|Year : 2014 | Volume
| Issue : 1 | Page : 2-4
Hormonal influence on the adaptability of the pulmonary system to exercise in proliferative phase of menstrual cycle in a group of perimenopausal women
Amrith Pakkala1, Ashok Laxman Bajentri2, Chitradurga Palaiah Ganashree3, Thippeswamy Raghavendra4
1 Department of Physiology, Peoples Education Society Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India
2 Department of Physiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
3 Department of Physiology, Basaveshwara Medical College, Chitradurga, Karnataka, India
4 Department of Anesthesiology, Basaveshwara Medical College, Chitradurga, Karnataka, India
|Date of Web Publication||17-Feb-2014|
40, SM Road 1st cross, T. Dasarahalli, Bangalore - 560 057
Source of Support: None, Conflict of Interest: None
Background: The role of estrogen on pulmonary function test (PFT) was well-known in the normal course of the menstrual cycle. Significant increase in both progesterone (37%) and estradiol (13.5%), whereas no change in plasma follicle stimulating hormone (FSH) and luteinizing hormone LH was observed in exercising women in previous studies. Therefore, this study was intended to see the limitations of the pulmonary system in adaptability to exercise in proliferative phase of menstrual cycle in perimenopausal women. Materials and Methods: Dynamic lung functions were assessed in two groups of perimenopausal women viz., athletes and non-athletes after treadmill exercise testing using computerized spirometry. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum mid expiratory flow MMEF, peak expiratory flow rate PEFR, and MEF 25-75% in either of the groups. Conclusion: This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase which is further accentuated by exercise.
Keywords: Adaptability, estrogen in exercise, PFT, proliferative phase
|How to cite this article:|
Pakkala A, Bajentri AL, Ganashree CP, Raghavendra T. Hormonal influence on the adaptability of the pulmonary system to exercise in proliferative phase of menstrual cycle in a group of perimenopausal women. Sifa Med J 2014;1:2-4
|How to cite this URL:|
Pakkala A, Bajentri AL, Ganashree CP, Raghavendra T. Hormonal influence on the adaptability of the pulmonary system to exercise in proliferative phase of menstrual cycle in a group of perimenopausal women. Sifa Med J [serial online] 2014 [cited 2019 Mar 21];1:2-4. Available from: http://www.imjsu.org/text.asp?2014/1/1/2/127218
| Introduction|| |
The role of hormones on the healthy pulmonary system in delivering oxygen to meet the demands of various degrees of exercise has been a matter of differences in opinion. There are conflicting reports that the respiratory system is not normally the most limiting factor in the delivery of oxygen to the muscles during maximal muscle aerobic metabolism whereas others do not subscribe to this.  Within this context it is appropriate to study the effect of proliferative phase of menstrual cycle on ventilatory functions after exercise.
Mechanical constraints on exercise hyperpnea have been studied as a factor limiting performance in endurance athletes.  Others have considered the absence of structural adaptability to physical training as one of the "weaknesses" inherent in the healthy pulmonary system response to exercise. 
Ventilatory functions are an important part of functional diagnostics,  aiding selection and optimization of training and early diagnosis of sports pathology. Assessment of exercise response of dynamic lung functions in the healthy pulmonary system in the trained and the untrained has a role in clearing gaps in the above areas especially a special group like perimenopausal women.
| Materials and Methods|| |
The present study was conducted as a part of cardiopulmonary efficiency studies on two groups of non-athletes (n = 10) and athletes (n = 10) comparable in age and sex.
Informed consent was obtained and clinical examination to rule out any underlying disease was done. Healthy young adult females between 42 and 45 years who regularly undergo training and participate in competitive middle distance running events for at least past 3 years were considered in the athlete group, whereas the non-athlete group did not have any such regular exercise program. Smoking, clinical evidence of anemia, obesity, and involvement of cardiorespiratory system was considered as exclusion criteria. Menstrual history was ascertained to confirm proliferative phase of menstrual cycle.
Detailed procedure of exercise treadmill test and computerized spirometry was explained to the subjects.
Dynamic lung functions were measured in both groups before exercise was evaluated following standard procedure of spirometry using computerized spirometer Spl-95. All subjects were made to undergo maximal exercise testing to VO 2 max levels on a motorized treadmill.
After exercise, the assessment of dynamic lung functions was repeated. All these set of recordings were done on both the non-athlete as well as the athlete groups.
Statistical analysis was done using paired Student's t-test for comparing parameters within the group before and after exercise testing and unpaired t-test for comparing the two groups of subjects.
