Trial Outcomes & Findings for Fat Mediated Modulation of Reproductive and Endocrine Function in Young Athletes (NCT NCT00946192)

NCT ID: NCT00946192

Last Updated: 2021-06-11

Results Overview

Change in bone density with transdermal estrogen versus oral estrogen or no estrogen in amenorrheic athletes

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

121 participants

Primary outcome timeframe

12 months

Results posted on

2021-06-11

Participant Flow

Participant milestones

Participant milestones
Measure
Estrogen Patch
17Beta-estradiol transdermal patch twice weekly application for 12 months Transdermal 17Beta-estradiol, progesterone: 100 mcg/day 17Beta-estradiol; transdermal twice weekly application for 12 months (with cyclic micronized progesterone pills (Prometrium): 200 mg taken orally daily Day 1 to Day 12 each month) + Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Estrogen Pill
One pill containing estrogen and progesterone taken daily for 21 days followed by placebo pills only for 7 days; regimen repeated for 12 months. Ethinyl Estradiol + Desogestrel: Oral ethinyl estradiol (0.03 mg) + desogestrel (0.15 mg) + Elemental calcium 1200 mg and Vit D 400 IU taken once daily
Control
Elemental calcium 1200 mg and Vit D 400 IU taken orally daily Sham Comparator: Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Overall Study
STARTED
43
40
38
Overall Study
COMPLETED
25
22
26
Overall Study
NOT COMPLETED
18
18
12

Reasons for withdrawal

Reasons for withdrawal
Measure
Estrogen Patch
17Beta-estradiol transdermal patch twice weekly application for 12 months Transdermal 17Beta-estradiol, progesterone: 100 mcg/day 17Beta-estradiol; transdermal twice weekly application for 12 months (with cyclic micronized progesterone pills (Prometrium): 200 mg taken orally daily Day 1 to Day 12 each month) + Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Estrogen Pill
One pill containing estrogen and progesterone taken daily for 21 days followed by placebo pills only for 7 days; regimen repeated for 12 months. Ethinyl Estradiol + Desogestrel: Oral ethinyl estradiol (0.03 mg) + desogestrel (0.15 mg) + Elemental calcium 1200 mg and Vit D 400 IU taken once daily
Control
Elemental calcium 1200 mg and Vit D 400 IU taken orally daily Sham Comparator: Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Overall Study
Lost to Follow-up
6
11
9
Overall Study
Withdrawal by Subject
10
7
3
Overall Study
Did not start medication
2
0
0

Baseline Characteristics

Fat Mediated Modulation of Reproductive and Endocrine Function in Young Athletes

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Estrogen Patch
n=43 Participants
17Beta-estradiol transdermal patch twice weekly application for 12 months Transdermal 17Beta-estradiol, progesterone: 100 mcg/day 17Beta-estradiol; transdermal twice weekly application for 12 months (with cyclic micronized progesterone pills (Prometrium): 200 mg taken orally daily Day 1 to Day 12 each month) + Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Estrogen Pill
n=40 Participants
One pill containing estrogen and progesterone taken daily for 21 days followed by placebo pills only for 7 days; regimen repeated for 12 months. Ethinyl Estradiol + Desogestrel: Oral ethinyl estradiol (0.03 mg) + desogestrel (0.15 mg) + Elemental calcium 1200 mg and Vit D 400 IU taken once daily
Control
n=38 Participants
Elemental calcium 1200 mg and Vit D 400 IU taken orally daily Sham Comparator: Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Total
n=121 Participants
Total of all reporting groups
Age, Continuous
19.86 years
STANDARD_DEVIATION 0.40 • n=5 Participants
20.30 years
STANDARD_DEVIATION 0.44 • n=7 Participants
19.35 years
STANDARD_DEVIATION 0.38 • n=5 Participants
19.84 years
STANDARD_DEVIATION 0.41 • n=4 Participants
Sex: Female, Male
Female
43 Participants
n=5 Participants
40 Participants
n=7 Participants
38 Participants
n=5 Participants
121 Participants
n=4 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
2 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
43 Participants
n=5 Participants
40 Participants
n=7 Participants
36 Participants
n=5 Participants
119 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Race (NIH/OMB)
Asian
4 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
5 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
White
37 Participants
n=5 Participants
38 Participants
n=7 Participants
35 Participants
n=5 Participants
110 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
2 Participants
n=7 Participants
2 Participants
n=5 Participants
5 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Region of Enrollment
United States
43 participants
n=5 Participants
40 participants
n=7 Participants
38 participants
n=5 Participants
121 participants
n=4 Participants
BMI
20.45 kg/m^2
STANDARD_DEVIATION 0.35 • n=5 Participants
20.80 kg/m^2
STANDARD_DEVIATION 0.39 • n=7 Participants
20.75 kg/m^2
STANDARD_DEVIATION 0.34 • n=5 Participants
20.67 kg/m^2
STANDARD_DEVIATION 0.36 • n=4 Participants

