Cortisol levels during prolonged exercise: the influence of menstrual phase and menstrual status.

The purpose of this study was to determine the influence of menstrual phase and menstrual status on the cortisol response during 90 minutes of treadmill running at 60% VO2max. Eight eumenhorrheic athletes were tested in the early follicular (EF) (day 3-5), late follicular (LF) (day 13-15) and mid-luteal (ML) (day 22-24) phases. Six amenorrheic athletes were tested on two separate occasions. The resting cortisol levels were similar in each menstrual phase and overall a decreasing pattern of cortisol response to exercise was observed in all menstrual phases (P greater than .05). The amenorrheic athletes had a significantly greater (P less than .01) pattern of cortisol response than was observed in eumenorrheic athletes. The net increment in cortisol levels during exercise were distinctly greater (P less than .01) in amenorrheic than eumenorrheic athletes (amenorrheic: 413.8 +/- 113.1, eumenorrheic: EF: -482.8 +/- 88.3, LF: -311.8 +/- 102.1, ML: -386.3 +/- 146.2 nmol.l-1). In conclusion the cortisol levels are independent of menstrual phase. Also a larger cortisol increment is observed in amenorrheic athletes in response to prolonged submaximal exercise. The elevated cortisol levels in amenorrheics at rest and throughout exercise provides further evidence that disturbances in the hypothalamic-pituitary-adrenal function are associated with exercise-induced amenorrhea, although the site(s) of physiological disturbance have not been identified.     

Substrate and hormone responses to exercise following a marathon run

The aim of this study was to examine selected substrate and hormone responses to 30-min treadmill runs performed several days before and after a competitive marathon (42.2 km) to determine the time course for return of altered responses to pre-race levels. Six experienced male runners (30.8 +/- 9.1 years) ran at their predicted race pace (77.1% +/- 4.1% of VO2max) 8-7 days prior (S-1) to the Boston Marathon and 2-3 (S-2), 6-7 (S-3), and 13-14 days (S-4) post-marathon. All 30-min runs were performed in the morning at a constant time for each subject following a 12-h fast. Blood samples were drawn immediately before and immediately after (within 1 min) the 30-min runs. Post-exercise glucose responses were higher (P less than 0.05) during S-2 and S-3 compared with S-1 values. S-2 post-exercise lactate concentrations were also higher than the corresponding S-1 value. Pre-exercise free fatty acid (FFA) levels during S-4, and the post-exercise FFA values during S-2, S-3, and S-4, were lower (P less than 0.05) than the corresponding S-1 concentrations. Pre- and post-exercise alanine levels during S-2 were higher (P less than 0.05) than the S-1 values. Both pre- and post-exercise insulin levels during S-2, S-3, and S-4 were greater (P less than 0.05) than corresponding S-1 concentrations. Glucagon concentrations were unchanged across all sessions.(ABSTRACT TRUNCATED AT 250 WORDS)     

Physical exercise and menstrual cycle alterations. What are the mechanisms?

The prevalence of menstrual cycle alterations in athletes is considerably higher than in sedentary controls. There appears to be a multicausal aetiology, which makes it extremely difficult to dissociate the effects of physical exercise on the menstrual cycle from the other predisposing factors. From cross-sectional studies it appeared that physical training eventually might lead to shortening of the luteal phase and secondary amenorrhoea. Prospective studies in both trained and previously untrained women have shown that the amount and/or the intensity of exercise has to exceed a certain limit in order to elicit this phenomenon. We hypothesise, therefore, that apart from a certain predisposition, athletes with a training-induced altered menstrual cycle are overreached (short term overtraining, which is reversible in days to weeks after training reduction). Menstrual cycle alterations are most likely caused by subtle changes in the episodic secretion pattern of luteinising hormone (LH) as have been found in sedentary women with hypothalamic amenorrhoea as well as in athletes after very demanding training. The altered LH secretion then, might be caused by an increased corticotrophin-releasing hormone (CRH) secretion which inhibits the gonadotrophin-releasing hormone (GnRH) release. In addition, increased CRH tone will lead to increased beta-endorphin levels which will also inhibit the GnRH signaller. Finally, the continuous activation of the adrenals will result in a higher catecholamine production, which may be converted to catecholestrogens. These compounds are known to be potent inhibitors of GnRH secretion. In conclusion, menstrual cycle alterations are likely to occur after very demanding training, which causes an increase secretion of antireproductive hormones. These hormones can inhibit the normal pulsatile secretion pattern of the gonadotrophins.     

