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: Endurance Training and Recovery in Different Phases of the Menstrual Cycle

Study Objective

The overall aim of study is to investigate if menstrual cycle phase influences the response during endurance training sessions (i.e, a low intensity session or a high intensity interval session) and the recovery afterwards. Through the use of standardized endurance training sessions in different phases of the menstrual cycle, the acute physiological and psychological effects of menstrual cycle phase will be investigated. In addition, sleep and recovery after each session will be investigated.

Inclusion Criteria

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

• Aged 17-45;
• Naturally menstruating (not using hormonal contraceptive 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;
• Training in an endurance sport (ex. running, cycling, triathlon, orienteering, cross country skiing, biathlon, etc.)
• Training at least 3 x per week / 5 hours per week

 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;
• 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;
• Experiencing any symptoms of menopause or perimonpause (ex. Menstrual irregularities, hot flashes, mood swings, hormonal irregularities)
• Post-partum- had a baby in the last 12 months
• Currently pregnant or currently trying to become pregnant
• A known eating disorder

Study Design- what does participation entail?

Summary

Participation in the study will last ~ 3 months. It will involve tracking your menstrual cycle and training, using at home ovulation test to identify ovulation and completing standardized endurance training sessions in the lab at specific times points of your menstrual cycle.

Prior to the test period, you will be asked to complete one pre-test session in the laboratory to assess your physical fitness and determine the intensity zones for your training sessions. 

The test period will last for two menstrual cycles. You will complete a training session in each of the three different MC phases

• Early follicular: within day 1-4 of the onset of menstrual bleeding
• Ovulatory: within 36 hours of a positive ovulation test
• Mid luteal: 7-9 days after positive ovulation

During one cycle of testing, you will complete 3x a standardized low intensity training session, and during the other cycle you will complete 3 x a high intensity interval session. It is possible to do the training sessions running on the treadmill or cycling on a cycle ergometer. The study period is illustrated in the image below.

Figure 1.Study schematic. Each graph represents one menstrual cycle, and each running figure represents a test session in the lab.

The training sessions are as follows:

High intensity interval session: 15 minute warm-up followed by 5 x 4 minute intervals at approximately 80% of max speed / power output, with 2 minutes of active recovery between each bout, finished with 10 minutes of low intensity

Low intensity session: 13 minutes warm-up, 60 minutes with 3x blocks of low intensity OR cycling 90 minutes with 5x blocks of low intensity at approx. 55% of maximum speed / power output with varied intensity

The exact details of participation are as follows:

Initially, you will answer a short questionnaire about menstrual cycle history and physical training. You will be asked to make an account for an online training diary (Olympiatoppen (OLT)  or BESTR) where we will need to report daily information about your 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.

You will be asked to track your menstrual cycle for at least 3 complete menstrual cycles (approximately 3 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.

During the early follicular phase of your first menstrual bleed you will asked to visit the laboratory to complete a pre-test to asses your physical fitness. This test includes a lactate profile tests (4-6 5-minute-long stages with gradually increasing intensity) and a VO2max test (increasing intensity until exhaustion). We will use the results from this test to establish the speeds/power output zones for your training sessions.

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 the standardized training sessions. The testing time points during each cycle will be: early follicular phase (during menstrual bleeding, day 1-4 of the menstrual cycle); ovulatory phase (within 36 hours of positive ovulation test, approximately 14 days after your menstrual bleed); and mid luteal phase (approximately 7-9 days after the late follicular testing). During one cycle of testing, you will complete 3x a standardized low intensity training session, and during the other cycle you will complete 3 x a high intensity interval session. It is possible to do the training sessions running on the treadmill or cycling on a cycle ergometer (see illustrations of test sessions described earlier).

During each test day, you will first be asked to provide a small blood sample (~ 10mL) which will be used to determine hormonal levels during specific points of the menstrual cycle and complete a short questionnaire. You will be provided a standardized breakfast before completing the training session. See image of the test day below.

Figure 2 . Diagram of a laboratory test day.  

Test Locations

Testing will occur at three centers across Norway.

• Tromsø, UiT, Alfheim Stadium
• Trondheim, Norwegian Univeristy of Science and Technology (NTNU), St. Olavs Hospital
• Olso, Norwegian School of Sport Science (NIH)

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 endurance athletes during training and competition. Increased knowledge of this field is important to facilitate and optimize training and performance development in female athletes. 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)
• A / Prof. Dionne Noordhof (dionne.a.noordhof@ntnu.no)

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

Contribute to research into women's health and exercise

Why take 5 minutes to complete this survey?

The survey is completely anonymous and contributes to increased knowledge about women's health and physiology. Half of Norwegian athletes (at elite level) have reported that they use hormonal contraception, but data at population level is incomplete and out of date. In addition to a general survey, we want to see if side effects or other ailments linked to the menstrual cycle, or the use of hormonal contraception, affect women's health and exercise.

Who can participate?

To contribute to this survey you must be:

• female and resident in Norway;
• 12 years or older.

Why are we conducting the study, and why is it so important?

We want to update and develop general knowledge about women's health in Norway, and the project will:

• describe the prevalence in the use of hormonal contraceptives;
• chart the type of hormonal contraception used;
• describe self-reported side effects associated with the menstrual cycle and use of hormonal contraception;
• survey prevalence and severity of menstrual cycle irregularities;
• describe physical activity level and training.

The results of this survey aim to contribute to ensuring that future research is adapted to Norwegian women and their physiology.

Do you have any questions about the study?

Get in touch with John Owen Osborne , postdoctoral fellow at the School of Sport, UiT Norway's Arctic University.

Email address: 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

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