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  • Assessment
    In premenopausal women not using contraception, what is the effect of estrogen, estradiol and progesterone on resting metabolic rate?
    • Conclusion

      Nonobese and obese, younger women (ages 18-28 years) who do not use estrogen, estradiol and progesterone contraception have individual RMR variability of 2-10% during a menstrual cycle with differences between highest and lowest RMR (kcal/day) ranging from 63-310 kcals/day. In addition, group mean RMR is higher in the luteal (post-ovulation) phase (48 kcal/day, p<0.05), in nonobese, premenopausal women, ages 18-28 years.

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In premenopausal women using contraception, what is the effect of estrogen, estradiol and progesterone on resting metabolic rate?
    • Conclusion

       

       

      Different estrogen, estradiol and progesterone contraception types with varying duration of use can range from no significant effect to a 5% group mean RMR increase (~72 kcals/day) compared to non-contraception users in premenopausal women.

       

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In women with Polycystic Ovarian Syndrome (PCOS), what is the effect of estrogen, estradiol and progesterone on resting metabolic rate?
    • Conclusion

      In one study of neutral research design (Morin-Papunen LC, et al, 2000), RMR (kcal/kg/24 h) increased by 5.6% (from a group mean of 17.8±0.4 kcal/kg/24 hours to 18.8±0.5 kcal/kg/24 hrs) at 6 months compared to baseline measures (P<0.01) during ethinyl estradiol-cyproterone acetate (i.e., Diane Nova) treatment in 32 obese (mean BMI = 37.2 ± 1.8 and age 29.9 ±1.5 years) females with PCOS. However, researchers found a slight worsening of glucose tolerance, thus, ethinyl estradiol-cyproterone acetate should be used with caution in obese women with PCOS, especially in those subjects with a familial disposition to type 2 diabetes mellitus.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    Overall, in premenopausal, non-obese women, what effects do estrogen, estradiol and progesterone have on resting metabolic rate?
    • Conclusion

      Group mean RMR is increased 48 kcal/day in the luteal (postovulation ) vs. follicular phase of the menstrual cycle and individual variability over the entire cycle ranges from 2-10%.  Oral contraception may increase group mean RMR up to 72 kcals/day but hormone replacement therapy from one injection does not impact RMR. 

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    Overall, what effect does treatment of Polycystic Ovarian Syndrome with ethinyl estradiol-cyproterone acetate have on resting metabolic rate?
    • Conclusion

      Treatment of PCOS with ethinyl estradiol-cyproterone acetate may increase RMR in obese subjects, but should not be employed for energy balance management due to the associated deterioration of glucose control.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.