Effects of menstrual phase and amenorrhea on exercise performance in runners

There are few well controlled studies in terms of subject selection, menstrual classification, and exercise protocol that have examined both maximal and submaximal exercise responses during different phases of the menstrual cycle in eumenorrheic runners and compared these runners to amenorrheic runners. Thus, the purpose of this study was to measure selected physiological and metabolic responses to maximal and submaximal exercise during two phases of the menstrual cycle in eumenorrheic runners and amenorrheic runners. Eight eumenorrheic runners (29.0 +/- 4.2 yr) and eight amenorrheic runners (24.5 +/- 5.7 yr) matched for physical, gynecological, and training characteristics were studied. The eumenorrheic runners performed one maximal and one submaximal (40 min at 80% VO2max) treadmill run during both the early follicular (days 2-4) and midluteal (6-8 d from LH surge) phases. The amenorrheic runners performed one maximal and one submaximal (40 min at 80% VO2max) treadmill run. Cycle phases were documented by urinary luteinizing hormone and progesterone assays and by plasma estradiol and progesterone assays. No differences were observed in oxygen uptake, minute ventilation, heart rate, respiratory exchange ratio, rating of perceived exertion, time to fatigue (maximal), and plasma lactate (following the maximal and submaximal exercise tests) between the follicular and luteal phases in the eumenorrheic runners and the amenorrheic runners. We conclude that neither menstrual phase (follicular vs luteal) nor menstrual status (eumenorrheic vs amenorrheic) alters or limits exercise performance in female athletes.     

Physiological responses to submaximal exercise at the mid-follicular, ovulatory and mid-luteal phases of the menstrual cycle

This study examined the responses of eumenorrheic women to 60 min of submaximal exercise at the mid-follicular (MF), ovulatory (OV) and mid-luteal (ML) phases of the menstrual cycle. Blood metabolite-hormonal measures, cardiorespiratory responses and ratings of perceived exertion (WE) (local, legs only; and total, entire body) were monitored at 15-min intervals throughout exercise. No significant effects for phase were observed in the blood measures or the cardiorespiratory responses, except for the respiratory exchange ratio (RER). The overall exercise OV RER (0.86 ± 0.02; mean ± SEM) was lower than at MF (0.94 ± 0.02) but not at ML (0.89 ± 0.01). Substrate utilization (%) and oxidation (g/min) calculations indicated that more fat was used during OV than at MF but not ML. Conversely, more carbohydrate was used during MF than OV. Additionally, local RPE was higher in OV than in the MF or ML trials at 30–60 min of exercise. These findings suggest that menstrual cycle hormonal fluctuations influence metabolic substrate usage and effort perception during submaximal exercise in eumenorrheic women.     

Catecholamine responses to acute and chronic exercise.

The body can adjust to a variety of stressors (physical activity, environmental, emotional, etc.) that are known to disrupt normal homeostatic conditions. Specific metabolic and physiological adaptations are required for both acute and chronic stimuli. The sympathoadrenal system is essential for such adjustments as they control and regulate a number of key bodily functions. In response to an acute bout of exercise, both central and peripheral alterations are elicited. The extent of these responses is dependent upon exercise intensity, duration, and tissue specificity. Further, endurance training results in adaptations that are tissue specific and enhance the ability for the maintenance of exercise energetics. While a number of markers are frequently used to assess the involvement of the sympathoadrenal response (plasma and tissue norepinephrine and epinephrine levels), it is important to examine more specific variables such as rates of turnover, synthesis and removal, and activity of key enzymes related to catecholamine metabolism.     

Influence of menstrual status on fluid replacement after exercise induced dehydration in healthy young women.

OBJECTIVE--To determine whether fluid replacement after exercise induced dehydration varies over the normal menstrual cycle. METHODS--Five subjects, with a regular menstrual cycle lasting 28 (SEM 2) d, were dehydrated by 1.8(0.1)% of their pre-exercise mass by cycle exercise in the heat. Trials were undertaken 2 d before (trial -2) and 5 and 19 d after the onset of menses (trials 6 and 20 respectively). After exercise, subjects ingested a fixed volume, equivalent to 150% of mass loss, of a commercially available sports drink over a 60 min period. RESULTS--Cumulative urine output [median (range)] over the 6 h following ingestion was the same on all trials: 714(469-750) ml on trial -2; 476(433-639) ml on trial 6; 534(195-852) ml on trial 20. There was no menstrual cycle effect on urinary electrolyte (Na+, K+, Cl-) excretion or serum electrolyte (Na+, K+, Cl-) concentrations. Plasma volume increased by 8-12% of the postexercise value following rehydration. The percentage of ingested fluid retained did not differ between trials at any time. Six hours after drink ingestion, net fluid balance was not different from the initial value on any of the trials. CONCLUSIONS--Acute replacement of exercise induced fluid losses is not affected by the normal menstrual cycle.     

