Changes in body composition and weight during the menopause transition

Abstract

BACKGROUND. The relation between the menopause transition (MT) and changes in body composition or weight remains uncertain. We hypothesized that, independent of chronological aging, the MT would have a detrimental influence on body composition. METHODS. Participants were from the longitudinal Study of Women's Health Across the Nation (SWAN) cohort. We assessed body composition by dual energy x-ray absorptiometry. Multivariable mixed effects regressions fitted piece-wise linear models to repeated measures of outcomes as a function of time before or after the final menstrual period (FMP). Covariates were age at FMP, race, study site, and hormone therapy. RESULTS. Fat and lean mass increased prior to the MT. At the start of the MT, rate of fat gain doubled, and lean mass declined; gains and losses continued until 2 years after the FMP. After that, the trajectories of fat and lean mass decelerated to zero slope. Weight climbed linearly during premenopause without acceleration at the MT. Its trajectory became flat after the MT. CONCLUSION. Accelerated gains in fat mass and losses of lean mass are MT-related phenomena. The rate of increase in the sum of fat mass and lean mass does not differ between premenopause and the MT; thus, there is no discernable change in rate of weight gain at the start of the MT.

Lower Central Fat Increase Risk of One-Year Muscle Mass Loss in Menopausal Women

“…The hormonal changes in menopause are known to lead to bone loss through increased bone turnover with a net deficit in the bone formation relative to bone resorption [ 4 , 5 ]. Several studies have also suggested that menopausal hormonal changes have an effect on the decline in muscle mass among middle-aged women [ 6 , 7 ].…”

Prospective associations between beverage intake during the midlife and subclinical carotid atherosclerosis: The Study of Women’s Health Across the Nation

“…Women also experience an accelerated progression of subclinical atherosclerosis during the menopausal transition [6, 7]. The steeper increase in atherosclerotic risk during the menopausal transition is likely explained by the associations between menopause and changes in cardiometabolic risk factors, including increases in total fat and visceral fat [8, 9], and elevations in total cholesterol and low-density lipoprotein (LDL) cholesterol [10]. These adverse changes, which go beyond the effects of chronological aging alone [8–10], may be preventable by lifestyle modifications [6].…”

The Metabolic Benefits of Menopausal Hormone Therapy Are Not Mediated by Improved Nutritional Habits. The OsteoLaus Cohort

“…In addition to the well-known vasomotor symptoms [2] and accelerated bone loss [3], MT significantly alters body composition with opposite effects on fat and lean body mass [4]. The Study of Women’s Health Across the Nation cohort, which followed longitudinally 1246 women of different ethnic backgrounds, confirmed that both the accelerated fat mass (FM) gain and the decline in lean mass are menopause-related and not merely age-dependent [5]. Several small interventional studies evaluated whether these changes are reversible with menopausal hormone therapy (MHT) and by what mechanisms [6].…”