PRIMARY outcome

Timeframe: 12 months

Change in bone density with transdermal estrogen versus oral estrogen or no estrogen in amenorrheic athletes

Outcome measures

Outcome measures
Measure
Estrogen Patch
n=25 Participants
17Beta-estradiol transdermal patch twice weekly application for 12 months Transdermal 17Beta-estradiol, progesterone: 100 mcg/day 17Beta-estradiol; transdermal twice weekly application for 12 months (with cyclic micronized progesterone pills (Prometrium): 200 mg taken orally daily Day 1 to Day 12 each month) + Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Estrogen Pill
n=22 Participants
One pill containing estrogen and progesterone taken daily for 21 days followed by placebo pills only for 7 days; regimen repeated for 12 months. Ethinyl Estradiol + Desogestrel: Oral ethinyl estradiol (0.03 mg) + desogestrel (0.15 mg) + Elemental calcium 1200 mg and Vit D 400 IU taken once daily
Control
n=26 Participants
Elemental calcium 1200 mg and Vit D 400 IU taken orally daily Sham Comparator: Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Change in Lumbar Bone Mineral Density
0.025 g/cm^2
Standard Error 0.011
0.008 g/cm^2
Standard Error 0.011
0.012 g/cm^2
Standard Error 0.012

SECONDARY outcome

Timeframe: 12 months

Change in total volumetric bone density at the tibia with transdermal estrogen versus oral estrogen or no estrogen in amenorrheic athletes

Outcome measures

Outcome measures
Measure
Estrogen Patch
n=24 Participants
17Beta-estradiol transdermal patch twice weekly application for 12 months Transdermal 17Beta-estradiol, progesterone: 100 mcg/day 17Beta-estradiol; transdermal twice weekly application for 12 months (with cyclic micronized progesterone pills (Prometrium): 200 mg taken orally daily Day 1 to Day 12 each month) + Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Estrogen Pill
n=24 Participants
One pill containing estrogen and progesterone taken daily for 21 days followed by placebo pills only for 7 days; regimen repeated for 12 months. Ethinyl Estradiol + Desogestrel: Oral ethinyl estradiol (0.03 mg) + desogestrel (0.15 mg) + Elemental calcium 1200 mg and Vit D 400 IU taken once daily
Control
n=27 Participants
Elemental calcium 1200 mg and Vit D 400 IU taken orally daily Sham Comparator: Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Change in Total Volumetric Bone Mineral Density (Tibia)
7.01 mg HA/cm^3
Standard Error 3.06
1.17 mg HA/cm^3
Standard Error 3.05
3.71 mg HA/cm^3
Standard Error 4.44

Adverse Events

Estrogen Patch

Serious events: 3 serious events
Other events: 10 other events
Deaths: 0 deaths

Estrogen Pill

Serious events: 0 serious events
Other events: 13 other events
Deaths: 0 deaths

Control

Serious events: 1 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Estrogen Patch
n=43 participants at risk
17Beta-estradiol transdermal patch twice weekly application for 12 months Transdermal 17Beta-estradiol, progesterone: 100 mcg/day 17Beta-estradiol; transdermal twice weekly application for 12 months (with cyclic micronized progesterone pills (Prometrium): 200 mg taken orally daily Day 1 to Day 12 each month) + Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Estrogen Pill
n=40 participants at risk
One pill containing estrogen and progesterone taken daily for 21 days followed by placebo pills only for 7 days; regimen repeated for 12 months. Ethinyl Estradiol + Desogestrel: Oral ethinyl estradiol (0.03 mg) + desogestrel (0.15 mg) + Elemental calcium 1200 mg and Vit D 400 IU taken once daily
Control
n=38 participants at risk
Elemental calcium 1200 mg and Vit D 400 IU taken orally daily Sham Comparator: Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Endocrine disorders
Fractures or sprains
7.0%
3/43 • Number of events 3 • 1 year
0.00%
0/40 • 1 year
0.00%
0/38 • 1 year
Respiratory, thoracic and mediastinal disorders
Sinus surgery
0.00%
0/43 • 1 year
0.00%
0/40 • 1 year
2.6%
1/38 • Number of events 1 • 1 year

