Skip to main content
SpringerLink
Log in

Managing Menopause and Post-reproductive Health: Beyond Hormones and Medicines

  • Chapter
  • First Online:
Postmenopausal Diseases and Disorders

Abstract

In response to some studies showing an association between menopausal hormone therapy (MHT) and risk of cancer and cardiovascular events, there has been increasing interest in nonhormonal- and nonmedication-based approaches to managing menopausal symptoms and optimising post-reproductive health. The aim is to maintain and promote good quality of life and independence for as long as possible.

This chapter examines the recent evidence (published within the past 10 years) for diet and exercise lifestyle options for post-reproductive health in women, specifically examining interventions for menopausal vasomotor symptoms, cardiovascular disease, osteoporosis and dementia and cognitive decline. Promoting a healthy diet and preventing both obesity and malnutrition needs to be combined with physical activity. All interventions must be cost-effective, culturally acceptable and enjoyable.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Investigators WGftWsHI. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288(3):321–33.

    Article  Google Scholar 

  2. Collaborators MWS. Breast cancer and hormone-replacement therapy in the Million Women Study. Lancet. 2003;362(9382):419–27.

    Article  CAS  Google Scholar 

  3. Manson JE, Aragaki AK, Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Chlebowski RT, Howard BV, Thomson CA, Margolis KL. Menopausal hormone therapy and long-term all-cause and cause-specific mortality: the Women’s Health Initiative randomized trials. JAMA. 2017;318(10):927–38.

    Article  PubMed  PubMed Central  Google Scholar 

  4. De Villiers T, Hall J, Pinkerton J, Pérez SC, Rees M, Yang C, Pierroz D. Revised global consensus statement on menopausal hormone therapy. Maturitas. 2016;91:153–5.

    Article  PubMed  Google Scholar 

  5. The NAMS. Hormone therapy position statement advisory panel. The 2017 hormone therapy position statement of the North American Menopause Society. Menopause. 2017;24(7):728–53.

    Article  Google Scholar 

  6. Grossman DC, Curry SJ, Owens DK, Barry MJ, Davidson KW, Doubeni CA, Epling JW, Kemper AR, Krist AH, Kurth AE. Hormone therapy for the primary prevention of chronic conditions in postmenopausal women: US preventive services task force recommendation statement. JAMA. 2017;318(22):2224–33.

    Article  PubMed  Google Scholar 

  7. Global strategy on diet, physical activity and health. Physical inactivity: a Global Public Health Problem World Health Organization. http://www.who.int/dietphysicalactivity/factsheet_inactivity/en/.

  8. Global strategy on diet, physical activity and health. Physical activity and older adults: World Health Organisation. http://www.who.int/dietphysicalactivity/factsheet_olderadults/en/.

  9. Yannakoulia M, Mamalaki E, Anastasiou CA, Mourtzi N, Lambrinoudaki I, Scarmeas N. Eating habits and behaviors of older people: where are we now and where should we go? Maturitas. 2018;114:14–21.

    Article  PubMed  Google Scholar 

  10. Artaza-Artabe I, Sáez-López P, Sánchez-Hernández N, Fernández-Gutierrez N, Malafarina V. The relationship between nutrition and frailty: effects of protein intake, nutritional supplementation, vitamin D and exercise on muscle metabolism in the elderly. A systematic review. Maturitas. 2016;93:89–99.

    Article  CAS  PubMed  Google Scholar 

  11. Agarwal E, Marshall S, Miller M, Isenring E. Optimising nutrition in residential aged care: a narrative review. Maturitas. 2016;92:70–8.

    Article  PubMed  Google Scholar 

  12. Marshall S, Bauer J, Isenring E. The consequences of malnutrition following discharge from rehabilitation to the community: a systematic review of current evidence in older adults. J Hum Nutr Diet. 2014;27(2):133–41.

    Article  CAS  PubMed  Google Scholar 

  13. Hess R, Thurston RC, Hays RD, Chang C-CH, Dillon SN, Ness RB, Bryce CL, Kapoor WN, Matthews KA. The impact of menopause on health-related quality of life: results from the STRIDE longitudinal study. Qual Life Res. 2012;21(3):535–44.

    Article  PubMed  Google Scholar 

  14. Zhu D, Chung H-F, Pandeya N, Dobson AJ, Kuh D, Crawford SL, Gold EB, Avis NE, Giles GG, Bruinsma F. Body mass index and age at natural menopause: an international pooled analysis of 11 prospective studies. Eur J Epidemiol. 2018;33(8):699–710. https://doi.org/10.1007/s10654-018-0367-y.

    Article  PubMed  Google Scholar 

  15. Avis NE, Crawford SL, Greendale G, Bromberger JT, Everson-Rose SA, Gold EB, Hess R, Joffe H, Kravitz HM, Tepper PG. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015;175(4):531–9.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Freeman EW, Sammel MD, Sanders RJ. Risk of long term hot flashes after natural menopause: evidence from the Penn Ovarian Aging Cohort. Menopause. 2014;21(9):924–32.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Wilson LF, Pandeya N, Byles J, Mishra GD. Hot flushes and night sweats symptom profiles over a 17-year period in mid-aged women: the role of hysterectomy with ovarian conservation. Maturitas. 2016;91:1–7.

