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Exercise Metabolism and Menstrual Cycle

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The Active Female

Abstract

Women’s sex hormones—estrogen and progesterone (Pg)—have been recognized to influence metabolism, muscular fitness, and body composition. Researchers in sex hormone variation during the menstrual cycle (MC) and substrate metabolism have focused predominantly on the study of aerobic exercise. There is consensus among researchers that women rely more on fat as a source of fuel and spare more glucose compared to men both at rest and during exercise. Predominantly, there are two differing streams of thought derived from research. One position is that there are no differences between MC phases, and the other position supports the hypothesis that glucose sparing and fat oxidation are increased when estrogen and Pg are elevated at rest and during exercise. These effects seem to disappear at intensities >75% of the maximal oxygen uptake (VO2max). Women exhibit an increased potential for higher performance in aerobic moderate-to-high intensity exercise that seems to vary with hormonal fluctuations. In the case of resistance training (RT), researchers have mainly analyzed the effects of sex hormones on muscular fitness and bone density. But, the effects of RT on substrate metabolism need further examination. Given the potential for glycogen storage at specific MC phases, estrogen and Pg could impact performance in power/velocity-related events. Still methodological limitations (i.e., sample size, number of time-points of the MC examined, or variability of the protocols utilized to determine the MC phases) might have contributed to inconsistent findings. Therefore, research in MC and substrate metabolism must be analyzed carefully.

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References

  1. Costello JT, Bieuzen F, Bleakley CM. Where are all the female participants in Sports and Exercise Medicine research? Eur J Sport Sci. 2014;14(8):847–51.

    PubMed  Google Scholar 

  2. Gruber CJ, Tschugguel W, Schneeberger C, Huber JC. Production and actions of estrogens. N Engl J Med. 2002;346(5):340–52.

    CAS  PubMed  Google Scholar 

  3. Bonen A, Haynes FJ, Watson-Wright W, Sopper MM, Pierce GN, Low MP, et al. Effects of menstrual cycle on metabolic responses to exercise. J Appl Physiol Respir Environ Exerc Physiol. 1983;55(5):1506–13.

    CAS  PubMed  Google Scholar 

  4. Carter SL, Rennie C, Tarnopolsky MA. Substrate utilization during endurance exercise in men and women after endurance training. Am J Physiol - Endocrinol Metab. 2001;280(6):43–6.

    Google Scholar 

  5. Devries MC, Hamadeh MJ, Phillips SM, Tarnopolsky MA. Menstrual cycle phase and sex influence muscle glycogen utilization and glucose turnover during moderate-intensity endurance exercise. Am J Physiol RegulIntegr Comp Physiol. 2006;291:1120–8.

    Google Scholar 

  6. Tremblay J, Peronnet F, Massicotte D, Lavoie C. Carbohydrate supplementation and sex differences in fuel selection during exercise. Med Sci Sports Exerc. 2010;42(7):1314–23.

    CAS  PubMed  Google Scholar 

  7. Zderic TW, Coggan AR, Ruby BC. Glucose kinetics and substrate oxidation during exercise in the follicular and luteal phases. J Appl Physiol. 2001;90(2):447–53.

    CAS  PubMed  Google Scholar 

  8. Samsudeen N, Rajagopalan A. Effect of different phases of menstrual cycle on cardio-respiratory efficiency in normal, overweight and obese female undergraduate students. J Clin Diagnostic Res. 2016;10(12):CC01.

    Google Scholar 

  9. Ortega-Santos CP, Barba-Moreno L, Cupeiro R, Peinado AB. Substrate oxidation in female adults during endurance exercise throughout menstrual cycle phases: Iron FEMME pilot study. J Hum Sport Exerc. 2018;13(3):553–65.

    Google Scholar 

  10. O’Leary CB, Lehman C, Koltun K, Smith-Ryan A, Hackney AC. Response of testosterone to prolonged aerobic exercise during different phases of the menstrual cycle. Eur J Appl Physiol. 2013;113(9):2419–24.

    PubMed  Google Scholar 

  11. O’Donnell E, Kirwan LD, Goodman JM. Aerobic exercise training in healthy postmenopausal women: effects of hormone therapy. Menopause. 2009;16(4):770–6.

    PubMed  Google Scholar 

  12. Long W, Wells K, Englert V, Schmidt S, Hickey MS, Melby CL. Does prior acute exercise affect postexercise substrate oxidation in response to a high carbohydrate meal? Nutr Metab 2008;5(1).

