Trial objectives and purpose: The primary aim is to study the effects of moderately increased testosterone concentration on aerobic performance (endurance running time to exhaustion), and secondary aims to investigate the effects on submaximal work on treadmill, anaerobic capacity, muscle strength, body composition, behaviour and well-being, blood parameters, steroid hormone profile, gynecological parameters and skeletal muscle parameters in young healthy women in a double-blind, randomized, placebo-controlled trial. Treatment: Ten weeks of transdermal treatment with testosterone cream 10 mg daily or placebo cream in a randomized design (1:1). Primary outcome: Aerobic performance (running time to exhaustion on treadmill) Secondary outcomes: 1. Submaximal work on treadmill (oxygen uptake, ventilation, heart rate, blood lactate and subjective rate of exhaustion) 2. Anaerobic performance (Wingate test) 3. Muscle strength (Cybex apparatus, force transducer, counter movement jump) 4. Body composition (Dual X-ray Absorptiometry: muscle mass, fat mass, bone mass) 5. Behaviour and well-being (Quality of life, Profile of mood state, Confidence Questionnaire, Aggression Questionnaire) 6. Blood parameters (hemoglobin, hematocrit, reticulocytes, ferritin, CRP) 7. Steroid hormone profile in blood and urine 8. Gynecological evaluation (ovarian and endometrial variables on ultrasound) 9. Skeletal muscle morphology, metabolic enzymes and muscle protein synthesis Study population: Fifty healthy menstruating women will be included in the study and randomized to treatment with testosterone or placebo. Inclusion criteria: 18-35 yrs of age; body mass index (BMI) 19-25; non-smoking; a moderate to high self-reported level of recreational physical activity; not taking hormonal contraception and willing to use highly efficient non-hormonal contraception during the study (intrauterine device, bilateral tubal occlusion, vasectomised partner, same-sex partner, or sexual abstinence); accepting to not participate in any sports competitive event during the study period plus one month. Exclusion criteria: the presence of cardiovascular, liver, biliary or renal disease; hyperlipidemia; uncontrolled high blood pressure; endocrinological disorder; oligomenorrhea (menstrual intervals of more than 6 weeks) or amenorrhea (no menstruation for at least 3 months); pregnancy; a history of thromboembolic disorder; any malignancy; and intake of hormonal contraception the last two months prior to the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
QUADRUPLE
Enrollment
48
Testosterone cream 10 mg (1 ml) daily, supplied every evening via a dose applicator to the upper outer thigh for 10 weeks.
Placebo cream (1 ml) daily, supplied every evening via a dose applicator to the upper outer thigh for 10 weeks.
Department of Obstetrics and Gynecology, Karolinska University Hospital
Stockholm, Sweden
Aerobic performance
Change in endurance exercise time to exhaustion on treadmill
Time frame: Baseline and 10 weeks of treatment
Submaximal work on treadmill
Change in oxygen uptake (L/min, mL/kg x min)
Time frame: Baseline and 10 weeks of treatment
Anaerobic performance (Wingate test)
Change in average power output on a cycle ergometer (W)
Time frame: Baseline and 10 weeks of treatment
Muscle strength (knee extension torque)
Change in peak muscle strength (N) and strength endurance (time)
Time frame: Baseline and 10 weeks of treatment
Functional power development-jump tests
Change in jump height (m) by squat jump and countermovement jump
Time frame: Baseline and 10 weeks of treatment
Physical activity during one week before treatment and one week before the end of treatment
Change in accelerometer counts
Time frame: Baseline and 10 weeks of treatment
Muscle mass
Change in muscle mass (g) by DXA
Time frame: Baseline and 10 weeks of treatment
Body fat percentage
Change in body fat (%) by DXA
Time frame: Baseline and 10 weeks of treatment
Bone mineral density
Change in bone mineral density (g/cm2) by DXA
Time frame: Baseline and 10 weeks of treatment
Psychological General Well-Being
Change in Psychological General Well-Being (PGWB) score 0 (poor quality of life) and 110 (good quality of life)
Time frame: Baseline and 10 weeks of treatment
Mood
Change in mood (POMS) score 0 (not at all) to 4 (very much)
Time frame: Baseline and 10 weeks of treatment
Confidence
Change in confidence (Confidence Questionnaire) score 1 (not at all) to 5 (very much)
Time frame: Baseline and 10 weeks of treatment
Aggression
Change in aggression (Aggression Questionnaire) score 1 (does not fit in with me at all) to 5 (totally fits in with me)
Time frame: Baseline and 10 weeks of treatment
Blood parameters
Change in blood parameters (hemoglobin, hematocrit, reticulocytes, ferritin, CRP)
Time frame: Baseline and 10 weeks of treatment
Steroid hormone profile in blood and urine
Change in steroid hormones and metabolites in blood (testosterone, dihydrotestosterone, androstenedione, estradiol, dehydroepiandrosterone and its sulfate, cortisol, progesterone, other reproductive hormones (LH, FSH, AMH), binding protein (SHBG) and steroid hormones and metabolites in urine (estrone, estrone sulfate, androsterone glucuronide, 5α androstane-3α, 17β-diol 17-glucuronide, androst-5-ene-diol-3β, 17β-diol, testosterone, androstenedione, epitestosterone, androsterone, etiocholanolone).
Time frame: Baseline and 10 weeks of treatment
Gynecological evaluation
Change in ultrasound assessments of the endometrium (mm) and ovaries (volume)
Time frame: Baseline and 10 weeks of treatment
Skeletal muscle
Change in morphology and concentration of metabolic enzymes (HAD, SC), markers of muscle protein synthesis (mTOR, p70), as well as markers from the muscle atrophy pathway (MABbx, MuRF-1)
Time frame: Baseline and 10 weeks of treatment
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