Peak Fat Oxidation during Submaximal Exercise Remains Consistent across Menstrual Cycle and Combined Oral Contraceptive Phases.

Abstract

Purpose: Substrate metabolism during exercise may vary across the menstrual cycle (MC) phases, likely due to estradiol (E2) and progesterone (P4). This study examined substrate metabolism during exercise in naturally menstruating (NoOC, n = 34) and women using combined oral contraceptives (COC, n = 19).

Methods: Participants were measured in a fasted state in the follicular (FOL) and luteal (LUT) phases, or the inactive (INACT) and active (ACT) phases of COC use. Serum E2 and P4 were assessed using immunoassays and body composition via bioimpedance. Peak fat oxidation (PFO) and FAT MAX , the intensity eliciting PFO, were evaluated using indirect calorimetry. FAT MAX was calculated using peak oxygen uptake (V̇O 2peak ), measured on the following day.

Results: PFO did not differ between FOL and LUT (0.40 ± 0.09 vs 0.41 ± 0.10 g·min -1 , P = 0.482) or INACT and ACT (0.48 ± 0.12 vs 0.44 ± 0.11 g·min -1 , P = 0.099). FAT MAX showed no phase-related variation (NoOC: FOL 47.3% ± 15.7% vs LUT 47.7% ± 13.6%, P = 0.727; COC: INACT 57.1% ± 12.3% vs ACT 52.5% ± 12.2% P = 0.172). PFO was 0.08 g·min -1 (95% confidence interval [CI] = 0.02-0.14 g·min -1 , P = 0.010) and FAT MAX 9.8% (95% CI = 1.0%-8.7%, P = 0.031) higher in the INACT versus FOL. The difference in PFO persisted after adjusting for fat-free mass and V̇O 2peak ( P = 0.033) but was not significant after excluding an outlier from the COC group ( P = 0.108).

Conclusions: PFO and FAT MAX remained stable between MC and COC phases, suggesting no need to standardize measurements by cycle phase. However, higher PFO and FAT MAX in the COC group during INACT compared with FOL suggests distinct effects of exogenous hormones on metabolism compared with endogenous hormones. Practitioners should consider these differences when assessing factors influencing substrate metabolism.