    Google Scholar 

  13. Devries MC, Lowther SA, Glover AW, Hamadeh MJ, Tarnopolsky MA. IMCL area density, but not IMCL utilization, is higher in women during moderate-intensity endurance exercise, compared with men. Am J Physiol - Regul Integr Comp Physiol. 2007;293(6).

    Google Scholar 

  14. Fu MHH, Maher AC, Hamadeh MJ, Ye C, Tarnopolsky MA. Exercise, sex, menstrual cycle phase, and 17β-estradiol influence metabolism-related genes in human skeletal muscle. Physiol Genomics. 2009;40(1):34–47.

    CAS  PubMed  Google Scholar 

  15. Abildgaard J, Pedersen AT, Green CJ, Harder-Lauridsen NM, Solomon TP, Thomsen C, et al. Menopause is associated with decreased whole body fat oxidation during exercise. Am J PhysiolMetab. 2013;304(11):E1227–36.

    CAS  Google Scholar 

  16. Price TB, Sanders K. Muscle and liver glycogen utilization during prolonged lift and carry exercise: male and female responses. Physiol Rep. 2017;5(4).

    Google Scholar 

  17. Raulino RS, de Aguiar FM, de Avelar NCP, Costa IG, Soares J d S, Lacerda ACR. Energy expenditure and substrate utilization during whole body vibration. Rev Bras Med do Esporte. 2015;21(2):122–6.

    Google Scholar 

  18. Farinatti P, Castinheiras Neto AG, Amorim PRS. Oxygen consumption and substrate utilization during and after resistance exercises performed with different muscle mass. Int J Exerc Sci. 2016;9(1):77–88.

    PubMed  PubMed Central  Google Scholar 

  19. Oosthuyse T, Bosch AN. Oestrogen’s regulation of fat metabolism during exercise and gender specific effects. In: Current opinion in pharmacology, vol. 12. Elsevier Ltd; 2012. p. 363–71.

    Google Scholar 

  20. de Jonge XJ, Thompson B, Han A. Methodological recommendations for menstrual cycle research in sports and exercise. Med Sci Sports Exerc. 2019;51(12):2610–7.

    Google Scholar 

  21. Hall JE, Guyton AC. Female physiology before pregnancy and female hormones. In: Guyton and Hall textbook of medical physiology. 13th ed. Elsevier; 2011. p. 987–1001.

    Google Scholar 

  22. Isacco L, Duch P, Boisseau N. Influence of hormonal status on substrate utilization at rest and during exercise in the female population. Sports Med. 2012;42:327–42.

    PubMed  Google Scholar 

  23. Lebrun CM, Joyce SM, Constantini NW. Effects of female reproductive hormones on sports performance. In: Endocrinology of Physical Activity and Sport. 2nd ed. Humana Press Inc.; 2013. p. 281–322.

    Google Scholar 

  24. Haizlip KM, Harrison BC, Leinwand LA. Sex-based differences in skeletal muscle kinetics and fiber-type composition. In: Physiology, vol. 30. American Physiological Society; 2015. p. 30–9.

    Google Scholar 

  25. Ruby B. Gender differences in carbohydrate metabolism: rest, exercise and post-exercise. In: Gender differences in metabolism: practical and nutritional implications. 1st ed. Routledge; 2017. p. 121–54.

    Google Scholar 

  26. Horton TJ, Hill JO. Prolonged fasting significantly changes nutrient oxidation and glucose tolerance after a normal mixed meal. J Appl Physiol. 2001;90(1):155–63.

    CAS  PubMed  Google Scholar 

  27. Lamont LS, McCullough AJ, Kalhan SC. Gender differences in leucine, but not lysine, kinetics. J Appl Physiol. 2001;91(1):357–62.

    CAS  PubMed  Google Scholar 

  28. D’Eon T, Braun B, Ph D. Carbohydrate and fat utilization at rest and during exercise. Medicine (Baltimore). 2002;11(3).

    Google Scholar 

  29. Ruby BC, Robergs RA, Waters DL, Burge M, Mermier C, Stolarczyk L. Effects of estradiol on substrate turnover during exercise in amenorrheic females. Med Sci Sports Exerc. 1997;29(9):1160–9.

    CAS  PubMed  Google Scholar 

  30. Kanaley JA, Boileau RA, Bahr JA, Misner JE, Nelson RA. Substrate oxidation and GH responses to exercise are independent of menstrual phase and status. Med Sci Sports Exerc. 1992;24(8):873–80.

