Effects of Resistance Training on Women With Functional Hypothalamic Amenorrhea

Official title

Impact of Strength Training on Mental Health and Physical Fitness in Women With Functional Hypothalamic Amenorrhea

Overview

Functional hypothalamic amenorrhea (FHA) is a condition where women lose their menstrual periods, typically due to a combination of stress and insufficient calorie intake to fuel their daily physical activity (low energy availability). Standard medical advice often requires these women to completely stop exercising to recover their energy balance and hormones. However, this "complete rest" approach can cause severe anxiety for active individuals and removes the necessary mechanical loading that keeps bones strong. This study evaluates the safety and effectiveness of an 8-week supervised resistance training (weightlifting) program as a realistic alternative treatment for active women with FHA. The researchers compare a group of women experiencing FHA to a control group of women with regular menstrual cycles. Over the 8 weeks, participants complete three moderate-intensity, full-body weightlifting sessions per week. The primary goal is to determine if women with FHA can successfully recover their menstrual cycles while continuing to lift weights. Additionally, the study monitors changes in muscle strength, jumping performance, body composition, resting heart rate, and psychological well-being. Ultimately, this study aims to provide healthcare providers and coaches with evidence-based strategies that allow female athletes to safely maintain their athletic identity and physical health during recovery.

Interventions

• Other Resistance Training Program
  Supervised 8-week resistance training program consisting of three non-consecutive full-body sessions per week. Each session included four multi-joint exercises targeting upper and lower body muscle groups. Training dosage: Volume: Two working sets of 6-8 repetitions per exercise. Intensity: Individualized loads progressed weekly from 60% to 80% of estimated 1RM. 1RM was estimated using the Epley equation. Effort: Performed at 0-1 repetitions in reserve (RIR). Rest:Standardized 1-minute interv

Primary outcome measures

• Incidence of Menstrual Recovery [Time frame: 8 weeks]

Secondary outcome measures (11)

• Change in Neuromuscular Performance (Lower Limb Power) [Time frame: Baseline and 8 weeks]
• Change in Neuromuscular Performance (Upper Limb Power) [Time frame: Baseline and 8 weeks]
• Change in Body Mass [Time frame: Baseline and 8 weeks]
• Change in Fat Mass [Time frame: Baseline and 8 weeks]
• Change in Body Mass Index [Time frame: Baseline and 8 weeks]
• Change in Health-Related Quality of Life [Time frame: Baseline and 8 weeks]
• Pittsburgh Sleep Quality Index [Time frame: Baseline and 8 weeks]
• Low Energy Availability in Females Questionnaire [Time frame: Baseline and 8 weeks]
• Eating Attitudes Test [Time frame: Baseline and 8 weeks]
• Menstrual Distress Questionnaire [Time frame: Baseline and 8 weeks]
• Change in Cardiac Autonomic Regulation [Time frame: Baseline and 8 weeks]

Eligibility criteria

Inclusion criteria

• General Profile: Active women aged 18 to 35 years.
• FHA Group: Clinical diagnosis of Functional Hypothalamic Amenorrhea, defined as the absence of menstruation for at least three consecutive months not attributable to other endocrine disorders.
• Control Group (EU): Eumenorrheic women with regular ovulatory cycles lasting between 24 and 35 days during the previous six months.
• Commitment: Agreement to participate in a supervised 8-week resistance training program and provision of medical documentation confirming menstrual status.

Exclusion criteria

• Hormonal Status: Current use of any hormonal contraceptives.
• Medical Conditions: Diagnosed endocrine disorders such as Polycystic Ovary Syndrome (PCOS), hyperandrogenism, or thyroid dysfunction.

Pregnancy: Current pregnancy.

• Physical Activity History: Engagement in any structured resistance training program during the three months prior to the start of the intervention.
• General Health: Any medical condition that could interfere with the study protocol or the ability to perform physical exercise.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Non-randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Treatment

Study locations

Spain · 1 center

• Universidad Católica de Murcia — Murcia

Publications

• Bunt S, Steverink N, Andrew MK, Schans CPV, Hobbelen H. Cross-Cultural Adaptation of the Social Vulnerability Index for Use in the Dutch Context. Int J Environ Res Public Health. 2017 Nov 14;14(11):1387. doi: 10.3390/ijerph14111387. PMID 29135914
• Cahoon EK, Nadyrov EA, Polyanskaya ON, Yauseyenka VV, Veyalkin IV, Yeudachkova TI, Maskvicheva TI, Minenko VF, Liu W, Drozdovitch V, Mabuchi K, Little MP, Zablotska LB, McConnell RJ, Hatch M, Peters KO, Rozhko AV, Brenner AV. Risk of Thyroid Nodules in Residents of Belarus Exposed to Chernobyl Fallout as Children and Adolescents. J Clin Endocrinol Metab. 2017 Jul 1;102(7):2207-2217. doi: 10.1210/j PMID 28368520

Identifiers

NCT: NCT07612735 · CE052508

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