Menstrual Cycle Hormonal Changes and Energy Substrate Metabolism in Exercising Women: A Perspective

This article discusses the research supporting that the hormonal changes across the menstrual cycle phases affect a woman’s physiology during exercise, specifically addressing aspects of energy substrate metabolism and macro-nutrient utilization and oxidation. The overarching aim is to provide a perspective on what are the limitations of earlier research studies that have concluded such hormonal changes do not affect energy metabolism. Furthermore, suggestions are made concerning research approaches in future studies to increase the likelihood of providing evidence-based data in support of the perspective that menstrual cycle hormonal changes do affect energy metabolism in exercising women.

Herbal dietary interventions for weight loss among regularly exercising women in Turkey

Purpose Obesity is a chronic disease that is conjoined with increased mortality. Parallel to rising obesity rates, herbal dietary interventions to lose weight are also increasing. The purpose of this study is to assess and evaluate the use of herbal dietary interventions for weight loss among regularly exercising women. Design/methodology/approach A total of 545 regularly exercising women (aged 19–64 years) were recruited from several local sports centers. A questionnaire form to evaluate demographic characteristics, nutritional habits and herbal dietary intervention habits was administered by a trained dietitian. Anthropometric measurements including weight, height, fat mass, total body water and fat free mass were measured using a bioelectrical impedance analysis device. Findings A total of 244 participants (44.8%) used herbal dietary interventions for weight loss within the last year. The most commonly used herbal dietary interventions were green tea (59.4%), lemon juice (27%), herbal tea mix (20.9%) and cinnamon powder (17.6%), respectively. Of the 244 women who used herbal dietary interventions for weight loss, 42.2% claimed that by using these products they experienced weight loss. Herbal dietary interventions were significantly higher among women with obesity (61.9%) than women with a healthy weight (37.5%). The use of herbal supplements increased among women who consider themselves as being overweight (p < 0.001). Furthermore, herbal dietary interventions decreased with more frequent attempts for a weight-loss diet (p < 0.001). Originality/value To the best of the authors’ knowledge, this study represents a first attempt at assessing the use of herbal dietary supplements for weight loss among regularly exercising Turkish women. With the increase of body mass index and body perception being as overweight, herbal dietary interventions were also increased. In particular, women with obesity (61.9%) used more herbal dietary interventions than women with healthy weight (37.5%). Moreover, women with an overweight body perception used more herbal supplements than those who thought they had a healthy body weight.

Prevalence and frequency of menstrual cycle symptoms are associated with availability to train and compete: a study of 6812 exercising women recruited using the Strava exercise app

ObjectivesThe menstrual cycle can affect sports participation and exercise performance. There are very few data on specific menstrual cycle symptoms (symptoms during various phases of the cycle, not only during menstruation) experienced by exercising women. We aimed to characterise the most common symptoms, as well as the number and frequency of symptoms, and evaluate whether menstrual cycle symptoms are associated with sporting outcomes.Methods6812 adult women of reproductive age (mean age: 38.3 (8.7) years) who were not using combined hormonal contraception were recruited via the Strava exercise app user database and completed a 39-part survey. Respondents were from seven geographical areas, and the questions were translated and localised to each region (Brazil, n=892; France, n=1355; Germany, n=839; Spain, n=834; UK and Ireland, n=1350; and USA, n=1542). The survey captured exercise behaviours, current menstrual status, presence and frequency of menstrual cycle symptoms, medication use for symptoms, perceived effects of the menstrual cycle on exercise and work behaviours, and history of hormonal contraception use. We propose a novel Menstrual Symptom index (MSi) based on the presence and frequency of 18 commonly reported symptoms (range 0–54, where 54 would correspond to all 18 symptoms each occurring very frequently).ResultsThe most prevalent menstrual cycle symptoms were mood changes/anxiety (90.6%), tiredness/fatigue (86.2%), stomach cramps (84.2%) and breast pain/tenderness (83.1%). After controlling for body mass index, training volume and age, the MSi was associated with a greater likelihood of missing or changing training (OR=1.09 (CI 1.08 to 1.10); p≤0.05), missing a sporting event/competition (OR=1.07 (CI 1.06 to 1.08); p≤0.05), absenteeism from work/academia (OR=1.08 (CI 1.07 to 1.09); p≤0.05) and use of pain medication (OR=1.09 (CI 1.08 to 1.09); p≤0.05).ConclusionMenstrual cycle symptoms are very common in exercising women, and women report that these symptoms compromise their exercise participation and work capacity. The MSi needs to be formally validated (psychometrics); at present, it provides an easy way to quantify the frequency of menstrual cycle symptoms.

Discriminating hypothalamic oligomenorrhea/amenorrhea from hyperandrogenic oligomenorrhea/amenorrhea in exercising women

The mechanism underlying oligo/amenorrhea in exercising women is often presumed as hypothalamic inhibition secondary to energy deficiency; however, hyperandrogenism may provide an alternative mechanism in some exercising women. Our purpose was to compare reproductive, metabolic, and androgen profiles of exercising women with eumenorrheic, ovulatory menstrual cycles (n = 91), oligo/amenorrhea without evidence of hyperandrogenism (Oligo/Amen; n = 83), and oligo/amenorrhea with evidence of hyperandrogenism (Oligo/Amen-HA; n = 17), and determine the prevalence of oligo/amenorrhea with evidence of hyperandrogenism in exercising women. Self-reported menstrual history and quantification of daily estrogen and progesterone urinary metabolites determined reproductive status. Resting energy expenditure, body composition, and metabolic hormone concentrations determined metabolic status. Serum androgens and calculated free androgen index (FAI) determined androgen status. Groups were similar in age (22.4 ± 0.3 years), height (165.1 ± 0.5 cm), resting energy expenditure (1198.4 ± 12.0 kcal/day), and total triiodothyronine (85.0 ± 1.5 ng/dL) concentration. Oligo/Amen-HA had greater weight (60.0 ± 1.6, 56.1 ± 0.7 kg), body mass index (22.3 ± 0.4, 20.6 ± 0.2 kg/m2), percentage body fat (27.3% ± 1.4%, 24.4% ± 0.6%), fat mass (16.2 ± 1.0, 13.8 ± 0.4 kg), insulin (5.8 ± 0.7, 4.2 ± 0.3 μIU/mL), leptin (12.2 ± 2.3, 6.6 ± 0.7 ng/mL), FAI (6.1 ± 0.3, 1.7 ± 0.1), and luteinizing hormone/follicle-stimulating hormone (1.9 ± 0.3, 1.3 ± 0.2) compared with Oligo/Amen, respectively. In our sample, 17% of those with oligo/amenorrhea had concurrent hyperandrogenism. This study supports that oligo/amenorrhea in some exercising women is related to hyperandrogenism. Novelty Caution must be utilized when discriminating hypothalamic oligo/amenorrhea from hyperandrogenic oligo/amenorrhea. In our sample, 17% of those with presumed hypothalamic oligo/amenorrhea had concurrent hyperandrogenism. Exercise and/or mild energy deficiency may be protective against developing severe hyperandrogenic symptoms.