Other adverse events

Other adverse events
Measure
Estrogen Patch
n=43 participants at risk
17Beta-estradiol transdermal patch twice weekly application for 12 months Transdermal 17Beta-estradiol, progesterone: 100 mcg/day 17Beta-estradiol; transdermal twice weekly application for 12 months (with cyclic micronized progesterone pills (Prometrium): 200 mg taken orally daily Day 1 to Day 12 each month) + Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Estrogen Pill
n=40 participants at risk
One pill containing estrogen and progesterone taken daily for 21 days followed by placebo pills only for 7 days; regimen repeated for 12 months. Ethinyl Estradiol + Desogestrel: Oral ethinyl estradiol (0.03 mg) + desogestrel (0.15 mg) + Elemental calcium 1200 mg and Vit D 400 IU taken once daily
Control
n=38 participants at risk
Elemental calcium 1200 mg and Vit D 400 IU taken orally daily Sham Comparator: Elemental calcium 1200 mg and Vit D 400 IU taken orally daily
Infections and infestations
Mononucleosis
0.00%
0/43 • 1 year
2.5%
1/40 • Number of events 1 • 1 year
0.00%
0/38 • 1 year
Respiratory, thoracic and mediastinal disorders
Upper respiratory symptoms
0.00%
0/43 • 1 year
0.00%
0/40 • 1 year
2.6%
1/38 • Number of events 1 • 1 year
Skin and subcutaneous tissue disorders
Skin tags
0.00%
0/43 • 1 year
2.5%
1/40 • Number of events 1 • 1 year
0.00%
0/38 • 1 year
Investigations
Electrolyte changes
0.00%
0/43 • 1 year
2.5%
1/40 • Number of events 1 • 1 year
0.00%
0/38 • 1 year
Nervous system disorders
Headache
4.7%
2/43 • Number of events 2 • 1 year
2.5%
1/40 • Number of events 1 • 1 year
0.00%
0/38 • 1 year
Vascular disorders
Dizziness
2.3%
1/43 • Number of events 1 • 1 year
0.00%
0/40 • 1 year
0.00%
0/38 • 1 year
Gastrointestinal disorders
Nausea
0.00%
0/43 • 1 year
5.0%
2/40 • Number of events 2 • 1 year
0.00%
0/38 • 1 year
General disorders
Fatigue
0.00%
0/43 • 1 year
2.5%
1/40 • Number of events 1 • 1 year
0.00%
0/38 • 1 year
Endocrine disorders
Breast tenderness
2.3%
1/43 • Number of events 1 • 1 year
2.5%
1/40 • Number of events 1 • 1 year
0.00%
0/38 • 1 year
Metabolism and nutrition disorders
Fluid retention
0.00%
0/43 • 1 year
2.5%
1/40 • Number of events 1 • 1 year
0.00%
0/38 • 1 year
General disorders
Bloating
4.7%
2/43 • Number of events 2 • 1 year
0.00%
0/40 • 1 year
0.00%
0/38 • 1 year
Endocrine disorders
Early menses
0.00%
0/43 • 1 year
2.5%
1/40 • Number of events 1 • 1 year
0.00%
0/38 • 1 year
Infections and infestations
Yeast infection
0.00%
0/43 • 1 year
2.5%
1/40 • Number of events 1 • 1 year
0.00%
0/38 • 1 year
Psychiatric disorders
Worsening depression
2.3%
1/43 • Number of events 1 • 1 year
2.5%
1/40 • Number of events 1 • 1 year
0.00%
0/38 • 1 year
Product Issues
Mood swings
0.00%
0/43 • 1 year
2.5%
1/40 • Number of events 1 • 1 year
0.00%
0/38 • 1 year
General disorders
Generalized discomfort
2.3%
1/43 • Number of events 1 • 1 year
0.00%
0/40 • 1 year
0.00%
0/38 • 1 year
Vascular disorders
Vasovagal response
0.00%
0/43 • 1 year
5.0%
2/40 • Number of events 2 • 1 year
0.00%
0/38 • 1 year
Skin and subcutaneous tissue disorders
Skin rash
2.3%
1/43 • Number of events 1 • 1 year
0.00%
0/40 • 1 year
0.00%
0/38 • 1 year
Gastrointestinal disorders
Gastritis
2.3%
1/43 • Number of events 1 • 1 year
0.00%
0/40 • 1 year
0.00%
0/38 • 1 year
Reproductive system and breast disorders
Decreased libido
0.00%
0/43 • 1 year
2.5%
1/40 • Number of events 1 • 1 year
0.00%
0/38 • 1 year
Gastrointestinal disorders
Diarrhea
2.3%
1/43 • Number of events 1 • 1 year
0.00%
0/40 • 1 year
0.00%
0/38 • 1 year

Additional Information

Madhu Misra, MD; Chief, Pediatric Endocrine

Massachusetts General Hospital and Harvard Medical School

Phone: 6177245602

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place