System In Postmenopausal Women Research Articles

The benefits and risks of menopause hormone therapy for the cardiovascular system in postmenopausal women: a systematic review and meta-analysis

BackgroundMenopause hormone therapy (MHT), as an effective method to alleviate the menopause-related symptoms of women, its benefits, risks, and potential influencing factors for the cardiovascular system of postmenopausal women are not very clear.ObjectivesTo evaluate cardiovascular benefits and risks of MHT in postmenopausal women, and analyze the underlying factors that affect both.Search strategyThe EMBASE, MEDLINE, and CENTRAL databases were searched from 1975 to July 2022.Selection criteriaRandomized Clinical Trials (RCTs) that met pre-specified inclusion criteria were included.Data collection and analysisTwo reviewers extracted data independently. A meta-analysis of random effects was used to analyze data.Main resultsThis systematic review identified 33 RCTs using MHT involving 44,639 postmenopausal women with a mean age of 60.3 (range 48 to 72 years). There was no significant difference between MHT and placebo (or no treatment) in all-cause death (RR = 0.96, 95%CI 0.85 to 1.09, I2 = 14%) and cardiovascular events (RR = 0.97, 95%CI 0.82 to 1.14, I2 = 38%) in the overall population of postmenopausal women. However, MHT would increase the risk of stroke (RR = 1.23, 95%CI 1.08 to 1.41,I2 = 0%) and venous thromboembolism (RR = 1.86, 95%CI 1.39 to 2.50, I2 = 24%). Compared with placebo, MHT could improve flow-mediated arterial dilation (FMD) (SMD = 1.46, 95%CI 0.86 to 2.07, I2 = 90%), but it did not improve nitroglycerin-mediated arterial dilation (NMD) (SMD = 0.27, 95%CI − 0.08 to 0.62, I2 = 76%). Compared with women started MHT more than 10 years after menopause, women started MHT within 10 years after menopause had lower frequency of all-cause death (P = 0.02) and cardiovascular events (P = 0.002), and more significant improvement in FMD (P = 0.0003). Compared to mono-estrogen therapy, the combination therapy of estrogen and progesterone would not alter the outcomes of endpoint event. (all-cause death P = 0.52, cardiovascular events P = 0.90, stroke P = 0.85, venous thromboembolism P = 0.33, FMD P = 0.46, NMD P = 0.27).ConclusionsMHT improves flow-mediated arterial dilation (FMD) but fails to lower the risk of all-cause death and cardiovascular events, and increases the risk of stroke and venous thrombosis in postmenopausal women. Early acceptance of MHT not only reduces the risk of all-cause death and cardiovascular events but also further improves FMD, although the risk of stroke and venous thrombosis is not reduced. There is no difference in the outcome of cardiovascular system endpoints between mono-estrogen therapy and combination therapy of estrogen and progesterone.

Association of activins, follistatins and inhibins with incident hip fracture in women with postmenopausal osteoporosis: a proof of concept, case-control study.

The activins-follistatins-inhibins (AFI) hormonal system is considered to regulate muscle and bone mass. We aimed to evaluate AFI in postmenopausal women with an incident hip fracture. In this post-hoc analysis of a hospital based case-control study, we evaluated circulating levels of the AFI system in postmenopausal women with a low-energy hip fracture admitted for fixation compared with postmenopausal women with osteoarthritis scheduled for arthroplasty. Circulating levels of follistatin (p = 0.008), FSTL3 (p = 0.013), activin B and AB (both p < 0.001), as well as activin AB/follistatin and activin AB/FSTL3 ratios (p = 0.008 and p = 0.029, respectively) were higher in patients than controls in unadjusted models. Differences for activins B and AB remained after adjustment for age and BMI (p = 0.006 and p = 0.009, respectively) and for FRAX-based risk for hip fracture (p = 0.008 and p = 0.012, respectively) but were lost when 25OHD was added to the regression models. Our data indicate no major changes in the AFI system in postmenopausal women at the time of hip fracture compared to postmenopausal women with osteoarthritis except for higher activin B and AB levels, whose significance, however, was lost when 25OHD was added to the adjustment models. Clinical Trials identifier: NCT04206618.

