how changes in exercise and psychosocial stress may influence the risk of menstrual cycle irregularities in female runners. The main questions it aims to answer are:

  • Does the implementation of exercise or psychosocial stress effect circulating reproductive hormones (i.e., estradiol, progesterone, luteinizing hormone) and menstrual cycle length?

  • Is there an additive effect of combined exercise and psychosocial on circulating reproductive hormones (i.e., estradiol, progesterone, luteinizing hormone) and menstrual cycle length?

Participants will be asked to do the following over the ~3 month enrollment period:
  • attend a laboratory visit at the beginning and end of the study to have their resting metabolic rate, aerobic fitness, and body composition tested

  • monitor their menstrual cycle length, daily perceived stress levels, physical activity, and diet each month

  • provide several urine and saliva samples each month

  • either maintain their usual physical activity and lifestyle habits (control group), increase the duration of their weekly running mileage by 30% (exercise stress group), complete cognitive function tasks designed to be stressful (psychosocial stress group), or increase the duration of their weekly running mileage by 30% and complete cognitive function tasks designed to be stressful (exercise + psychosocial stress group) during the final month of enrollment.

Researchers will compare control, exercise stress, psychosocial stress, and exercise + psychosocial stress groups to see if there is an effect on circulating reproductive hormones (i.e., estradiol, progesterone, luteinizing hormone) and menstrual cycle length.

Condition or Disease Intervention/Treatment Phase
  • Behavioral: Exercise Stress
  • Behavioral: Psychosocial Stress
N/A

Study Design

Study Type:
Interventional
Anticipated Enrollment :
54 participants
Allocation:
Randomized
Intervention Model:
Factorial Assignment
Masking:
None (Open Label)
Primary Purpose:
Basic Science
Official Title:
Independent and Synergistic Effects of Physical and Psychosocial Stress on Functional Hypothalamic Amenorrhea in Exercising Women
Anticipated Study Start Date :
Aug 1, 2023
Anticipated Primary Completion Date :
Aug 30, 2025
Anticipated Study Completion Date :
Aug 30, 2025

Arms and Interventions

Arm Intervention/Treatment
No Intervention: Control

Participants will be asked to maintain their usual physical activity and lifestyle habits.

Experimental: Exercise Stress

The duration of participant's weekly running mileage will be increased by 30% while intensity is maintained.

Behavioral: Exercise Stress
Increased exercise volume

Experimental: Psychosocial Stress

Participants will be asked to complete cognitive function tasks designed to be stressful while maintaining their usual physical activity habits.

Behavioral: Psychosocial Stress
cognitive tasks

Experimental: Exercise + Psychosocial Stress

Participants will be asked to complete cognitive function tasks designed to be stressful while the duration of their weekly running mileage is increased by 30% and intensity maintained.

Behavioral: Exercise Stress
Increased exercise volume

Behavioral: Psychosocial Stress
cognitive tasks

Outcome Measures

Primary Outcome Measures

  1. Urinary estrone-3-glucuronide (E3G) [3 months]

    ng/mL

  2. Urinary pregnanediol glucuronide (PdG) [3 months]

    ug/mL

  3. Urinary luteinizing hormone (LH) [3 months]

    MIU/mL

  4. Menstrual cycle length [3 months]

    days

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years to 35 Years
Sexes Eligible for Study:
Female
Accepts Healthy Volunteers:
Yes
Inclusion Criteria:
  • have participated in structured running exercise at least 4 days per week, completing at least 30 miles per week, for the past 12 months

  • can complete a 5-km race in less than 25:00

  • have regular periods every 21 to 35 days

  • have not used hormonal contraceptives for at least the past 6 months

  • are not currently or trying to become pregnant or are breastfeeding, and have not been pregnant or breastfeeding for the past 12 months

  • have never been diagnosed with a menstrual cycle disorder (e.g., menorrhagia, amenorrhea, dysmenorrhea, polycystic ovary syndrome [PCOS], endometriosis, premenstrual dysphoric disorder [PMDD], menstrual migraines, ovarian cancer, ovarian insufficiency, uterine or endometrial cancer)

  • have never been diagnosed with a metabolic disease (e.g., hypothyroidism, hyperthyroidism, Cushing disease, Addison's disease, diabetes)

Exclusion Criteria:
  • missing > 4 consecutive days of structured running exercise

  • they indicate they "Could not participate at all due to a health problem" or have had to modify their exercise training, felt their injury, illness, or other health problem has affected their exercise performance, or experienced symptoms/ health complaints greater than "To a minor extent" on the Oslo Sports Trauma Research Center Questionnaire (exercise training intervention group)

  • demonstrate clinical low energy availability as defined as energy availability <30 Kcal/kg fat free mass in the first two months of at-home monitoring

  • report menstrual cycle lengths <21 days or >35 days in the first two months of at-home monitoring

  • do not demonstrate an anticipated rise in progesterone levels during the latter half of their cycle or luteinizing hormone levels at mid-cycle compared to tests taken during the first few days after menses in the first two months of at-home monitoring

  • begin taking a hormonal contraceptive

  • become pregnant

  • are diagnosed with a menstrual cycle disorder (e.g., menorrhagia, amenorrhea, dysmenorrhea, polycystic ovary syndrome [PCOS], endometriosis, premenstrual dysphoric disorder [PMDD], menstrual migraines, ovarian cancer, ovarian insufficiency, uterine or endometrial cancer)

  • are diagnosed with a metabolic disease (e.g., hypothyroidism, hyperthyroidism, Cushing disease, Addison's disease, diabetes), 10) are diagnosed with a major cardiovascular disease, respiratory disease, or musculoskeletal injury

  • are unable to follow instructions for any of the procedures

Contacts and Locations

Locations

Site City State Country Postal Code
1 University of Colorado Colorado Springs Colorado Springs Colorado United States 80918

Sponsors and Collaborators

  • University of Colorado, Colorado Springs

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Marissa Baranauskas, Assistant Professor, University of Colorado, Colorado Springs
ClinicalTrials.gov Identifier:
NCT05967819
Other Study ID Numbers:
  • CRCW FHA
First Posted:
Aug 1, 2023
Last Update Posted:
Aug 1, 2023
Last Verified:
Jul 1, 2023
Individual Participant Data (IPD) Sharing Statement:
No
Plan to Share IPD:
No
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Keywords provided by Marissa Baranauskas, Assistant Professor, University of Colorado, Colorado Springs
Additional relevant MeSH terms:

Study Results

No Results Posted as of Aug 1, 2023