A P-value of <0.01 was considered as significant.
| Results|| |
It is clear from [Table 1] that there is no significant difference between the study and control groups anthropometrically. VO 2 max is significantly higher among athletes.
|Table 1: Comparison of anthropometric data and VO2 max of non-athletes and athletes with statistical analysis|
Click here to view
From [Table 2] and [Table 3], it is clear that there is no significant difference between the two groups as far as dynamic lung functions are concerned before and after exercise.
|Table 2: Comparison of dynamic lung functions of non-athletes before exercise testing (BE) and after exercise testing (AE) with statistical analysis non-athletes (n = 10)|
Click here to view
|Table 3: Comparison of dynamic lung functions of athletes before exercise testing (BE) and after exercise testing (AE) with statistical analysis athletes (n = 10)|
Click here to view
| Discussion|| |
Considerable information can be obtained by studying the exercise response of dynamic lung functions in untrained and trained subjects.
Intragroup comparison is helpful in noting the exercise response and intergroup comparison in evaluating adaptations of the respiratory system to training.
On comparing the anthropometric data of the two study groups it is clear that the age- and sex-matched subjects have no statistically significant difference in height, weight, and body mass index (BMI) taking a P-value of <0.01 as significant.
VO 2 max values were higher in athletes and was statistically significant (P < 0.001). This observation is expected in view of the training stimulus and adaptability of both the pulmonary system and the cardiovascular system. VO 2 max is an objective index of the functional capacity of the body's ability to generate power.
Forced vital capacity (FVC) is the volume expired with the greatest force and speed from total lung capacity TLC and FEV1 that expired in the 1 st second during the same maneuver. The FEV1 was initially used as an indirect method of estimating its predecessor as the principal pulmonary function test, the maximal breathing capacity. 
On comparing the response of exercise within the two study groups and in between them, there is no statistically significant difference in FVC and FEV1 under any condition.
A normal FEV1/FVC ratio is observed always.
Another way of looking at forced expiration is to measure both expiratory flow and the volume expired. The maximum flow obtained can be measured from a flow-volume curve is the peak expiratory flow rate (PEFR). The peak flow occurs at high lung volumes and is effort dependent. Flow at lower lung volumes is effort independent. Flow at lower lung volumes depends on the elastic recoil pressure of the lungs and the resistance of the airways upstream or distal to the point at which dynamic compression occurs. Measurements of flow at low lung volumes, mid expiratory flow MEF 25-75% are often used as indices of peripheral or small airways resistance. 
On examining [Table 2] and [Table 3], it is clear that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum MEF (MMEF), PEFR, and MEF 25-75% in either of the groups. This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen. 
Thirty minutes of exercise at 74% of VO 2 was found to cause a significant increase in both progesterone 37% and estradiol 13.5%, whereas no change in plasma FSH and LH was observed in exercising women;  others have confirmed these findings.  This finding supports the hypothesis that the respiratory system is not normally the most limiting factor in the delivery of oxygen even under the predominant influence of estrogen in proliferative phase which is further accentuated by exercise.
Limitations of this study
The hormonal status was not assessed in the perimenopausal age group and hence this may be considered while interpreting the results. In view of difficulty in enrolling subjects in the perimenopausal age groups as far as athletes are concerned, only 10 subjects were studied in each arm of the study.
| Summary|| |
Dynamic lung functions are an indicator of the influence of adaptability of respiratory system to the exercise stimulus. Hormonal influences on this phenomenon are well-known. The perimenopausal group gives an opportunity to explore the extent of this hormonal influence. In this study no significant difference was found in either of the two groups studied and it was thus concluded that exercise per se does not change the extent of adaptability in this special group of perimenopausal women.
| References|| |
|1.||Guyton AC, Hall JE, editors. Text Book of Medical Physiology. 11 th ed. Philadelphia: Saunders; 2006. p. 1061-2. |
|2.||Johnson BD, Saupe KW, Dempsey JA. Mechanical constraints on exercise hypernea in endurance athletes. J Appl Physiol 1992;73:874-86. |
|3.||Dempsey JA, Johnson BD, Saupe KW. Adaptations and limitations in the pulmonary system during exercise. Chest 1990;97:81-7S. |
|4.||Andziulis A, Gocentas A, Jascaniniene N, Jaszczanin J, Juozulynas A, Radzijewska M. Respiratory function dynamics in individuals with increased motor activity during standard exercise testing. Fiziol Zh 2005;51:86-95. |
|5.||Seaton A, Seaton D, Leitch AG, editors. Crofton and Douglas's Respiratory Diseases. 5 th ed. Oxford: Oxford University press; 2000. p. 43-5. |
|6.||Ganong WF. Review of Medical Physiology. 22 nd ed. 2005. p. 444. |
|7.||Bonen A, Ling WY, MacIntyre KP, Neil R, McGrail JC, Belcastro AN. Effects of exercise on the serum concentrations of FSH, LH, progesterone and estradiol. Eur J Appl Physiol Occup Physiol 1979;42:15-23. |
|8.||Jurkowski JE, Jones NL, Walker C, Younglai EV, Sutton JR. Ovarian hormonal responses to exercise. J Appl Physiol Respir Environ Exerc Physiol 1978;44:109-14. |
[Table 1], [Table 2], [Table 3]