Cardiovascular autonomic responses in reproductive and post-menopausal women

Background: Autonomic responses are a sensitive indicator for assessing balance in sympatho-vagal system. Many studies have shown an increased response in the sympathetic system in post-menopausal women. Alteration in autonomic nerve function causes an increased incidence of hypertension, arrhythmias, or acute coronary syndrome. Thus, this study aims to find out the heart rate variability (HRV) among reproductive and post-menopausal women. Aims and Objectives: The aim of the study was to compare the cardiovascular autonomic responses among reproductive and post-menopausal women. Materials and Methods: This cross-sectional study was conducted in the department of physiology at government medical college, Kottayam on 40 reproductive and 40 post-menopausal women. Using PHYSIOPAC-PP4 (Medicaid Systems Chandigarh) machine, an electrocardiogram was recorded in both groups in the supine position for 5 min. The frequency and time domain data obtained were analyzed using SPSS software. Results: The mean age group in reproductive women was 43 and post-menopausal women was 54. In the power spectrum analysis of HRV parameters the mean value of frequency domain Low frequency (LF) in reproductive women was 72.05 (S.D = 5.706) and post-menopausal women was 79.48 (S.D = 3.789). The high frequency (HF) in reproductive women was 28 (S.D = 5.588) and post-menopausal women were 20.53 (S.D = 3.789). The LF/HF ratio mean value obtained in reproductive women was 2.723 (S. D = 0.759) and post–menopausal was 3.992 (S.D 0.785). In the various time domain parameters, we estimated the mean value of the root mean square of successive differences (RMSSD) between normal heartbeats RMSSD and obtained the value in reproductive women as 25.05 (S.D = 11.88) and post-menopausal women as 12.68 (S.D = 5.535). The RR interval triangular index mean value in reproductive women was 0.0520 (S.D = 0.013) and post-menopausal women were 0.0345 (S.D = 0.01). In all these parameters, the P-value was found to be &lt;0.001, so statistically highly significant. Conclusion: In this study, higher values in time domain and frequency domain parameters for assessing sympathetic functions were seen in postmenopausal women when compared to women of the reproductive age group which was statistically significant. This may be due to age and hormonal influences. The power spectrum analysis of HRV parameters was proved to be a noninvasive method to assess the sympathovagal balance in the study group of women.

Endocrinal metabolic regulation on the skeletal system in post-menopausal women.

Osteoporosis is a common endocrinologic disorder characterized as a chronic bone loss condition. Sexual dimorphism is ubiquitous in the incidence of osteoporosis with post-menopausal women being acutely affected. Gonadal sex hormones including estrogen act as crucial regulators of bone mass; therefore, loss of such hormones leads to an imbalance in skeletal turnover leading to osteoporosis. Estrogen can influence both bone formation as well as resorption by reducing osteoblast activity and enhancing osteoclastogenesis. Additionally, estrogen is a potent regulator of systemic metabolism. Recent studies have provided clues that estrogenic effect on bone might also involve alterations in bone cell metabolism and bioenergetic potential. While direct effects of gonadal hormones ability to alter intracellular metabolism of bone cells has not been studied, there is precedence within the literature that this is occurring and contributing to post-menopausal bone loss. This review aims to serve as a perspective piece detailing the prospective role of gonadal hormones regulating bone cell metabolic potential.

Vitamin D and the Immune System in Menopause: A Review.

Menopause is a normal phenomenon in a woman’s life cycle involving multiple health-related issues that contribute to physical instability. Changes in the immune system in postmenopausal women are caused by estrogen deprivation along with age. Increased proinflammatory serum marker levels, cytokine responses in body cells, decreased CD4 T and B lymphocyte levels, and natural killer cell cytotoxic activity are also observed during postmenopause. Moreover, vitamin D, in addition to its classical effects on calcium homeostasis and bone density, plays an important role. Current evidence indicates that vitamin D regulates innate and adaptive immune responses; however, vitamin D deficiency is linked to increased autoimmune activity and infection susceptibility. This review provides an overview of the consequences of immune alterations as an outcome of aging in postmenopausal women and the benefit of vitamin D supplementation.

Abstract #796012: Phase 1B Evaluation of the Pharmacokinetics and Pharmacodynamics of Abaloparatide Solid Microstructured Transdermal System in Postmenopausal Women with Low Bone Mineral Density

Abstract #796012: Phase 1B Evaluation of the Pharmacokinetics and Pharmacodynamics of Abaloparatide Solid Microstructured Transdermal System in Postmenopausal Women with Low Bone Mineral Density

Efficacy of fractional CO2 laser treatment in postmenopausal women with genitourinary syndrome: a multicenter study.

