Effect of physical activity on menopausal symptoms in non-vigorously active postmenopausal women

Abstract

Menopause is the time in a woman’s life when regular menstrual periods cease, due to a natural change in sex hormones, which may be accompanied by unwelcome symptoms. PURPOSE: To determine whether physical activity is associated with a reduction in menopausal symptoms (hot flashes, insomnia, numbness, fatigue, headaches, psychological symptoms, urogenital symptoms and physical symptoms). Providing that symptom differences among activity levels exist, a secondary purpose was to suggest an adequate level of physical activity for relief of menopausal symptoms. METHODS: Women (n=401) who were not taking hormone replacement therapy completed two questionnaires based on a 7-day recall of an average week: the Leisure-Time Exercise Questionnaire (Godin & Shephard, 1985) and the Menopausal Index (St. Germain, Peterson, Robinson, & Alekel, 2001). Women were divided into quintiles according to their physical activity scores (1=least active, 5=most active) and compared for menopausal symptoms using first a MANCOVA with covariate percent fat, as this was the only covariate that had significant group mean differences. Secondly a MANOVA with the appropriate post-hoc analysis was conducted. RESULTS: The mean (SD) age of the participants was 58.2 (6.3), the mean years postmenopausal was 6.7 (6.0), the mean percent body fat was 37.4 (5.6) %, and 16.5% had a previous hysterectomy. Univariate tests did not identify significant group differences for hysterectomy (p=0.774) or time since menopause (p=0.440); however, there were significant group differences for percent body fat (p=0). The MANCOVA was not significant between physical activity groups with percent fat as a covariate (Wilks’ Lamda p = 0.126). The MANOVA indicated a significant group main effect of physical activity on menopausal symptoms (Wilks’ Lamda p = 0.034). Of the 8 symptoms under review there were significant group differences for fatigue (p=0.05), and physical symptoms (p=0.004). The post-hoc analyses identified that two least active groups reported above average fatigue occurrence whereas the three most active groups reported below average fatigue occurrence. Group 2 had significantly more physical symptom complaints than groups 4 & 5. Of the three symptoms comprising physical symptoms, there were significant differences for weight gain (p=0.004) but not for breast tenderness (p=0.742) or aches and pains (p=0.175). Groups 1 & 2 reported significantly higher frequency of weight gain than groups 4 & 5. CONCLUSION: Any indirect effect of physical activity on menopausal symptoms is most likely through the alteration of body composition. Women with lower percent body fat report less weight gain and fatigue. There was no significant relationship between physical activity levels and reporting of hot flashes/night sweats, insomnia, limb numbness, headache, psychological symptoms or urogenital symptoms. A randomized controlled clinical trial would likely determine the relationship between higher activity levels and symptom reduction. For future research it is recommended that groups be matched based on percent body fat prior to randomization and that a greater amount of physical activity be prescribed.