Menopausal Status and Physical Performance in Middle Aged Women: A Cross-Sectional Community-Based Study in Northeast Brazil

Abstract

ObjectiveTo examine associations between menopausal status and physical performance in middle-aged women from the Northeast region of Brazil.MethodsCross-sectional study of women between 40 to 65 years old living in Parnamirim. Women were recruited by advertisements in primary care neighborhood centers across the city. Physical performance was assessed by grip strength, gait speed and chair stands. Menopausal status was determined using the Stages of Reproductive Aging Workshop classification and women were classified in: premenopausal, perimenopausal or postmenopausal. Multiple linear regression analyses were performed to model the effect of menopausal status on each physical performance measure, adjusting for covariates (age, family income, education, body mass index, parity and age at first birth).ResultsThe premenopausal women were significantly stronger and performed better in chair stands than perimenopausal and postmenopausal women. Gait speed did not vary significantly by menopausal status. In multivariate analyses, menopausal status remained statistically significant only for grip strength. In fully adjusted analyses, premenopausal women had grip strength mean of 2.226 Kgf (95% CI: 0.361 – 4.091) higher than the postmenopausal group.ConclusionsThis study provides further evidence for the associations between menopause and physical performance in middle-aged women, since grip strength is weaker in peri and postmenopausal women compared to premenopausal, even adjusted for age and other covariates.

Physical performance in relation to menopause status and physical activity

“…Our results are in line with those of previous studies showing that postmenopausal women have lower handgrip strength than premenopausal women. 12,13 In this study, absolute handgrip strength showed a significant declining trend of 25 N. Moreover, after controlling for confounders, the postmenopausal women remained significantly weaker (by 12 N) than the premenopausal women. Earlier cross-sectional studies 15,16 reported no difference in handgrip strength across menopause status groups.…”

“…Other studies that have measured performance in the chair rise test, which is a crude surrogate of muscle power, have reported no difference in performance across menopause status. 13,14,16 Bassey et al 15 measured leg extension muscle power in a rig but found no variation across the menopausal transition stages. The discrepancy between our results and those reported by Bassey et al 15 can be explained by differences in the menopause status classification and strength tests employed.…”

“…[15][16][17] For example, the few studies that have investigated differences or changes in walking speed during the menopausal transition have reported mixed results. A cross-sectional study with 389 participants aged 40 to 65 reported no significant difference between pre-, peri-, and postmenopausal women in habitual walking speed, 13 whereas a follow-up study by Sowers et al 14 showed significantly greater decline in walking speed among middleaged postmenopausal compared with either pre-or perimenopausal women.…”

“…Cross-sectional studies investigating differences in muscle strength across menopause status in middle-aged women have shown that postmenopausal women have lower strength and lower body muscle power than premenopausal women. [11][12][13] A 5-year follow-up study by Sowers et al 14 also showed that the decline in muscle strength is greater among middle-aged women characterized as postmenopausal compared with either pre-or perimenopausal women. Contradictory results, however, have also been published.…”

Associations of physical performance and physical activity with mental well-being in middle-aged women

“…Age-associated decline in physical functioning that results in mobility limitations or disabilities among older people [6] may also be related to low mental well-being [7]. We and others have shown that postmenopausal women have diminished muscle strength and power in comparison to premenopausal women, which may suggest that the decline in physical functioning accelerates already during midlife [8,9]. However, the physical performance of more physically active middle-aged women is greater than that of less physically active peers [8].…”