Full Project Description

The differences between men and women in physical development accelerate from the onset of puberty, mainly driven by changes in circulating levels of sex-specific hormones. Thus, women will respond differently to exercise than men, and should not be treated as “small men”. However, our current understanding of exercise physiology is mainly developed via research on men, and there is sparse understanding of women's exercise physiology due to limited consideration for sex-specific differences such as the influence of the menstrual cycle and use of hormonal contraceptives.

The primary objective of the female endurance athlete (FENDURA) project is to provide the scientific basis for optimizing long-term training responses and performance development of female athletes in endurance sports and in the prevention of health-related side-effects specific to female athletes. We will 1) Compare the physiological, performance and training development of world-class female endurance competitors to those who had similar potential, but did not succeed; 2) Examine how the menstrual cycle and hormonal contraceptives influence training quality, performance, and possible side-effects in female cross-country skiers and biathletes;

Through these studies, we aim to develop new knowledge that will increase coaches and athletes’ focus on the development of female endurance athletes, and hopefully improve the performance of female endurance athletes. In addition, we aim to develop the understanding that will benefit the health of all women participating in sports and possibly, as well, enhance sport participation.

This project, led by the School of Sport Sciences at UiT The Arctic University of Norway and funded by the Tromsø Research Foundation, will be established in collaboration with the main partners; the Norwegian Olympic Top Sport Center (Olympiatoppen) and the NTNU Center for Elite Sport Research, as well as national and international research networks. We will assure high-quality academic training of upcoming researchers to ensure sustainability of research activity in the project sphere, and build a solid foundation in Northern Norway for an inter-disciplinary, world-leading research group focusing on female physiology, exercise and performance, which would place UiT as an internationally recognized academic institution in this field. The total budget is 33 million NOK.

Project: Physiological Testing in Different Phases of the Menstrual Cycle

Study Objective

The overall aim of study is to investigate if menstrual cycle phase influences endurance performance and performance determining variables in endurance-trained female athletes. Through the use of a standardized fitness test in different phases of the menstrual cycle, the acute physiological and psychological effects of menstrual cycle phase will be investigated. 

Inclusion Criteria

To participate in the study, you must meet the following criteria:

• Aged 18-40;
• Competing in an endurance sport at a regional, national or international level;
• Naturally menstruating;
• Not using hormonal contraceptives for at least three months prior to the onset of the study;
• Have an average cycle length no shorter than 21 days, and no longer than 35 days;
• Engaged in systematic training for an endurance sport for at least the past three years.

 Exclusion Criteria

Unfortunately, you can not participate in this study if you meet any of the following criteria:

• Use a hormonal contraceptive (currently or within the past three months);
• Have a clinically defined menstrual disorder other than oligomenorrhea (functional hypothalamic amenorrhea);
• Previous injuries or illnesses preventing you from training regularly within two weeks prior to the study;
• Ongoing illness, disease, or injury that poses a risk to you while participating;
• Pregnancy;
• Nicotine usage;
• A known eating disorder.

Study Design- what does participation entail?

Summary

Participation in the study will last ~ 4 months. It will involve completing some short questionnaires and tracking your menstrual cycle and training,  and completing a standardized fitness test at specific times of your menstrual cycle.

Prior to the test period, you will be asked to complete one familiarization session in the laboratory to learn the standardized fitness test and go for one DEXA scan to assess bone mineral density and body composition. During the test period, participants will complete a standardized fitness test in each of the three different MC phases (early follicular (EF), late follicular (LF) and mid luteal (ML)) for two consecutive menstrual cycles. Thus, each participant will complete the standardized fitness test seven times; once during the lead in period, and six times during the test period. The study design is visually represented in the schematic below (Figure 1):

Figure 1.Study schematic. Each graph represents one menstrual cycle. EF. Early follicular. LF. Late follicular. ML. Mid luteal.

The exact details of participation are as follows:

Initially, you will answer a short questionnaire about training and competition in connection to the menstrual cycle, as well as your history of hormonal contraceptive use. We will also ask you for consent to access your data from the Olympiatoppen (OLT) training diary, where we will collect daily information about menstrual cycle (ie. Menstrual cycle day, pain associated with the menstrual cycle, energy levels) training (ie. type of training session, heart rate zones, daily form, load and form of movement) and recovery measures (ie. sleep quality and resting heart rate) and any additional comments. If you regularly record heart rate during your training sessions, we also ask for access to these training files to allow for a detailed determination of training load.

You will be asked to track your menstrual cycle for 4 complete cycles (approximately 4 months), in your online training diary (OLT-dagbok or Bestr). You will also be asked to use a simple, at-home urinary ovulation testing kit (Clearblue Digital Ovulation Test) during each cycle to determine ovulation and provide information for scheduling the exercise testing sessions.

Before the first laboratory exercise test, you visit the laboratory to practice and become familiar with the procedures and equipment that will be used in the subsequent visits and exercise tests. You will also be asked to undertake a dual-energy x-ray absorptiometry (DXA) scan to determine your bone mineral density and body composition before the first laboratory exercise test. In connections with the DXA test you will be asked to complete a general health and activity questionnaire.

During the test period you will then be asked to visit the laboratory at 3 specific times during the menstrual cycle for 2 consecutive menstrual cycles (see Figure 1) to complete a standardized fitness test. The testing time points during each cycle will be: early follicular phase (during menstrual bleeding, day 1-5 of the menstrual cycle); late follicular phase (within 36 hours of positive ovulation test, approximately 10 days after your menstrual bleed); and mid luteal phase (approximately 7-9 days after the late follicular testing).

