|Year : 2013 | Volume
| Issue : 1 | Page : 43-45
Adaptability of the pulmonary system to exercise in proliferative phase of the menstrual cycle in a group of perimenopausal women: A preliminary study
Amrith Pakkala1, T Ragavendra2, CP Ganashree3
1 Department of Physiology, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh, India
2 Department of Anesthesiology, Basaveshwara Medical College, Chitradurga, Karnataka, India
3 Department of Physiology, Basaveshwara Medical College, Chitradurga, Karnataka, India
|Date of Web Publication||17-Aug-2013|
Department of Physiology, PES Institute of Medical Sciences and Research, Kuppam, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
Background: The role of estrogen on pulmonary function tests was well-known in the normal course of the menstrual cycle. Significant increases in both progesterone (37%) and estradiol (13.5%), whereas no change in plasma follicle stimulating hormone and leutinizing hormone FSH and 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 the proliferative phase of the menstrual cycle in perimenopausal women. Materials and Methods: Healthy young adult females between 42 years 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. The two groups were in perimenopausal age group. They were made to undergo computerized spirometry after undergoing maximal exercise testing on a motorized treadmill. Results: It was observed that exercise per se does not cause a statistically significant change in dynamic lung function parameters maximum mid expiratory flow rate MMEF, peak expiratory flow rate, mid expiratory flow 25% to 75% in either of the groups. Discussion: 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, Pulmonary function test, Proliferative phase
|How to cite this article:|
Pakkala A, Ragavendra T, Ganashree C P. Adaptability of the pulmonary system to exercise in proliferative phase of the menstrual cycle in a group of perimenopausal women: A preliminary study. J Med Soc 2013;27:43-5
|How to cite this URL:|
Pakkala A, Ragavendra T, Ganashree C P. Adaptability of the pulmonary system to exercise in proliferative phase of the menstrual cycle in a group of perimenopausal women: A preliminary study. J Med Soc [serial online] 2013 [cited 2020 Oct 25];27:43-5. Available from: https://www.jmedsoc.org/text.asp?2013/27/1/43/116639
| 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. Genomic actions are exerted by steroids such as estrogen, progesterone, testosterone with intracellular receptors.  The prevention and treatment of negative affect associated with the menopause is becoming increasingly important. Various data suggested that natural changes in endogenous estrogen levels may underlie women increased susceptibility to physiological limitations as a result of the aging process.  Fluctuations of ventilation and alveolar pCO 2 in various phases of the menstrual cycle have been ascribed to the action of progesterone, though this may not be the sole determinant of these changes.  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 the 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 the 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 cardio-pulmonary efficiency studies on two groups of non-athletes (n = 10) and athletes (n = 10) comparable in age, sex, and body mass index (BMI).
Informed consent was obtained and clinical examination to rule out any underlying disease was done. Healthy young adult females between 42 years 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, involvement of cardio-respiratory system was considered as exclusion criteria. Menstrual history was ascertained to confirm the proliferative phase of the 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 the computerized spirometer Spl-95. All subjects were made to undergo maximal exercise testing to maximum oxygen consumption VO 2 max levels on a motorized treadmill.
After exercise, the assessment of dynamic lung functions was repeated. All these set of recordings were carried out on both the non-athlete as well as the athlete groups.
Statistical analysis was done using paired students 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 < 0.01 was considered as significant.
| Results|| |
It is clear that there is no significant difference in age and other anthropometric data between the study and control groups.
On comparing the dynamic lung functions of non- athletes befosre and after exercise testing there is no significant difference. Similar results are obtained in the athlete group.
| Discussion|| |
Considerable information can be obtained by studying the exercise response of dynamic lung functions in untrained and trained subjects.
Intra group comparison is helpful in noting the exercise response and inter-group comparison in evaluating adaptations of the respiratory system to training.
On comparing the anthropometric data [Table 1] of the two study groups, it is clear that age and sex matched subjects have no statistically significant difference in height, weight and BMI taking a P < 0.01 as significant.
|Table 1: Comparison of anthropometric data and VO2 max of non-athletes and athletes with statistical analysis |
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VO 2 max values were higher in athletes and were statistically significant (P < 0.001). This observation is expected in view of the training stimulus and adaptability of both the pulmonary system and the cardio vascular 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 forced expiratory volume in first second FEV 1 that expired in the 1 st second during the same maneuver. The FEV 1 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 [Table 2] and [Table 3] and in between them, there is no statistically significant difference in FVC and FEV1 under any condition.
|Table 2: Comparison of dynamic lung functions of non-athletes before exercise testing and after exercise testing with statistical analysis. Non-athletes (n=10)|
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|Table 3: Comparison of dynamic lung functions of athletes before exercise testing and after exercise testing with statistical analysis. Athletes (n=10)|
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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 the 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 mid expiratory flow MMEF, peak expiratory flow rate (PEFR), mid expiratory flow 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. These findings are in line with other studies Bonen et al. and Jurkowski et al. ,
At 30 min 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 follicle stimulating hormone and leutinizing hormone 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 sample size of 10 subjects in each group is small and limits the general applicability of these results. This has to be viewed in the context of the nature of subjects that is female athletes in the perimenopausal group availability of willing subjects being difficult.
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[Table 1], [Table 2], [Table 3]