    CAS  PubMed  Google Scholar 

  31. De Souza MJ, Maguire MS, Rubin KR, Maresh CM. Effects of menstrual phase and amenorrhea on exercise performance in runners. Med Sci Sports Exerc. 1990;22(5):575–80.

    PubMed  Google Scholar 

  32. Campbell SE, Febbraio MA. Effects of ovarian hormones on exercise metabolism. In: Current opinion in clinical nutrition and metabolic care, vol. 4; 2001. p. 515–20.

    Google Scholar 

  33. Hackney AC. Influence of oestrogen on muscle glycogen utilization during exercise. Acta Physiol Scand. 1999;167(3):273–4.

    CAS  PubMed  Google Scholar 

  34. Oosthuyse T, Bosch AN. The effect of the menstrual cycle on exercise metabolism: implications for exercise performance in eumenorrhoeic women. In: Sports medicine, vol. 40; 2010. p. 207–27.

    Google Scholar 

  35. Godsland I. The influence of female sex steroids on glucose metabolism and insulin action. J Intern Med. 1996;738:1–60.

    CAS  Google Scholar 

  36. Yeung EH, Zhang C, Mumford SL, Ye A, Trevisan M, Chen L, et al. Longitudinal study of insulin resistance and sex hormones over the menstrual cycle: the biocycle study. J Clin Endocrinol Metab. 2010;95(12):5435–42.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Elkind-Hirsch KE, Valdes CT, Malinak LR. Insulin resistance improves in hyperandrogenic women treated with Lupron. Fertil Steril. 1993;60(4):634–41.

    CAS  PubMed  Google Scholar 

  38. Heiling VJ, Jensen MD. Free fatty acid metabolism in the follicular and luteal phases of the menstrual cycle. J Clin Endocrinol Metab. 1992;74(4):806–10.

    CAS  PubMed  Google Scholar 

  39. Paul DR, Mulroy SM, Horner JA, Jacobs KA, Lamb DR. Carbohydrate-loading during the follicular phase of the menstrual cycle: effects on muscle glycogen and exercise performance. Int J Sport Nutr. 2001;11(4):430–41.

    CAS  Google Scholar 

  40. McLay RT, Thomson CD, Williams SM, Rehrer NJ. Carbohydrate loading and female endurance athletes: effect of menstrual-cycle phase. Int J Sport Nutr Exerc Metab. 2007;17(2):189–205.

    CAS  PubMed  Google Scholar 

  41. Beckett T, Tchernof A, Toth MJ. Effect of ovariectomy and estradiol replacement on skeletal muscle enzyme activity in female rats. Metabolism. 2002;51(11):1397–401.

    CAS  PubMed  Google Scholar 

  42. Kalkhoff RK. Metabolic effects of progesterone. Am J Obstet Gynecol. 1982;142(6 II):735–8.

    CAS  PubMed  Google Scholar 

  43. Matute ML, Kalkhoff RK. Sex steroid influence on hepatic gluconeogenesis and glycogen formation. Endocrinology. 1973;92(3):762–8.

    CAS  PubMed  Google Scholar 

  44. Sugaya A, Sugiyama T, Yanase S, Shen XX, Minoura H, Toyoda N. Expression of glucose transporter 4 mRNA in adipose tissue and skeletal muscle of ovariectomized rats treated with sex steroid hormones. Life Sci. 2000;66(7):641–8.

    CAS  PubMed  Google Scholar 

  45. Campbell SE, Febbraio MA. Effect of the ovarian hormones on GLUT4 expression and contraction-stimulated glucose uptake. Am J Physiol - Endocrinol Metab. 2002;282(5):E1139–46.

    CAS  PubMed  Google Scholar 

  46. Diamond MP, Grainger DA, Rossi G, Connolly-Diamond M, Sherwin RS. Counter-regulatory response to hypoglycemia in the follicular and luteal phases of the menstrual cycle. FertilSteril. 1993;60(6):988–93.

    CAS  Google Scholar 

  47. Toth EL, Suthijumroon A, Crockford PM, Ryan EA. Insulin action does not change during the menstrual cycle in normal women*. J Clin Endocrinol Metab. 1987;64(1):74–80.

    CAS  PubMed  Google Scholar 

  48. Devries MC. Sex-based differences in endurance exercise muscle metabolism: impact on exercise and nutritional strategies to optimize health and performance in women. Exp Physiol. 2016;101(2):243–9.

    PubMed  Google Scholar 

  49. Tarnopolsky LJ, MacDougall JD, Atkinson SA, Tarnopolsky MA, Sutton JR. Gender differences in substrate for endurance exercise. J Appl Physiol. 1990;68(1):302–8.

