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Energy Deficiency on Hormones in Contraceptive Users

10 giugno 2026 aggiornato da: Todd Schroeder, University of Southern California

Effects of a Modest Energy Deficit on Reproductive Hormones Across the Menstrual Cycle in Contraceptive Users

The purpose of the present study is to characterize the endocrine and metabolic responses to a modest, short-term energy deficiency (~250 kcal/day) across the menstrual cycle in recreationally active women using different contraceptive methods (oral contraceptive, hormonal IUD, and non-hormonal IUD). This study will leverage daily urinary hormone metabolite tracking and comprehensive metabolic assessments, providing foundational data addressing an important and previously unexamined interaction between energy availability and hormonal regulation in contraceptive users.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

The purpose of the present study is to characterize the endocrine and metabolic responses to a modest, short-term energy deficiency (~250 kcal/day) across the menstrual cycle in recreationally active women using different contraceptive methods. The investigators will be focusing on oral contraceptive users, hormonal IUD, and non-hormonal (i.e., copper IUD). Daily urinary hormone metabolite tracking and comprehensive metabolic assessments (i.e., resting metabolic rate, body composition via DXA, exercise logs, and energy intake) will be used to provide foundational data addressing an important and previously unexamined interaction between energy availability and hormonal regulation in contraceptive users.

Based on evidence that female reproductive hormones are sensitive to energetic stress, that estrogen plays a central role in regulating metabolism and endocrine function, and that hormonal contraceptive methods differentially alter endogenous hormone profiles, the central hypothesis of this study is that a modest, controlled energy deficiency (~250 kcal/day) will alter reproductive hormone profiles across the menstrual cycle in recreationally active women using contraceptives. Specifically, it is hypothesized that changes in urinary reproductive hormone measures will be detectable during an energy-deficient cycle compared to a baseline cycle, and that the magnitude and pattern of these changes will differ by contraceptive type, with hormonal oral contraceptive users demonstrating a different hormonal response to energy deficiency than copper or hormonal intrauterine device users.

A secondary hypothesis is that energy deficiency-induced hormonal changes will be associated with alterations in resting metabolic rate and body composition, and that these associations may be moderated by exercise energy expenditure and perceived stress. Collectively, these hypotheses are grounded in prior research demonstrating hormonal sensitivity to energetic perturbations and the distinct endocrine environments created by different contraceptive methods, while addressing a clear gap in the current literature regarding the interaction between energy availability and hormonal regulation in contraceptive users.

Tipo di studio

Interventistico

Iscrizione (Stimato)

30

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

  • Nome: Emily Lundstrom, PhD
  • Numero di telefono: 3234422180
  • Email: elundstr@usc.edu

Luoghi di studio

  • Stati Uniti
    • California
      • Los Angeles, California, Stati Uniti, 90033
        • University of Southern California Health Sciences Campus Center for Health Professions
        • Contatto:

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • Female, aged 18-35 years
  • Recreationally active (engaging in structured exercise between 8-15 hours per week)
  • BMI of 18.5-29.9 as a BMI below or above these cut points results in highly varied menstrual cycle lengths17
  • Not currently experiencing an eating disorder or disordered eating, or having a diagnosed eating disorder in the last 3 years
  • Non-pregnant or planning to become pregnant
  • Medically free from chronic diseases
  • Currently using one of the following contraceptive methods for ≥3 months:

Monophasic oral contraceptive

  • Hormonal intrauterine device (H-IUD)
  • Copper intrauterine device
  • Weight stable (no weight change >5% body weight within the past 3 months)
  • Weight greater than or equal to 110 lbs
  • Not suffering from known gynecological disease (i.e., PCOS, endometriosis, etc.) that may influence menstrual cycle regularity
  • Willing and able to maintain current exercise habits throughout the study
  • Willing to follow study dietary guidance to achieve a ~250 kcal/day energy deficit during Cycle 2

Exclusion Criteria:

  • Amenorrhea or oligomenorrhea
  • Perimenopausal or menopausal
  • Currently pregnant, planning pregnancy, or breastfeeding
  • Use of hormonal contraception other than monophasic oral contraceptives or hormonal IUD (implant, nuvaring, etc.)
  • Initiation or change of contraceptive method within the past 3 months
  • Diagnosis of polycystic ovary syndrome (PCOS), endometriosis, hypothalamic amenorrhea, or other known reproductive endocrine disorder
  • Current or history of eating disorder or clinically diagnosed disordered eating
  • Current participation in intentional weight loss or weight gain program
  • Use of medications known to affect metabolism or hormone levels (e.g., systemic corticosteroids, thyroid medications, insulin, GLP-1 agonists)
  • Known metabolic, cardiovascular, renal, hepatic, or endocrine disease
  • Musculoskeletal injury limiting exercise participation within the past 3 months
  • Smoking or nicotine use
  • Contraindications to DXA scanning (e.g., pregnancy, recent high-radiation diagnostic imaging exceeding institutional limits)
  • Inability or unwillingness to comply with study procedures

