Physical Performance During the Menopausal Transition and the Role of Physical Activity

Background: To examine longitudinal changes in physical performance during the menopausal transition and the role of physical activity (PA) in these changes. Methods: Based on follicle-stimulating hormone levels and bleeding diaries, women (47-55 years) were classified as early (n = 89) and late perimenopausal (n = 143) and followed prospectively until postmenopausal status, with mean duration of 17.5 and 13.8 months, respectively. Physical performance was measured by handgrip force, knee extension torque, vertical jumping height, maximal walking speed, and 6-minute walking distance. Physical activity was self-reported and categorized as inactive, low, medium, and high. Longitudinal associations of menopausal status, physical performance, and related changes with PA level were analyzed using generalized estimation equations adjusted for duration of hormonal therapy. Results: A significant decline over the menopausal transition in handgrip force (-2.1%, 95% CI -3.8 to -0.4), knee extension torque (-2.6%, 95% CI -4.5 to -0.8), and vertical jumping height (-2.6%, 95% CI -4.2 to -1.1) and a significant increase in 6-minute walking distance (2.1%, 95% CI 1.4 to 2.7) were observed in the total sample. A significant interaction of PA by time was observed in handgrip force and in vertical jumping height. High PA women had greater increase in handgrip strength but greater decline in vertical jumping height than medium, low, and inactive women (all p <= .001). Conclusions: Both early and late perimenopausal women show decline in muscle strength and power during the transition to postmenopause. Physical activity seems to influence physical performance during the menopausal transition but understanding the benefits of PA requires interventional studies.