Over recent years, military service women have shown increasing interest in utilizing long-acting reversible contraceptives (LARCs; i.e., implants or intrauterine devices, IUDs). While clinically, LARC have been proven safe and effective at preventing pregnancy \& decreasing menstrual symptoms, it is unclear what impact this type of contraceptive may have on physiological responses to extreme environments (heat, cold and high altitude). Additionally, iron deficiency and iron deficiency anemia are prevalent in U.S. military women which likely affect health and performance. There is evidence to suggest that the prevalence of iron deficiency and iron deficiency anemia is lower in women utilizing LARCs, which preserve iron stores, likely due to reduced menstrual blood loss that compounds with each cycle over the course of months. Due to the increasing interest in the utilization of LARCs it is important to understand what, if any, impact these methods of contraception may have on a female Soldier's physiological responses. The overall goal of the present study is to characterize iron status and physiological responses (including but not limited to sweating, skin blood flow, ventilation, and heart rate) to extreme environmental stressors of heat, cold and high altitude (i.e. hypobaric hypoxia) in women utilizing LARCs. Up to thirty-three individuals (n=18 LARCs, n=15 monophasic oral contraceptives) will complete testing visits separated by at least 48 hours for environmental testing visits. During heat stress testing, measures of core body temperature, skin temperature, and sweat rate will be measured during a standardized protocol in hot, humid conditions. During cold stress, measures of body core temperature, metabolic heat production, skin blood flow and temperature (at both distal extremity and proximal body sites) will be assessed in order to better quantify the impact of exogenous sex hormones via LARCs and OCs in volunteers exposed to the cold. Measurements will be obtained during a standardized protocol in cold air (\~90 min; 10°C). For altitude, cardiopulmonary responses will be assessed during rest and exercise during an acute altitude exposure (4300m). Blood samples will be collected throughout the investigation in order to quantify sex hormone concentrations, iron status, and inflammatory biomarkers in response to environmental stressors. The investigators will also utilize laboratory tests (i.e., carbon monoxide (CO) rebreathing technique) and collect blood samples to quantity iron stores in these groups of women. To characterize iron status, the Soldier Performance Health and Readiness (SPHERE) epidemiological data repository will be utilized to quantify the prevalence of iron deficiency and iron deficient anemia diagnoses between women using LARCs and women not utilizing LARCs.
Study Type
OBSERVATIONAL
Enrollment
33
Testing blood volume measures, iron stores, and physiological responses to acute environmental exposures of heat, cold, and high-altitude (each environment independently)
US Army Research Institute of Environmental Medicine
Natick, Massachusetts, United States
RECRUITINGIron status
Iron stores as measured by ferritin levels
Time frame: upon initial visit
Ventilation
ventilatory response to high altitude exposure at rest and during exercise
Time frame: intermittently throughout high-altitude trial (5 timepoints overall over ~6-7 hours)
Thermoregulation in the heat - core temperature
Measure of core temperature
Time frame: measured intermittently throughout trial (at least every 5 minutes) for 2 hour exposure
Thermoregulation in the cold - skin blood flow
Measure of thermoregulation during resting cold stress to include skin blood flow
Time frame: measured intermittently throughout cold trial (at least every 5 minutes) for 2 hour exposure
Thermoregulation in the heat - skin temperature
Time frame: measured intermittently throughout trial (at least every 5 minutes) for 2 hour exposure
Thermoregulation in the heat - sweating rate
Calculated from pre- and post-nude body mass corrected for fluid consumed and urine produced
Time frame: Only measured during heat stress visit, at one timepoint immediately after exercise on heat stress visit (post-exercise, within 10-20 minutes)
Thermoregulation in the cold - core temperature
Time frame: measured intermittently throughout cold trial (approximately every 5-10 min) for 2 hour exposure
Thermoregulation in the cold - skin blood flow
Time frame: measured intermittently throughout cold trial (approximately every 5-10 minutes) for 2 hour exposure
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.