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Selezione
  • Assegnazione: Non randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Monophasic low dose oral contraceptive users
The first group will be only individuals who are on a low dose, monophasic oral contraceptive that they have elected to be on prior to enrollment in the study. They will undergo a baseline monitoring menstrual cycle that will include daily urinary hormone monitoring, baseline metabolic and body composition assessments, and assessment of baseline energy expenditure and energy intake. During a two week washout week, participants will not be monitoring hormones, but will be subjected to a ~250 kcal/day energy deficit. Following this imposed energy deficiency, they will resume urinary metabolite testing and exercise intake and expenditure tracking. They will undergo this monitoring for a final menstrual cycle and metabolic and body composition assessments, and assessment of energy expenditure and energy intake.
Comportamentale: Energy Deficiency of approximately ~250 kcal/day
Following an initial baseline menstrual cycle, participants will be subjected to at least two weeks of a ~250 kcal/day energy deficit monitored through daily diet tracking.
Sperimentale: Hormonal IUD
The second group will be only individuals who have a hormonal IUD that they have elected to be on prior to enrollment in the study. They will undergo a baseline monitoring menstrual cycle that will include daily urinary hormone monitoring, baseline metabolic and body composition assessments, and assessment of baseline energy expenditure and energy intake. During a two week washout week, participants will not be monitoring hormones, but will be subjected to a ~250 kcal/day energy deficit. Following this imposed energy deficiency, they will resume urinary metabolite testing and exercise intake and expenditure tracking. They will undergo this monitoring for a final menstrual cycle and metabolic and body composition assessments, and assessment of energy expenditure and energy intake.
Comportamentale: Energy Deficiency of approximately ~250 kcal/day
Following an initial baseline menstrual cycle, participants will be subjected to at least two weeks of a ~250 kcal/day energy deficit monitored through daily diet tracking.
Sperimentale: Non-Hormonal (i.e., Copper) IUD
The last group will be only individuals who have a non-hormonal/copper IUD that they have elected to be on prior to enrollment in the study. They will undergo a baseline monitoring menstrual cycle that will include daily urinary hormone monitoring, baseline metabolic and body composition assessments, and assessment of baseline energy expenditure and energy intake. During a two week washout week, participants will not be monitoring hormones, but will be subjected to a ~250 kcal/day energy deficit. Following this imposed energy deficiency, they will resume urinary metabolite testing and exercise intake and expenditure tracking. They will undergo this monitoring for a final menstrual cycle and metabolic and body composition assessments, and assessment of energy expenditure and energy intake
Comportamentale: Energy Deficiency of approximately ~250 kcal/day
Following an initial baseline menstrual cycle, participants will be subjected to at least two weeks of a ~250 kcal/day energy deficit monitored through daily diet tracking.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Urinary hormone exposure
Lasso di tempo: From enrollment to energy deficit menstrual cycle is 3 months/90 days
Participants will be asked to track daily urine concentrations of estrogen and progesterone throughout a baseline (i.e., non-energy-deficient state) menstrual cycle and a menstrual cycle with an imposed energy deficit. The outcome will compare hormone exposure measured by the urinary concentrations between the two cycles.
From enrollment to energy deficit menstrual cycle is 3 months/90 days

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Estimated versus actual resting metabolic rate
Lasso di tempo: From enrollment to completion 90 days/3 months
Body composition and estimated metabolic rate will be collected using DXA. The DXA will be measured at baseline and at the conclusion of the energy-deficient menstrual cycle. Resting metabolic rate will be measured via indirect calorimetry testing at baseline, at the beginning of the second monitored (i.e., energy-deficient) menstrual cycle, and at the conclusion of the energy-deficient menstrual cycle. The estimated and actual metabolic rate will be compared as an assessment of energy status. Participants will also be asked to track exercise using a paper log or wearable device to estimate exercise energy expenditure (EEE), and daily intake (EI) will be measured via a paper log or an application. These values will be subtracted (EI-EEE) and normalized to fat-free mass collected via DXA to estimate energy availability.
From enrollment to completion 90 days/3 months
Eating behaviors and attitudes will be measured using the EDEQ and the Three Factor Eating Questionnaire
Lasso di tempo: From enrollment to conclusion 90 days/3 months
The Eating Disorder Examination Questionnaire is a 12 item questionnaire scaled from 0 to 3 (0 being 0 days and 3 being 6 to 7 days) assessing feelings around eating behaviors, body image, and restraint. The Three Factor Eating questionnaire is an 18-question survey that assesses cognitive restraint, emotional eating, and uncontrolled eating on a 4 point Likert scale (0 being never and 3 being at least once a week).
From enrollment to conclusion 90 days/3 months
Subjective stress levels will measured using the Perceived Stress Scale
Lasso di tempo: From enrollment to conclusion 90 days/3 months
The Subjective Stress Scale measures percieved stress through 10 questions about recent stress perceptions on a 0 to 4 Likert scale (0 being never; and 4 being very often).
From enrollment to conclusion 90 days/3 months
Low Energy Availability Indicators will be assessed using the LEAF-Q
Lasso di tempo: From enrollment to conclusion 90 days/3 months
The low energy availability in Females Questionnaire (LEAF-Q) is used to identify female athletes 'at risk' of low energy availability. This questionnaire assesses physiological symptoms associated with LEA, including 25 questions arranged into 3 sections; eating and reproductive assessment, injury assessment, and gastrointestinal symptom assessment. A total score of ≥8 out of 25 questions indicates that the athlete is at risk of LEA. There is a standardized scoring system that varies by question and subquestion.
From enrollment to conclusion 90 days/3 months
Body composition will be measured using DXA
Lasso di tempo: From enrollment to conclusion 90 days/3 months
Dual-energy x-ray absorbtometry will be used to assess body composition including segmental analysis of body fat and lean mass.
From enrollment to conclusion 90 days/3 months

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

University of Southern California

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 settembre 2026

Completamento primario (Stimato)

1 giugno 2027

Completamento dello studio (Stimato)

1 dicembre 2027

Date di iscrizione allo studio

Primo inviato

23 aprile 2026

Primo inviato che soddisfa i criteri di controllo qualità

10 giugno 2026

Primo Inserito (Effettivo)

16 giugno 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

16 giugno 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

10 giugno 2026

Ultimo verificato

1 giugno 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • HS-26-00204

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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