Genitourinary syndrome of menopause (GSM), especially vulvovaginal atrophy (VVA), is one of the most common conditions among women in either natural (4%-47%) or medically induced (23.4%-61.5%) menopause. The aims of this study are to assess the efficacy and effectiveness of CO2 laser in postmenopausal women with clinical signs and symptoms of GSM, in particular VVA, and to evaluate both possible early and late side effects related to this kind of treatment. This retrospective, multicenter study was conducted after collecting data from a pre-existing database. We performed three to four CO2 laser treatments on all the women enrolled in this protocol. We used a fractional CO2 laser system (SmartXide VLR, Deka m.e.l.a., Florence, Italy) with a VulvoVaginal Laser Reshaping (VLR) scanning system and appropriate handpieces for the vaginal area. All women before and after the treatment were assessed. The pre- and post-treatment averages of the symptoms, the standard deviation, and the P values were calculated. Six hundred forty-five women who met the inclusion criteria were considered. In all the parameters examined (dyspareunia, vaginal orifice pain, dryness/atrophy, itching, burning, pH) statistically significant data were found between the pretreatment and the post-treatment (dryness: before = 8.30, after = 2.97 [P < 0.0001], dyspareunia: before = 8.70, after = 3.51 [P < 0.0001]; burning: before = 6.12, after = 1.78 [P < 0.0001]; vaginal orifice pain: before = 8.07, after = 2.94 [P < 0.0001]; itching: before = 6.09, after = 1.32 [P < 0.0001]). Our results show the effectiveness and a good degree of tolerance of treatment with the CO2 laser system in postmenopausal women with GSM.

Efficacy &amp; Safety of Abaloparatide-Solid Microstructured Transdermal System in Postmenopausal Women With Osteoporosis

Efficacy &amp; Safety of Abaloparatide-Solid Microstructured Transdermal System in Postmenopausal Women With Osteoporosis

Haemodynamic parameters in postmenopausal women - beneficial effect of moderate continuous exercise training.

Physical effort plays a positive role in reducing the risk of cardiovascular diseases. The aim of this study was to assess the cardiovascular status in postmenopausal women after several years of regular amateur training. A total of 55 generally healthy females aged 50-70 years, of whom 38 were members of a senior exercise group and 17 comprised a control group, were enrolled in the study. Parameters of blood flow, vascular resistance, myocardial contractility and thoracic fluid content were measured in a 10-minute supine resting test by impedance cardiography. Thereafter, central blood pressure, augmentation index and pulse wave velocity were measured by applanation tonometry. Exercising women have a better outcome than the control group, when evaluated both with impedance cardiography and with applanation tonometry. They have a lower heart rate - HR (65.1 vs 71.5; p = 0.033), higher blood flow (stroke index - SI, 58.6 vs 50.3; p = 0.040), better myocardial contractility (acceleration index - ACI, 108.8 vs 88.1; p = 0.027), higher preload (thoracic fluid content index - TFCI, 20.5 vs 18.1; p = 0.002), lower afterload (systemic vascular resistance index - SVRI, 1972.9 vs 2110.5; p = 0.026), lower central systolic blood pressure - cBPsys (119.0 vs 129.5; p = 0.037), lower augmentation pressure - AP (10.3 vs 15.0; p = 0.044) and lower pulse wave velocity - PWV (7.4 vs 8.4; p = 0.001). Regular moderate continuous aerobic exercise training has a beneficial impact on the cardiovascular system in postmenopausal women.

Comparison of Autonomic Functions in Perimenopausal Women with Postmenopausal Women

Comparison of Autonomic Functions in Perimenopausal Women with Postmenopausal Women

