54 Participants Needed

Physical and Psychosocial Stress for Amenorrhea

(FHA Trial)

MB
KR
Overseen ByKristen Rudd, PhD
Age: 18 - 65
Sex: Female
Trial Phase: Academic
Sponsor: University of Colorado, Colorado Springs
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how exercise and stress affect menstrual cycles in female runners and cyclists. It aims to determine if increased exercise or stress alters hormone levels and cycle length, and whether their combination has a greater impact. Participants will either maintain their usual routines or increase exercise (exercise stress) and stress levels (psychosocial stress) to observe the effects. Ideal candidates are women who regularly run or cycle and have consistent menstrual cycles. As an unphased trial, this study provides a unique opportunity to contribute to understanding the interplay between exercise, stress, and menstrual health.

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, you must not have used hormonal contraceptives for at least the past 6 months and should not begin taking them during the trial.

What prior data suggests that these stress protocols are safe for participants?

Research has shown that exercise can affect menstrual cycles in some women. About 5% to 20% of women who exercise extensively may experience exercise-induced amenorrhea, where periods become irregular or stop. This condition is more common among elite athletes, such as runners, affecting up to 40% to 50%. It's important to note that effects can vary from person to person.

Studies have also shown that stress can impact menstrual cycles. Higher stress levels have been linked to issues like irregular periods and infertility. Stress can alter hormone levels, affecting the menstrual cycle.

When exercise and stress combine, the effects might intensify. Some research suggests that up to 80% of women who exercise vigorously could experience menstrual problems. However, the exact effects depend on individual factors, such as stress levels and exercise intensity.

Overall, while these factors can influence menstrual health, the specific impact varies for each person. Researchers closely monitor study participants to ensure their safety and well-being.12345

Why are researchers excited about this trial?

Researchers are excited about exploring stress as a treatment for amenorrhea because it shifts the focus from traditional medical interventions, like hormonal therapies, to lifestyle-based approaches. The trial examines both exercise stress and psychosocial stress, which could offer a more holistic way to manage this condition. By increasing physical activity levels and using cognitive tasks to stimulate stress, these methods could potentially regulate menstrual cycles naturally. This approach might appeal to those seeking non-pharmacological options and could also provide insights into the broader effects of stress on the body.

What evidence suggests that this trial's treatments could be effective for amenorrhea?

Research has shown that both exercise and stress affect menstrual cycles. Intense exercise is linked to menstrual issues, with up to 80% of active women experiencing some form of menstrual problem. Similarly, studies have indicated that stress often connects to irregular periods and other reproductive health concerns. This trial will explore these effects through different treatment arms. Participants in the Exercise Stress arm will increase their weekly running or cycling mileage by 30%. Those in the Psychosocial Stress arm will complete cognitive tasks designed to be stressful. Another group will experience both Exercise and Psychosocial Stress combined. These findings suggest that changes in exercise and stress levels can significantly impact hormones and menstrual regularity.12367

Are You a Good Fit for This Trial?

This trial is for female runners and cyclists who can complete a 5-km race in under 25 minutes, have regular menstrual cycles every 21 to 35 days, haven't used hormonal contraceptives or been pregnant/breastfeeding for the past six months, exercise regularly, and don't have metabolic diseases or menstrual disorders.

Inclusion Criteria

Participates in structured running or cycling exercise for at least 30 minutes on 4 days per week or more
Have regular periods every 21 to 35 days
Are not currently or trying to become pregnant or are breastfeeding, and have not been pregnant or breastfeeding for the past 12 months
See 3 more

Exclusion Criteria

I have a diagnosed menstrual cycle disorder.
I have a major heart, lung, or muscle/bone condition.
Missing > 4 consecutive days of structured running or cycling exercise
See 8 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants attend a laboratory visit to have their resting metabolic rate, aerobic fitness, and body composition tested

1 week
1 visit (in-person)

Intervention

Participants either maintain their usual physical activity and lifestyle habits, increase their weekly running or cycling mileage by 30%, complete cognitive function tasks designed to be stressful, or both

4 weeks
Monthly monitoring

Follow-up

Participants are monitored for changes in menstrual cycle length and reproductive hormones

3 months

What Are the Treatments Tested in This Trial?

