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CompletedNCT05107804Updated Nov 4, 2021

Energy Restriction and Hormones in Premenopausal Women

An interventional study of Exercise+CR and Light Conditioning in Menstruation Disturbances and Luteal Phase Defect, sponsored by Penn State University. Completed. Open to female participants aged 25 Years to 40 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-11-04.

Sponsored by Penn State University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 20 years 7 months after the study started (first participant enrolled Mar 2001, registered Oct 2021).
Phase
Not applicable
Study type
Interventional
Enrollment
47
Allocation
Randomized
Ages
25 Years to 40 Years
Sex
Female
01

Study 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 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.

02

Conditions studied

  • Menstruation Disturbances
  • Luteal Phase Defect

Keywords

  • Energy Balance
  • Menstrual Cycle Disturbance
  • Luteal Phase Defect
  • Menstruation Disturbances
  • Pathologic Processes
03

In context

Menstruation Disturbances

84 studies on the registry are indexed under Menstruation Disturbances; 19 are open to participants now.

This study's enrollment of 47 is below the median of 60 across 50 interventional studies indexed under Menstruation Disturbances.

Browse Menstruation Disturbances studies →

Lead sponsor

Penn State University is the lead sponsor of 261 studies on the registry; 50 are open to participants now.

Of its 13 completed or terminated interventional studies of FDA-regulated products, 10 (77%) have results posted.

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

04

Who can participate

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

Inclusion criteria

  • 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.

Exclusion criteria

Exclusion Criteria:

  • 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
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
47 participants (actual)

Study arms

  • Experimental
    Exercise with caloric-restriction

    Exercise: 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.

    Other: Exercise+CR

  • Active comparator
    Light Conditioning (reference group)

    Exercise: 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.

    Other: Light Conditioning

Interventions

  • OtherExercise+CR

    Exercise with caloric-restriction

  • OtherLight Conditioning

    Light Conditioning Exercise

06

What researchers measure

Primary outcomes

  1. Change in estrogen and IGF-1

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

    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)

Secondary outcomes

  1. Change in body composition

    Change in percent body fat (%)

    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)

  2. Change in body composition

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

    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)

  3. Change in reproductive hormones

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

    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)

  4. Change in reproductive hormones

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

    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)

  5. Change in metabolic hormones

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

    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)

  6. Change in metabolic hormones

    Change in metabolic hormone insulin (μIU/mL)

    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)

  7. Change in metabolic hormones

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

    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)

  8. Change in metabolic hormones

    Change in metabolic hormone total triiodothyronine (ng/dL)

    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)

  9. Change in menstrual cycle phase length

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

    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)

07

Study locations

No study locations are listed for this record.

08

References and documents

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 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 4, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05107804
Lead sponsor
Penn State University
Collaborators
National Institutes of Health (NIH), United States Department of Defense, National Center for Research Resources (NCRR)
Responsible party
Nancy Williams (Professor and Head, Department of Kinesiology, Penn State University) — Principal investigator
First posted
Nov 4, 2021
Start date
Mar 2001
Primary completion
Nov 2006
Completion
Nov 2006
Last update
Nov 4, 2021

Study contacts

Nancy Williams, ScD
principal investigator · Penn State University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Oct 2021. You cannot join it, but the record below documents what was studied.

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