The menstrual cycle and exercise: performance, muscle glycogen, and substrate responses

Six eumenorrheic females (age = 26.3 +/- 2.4 yrs; X +/- SE) exercised until exhaustion (EE; 70% VO2max) at the midluteal (LP, 7-8 days after ovulation) and midfollicular (FP, days 7-8) phases of their menstrual cycles. Phases were confirmed by estradiol and progesterone concentrations. Each EE test was preceded by a depletion exercise bout (DE; 90 min, 60% VO2max and 4 x 1 min, 100% VO2max) and 3 days of rest/diet control. Muscle biopsies 1% (vastus lateralis) were taken post-DE, pre-EE, and post-EE and then analyzed for glycogen content. There was a strong tendency (P less than 0.07) for EE duration to be greater during LP (139.2 +/- 14.9 min) than FP (126 +/- 17.5 min). Glycogen repletion (pre-EE minus post-DE) following DE was greater (P = 0.05) during the LP than FP (88.2 +/- 4.7 vs 72.8 +/- 5.7 mumol/g w. w. muscle). However, EE glycogen utilization (pre-EE minus post-EE/EE time) did not differ between phases (LP = 0.41 +/- 0.08 mumol/g w. w. muscle/min vs FP = 0.33 +/- 0.11 mumol/g w. w. muscle/min; P = 0.17). The results suggest that exercise performance and muscle glycogen content are enhanced during the LP of the menstrual cycle. These findings imply athletic performance may be affected by the phases of the menstrual cycle.     

Anxiety responses to maximal exercise testing.

The influence of maximal exercise testing on state anxiety was examined in three separate studies. Highly trained male distance runners (Study 1, n = 12) as well as college students with average (Study 2, n = 16) and below average (Study 3, n = 32) physical fitness levels completed graded maximal exercise tests. This last group was also randomly assigned to either a control or an 8 week training programme in order to determine the effect of increased fitness on the psychological responses to maximal exercise testing. Physical fitness was determined by the measurement of maximal oxygen uptake. State anxiety (State-Trait Anxiety Inventory) was assessed before and from 2-15 min following exercise. It was found that the state anxiety responses to maximal exercise testing were not influenced by re-testing or by 8 weeks of endurance training. Across the three study groups, the anxiety response was variable during the first 5 min following exercise testing; increases, decreases and no changes in anxiety were observed when compared to pre-exercise levels. The anxiety response to maximal exercise appeared to be dependent on the pre-exercise anxiety levels as well as the timing of the post-exercise assessments. It is concluded that maximal exercise testing can be associated with negative mood shifts during the first 5 min after exercise; however, this response is transitory and followed by positive mood shifts 10-15 min following such tests.     

The impact of exercise modality and menstrual cycle phase on circulating cardiac troponin T

ObjectivesIt is unclear whether exercise modality (moderate-intensity continuous [MCE]; high-intensity interval [HIE]) and menstrual cycle phase (follicular [FP]; luteal [LP]), individually or in combination, mediate the commonly observed exercise-induced elevation in cardiac troponin T (cTnT). This study examines cTnT responses to MCE and HIE during both the FP and LP.DesignRandomised crossover study.MethodsSeventeen healthy, eumenorrheic women completed four trials including MCE (60% VO_2max steady-state cycling until 300 kJ) and work‐equivalent HIE (repeated 4-min cycling at 90% VO_2max interspersed with 3-min rest) during both the FP and LP. The FP and LP were verified based on ovarian hormones. Serum cTnT was assessed using a high-sensitivity assay before, immediately after, and 1 (1HR), 3 (3HR) and 4 (4HR) hours after exercise. cTnT values were corrected for plasma volume changes.ResultscTnT was significantly elevated (p < 0.05) post-exercise in both MCE (at 3HR and 4HR) and HIE (at 1HR, 3HR and 4HR). No statistically significant difference (p > 0.05) in peak post-exercise cTnT, which mostly occurred at 3HR, was seen among the four trials (median [range], ng l⁻¹: 5.2 [1.7–18.1] after MCE during FP; 4.8 [1.7–24.9] after MCE during LP, 8.2 [3.9–24.8] after HIE during FP and 6.9 [1.7–23.1] after HIE during LP).ConclusionsA single 300 kJ bout of both MCE or HIE resulted in a significant post-exercise increase in cTnT, with no differences in peak cTnT response between menstrual cycle phases or between exercise modes, but the cTnT elevation occurs slightly earlier after HIE.     