During each standardized fitness testing session, you will first be asked to provide a small blood sample (~ 25mL) which will be used to determine hormonal levels during specific points of the menstrual cycle and complete two short questionnaires. You will then be provided a standardized breakfast before performing the following fitness tests:

• submaximal lactate running test on a treadmill;
• countermovement jump test;
• 30 second double polling power test on a ski ergometer;
• maximal oxygen consumption (VO2max) running test on a treadmill.

Test Locations

Testing will occur at five centers across Norway.

• Tromsø, UiT, Alfheim Stadium
• Trondheim, Norwegian Univeristy of Science and Technology (NTNU)
• Olso, Norwegian School of Sport Science (NIH)
• Olso, Kristiania Univeristy College
• Meråker, Nord University

Please contact Madison Taylor, for more information: madison.taylor@uit.no

Possible advantages and disadvantages for participating in this study

The benefits for participating in this study are improved fitness and knowledge of how to take care of your health. You will be informed of your level of fitness with a test report summary at the end of the study period. Furthermore, by participating in the study, you can contribute to a greater understanding of how the menstrual cycle can affect female skiers during training and competition. Increased knowledge of this field is important to facilitate and optimize training and performance development in female skiers. In this context, we hope the study will give you the opportunity to increase your own awareness of how your body responds to exercise and competitions in connection with the various phases of the menstrual cycle. Additionally, you will given a discount code for the Polar web shop if you choose to purchase a new heart rate monitor or watch.

Any exercise and physical activity may result in feelings of fatigue and muscle soreness, when compared to rest. There is also the very rare possibility of considerable injury or sudden death during exercise. However, this risk is very low and is by far outweighed by the benefits of regular exercise. As a highly trained endurance athlete, you are accustomed to performing maximally during training and competitions, and the discomfort that comes with exercising. Therefore, this study is not likely to result in increased physiological stress for you. You will also be asked to complete screening health questionnaires that will be reviewed prior to testing to avoid physical exercise during illness or other medical condition. 

Contact information

If you have questions about this study, please feel free to contact:

• Ms. Madison Taylor ( madison.taylor@uit.no )
• A / Prof. Boye Welde ( boye.welde@uit.no )
• Prof. Øyvind Sandbakk ( oyvind.sandbakk@ntnu.no )
• Dr. Erik Andersson ( erik.andersson@uit.no )
• Dr. John Osborne ( john.owen.osborne@uit.no )

Project: Utbredelse i bruk av hormonelle prevensjonsmidler og menstruasjonssyklussymptomer i Norge

Bidra til forskning på kvinnehelse og trening

Hvorfor bruke 5 minutter på å fylle ut denne undersøkelsen?

Spørreundersøkelsen er helt anonym og bidrar til økt kunnskap om kvinners helse og fysiologi. Halvparten av norske idrettsutøvere (på elitenivå) har rapportert at de bruker hormonell prevensjon, men data på befolkningsnivå er ufullstendig og utdatert. I tillegg til en generell kartlegging ønsker vi å se om bivirkninger eller andre plager knyttet til menstruasjonssyklus, eller bruk av hormonell prevensjon, påvirker kvinners helse og trening.

Hvem kan delta?

For å bidra inn i denne undersøkelsen må du være:

• kvinne og bosatt i Norge;
• 16 år eller eldre.

Hvorfor gjennomfører vi studien, og hvorfor er den så viktig?

Vi ønsker å oppdatere og utvikle den generelle kunnskapen rundt kvinnehelse i Norge, og prosjektet skal:

• beskrive utbredelsen i bruk av hormonelle prevensjonsmidler;
• kartlegge hvilken type hormonell prevensjon som brukes;
• beskrive selvrapporterte bivirkninger forbundet med menstruasjonssyklusen og bruk av hormonell prevensjon;
• kartlegge utbredelse og alvorlighetsgrad av uregelmessigheter i menstruasjonssyklusen;
• beskrive fysisk aktivitetsnivå og trening.

Resultatene av denne kartleggingen har som mål å bidra til at framtidig forskning er tilpasset norske kvinner og deres fysiologi.

Har du noen spørsmål om studien?

Ta kontakt med John Owen Osborne, postdoktor ved Idrettshøgskolen, UiT Norges arktiske universitet.

E-postadresse: john.owen.osborne@uit.no

FENDURA doktorgradsstipendiat, Madison Taylor, intervjuet av NRK

Lytt til podcast 'I det lange løp' med doktorgradsstipendiater, Hanne Staff og Tina Pettersen Engseth

Apple Podcasts: Link

Spotify: Link

Prosjektleder Boye Welde intervjuet av NRKP1

Boye Welde  –  Associate Professor

Øyvind Sandbakk  –  Professor

Bente Morseth  –  Professor

John Owen Osborne  –  Postdoctoral Fellow on the FENDURA project

Erik P Andersson  –  Postdoctoral fellow

Dionne Noordhof  –  Associate Professor

Thomas Haugen  –  Associate Professor

Guro Strøm Solli  –  Lecturer

Tor Oskar Thomassen  –  Associate Professor

Hanne Cesilie Staff  –  Doctoral Research Fellow

Tina Pettersen Engseth  –  Doctoral Research Fellow

Madison Taylor  –  Doctoral Research Fellow

Boye Welde  –  Associate Professor

Øyvind Sandbakk  –  Professor

Bente Morseth  –  Professor

John Owen Osborne  –  Postdoctoral Fellow on the FENDURA project