Women, Menopause, Exercise Therapy Strategies
محورهای موضوعی : فیزیولوژی ورزشی
Masoumeh Hosseini
1
,
Qazal Marvastinia
2
1 - Department of Physical Education and Sport Sciences, ET.C., Islamic Azad University, Tehran, Iran
2 - Department of Physical Education and Sport Sciences, ET.C., Islamic Azad University, Tehran, Iran
کلید واژه: Menopause, Estrogen, Exercise,
چکیده مقاله :
Menopause represents a natural physiological transition from the reproductive stage to permanent infertility and is accompanied by a wide range of physical, psychological, and social changes that substantially influence women’s quality of life (1). Clinically, menopause is defined as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity and a marked decline in estrogen production (2). This hormonal alteration is associated with vasomotor symptoms such as hot flashes and night sweats, sleep disturbances, impaired concentration, and mood disorders. Over the long term, menopause is linked to an increased risk of cardiovascular disease, stroke, and osteoporosis (3).
The decline in estrogen levels during menopause, combined with increased visceral fat accumulation and weight gain, significantly elevates cardiovascular risk (4). Aging, reduced physical activity, and psychosocial stressors further contribute to unfavorable changes in body composition during this period. Notably, women experience an annual loss of approximately 1–2% of skeletal muscle mass after the age of 40, which adversely affects metabolic health, physical function, and long-term independence (5). Osteoporosis is the most prevalent metabolic bone disorder in postmenopausal women, affecting more than half of women over the age of 50 (6). This condition is characterized by a reduction in bone mineral density and deterioration of bone microarchitecture, leading to an increased risk of fractures. Epidemiological evidence indicates that women are nearly eight times more likely than men to develop osteoporosis, emphasizing the need for preventive strategies (7). Among non-pharmacological interventions, regular physical activity plays a pivotal role in mitigating menopausal complications. Consistent exercise improves cardiovascular and bone health, enhances metabolic rate, reduces abdominal adiposity, improves sleep quality, and promotes psychological well-being (8). Long-term adherence to structured exercise programs may also reduce the incidence of cardiovascular disease in postmenopausal women (9).
Various exercise modalities have demonstrated benefits in alleviating menopausal symptoms. Mind–body exercises such as yoga have been shown to reduce blood pressure and improve flexibility and sleep quality. Aerobic exercises enhance cardiac and pulmonary function, while resistance training is particularly effective in preserving muscle mass, improving metabolic health, and reducing the risk of osteoporosis, cardiovascular disease, and type 2 diabetes. Resistance-based exercises have also been associated with improved mental health outcomes in postmenopausal women (10-14).
In conclusion, given the well-established benefits of exercise and the minimal adverse effects associated with most physical activity modalities, transitioning from a sedentary lifestyle to regular physical activity is essential for alleviating menopausal symptoms and promoting long-term health. It is recommended that postmenopausal women adopt individualized and supervised exercise programs to reduce menopause-related complications and enhance overall quality of life.
Menopause represents a natural physiological transition from the reproductive stage to permanent infertility and is accompanied by a wide range of physical, psychological, and social changes that substantially influence women’s quality of life (1). Clinically, menopause is defined as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity and a marked decline in estrogen production (2). This hormonal alteration is associated with vasomotor symptoms such as hot flashes and night sweats, sleep disturbances, impaired concentration, and mood disorders. Over the long term, menopause is linked to an increased risk of cardiovascular disease, stroke, and osteoporosis (3).
The decline in estrogen levels during menopause, combined with increased visceral fat accumulation and weight gain, significantly elevates cardiovascular risk (4). Aging, reduced physical activity, and psychosocial stressors further contribute to unfavorable changes in body composition during this period. Notably, women experience an annual loss of approximately 1–2% of skeletal muscle mass after the age of 40, which adversely affects metabolic health, physical function, and long-term independence (5). Osteoporosis is the most prevalent metabolic bone disorder in postmenopausal women, affecting more than half of women over the age of 50 (6). This condition is characterized by a reduction in bone mineral density and deterioration of bone microarchitecture, leading to an increased risk of fractures. Epidemiological evidence indicates that women are nearly eight times more likely than men to develop osteoporosis, emphasizing the need for preventive strategies (7). Among non-pharmacological interventions, regular physical activity plays a pivotal role in mitigating menopausal complications. Consistent exercise improves cardiovascular and bone health, enhances metabolic rate, reduces abdominal adiposity, improves sleep quality, and promotes psychological well-being (8). Long-term adherence to structured exercise programs may also reduce the incidence of cardiovascular disease in postmenopausal women (9).