Neuroendocrine-immune interactions and responses to exercise

This article reviews the interaction between the neuroendocrine and immune systems in response to exercise stress, considering gender differences. The body's response to exercise stress is a system-wide effort coordinated by the integration between the immune and the neuroendocrine systems. Although considered distinct systems, increasing evidence supports the close communication between them. Like any stressor, the body's response to exercise triggers a systematic series of neuroendocrine and immune events directed at bringing the system back to a state of homeostasis. Physical exercise presents a unique physiological stress where the neuroendocrine and immune systems contribute to accommodating the increase in physiological demands. These systems of the body also adapt to chronic overload, or exercise training. Such adaptations alleviate the magnitude of subsequent stress or minimize the exercise challenge to within homeostatic limits. This adaptive capacity of collaborating systems resembles the acquired, or adaptive, branch of the immune system, characterized by the memory capacity of the cells involved. Specific to the adaptive immune response, once a specific antigen is encountered, memory cells, or lymphocytes, mount a response that reduces the magnitude of the immune response to subsequent encounters of the same stress. In each case, the endocrine response to physical exercise and the adaptive branch of the immune system share the ability to adapt to a stressful encounter. Moreover, each of these systemic responses to stress is influenced by gender. In both the neuroendocrine responses to exercise and the adaptive (B lymphocyte) immune response, gender differences have been attributed to the 'protective' effects of estrogens. Thus, this review will create a paradigm to explain the neuroendocrine communication with leukocytes during exercise by reviewing (i) endocrine and immune interactions; (ii) endocrine and immune systems response to physiological stress; and (iii) gender differences (and the role of estrogen) in both endocrine response to physiological stress and adaptive immune response.     

Atrial natriuretic factor responses to submaximal and maximal exercise.

The aim of this study was to evaluate and compare the plasma concentration of atrial natriuretic factor (ANF), K+, Na+, blood lactate, heart rate, and blood pressure in moderately trained women. Ten healthy women were studied on a cycle ergometer during 20 min of constant submaximal and maximal exercise, as well as during recovery. The ANF concentration was determined by radioimmunoassay. The results show that, except for Na+, all the other variables increased significantly with an increase in the duration and intensity of the exercise (P < 0.05, P < 0.001). In recovery, the values fell (P < 0.01, P < 0.001). Submaximal and maximal exercise both cause increases in ANF and this increase is due to the duration and intensity of exercise. However, maximal exercise, rather than submaximal exercise, is the major stimulus for the concentration of plasma ANF. ANF concentration may be a useful test for evaluating the releasing function of ANF in the heart.     

Stability and variability in hormonal responses to prolonged exercise.

To study the dynamics of alterations in blood hormones and their individual variability during prolonged exercise, changes in plasma levels of corticotropin, cortisol, aldosterone, testosterone, progesterone, somatotropin, insulin and C-peptide were recorded in 32 endurance athletes and 50 untrained persons during a 2-hour exercise on a cycle ergometer at 60% VO2max. Common changes were activation of the pituitary corticotropin function, mostly at the end of exercise, rises in aldosterone and somatotropin concentrations and decreases in insulin and C-peptide levels during exercise. The activation of pituitary-adrenocortical system and the decrease of insulin but not C-peptide levels were more pronounced in athletes than in untrained persons. A large inter-individual variability existed in changes of cortisol, testosterone and progesterone in both groups. Five variants were found in the dynamics of cortisol concentration. Whereas the alterations of corticotropin were characterized mainly by a biphasic increase, the dynamics of corticotropin and cortisol coincided only in one variant out of five. Most characteristic for the postexercise recovery period were decreased activity of the pituitary-adrenocortical system and delayed normalization of aldosterone level.     

Influence of exercise and menstrual cycle phase on plasma homocyst(e)ine levels in young women--a prospective study.

