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CompletedNCT02224976Updated Jan 28, 2016

Effect of Intense Training on Ovarian Function and Bone Turnover

An interventional study of Intensified Training in Amenorrhea, sponsored by USDA, Western Human Nutrition Research Center. Completed at 1 site in United States. Open to female participants aged 18 Years to 40 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2016-01-28.

Sponsored by USDA, Western Human Nutrition Research Center · Not applicable, Interventional, and Basic science

Phase
Not applicable
Study type
Interventional
Enrollment
18
Allocation
Not applicable
Ages
18 Years to 40 Years
Sex
Female
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Study summary

The investigators propose a prospective, longitudinal, department funded study protocol to evaluate whether changes in energy availability, during a period of highly intensified exercise training, will increase bone turnover markers and decrease ovarian function and exercise performance, in a dose-dependent fashion in competitive female athletes.

Read the detailed description

Female athletes participating in sports which emphasize leanness as a factor to success, while also imposing large exercise training loads, present a high prevalence of endocrine and metabolic alterations linked to low energy stores, including suppressed ovarian function and bone loss. Increased bone turnover resulting from low energy stores and suppressed estrogen production may hold the most adverse consequences for long term health, increasing the risk of premature osteopenia, while increasing the risk of stress fractures in the short term. Chronically low energy stores may also contribute to the development of overreaching and overtraining syndromes, characterized by excessive, lasting fatigue and long-term decreases in performance, which can compromise these athletes' health and athletic career. The investigators propose the first longitudinal study aiming to demonstrate the link between low energy status, impaired ovarian function, bone turnover and decreased performance in free-living, competitive female athletes. After a 4-week baseline period of habitual training, athletes will undergo 4 weeks of intensified training (IT), during which the exercise load is increased by 30% from their individual baseline load in order to sharply increase energy expenditure. As athletes will be let to freely adjust their food intake, the investigators aim to test the hypothesis that athletes will fail to adjust food intake sufficiently to match energy expenditure, and that the resulting decrease in energy availability (EA, energy intake - energy expenditure from exercise) will influence, in a dose-dependent fashion, the suppression of estrogen production, the increase in bone turnover and the severity of performance decrement. The IT period will then be followed by a 2-week taper (REC), in which exercise training volume will be reduced by 50% from baseline. The investigators will assess whether EA returns to baseline values, and characterize changes in bone turnover during this recovery period. It is hypothesized that any improvements in exercise performance resulting from IT + REC will occur in athletes who were able to remain closest to a balanced energy state during IT. Concretely linking EA to both performance and bone health may incentivize female athletes to adopt more adequate feeding behaviors for their activity level.

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Conditions studied

  • Amenorrhea

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Keywords

  • exercise training
03

In context

Amenorrhea

80 studies on the registry are indexed under Amenorrhea; 13 are open to participants now.

This study's enrollment of 18 is below the median of 60 across 43 interventional studies indexed under Amenorrhea.

Browse Amenorrhea studies →

Lead sponsor

USDA, Western Human Nutrition Research Center is the lead sponsor of 53 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 40 Years
Sexes eligible
Female
Accepts healthy volunteers
Yes

Inclusion criteria

  • competitive endurance runners (racing in events ranging from 10km to ultra-marathons)
  • training at least 5 days per week over the past 12 months, and more than 30 miles per week
  • regular menstrual cycles (24-35 days) over the past 6 months
  • maximal oxygen consumption (VO2max) > 50ml/kg/min
  • English speaking

Exclusion criteria

Exclusion Criteria:

  • smoker
  • amenorrhea
  • pregnant or lactating in the past 2 years
  • chronic disease that will affect bone health, metabolism or the cardiorespiratory system
  • take medications that have cardiovascular or metabolic effects
  • present any contra-indication to exercise testing (cardiovascular abnormalities)
  • report any major illness or injury preventing training for more than 4 weeks over the past 3 months
  • a history of clinical anorexia nervosa or bulimia nervosa
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Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
18 participants (actual)

Study arms

  • Experimental
    Intensified training

    Volunteers will increase exercise training by 30% from baseline

    Behavioral: Intensified Training

Interventions

  • BehavioralIntensified Training

    Volunteers will increase exercise training by 30% from baseline

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What researchers measure

Primary outcomes

  1. Change in energy availability (energy intake - energy expenditure of physical activity)

    The investigators aim to capture the spectrum and variability of energy availability in endurance athletes under normal training conditions, describing in detail training regimen, total energy expenditure and nutrition habits during three distinct phases of training that are habitually followed by endurance athletes.

    Time frame: Baseline (week 4), after 4 weeks of intensified training (week 8) and after a two-week recovery period (week 10)

Secondary outcomes

  1. Change in athletic performance

    The investigators will measure the effect of energy availability on exercise performance during baseline, after 4 weeks of intensified training, and after a 2-week recovery, by measuring the relationship of energy availability to maximal oxygen consumption (VO2max) and 3200 meter time trial performance. The investigators will test the hypothesis that performance will be affected by changes in energy availability in a dose-dependent fashion.

    Time frame: Baseline (week 4), after 4 weeks of intensified training (week 8) and after a two-week recovery period (week 10)

  2. Change in ovarian function

    The investigators will measure salivary estradiol and progesterone concentrations daily throughout the study, in order to test the hypothesis that ovarian function may be suppressed by intensified training and decreased energy availability.

    Time frame: Baseline (week 4), after 4 weeks of intensified training (week 8) and after a two-week recovery period (week 10)

  3. Change in bone turnover markers

    The investigators will measure plasma bone turnover markers during baseline and at the end of the intensified training period, in order to test the hypothesis that bone turnover may be compromised by intensified training and decreased energy availability.

    Time frame: Baseline (week 4), after 4 weeks of intensified training (week 8) and after a two-week recovery period (week 10)

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Study locations

1 site
  • USDA Western Human Nutrition Research Center
    Davis, California 95616, United States
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References and documents

Publications

  • Schaal K, VanLoan MD, Hausswirth C, Casazza GA. Decreased energy availability during training overload is associated with non-functional overreaching and suppressed ovarian function in female runners. Appl Physiol Nutr Metab. 2021 Oct;46(10):1179-1188. doi: 10.1139/apnm-2020-0880. Epub 2021 Mar 2. PubMed 33651630 ↗

Individual participant data

Plan to share: Undecided

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 28, 2016, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02224976
Lead sponsor
USDA, Western Human Nutrition Research Center
Collaborators
University of California, Davis
Responsible party
Sponsor
First posted
Aug 25, 2014
Start date
Jan 2014
Primary completion
Dec 2015
Completion
Dec 2015
Last update
Jan 28, 2016

Study contacts

Gretchen A Casazza, PhD
principal investigator · University of California, Davis

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Sep 2015. You cannot join it, but the record below documents what was studied.

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