    CAS  PubMed  Google Scholar 

  50. Horton TJ, Miller EK, Glueck D, Tench K. No effect of menstrual cycle phase on glucose kinetics and fuel oxidation during moderate-intensity exercise. Am J Physiol - Endocrinol Metab. 2002;282(4):45–4, E752–62.

    Google Scholar 

  51. Knechtle B, Müller C, Willmann F, Kotteck K, Eser P, Knecht H. Fat oxidation in men and women endurance athletes in running and cycling. Int J Sports Med. 2004;25(1):38–44.

    CAS  PubMed  Google Scholar 

  52. Hafen P, Vehrs P. Sex-related differences in the maximal lactate steady state. Sports. 2018;6(4):154.

    PubMed  PubMed Central  Google Scholar 

  53. Zehnder M, Ith M, Kreis R, Saris W, Boutellier U, Boesch C. Gender-specific usage of intramyocellular lipids and glycogen during exercise. Med Sci Sports Exerc. 2005;37(9):1517–24.

    CAS  PubMed  Google Scholar 

  54. Tarnopolsky MA, Atkinson SA, Phillips SM, MacDougall JD. Carbohydrate loading and metabolism during exercise in men and women. J Appl Physiol. 1995;78(4):1360–8.

    CAS  PubMed  Google Scholar 

  55. Roepstorff C, Steffensen CH, Madsen M, Stallknecht B, Kanstrup IL, Richter EA, et al. Gender differences in substrate utilization during submaximal exercise in endurance-trained subjects. Am J Physiol - Endocrinol Metab. 2002;282(2):45–2.

    Google Scholar 

  56. Piers LS, Diggavi SN, Rijskamp J, Van Raaij JMA, Shetty PS, Hautvast JGAJ. Resting metabolic rate and thermic effect of a meal in the follicular and luteal phases of the menstrual cycle in well-nourished Indian women. Am J ClinNutr. 1995;61(2):296–302.

    CAS  Google Scholar 

  57. Hackney AC. Effects of the menstrual cycle on resting muscle glycogen content. HormMetab Res. 1990;22(12):647.

    CAS  Google Scholar 

  58. Rooney TP, Kendrick ZV, Carlson J, Ellis GS, Matakevich B, Lorusso SM, et al. Effect of estradiol on the temporal pattern of exercise-induced tissue glycogen depletion in male rats. J Appl Physiol. 1993;75(4):1502–6.

    CAS  PubMed  Google Scholar 

  59. Esbjörnsson-Liljedahl M, Sundberg CJ, Norman B, Jansson E. Metabolic response in type I and type II muscle fibers during a 30-s cycle sprint in men and women. J Appl Physiol. 1999;87(4):1326–32.

    PubMed  Google Scholar 

  60. Hackney AC, Curley CS, Nicklas BJ. Physiological responses to submaximal exercise at the mid-follicular, ovulatory and mid-luteal phases of the menstrual cycle. Scand J Med Sci Sports. 2007;1(2):94–8.

    Google Scholar 

  61. Hackney AC, McCracken-Compton MA, Ainsworth B. Substrate responses to submaximal exercise in the midfollicular and midluteal phases of the menstrual cycle. Int J Sport Nutr. 1994;4(3):299–308.

    CAS  PubMed  Google Scholar 

  62. Suh SH, Casazza GA, Horning MA, Miller BF, Brooks GA. Luteal and follicular glucose fluxes during rest and exercise in 3-h postabsorptive women. J Appl Physiol. 2002;93(1):42–50.

    CAS  PubMed  Google Scholar 

  63. Suh SH, Casazza GA, Horning MA, Miller BF, Brooks GA. Effects of oral contraceptives on glucose flux and substrate oxidation rates during rest and exercise. J Appl Physiol. 2003;94(1):285–94.

    CAS  PubMed  Google Scholar 

  64. Farinatti PTV, Castinheiras Net AG. The effect of between-set rest intervals on the oxygen uptake during and after resistance exercise sessions performed with large-and small-muscle mass. J Strength Cond Res. 2011;25(11):3181–90.

    PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Functional Biology, School of Medicine and Health Sciences, University of Oviedo, Oviedo, Asturias, Spain

    Maria Fernandez-del-Valle

  2. Health Research Institute of the Principality of Asturias (ISPA), Oviedo, Asturias, Spain

    Maria Fernandez-del-Valle

Authors
  1. Maria Fernandez-del-Valle
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Corresponding author

Correspondence to Maria Fernandez-del-Valle .