ПРОЦЕССЫ ЛИПОПЕРОКСИДАЦИИ И АНТИОКСИДАНТНАЯ СИСТЕМА У ЖЕНЩИН КЛИМАКТЕРИЧЕСКОГО ПЕРИОДА С ИНСОМНИЕЙ

According to the current data, most menopausal women have reduced life quality and one of the main criteria is sleep quality. It is well known, that sleep loss may cause oxidative stress. The aim of this study was to assess lipid peroxidation and antioxidant system in postmenopausal women with insomnia. Materials and methods: 41 postmenopausal women (18 patients with insomnia, 23 women without insomnia (control)) were examined. Sleep disorders were assessed by using sleep questionnaire (Stanford Sleep Research Center, USA), Epworth Sleepiness Scale, Insomnia Severity Index. The materials for biochemical studies were blood plasma and red cells. Lipid peroxidation and antioxidant system parameters by spectrophotometric and fluorometric methods were determined. Statistical analysis was performed by non-parametric test. The study results showed increase primary products levels in patients with insomnia compared with the control group. Main and control group antioxidant system parameters have no differences. Oxidative stress coefficient in group with insomnia higher than control. Conclusions: insomnia in postmenopausal women is associated with the development of oxidative stress.

Effect of Yoga on Heart Rate Variability in Women with Metabolic Syndrome

Background: The purpose of this study was to investigate the correlation between yoga and autonomic nervous system in women with metabolic syndrome. Methods: A randomized controlled study was performed in participants recruited from a public center for managing chronic diseases located in Gyeong-gi Province. The 39 women participants diagnosed with metabolic syndrome were randomly assigned to the 12-week yoga exercise group (n=22) or the wait-listed control group (n=17). Biochemical laboratory tests and heart rate variability were measured before and after the 12-week program. Results: In post-menopausal women, the low frequency power of frequency domain significantly decreased in the yoga exercise group compared to the control group (P=0.07). On the time domain of heart rate variability and metabolic syndrome components, there were no significant differences between the groups. Conclusions: Sympathetic activity was decreased in post-menopausal women with metabolic syndrome who practiced yoga. Our results suggest that yoga might be beneficial in improving the autonomic nervous system in post-menopausal women with metabolic syndrome. Korean J Health Promot 2014;14(4):147-154

The relationship of subjective sleep quality and cardiac autonomic nervous system in postmenopausal women with insomnia under auricular acupressure

The aim of this study is to examine the relationship between the changes in self-reported sleep symptoms and cardiac sympathovagal activity among women with postmenopausal insomnia (PI) who received auricular acupressure (AA) therapy. A pretest/posttest study design was conducted at Taipei Veterans General Hospital, Taiwan, from August 2008 to July 2009. Forty-five women (mean ± SD age, 56.2 ± 5.4 years) with PI (4.9 ± 3.5 years of insomnia) received an AA therapy course on five auricular points every night before going to sleep for 4 weeks. Heart rate variability (HRV), the Chinese version of the Pittsburgh Sleep Quality Index, and the Menopause Rating Scale were measured before and after AA treatment. The total sleep duration and sleep efficiency were increased, and the sleep latency was shortened significantly (P < 0.01) after AA therapy. The total Menopause Rating Scale and somatovegetative subscale scores were reduced significantly (P < 0.05) after the intervention. A greater percentage change in Pittsburgh Sleep Quality Index was moderately correlated with both a lower percentage change in high-frequency power of HRV (r = -0.660, P < 0.001) and a greater percentage change in normalized low-frequency power (nLF) of HRV (r = 0.599, P < 0.001). An elevation of high-frequency power and a reduction of nLF of HRV were observed in the responder group, whereas a raise in nLF of HRV was noted in the nonresponder group. This study suggests that AA intervention leads to more cardiac parasympathetic and less cardiac sympathetic activity, which contributes to the improvement of PI.

The balance between soluble receptors regulating IL-6 trans-signaling is predictive for the RANKL/osteoprotegerin ratio in postmenopausal women with rheumatoid arthritis