Interventions

  • Exercise Stress
  • Psychosocial Stress
Trial Overview The study examines how increased physical activity and stress affect reproductive hormones and menstrual cycle length. Women will be divided into groups: some maintain their routine while others add more exercise or stressful cognitive tasks to see if these changes impact hormone levels and menstruation.
How Is the Trial Designed?
4Treatment groups
Experimental Treatment
Active Control
Group I: Psychosocial StressExperimental Treatment1 Intervention
Group II: Exercise StressExperimental Treatment1 Intervention
Group III: Exercise + Psychosocial StressExperimental Treatment2 Interventions
Group IV: ControlActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Colorado, Colorado Springs

Lead Sponsor

Trials
20
Recruited
5,500+

Published Research Related to This Trial

Amenorrheic athletes had significantly higher cortisol levels (585 nmol/L) compared to eumenorrheic athletes (411 nmol/L) and nonathletic women (397 nmol/L), indicating that elevated cortisol may play a role in exercise-associated amenorrhea.
Lower bone mineral density was observed in amenorrheic athletes, suggesting that high cortisol levels not only affect menstrual cycles but may also contribute to bone health issues, putting these athletes at risk for prolonged menstrual irregularities.
High serum cortisol levels in exercise-associated amenorrhea.Ding, JH., Sheckter, CB., Drinkwater, BL., et al.[2019]
In a study of 12 physically-active women, salivary estradiol levels increased significantly from the early follicular phase to the mid luteal phase, but this was associated with a decrease in VO2max performance during aerobic exercise.
The findings suggest that while there is a natural rise in estradiol during the menstrual cycle, most exercise performance and emotional states did not show significant differences between the two phases, indicating that menstrual cycle phase may not greatly impact exercise outcomes.
The impact of menstrual-cycle phase on basal and exercise-induced hormones, mood, anxiety and exercise performance in physically active women.Paludo, AC., Cook, CJ., Owen, JA., et al.[2021]
In a study of 61 exercising women aged 18-35, those with functional hypothalamic amenorrhea (FHA) exhibited lower metabolic rates and hormonal levels, indicating that both psychological and metabolic factors contribute to this condition.
Women with FHA showed significant psychological stress indicators, such as a greater drive for thinness and need for social approval, which were correlated with stress and mood issues, highlighting the importance of addressing psychological factors in treatment.
Eating behaviours related to psychological stress are associated with functional hypothalamic amenorrhoea in exercising women.Strock, NCA., De Souza, MJ., Williams, NI.[2020]

Citations

Exercise and menstrual function - PMCUp to four fifths of women who exercise vigorously may have some form of menstrual dysfunction.
Current understanding of hypothalamic amenorrhoea - PMCFHA is predominantly caused by significant weight loss, intense exercise or stress, or a combination of such. In addition, there may be a genetic ...
Physical and Psychosocial Stress for Amenorrhea (FHA Trial)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 ...
Effects of Physical and Psychosocial Stress on Functional ...The goal of this clinical trial is to determine how changes in exercise and psychosocial stress may influence the risk of menstrual cycle irregularities.
The effect of exercise on menstrual symptoms: a randomized ...In conclusion, exercise can decrease the menstrual symptoms in women with menstrual symptoms as a primary outcome. Second, exercise can also ...
Functional Hypothalamic Amenorrhea: Recognition and ...The aim of this concise review is to summarize the current knowledge of functional hypothalamic amenorrhea, review its pathophysiology and the adverse health ...
Effects of high-intensity interval training in combination with ...This study aimed to investigate the effects of high-intensity interval training (HIIT) and detraining on the quality of life and mental health of 23 women with ...
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