Various exercise modalities have demonstrated benefits in alleviating menopausal symptoms. Mind–body exercises such as yoga have been shown to reduce blood pressure and improve flexibility and sleep quality. Aerobic exercises enhance cardiac and pulmonary function, while resistance training is particularly effective in preserving muscle mass, improving metabolic health, and reducing the risk of osteoporosis, cardiovascular disease, and type 2 diabetes. Resistance-based exercises have also been associated with improved mental health outcomes in postmenopausal women (10-14).
In conclusion, given the well-established benefits of exercise and the minimal adverse effects associated with most physical activity modalities, transitioning from a sedentary lifestyle to regular physical activity is essential for alleviating menopausal symptoms and promoting long-term health. It is recommended that postmenopausal women adopt individualized and supervised exercise programs to reduce menopause-related complications and enhance overall quality of life.
1. Santoro N, Epperson CN, Mathews SB. Menopausal symptoms and their management. Endocrinol Metab Clin North Am. 2015;44(3):497–515.
2. Harlow SD, Gass M, Hall JE, et al. Executive summary of the Stages of Reproductive Aging Workshop +10. Menopause. 2012;19(4):387–395.
3. Manson JE, Aragaki AK, Rossouw JE, et al. Menopausal hormone therapy and long-term health outcomes. JAMA. 2017;318(10):927–938.
4. Lizcano F, Guzmán G. Estrogen deficiency and the origin of obesity during menopause. Biomed Res Int. 2014;2014:757461.
5. Mitchell WK, Williams J, Atherton P, et al. Sarcopenia, dynapenia, and the impact of advancing age on human skeletal muscle size and strength. J Cachexia Sarcopenia Muscle. 2012;3(4):213–228.
6. Compston JE, McClung MR, Leslie WD. Osteoporosis. Lancet. 2019;393(10169):364–376.
7. Sözen T, Özışık L, Başaran NÇ. An overview and management of osteoporosis. Eur J Rheumatol. 2017;4(1):46–56.
8. Elavsky S, McAuley E. Physical activity, symptoms, esteem, and life satisfaction during menopause. Maturitas. 2005;52(3–4):374–385.
9. Swift DL, Johannsen NM, Lavie CJ, et al. The role of exercise and physical activity in weight loss and maintenance. Prog Cardiovasc Dis. 2014;56(4):441–447.
10. Daly RM, Dalla Via J, Duckham RL, et al. Exercise for the prevention of osteoporosis in postmenopausal women. Curr Osteoporos Rep. 2019;17(6):329–338.
11. Naghizadeh, N., Riyahi Malayeri, S., Roozbahani, M., Khademi, A., Shirvani, H. The Effectiveness of Endurance Training and Nano Curcumin Supplementation on the Expression of Mir-21and P53 Genes in Brain Tumor Tissue in an Animal Model of Glioblastoma Multiform. Journal of Nutrition,Fasting and Health, 2024; 12(1): 26-35. doi: 10.22038/jnfh.2023.73964.1455
12. Riyahi Malayeri S, Hoseini M. The Effect of Acute Exercise on Vaspin and Chemerin Levels in Obese Men. jbrms 2021; 8 (1) :58-66.URL: http://jbrms.medilam.ac.ir/article-1-528-en.html.
13. Ashtary-Larky D, Kashkooli S, Bagheri R, Lamuchi-Deli N, Alipour M, Mombaini D, Baker JS, Ramezani Ahmadi A, Wong A. The effect of exercise training on serum concentrations of chemerin in patients with metabolic diseases: a systematic review and meta-analysis. Arch Physiol Biochem. 2023 Oct;129(5):1028-1037. doi: 10.1080/13813455.2021.1892149. Epub 2021 Mar 2. PMID: 33651961.
14. Hosseini M, Eftekhar B, Riyahi Malayeri S. Effect of Interval Training with Curcumin Consumption on Some Adipokines in Menopausal Obese Rats. JRUMS 2017; 16 (6) :505-516.URL: http://journal.rums.ac.ir/article-1-3644-fa.html