The objective of this study is to investigate the relationship between soluble components of the interleukin 6 (IL-6) system mediating and modifying IL-6 trans-signaling and the RANKL-RANK-osteoprotegerin system in postmenopausal women with rheumatoid arthritis (RA). The following parameters were investigated in 126 postmenopausal women with RA: IL-6, soluble IL-6-receptor (sIL-6R), soluble glycoprotein 130 (sgp130), sRANKL, osteoprotegerin (OPG), osteocalcin, erythrocyte sedimentation rate and C-reactive protein in sera, pyridinolin and desoxypyridinolin crosslinks in the morning urine. Bone mineral density (BMD) was measured by dual X-ray absorptiometry at the lumbar spine (BMD-LS) and at the femoral neck (BMD-FN). Predictors of RANKL/OPG ratio and BMD were evaluated by multiple linear regression analysis. The following determinants of the RANKL/OPG ratio were identified: sIL-6R/sgp130 ratio and daily glucocorticoid (GC) dose as positive determinants in the whole group (R (2) = 0.56; P = 0.001), sIL-6R/sgp130 ratio as the exclusive positive determinant in patients with GC therapy (R (2) = 0.48; P = 0.001) and sgp130 as negative determinant in patients without GC (R (2) = 0.42; P = 0.031). Sgp130 was highly significantly positively correlated with OPG in the whole group (P < 0.001) as well as in patients with (n = 70; P < 0.05) and without GC therapy (n = 56; P < 0.01). sIL-6R was the main negative predictor of BMD-LS (R (2) = 0.41; P = 0.019). High sIL-6R/sgp130 ratio and/or low sgp130 are associated with a high sRANKL/OPG ratio in sera of postmenopausal women with RA indicating the critical significance of IL-6 trans-signaling for an increase in the RANKL/OPG ratio and of bone resorption. Inhibition of IL-6 trans-signaling may be an effective bone-protecting principle in postmenopausal women with RA.

The benefits of hormone replacement therapy on plasma and platelet antioxidant status and fatty acid composition in healthy postmenopausal women

Oxidative stress is suggested to play an important role in the pathogenesis of cardiovascular disease (CVD). Various hormone replacement therapy (HRT) protocols are used to reduce the CVD risk in postmenopausal women. Recent studies found that HRT lowers lipid levels and improves vascular endothelial function in postmenopausal women. In this study the effects of HRT on plasma and platelet membrane fatty acid composition and the oxidant-antioxidant system in postmenopausal women are investigated. Blood samples were obtained from 50 postmenopausal women. Before starting treatment, all participants underwent clinical, biochemical and hormonal screening procedures including gynecologic and physical breast examination. Then oral HRT (2 mg estrodiol valerate + 1 mg cyproterone acetate) were given to all subjects for 1 year. Levels of malondialdehyde (MDA), total thiol (t-SH) and fatty acid contents, activities of glutathione-Stransferase (GST) and superoxide dismutase (SOD) were measured before and after treatment. Platelet membrane palmitic, stearic and oleic acid contents decreased (6.5%, 22.5% and 21.9% respectively) and linoleic and arachidonic acid contents increased (21.2% and 25.4% respectively) after HRT. Platelet MDA, GST and SOD levels were lower and t-SH content was higher than pre-treatment levels. These results indicate that hormone replacement therapy may affect platelet membrane fatty acid content and oxidant-antioxidant balance in postmenopausal women.

Electrical Acupoint Stimulation Changes Body Composition and the Meridian Systems in Postmenopausal Women with Obesity

This study evaluates the effects of electrical stimulation on body composition and the meridian system in postmenopausal women with obesity. Forty-one postmenopausal women were recruited in Taiwan. The body composition was used as a screening test for obesity (percentage of body fat: > 30%, waist circumference: > 80 cm). The experimental group (EG, n = 20) received modulated middle-frequency electrical stimulation treatment for 20 min twice a week for 12 consecutive weeks at the Zusanli (ST36) and Sanyinjiao (SP6) acupoints. The control group (CG, n = 21) did not receive any intervention. The measurements of body composition and the meridian system were recorded for both groups in the pre- and post-study. The results showed that the data of body composition (weight, waist and hip circumference, percentage of body fat, and percentage of lean muscle mass) changed considerably in the EG (p < 0.05); however, no significant difference was observed in the CG. The left triple burner meridian changed notably in both EG and CG throughout the study (p < 0.05), however there was no difference between the two groups in the overall mean value, up-down ratio, qi and blood ratio, and yin-yang ratio. Our findings suggest that modulated middle-frequency electrical stimulation could help to improve body composition in postmenopausal women with obesity, potentially providing them with better care and health by integrating Western medicine and traditional Chinese medicine.