Editor information

Editors and Affiliations

  1. Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, USA

    Jacalyn J. Robert-McComb

  2. Orthopedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center, Lubbock, TX, USA

    Mimi Zumwalt

  3. Functional Biology, University of Oviedo, Oviedo, Asturias, Spain

    Maria Fernandez-del-Valle

Chapter Review Questions

Chapter Review Questions

  1. 1.

    Which of the following methodologies are recommended to improve research in menstrual cycle and substrate utilization?

    1. (a)

      Sample size big enough (~20 participants or more)

    2. (b)

      Exclusion of late follicular estrogen peak

    3. (c)

      Use only one method to verify menstrual cycle phase

    4. (d)

      None of the above

  2. 2.

    Estrogen receptor alpha (ERα) is largely expressed in ___________ (which are the types of fibers more predominant in women) and it is associated to ____________.

    1. (a)

      Type 1 muscle fibers, decreased fat oxidation

    2. (b)

      Type 2a muscle fibers, decreased glucose tolerance

    3. (c)

      Type 1 muscle fibers, increased lipolysis

    4. (d)

      Type 2a muscle fibers, decreased lipolysis

  3. 3.

    _____ is determined by endogenous release and production of plasma glucose.

    1. (a)

      Ra

    2. (b)

      Rd

    3. (c)

      Glycerol

    4. (d)

      Leucine

  4. 4.

    Which of the following is a key element in the transport of fats that increase with E2 concentrations in women with normal menstrual cycle?

    1. (a)

      β-3-hydroxyacyl-CoA dehydrogenase (β-HAD)

    2. (b)

      Glycogen synthase

    3. (c)

      Carnitine palmitoyltransferase-1 (CPT-1)

    4. (d)

      Lactate Dehydrogenase

  5. 5.

    In premenopausal women, insulin resistance begins to increase at the end of _______________.

    1. (a)

      Early follicular phase

    2. (b)

      Late follicular phase

    3. (c)

      Early luteal phase

    4. (d)

      Late luteal phase

  6. 6.

    Estrogen-to-progesterone ratio (E/P) is an important factor to consider when studying substrate metabolism given

    1. (a)

      Women with a higher E/P (lower concentration of Pg relative to E2) during early follicular phase have an increased fat oxidation and exercise performance

    2. (b)

      Women with a lower E/P (higher concentration of Pg relative to E2) during early follicular phase have an increased fat oxidation and exercise performance

    3. (c)

      Women with a higher E/P (lower concentration of Pg relative to E2) during mid-point luteal phase have an increased fat oxidation and exercise performance

    4. (d)

      Women with a lower E/P (higher concentration of Pg relative to E2) during mid-point luteal phase have an increased fat oxidation and exercise performance

  7. 7.

    When exercising at high intensity (i.e., Wingate test) women utilize _______________ muscle glycogen than men.

    1. (a)

      10–25% more

    2. (b)

      10–25% less

    3. (c)

      25–50% more

    4. (d)

      25–50% less

  8. 8.

    Mobilization and oxidation rates of carbohydrates and lipids are not significantly different between MC phases when exercising at

    1. (a)

      intensities ~25% VO2max

    2. (b)

      intensities ~55% VO2max

    3. (c)

      intensities ~75% VO2max

    4. (d)

      none of the above

  9. 9.

    Liver glycogen is utilized to ________ extent during ______________ when performing muscular endurance exercise.

    1. (a)

      less, late luteal phase

    2. (b)

      more, late luteal phase

    3. (c)

      less, early follicular phase

    4. (d)

      none of the above

  10. 10.

    Which is the verification limit for progesterone to detect minimum luteal phase progesterone level that indicates an ovulatory cycle or non-luteal phase-deficient cycle?

    1. (a)

      Pg > 1 nmol L

    2. (b)

      Pg > 5 nmol L

    3. (c)

      Pg > 16 nmol L

    4. (d)

      Pg > 26 nmol L

Answers

  1. 1.

    a

  2. 2.

    c

  3. 3.

    a

  4. 4.

    c

  5. 5.

    b

  6. 6.

    c

  7. 7.

    d

  8. 8.

    c

  9. 9.

    a

  10. 10.

    c

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Fernandez-del-Valle, M. (2023). Exercise Metabolism and Menstrual Cycle. In: Robert-McComb, J.J., Zumwalt, M., Fernandez-del-Valle, M. (eds) The Active Female. Springer, Cham. https://doi.org/10.1007/978-3-031-15485-0_7

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