Trial reportAmerican journal of physiology. Endocrinology and metabolism2015
Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction.
Trial report in American journal of physiology. Endocrinology and metabolism, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04938622 (Bioenergetics of Exercise-Induced Menstrual Disturbances), which is not on this map. Cited by 58 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Bioenergetics of Exercise-Induced Menstrual Disturbances
Who cites it
58 citing papers in PubMed, 3 syntheses or guidelines pooled it, 144 citations in OpenAlex.
- 2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 2: Clinical Guidelines for Screening, Diagnosis, Treatment, and Return to Play for Adolescents and Adults.Sports medicine (Auckland, N.Z.) · 2026Guideline
- Does exercise affect bone mineral density and content when added to a calorie-restricted diet? A systematic review and meta-analysis of controlled clinical trials.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Pooled it
- Effect of Exercise on Ovulation: A Systematic Review.Sports medicine (Auckland, N.Z.) · 2017Pooled it
- Randomised controlled trial of the effects of increased energy intake on menstrual recovery in exercising women with menstrual disturbances: the 'REFUEL' study.Human reproduction (Oxford, England) · 2021Trial
- Energy Availability Is Associated With Luteinizing Hormone Pulse Frequency and Induction of Luteal Phase Defects.The Journal of clinical endocrinology and metabolism · 2020Trial
- Menstrual Disruption with Exercise Is Not Linked to an Energy Availability Threshold.Medicine and science in sports and exercise · 2018Trial
- Less-than-expected weight loss in normal-weight women undergoing caloric restriction and exercise is accompanied by preservation of fat-free mass and metabolic adaptations.European journal of clinical nutrition · 2017Trial
- The effects of physical activity on female fertility: a narrative review.Journal of assisted reproduction and genetics · 2026Review
- Relative Energy Deficiency in Sport (REDs) and Body Composition.Sports (Basel, Switzerland) · 2026Review
- Menstrual Cycle Characteristics and Perceived Impact in Female Volleyball Players.Sports (Basel, Switzerland) · 2026Article
- Monitoring Menstrual Health in Footballers: Considerations for Tracking Menstrual and Hormonal Contraceptive Cycles in the Field to Support Performance.Sports medicine (Auckland, N.Z.) · 2026Review
- Self-reported physical activity intensity and training volume are not related to menstrual health among recreationally active Swiss females.BMC women's health · 2026Article
- Article
- Gendering the Menstrual Cycle in Behavioral Neuroendocrinology.American journal of human biology : the official journal of the Human Biology Council · 2026Review
- The impact of intermittent energy restriction on women's health.The Proceedings of the Nutrition Society · 2026Review
- 2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 1: State of the Science and Introduction of a New Adolescent Model.Sports medicine (Auckland, N.Z.) · 2026Review
- Infertility burden among women firefighters: a cross-sectional exploratory analysis.Occupational and environmental medicine · 2025Article
- Caloric Restriction, the Menstrual Cycle, and Sleep in Women Without Obesity.The Journal of clinical endocrinology and metabolism · 2025Article
- Established dietary interventions and time-restricted eating for cardiovascular disease prevention.Cell reports. Medicine · 2025Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
We assessed the impact of energy deficiency on menstrual function using controlled feeding and supervised exercise over four menstrual cycles (1 baseline and 3 intervention cycles) in untrained, eumenorrheic women aged 18-30 yr. Subjects were randomized to either an exercising control (EXCON) or one of three exercising energy deficit (ED) groups, i.e., mild (ED1; -8 ± 2%), moderate (ED2; -22 ± 3%), or severe (ED3; -42 ± 3%). Menstrual cycle length and changes in urinary concentrations of estrone-1-glucuronide, pregnanediol glucuronide, and midcycle luteinizing hormone were assessed. Thirty-four subjects completed the study. Weight loss occurred in ED1 (-3.8 ± 0.2 kg), ED2 (-2.8 ± 0.6 kg), and ED3 (-2.6 ± 1.1 kg) but was minimal in EXCON (-0.9 ± 0.7 kg). The overall sum of disturbances (luteal phase defects, anovulation, and oligomenorrhea) was greater in ED2 compared with EXCON and greater in ED3 compared with EXCON AND ED1. The average percent energy deficit was the main predictor of the frequency of menstrual disturbances (f = 10.1, β = -0.48, r(2) = 0.23, P = 0.003) even when weight loss was included in the model. The estimates of the magnitude of energy deficiency associated with menstrual disturbances ranged from -22 (ED2) to -42% (ED3), reflecting an energy deficit of -470 to -810 kcal/day, respectively. This is the first study to demonstrate a dose-response relationship between the magnitude of energy deficiency and the frequency of exercise-related menstrual disturbances; however, the severity of menstrual disturbances was not dependent on the magnitude of energy deficiency.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.