Black cohosh has central opioid activity in postmenopausal women

To test whether black cohosh (BC) exhibits an action on the central endogenous opioid system in postmenopausal women. This was a mechanistic study conducted in the same individuals of luteinizing hormone pulsatility with a saline/naloxone challenge (n = 6) and positron emission tomography with [C]carfentanil, a selective micro-opioid receptor radioligand (n = 5), before and after 12 weeks of unblinded treatment with a popular BC daily supplement. BC treatment for 12 weeks at a standard dose (Remifemin, 40 mg/day) had no effect on spontaneous luteinizing hormone pulsatility or estrogen concentrations. With naloxone blockade, there was an unexpected suppression of mean luteinizing hormone pulse frequency (saline vs naloxone = 9.0 +/- 0.6 vs 6.0 +/- 0.7 pulses/16 h; P = 0.056), especially during sleep when the mean interpulse interval was prolonged by approximately 90 minutes (saline night interpulse interval = 103 +/- 9 min vs naloxone night interpulse interval = 191 +/- 31 min, P = 0.03). There were significant increases in mu-opioid receptor binding potential in the posterior and subgenual cingulate, temporal and orbitofrontal cortex, thalamus, and nucleus accumbens ranging from 10% to 61% across brain regions involved in emotional and cognitive function. In contrast, binding potential reductions of lesser magnitude were observed in regions known to be involved in the placebo response (anterior cingulate and anterior insular cortex). Using two different challenge paradigms for the examination of central opioid function, a neuropharmacologic action of BC treatment was demonstrated in postmenopausal women.

Effect of Hormone Therapy on Exercise Capacity in Early Postmenopausal Women

To compare the exercise capacity of postmenopausal women with matched premenopausal controls, as well as postmenopausal women before and after 3 months of hormone therapy (HT). This study examined the response to strenuous isotonic exercise in 30 women with recently developed menopause (age, mean+/-standard deviation, 50.6+/-1.1 years) without cardiovascular risk factors or diseases. Thirty premenopausal subjects, matched one-to-one for age and biophysical characteristics, were the control group. Postmenopausal women underwent examination before (T(0)) and 3 months after (T(1)) HT (oral 0.625 mg conjugated estrogen and 2.5 mg medroxyprogesterone acetate/day) with high-resolution ultrasound determination of peripheral flow-mediated vasodilation and an integrative cardiopulmonary test. Postmenopausal women showed an impairment of flow-mediated vasodilation (P<.001) in the radial artery and a worsening of physical performance, primarily exemplified by lower maximal workload (P<.01) and peak oxygen consumption (Vo(2)max, P<.001) compared with premenopausal women. After 3 months on HT, ergometabolic parameters and vasodilation reserve were at a level comparable to premenopausal women. Flow-mediated vasodilation measurements after 3 months on HT significantly correlated with those of peak oxygen consumption (r=0.77, P<.001) and the ratio between the increase in oxygen consumption and that in work rate (DeltaVo(2)/DeltaWR) (r=0.73, P<.001). The peripheral circulation is the limiting system in postmenopausal women experiencing exercise intolerance, and there are benefits in introducing HT.

Antiatherogenic Effect of Isoflavones in Ovariectomized Apolipoprotein E-Deficient Mice

The consumption of isoflavone-containing foods such as soybean and soybean products has been reported to have beneficial effects on the cardiovascular system in postmenopausal women. The present study was carried out to examine the mechanism underlying the beneficial effects of isoflavones in apolipoprotein (apo) E-deficient mice subjected to ovarian resection. Compared with sham-operated mice, ovariectomized mice had a larger arterial lesion area in the aortic root. Feeding the ovariectomized mice an isoflavone-containing diet (0.055 mg/kJ of total isoflavones/cal of diet) reduced the size of these lesions more than did feeding them with an isoflavone-free diet. Neither ovariectomy nor diet had a significant effect on the concentration of cholesterol in serum and urinary levels of isoprostanes, which are biomarkers for oxidative stress in vivo. The ovariectomized mice showed a greater increase in mRNA abundance for monocyte chemoattractant protein (MCP)-I in the aorta and in the level of nitric oxide (NO) secreted by peritoneal macrophages in culture than did the sham-operated mice. The isoflavone-containing diet lowered the MCP-I expression and the NO secretion more than did the isoflavone-free diet. These results suggest that dietary isoflavones confer an antiatherogenic effect by preventing the activation of macrophages due to the removal of ovaries.

Effects of 8-Month Vibration Plus Resistance Training on the Musculoskeletal System in Postmenopausal Women

Effects of 8-Month Vibration Plus Resistance Training on the Musculoskeletal System in Postmenopausal Women