Effect of the Menopausal Transition on Physical Performance: A Longitudinal Study

Abstract

Low muscle strength and decline in the power are associated with low walking speed and with mobility limitations, disabilities and falls among older populations. Whether menopause per se accelerates decline in physical performance in women and in this way contributes to functional limitations in later years remains controversial. PURPOSE: The aim of this study was to examine changes in physical performance in women aged 47 to 55 following the menopausal transition. METHODS: This longitudinal study is a part of the Estrogenic Regulation of Muscle Apoptosis study. Women aged 47 to 55 were randomly selected from the Finnish National Registry (n=6878) and perimenopausal women (n=228) were followed until postmenopausal. The baseline menopausal status was defined based on menstrual cycle diary and follicle stimulating hormone (FSH) level. The progression of menopausal transition was followed at three-to-six months’ intervals for early perimenopausal and late perimenopausal women, respectively. When FSH >30 IU/l was recorded, the measurement was repeated within two-to-four weeks and if FSH was determined in two consecutive blood samples to be elevated and no bleeding had occurred in past 6 months participant was considered to be postmenopausal. To capture a comprehensive understanding of the physical performance, measures of muscle power (vertical jump), muscle strength (grip and knee extension), aerobic capacity (6min walking distance), and walking speed were carried out. RESULTS: A significant decline in hand grip force for -2.9 % (95%CI -4.5, -1.1; d=0.20) in knee extension force for -3.1% (95%CI -4.8, -1.3; d=0.23) and in vertical jumping height for -3.24 % (95CI -4.6, -1.7; d=0.28) was observed following the menopausal transition. Walking distance significantly increased for 1.9 % (95%CI 1.2, 2.7, d=0.38) while in walking speed changes were 0.24 % (95%CI -1.1, 1.6; d=0.02) non-significant. CONCLUSIONS: The menopausal transition influences muscle strength and power, whereas the influence on mobility/walking was less evident and may follow after. Supported by the funding from the European Union’s Horizon 2020 research and innovation Programme under the Marie Sklodowska-Curie grant agreement No675003, and by the Academy of Finland (ERMA study grant agreement 275323).