Resting Energy Expenditure, Metabolic and Sex Hormones in Two Phases of the Menstrual and Hormonal Contraceptive Cycles.

ABSTRACT

INTRODUCTION: Resting energy expenditure (REE) may fluctuate during the menstrual cycle (MC), due to the physiological effects of estradiol (E2) and progesterone (P4). This study examined changes in REE and metabolic hormones (leptin, ghrelin, thyroid hormones), and dietary intake in two hormonally distinct groups, naturally menstruating women (NoOC) and women using monophasic combined oral contraceptives (COC). METHODS: Measurements included REE by indirect calorimetry, body composition by bioimpedance, and blood samples for hormone analysis in the early follicular and mid-luteal phases of the MC in NoOC-group (n = 38) or the active and inactive phases of the COC cycle (COC, n = 19). Participants recorded their food intake for 3 days after measurements. A secondary analysis was completed for the NoOC-group without REE outliers (difference between measurements >1.5 × interquartile range, n = 4). RESULTS: In the NoOC-group, luteal phase REE was 40 kcal higher than follicular phase REE [95% confidence interval (CI) -2 kcal/d-82 kcal/d, d = 0.20, p = 0.061]. Leptin (d = 0.35, p < 0.001), T3 (d = 0.26, p = 0.05) and fat intake (d = 0.48, p = 0.027) were lower, and T4 (d = 0.21, p = 0.041) was higher in the luteal phase. After excluding outliers, REE was 44 kcal higher in the luteal phase than in the follicular phase (95% CI 12 kcal/d-76 kcal/d, d = 0.22, p = 0.007). In the COC-group, the mean difference in REE was -2 kcal (95% CI-82 kcal/d-79 kcal/d) between active and inactive phases, while T3 was higher in the inactive phase (d = 0.01, p = 0.037). CONCLUSIONS: REE increases only slightly from the follicular to the luteal phase but remains unchanged between COC phases. Increases in T3, leptin, and fat intake during the luteal phase might echo metabolic fluctuations that parallel female sex hormones during the MC.