A Randomized Controlled Trial of Ovarian Suppression in Premenopausal Women: No Change in Free-Living Energy Expenditure

Abstract

Objective: The purpose of this study was to determine whether suppression of ovarian function (gonadotropin-releasing hormone agonist [GnRHAG ]) for 24 weeks in premenopausal women approaching menopause causes changes in body composition and a decline in free-living physical activity energy expenditure (PAEE) and whether endurance exercise training attenuates the changes.

Methods: Premenopausal women who were approaching menopause (mean [SD]: age 46 [3] years, BMI 26.3 [4.8] kg/m2 ) were randomized to 24 weeks of GnRHAG (n = 14), GnRHAG + Exercise (n = 11), or placebo (n = 9). Endurance exercise was performed 4 days per week with the goal of expending 200 to 300 kcal per session. Primary outcome measurements included body composition by dual-energy x-ray absorptiometry, total daily energy expenditure (TDEE), and PAEE by doubly labeled water, and resting energy expenditure (REE) by indirect calorimetry.

Results: Changes in TDEE, PAEE, REE, or body composition were not different between groups. However, within the GnRHAG group, fat mass increased (mean [SE]: total 1.7 [0.4] kg, trunk 0.9 [0.2] kg, leg 0.6 [0.2] kg) and fat-free leg mass decreased (mean [SE]: -0.4 [0.2] kg) significantly.

Conclusions: In premenopausal women approaching menopause, ovarian hormone suppression resulted in increased adiposity without alterations in TDEE, PAEE, or REE.

Trial registration: ClinicalTrials.gov NCT01712230.

Conflict of interest statement

DISCLOSURE: The authors declared no conflict of interest.

© 2020 The Obesity Society.

Figures

Figure 1.

CONSORT diagram

Figure 2.

Changes in components of free-living energy expenditure after 24 weeks of Placebo, GnRHAG, or GnRHAG+Exercise adjusted for changes in fat mass and fat-free mass.

Figure 3.

Changes in components of body composition measured by DXA after 24 weeks of Placebo, GnRHAG, or GnRHAG+Exercise. *p<0.05 for within-group change.