Effects of integrated exercise approach on total testosterone levels in eumenorrheic women: a randomized controlled trial.

Testosterone modulated by exercise plays a pivotal role in maintaining the overall health of both males and females. Therefore, this study aimed to determine the effects of an integrated exercise approach on total testosterone levels during different phases of the menstrual cycle in eumenorrheic females. This was a two-armed parallel design, single-blinded, randomized controlled trial held from March 14, 2023, to February 21, 2024, in Aadil Hospital Defense Lahore. Forty eumenorrheic females within the age range of 20 to 40 years, with a BMI ranging from 18.5 to 24.9, who were able to maintain sitting balance without the need for upper limb support or who had a minimum score of 25 on the trunk control test were recruited for the study. They were then divided into 2 groups using a random table generator and concealed envelope allocation. The treatment group was given an exercise plan 3 times per week for 16 weeks along with an awareness program for menstrual hygiene and maintaining an active lifestyle, while the control group was given an awareness program to maintain menstrual hygiene and an active lifestyle along with a recommendation to walk for 30 min 3 times a week for 16 weeks. The testosterone levels were calculated pre-intervention, mid-intervention, and post-intervention. Mixed model ANOVA was used for within- and between-group analyses. The data were analyzed using SPSS v21. The educational backgrounds of the participants were diverse, with 17.5% having completed matric, 47.5% holding a bachelor's degree, and 17.5% having a master's degree or PhD. Regarding occupation, 35% were students, 32.5% were housewives, and 32.5% were working professionals. Marital status varied, with 37.5% married, 45% unmarried, and 17.5% divorced. Total testosterone levels (ng/dl) were measured at different menstrual cycles for the experimental and control groups. During the follicular phase, the experimental group showed pre-exercise levels of 25.80 ± 2.57 (95% CI: 24.24-27.35) and post-intervention levels within 15 min of exercise of 33.04 ± 8.67 (95% CI: 28.85-37.23). In the mid-cycle phase, the pre-exercise level was 36.48 ± 2.80 (95% CI: 33.47-37.48), and the post-intervention level was 40.80 ± 7.12 (95% CI: 37.15-44.46). The luteal phase showed pre-exercise levels of 31.10 ± 3.44 (95% CI: 29.90-34.31) and post-intervention levels within 15 min of exercise of 34.97 ± 5.60 (95% CI: 31.95-38.00). Compared with the experimental group, the control group exhibited consistent testosterone levels with minor variations across all phases. The mixed model ANOVA results for the between-group effect were highly significant, with p = 0.00 and an effect size of 0.99. Integrated exercise leads to an increase in testosterone levels in females immediately after exercise, which decreases below pre-exercise levels within 24 h of exercise, with the testosterone level peaking in the mid-cycle phase of the menstrual cycle. This immediate increase in testosterone levels can lead to increased strength, cognition and sexual functions in females.Trial registration number. This clinical trial was submitted by Dr. Rabiya Noor on clinicaltrials.gov for registration with ID: NCT05460741 first posted on 31/05/2022, last updated on 03/04/2024, and last verified on 29/04/2024.