Plasma total homocysteine (tHcy) has been identified as an independent risk factor for cardiovascular diseases (CVD). The difference in tHcy between the sexes has most often been related to the sex hormones, but also to a higher muscle mass in men. The purpose of this study was to assess the effects of acute exercise, brief exhaustive training, and menstrual cycle phase on circulating plasma tHcy concentrations. Fifteen untrained eumenorrheic women (mean age [+/-SD]: 18.7+/-0.4 yr, body fat: 25.8+/-3.4%, VO2max: 43.8+/-2.3 ml x kg(-1) x min(-1)) volunteered for the present study, which covered two menstrual cycles. During the second cycle the subjects participated in two exhaustive 5-day training programs on a cycle ergometer: one in the follicular (FPh) and one in the luteal phase (LPh). Pre- and posttraining plasma tHcy and total estrogen (E) responses were determined in blood samples obtained immediately before, during and immediately after incremental exercise to exhaustion. tHcy levels showed a large between-subject variation, but differences between FPh and LPh levels were consistent (P=0.063). Mean tHcy levels at rest were 9.44+/-1.65 micromol/L and 8.93+/-1.71 micromol/L during the FPh and LPh, respectively. Brief exhaustive training did not elicit any changes in plasma tHcy concentrations, although posttraining LPh E levels were lower (P<0.01). Overall, the differences between FPh and LPh values for tHcy and E were attenuated by training. Acute exercise increased plasma tHcy concentrations (P<0.001). At exhaustion, tHcy levels increased by 17% and 16% during the FPh and LPh, respectively. This was also significantly above tHcy levels at submaximal exercise (P=0.044). After a short period of training tHcy levels did not increase as much during acute exercise as they did before training; however, the increments were still significant (P=0.048). In conclusion, acute exercise in women produces significant increases in plasma tHcy concentrations, whereas brief exhaustive training does not significantly alter plasma tHcy levels. Our findings also suggest that plasma tHcy concentrations are menstrual cycle phase-dependent and that there is a close association between estrogen status and tHcy levels.     

Psychobiologic responses to exercise at different times of day.

The primary purpose of this investigation was to determine whether selected psychobiologic responses to running exercise vary as a function of the time of day at which exercise is performed. Twelve adult males completed four bouts of randomly assigned, submaximal exercise (20-min runs at 70% VO2max) at 0800, 1200, 1600 and 2000 h. Since selected personality traits have previously been shown to influence circadian rhythms, personality assessments (i.e., Eysenck Personality Questionnaire, EPQ; Morningness-Eveningness Questionnaire, MEQ; Spielberger's State-Trait Anger Expression Inventory, STAIX; and State-Trait Anxiety Inventory, STAI) were made during the initial testing session. The group studied scored within the normal range on the traits assessed by the EPQ, STAIX, and STAI. Also, subjects were not able to be classified as either "morning" or "evening" types based on MEQ scores. Ten minutes before as well as 10 and 20 min following the exercise bouts, state anxiety, state anger, blood pressure, and heart rate were assessed. Multivariate ANOVAs (four time of day conditions x three trials) revealed significant main effects for the trial factor for state anxiety, state anger, heart rate, and systolic blood pressure. State anxiety, state anger, and systolic blood pressure were found to be reduced at both the 10 and 20 min post-exercise assessment periods when compared with pre-exercise levels. ANOVAs performed on the difference scores showed that the mood improvements and cardiovascular changes were independent of the time of day that exercise was performed, and these findings were confirmed by ANCOVAs, which adjusted for differences in initial values across the four time of day conditions.(ABSTRACT TRUNCATED AT 250 WORDS)     

The effect of warm-up on responses to intense exercise.

The purpose of this study was to determine if prior physical activity (warm-up) affected physiological responses to intense exercise. Eight highly trained collegiate swimmers performed a paced 365.8-m (440 yds) intense swim (mean +/- SE, 94.4 +/- 3.3% VO2max) 5 min after the following warm-up conditions: trial N, no warm-up; trial S, an intensity-specific interval set (4 x 45.7 m with one-min rest intervals at the intense swim pace); trial M, a mild-intensity, long-duration swim (1371.6 m at 64.7 +/- 3.3% VO2max); and trial MS, a mild-intensity, long-duration swim (1188.7 m at the same pace as trial M) followed by the intensity-specific interval set (trial S). When comparing trial N with trials M and MS, stroke distance (m/stroke) was significantly (p less than 0.05) lower during the last 91.4 m of the intense, paced swim and 3-, 5-, 8- and 10-min recovery blood lactate levels and one-minute recovery heart rates were significantly elevated (p less than 0.05). There was no significant difference (p greater than 0.05) in stroke distance during the final 91.4 m of the intense swim between trials S and N. There were no significant differences for any variables between trials M and MS. These results suggest that a warm-up consisting of mild-intensity, long-duration exercise was beneficial compared to no warm-up and that intensity-specific exercise was not a vital component of warm-up. Although performance was not directly measured, these data demonstrate the benefit of warm-up.