    Article  PubMed  Google Scholar 

  18. Stuursma A, van Driel C, Wessels N, de Bock G, Mourits M. Severity and duration of menopausal symptoms after risk-reducing salpingo-oophorectomy. Maturitas. 2018;111:69–76.

    Article  CAS  PubMed  Google Scholar 

  19. Thurston RC, Sowers MR, Sutton-Tyrrell K, Everson-Rose SA, Lewis TT, Edmundowicz D, Matthews KA. Abdominal adiposity and hot flashes among midlife women. Menopause. 2008;15(3):429–34.

    Article  PubMed  PubMed Central  Google Scholar 

  20. National Institute of Clinical Excellence (NICE). Scenario: managing the menopause. 2015. http://cks.nice.org.uk/menopause#!scenario.

  21. Herber-Gast G-CM, Mishra GD. Fruit, Mediterranean-style, and high-fat and-sugar diets are associated with the risk of night sweats and hot flushes in midlife: results from a prospective cohort study. Am Clin Nutr. 2013;97(5):1092–9.

    Article  CAS  Google Scholar 

  22. Beezhold B, Radnitz C, McGrath RE, Feldman A. Vegans report less bothersome vasomotor and physical menopausal symptoms than omnivores. Maturitas. 2018;112:12–7.

    Article  PubMed  Google Scholar 

  23. Kroenke CH, Caan BJ, Stefanick ML, Anderson G, Brzyski R, Johnson KC, LeBlanc E, Lee C, La Croix AZ, Park HL. Effects of a dietary intervention and weight change on vasomotor symptoms in the Women’s Health Initiative. Menopause. 2012;19(9):980–8.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Australian Dietary Guidelines. Canberra: NHMRC, Australian Government; 2013. https://www.nhmrc.gov.au/guidelines-publications/n55.

  25. Reame NK. Fat, fit or famished? No clear answers from the WHI about diet and dieting for long-standing hot flashes. Menopause. 2012;19(9):956–8.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Huang AJ, Subak LL, Wing R, West DS, Hernandez AL, Macer J, Grady D. An intensive behavioral weight loss intervention and hot flushes in women. Arch Intern Med. 2010;170(13):1161–7.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Goughnour S, Thurston R, Althouse A, Freese K, Edwards R, Hamad G, McCloskey C, Ramanathan R, Bovbjerg D, Linkov F. Assessment of hot flushes and vaginal dryness among obese women undergoing bariatric surgery. Climacteric. 2016;19(1):71–6.

    Article  CAS  PubMed  Google Scholar 

  28. Franco OH, Chowdhury R, Troup J, Voortman T, Kunutsor S, Kavousi M, Oliver-Williams C, Muka T. Use of plant-based therapies and menopausal symptoms: a systematic review and meta-analysis. JAMA. 2016;315(23):2554–63.

    Article  CAS  PubMed  Google Scholar 

  29. Glisic M, Kastrati N, Musa J, Milic J, Asllanaj E, Fernandez EP, Nano J, Rosales CO, Amiri M, Kraja B. Phytoestrogen supplementation and body composition in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Maturitas. 2018;115:74–83.

    Article  CAS  PubMed  Google Scholar 

  30. Lambert MNT, Thorup AC, Hansen ESS, Jeppesen PB. Combined Red Clover isoflavones and probiotics potently reduce menopausal vasomotor symptoms. PLoS One. 2017;12(6):e0176590.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  31. Di Lorenzo C, Ceschi A, Kupferschmidt H, Lüde S, De Souza NE, Dos Santos A, Colombo F, Frigerio G, Nørby K, Plumb J. Adverse effects of plant food supplements and botanical preparations: a systematic review with critical evaluation of causality. Br J Clin Pharmacol. 2015;79(4):578–92.

    Article  PubMed  Google Scholar 

  32. Teschke R, Schwarzenboeck A, Schmidt-Taenzer W, Wolff A, Hennermann K-H. Herb induced liver injury presumably caused by black cohosh: a survey of initially purported cases and herbal quality specifications. Ann Hepatol. 2016;10(3):249–59.

    Article  Google Scholar 

  33. Hunter M, Gupta P, Chedraui P, Blümel J, Tserotas K, Aguirre W, Palacios S, Sturdee D. The international menopause study of climate, altitude, temperature (IMS-CAT) and vasomotor symptoms. Climacteric. 2012;16(1):8–16.

    Article  PubMed  Google Scholar 

  34. Faubion SS, Sood R, Thielen JM, Shuster LT. Caffeine and menopausal symptoms: what is the association? Menopause. 2015;22(2):155–8.

    Article  PubMed  Google Scholar 

  35. Daley A, Stokes-Lampard H, Thomas A, MacArthur C. Exercise for vasomotor menopausal symptoms. Cochrane Database Syst Rev. 2014;11:CD006108.

    Google Scholar 

  36. Daley AJ, Thomas A, Roalfe AK, Stokes-Lampard H, Coleman S, Rees M, Hunter M, MacArthur C. The effectiveness of exercise as treatment for vasomotor menopausal symptoms: randomised controlled trial. BJOG. 2015;122(4):565–75.

    Article  CAS  PubMed  Google Scholar 

  37. Aparicio V, Borges-Cosic M, Ruiz-Cabello P, Coll-Risco I, Acosta-Manzano P, Špacírová Z, Soriano-Maldonado A. Association of objectively measured physical activity and physical fitness with menopause symptoms. The Flamenco Project. Climacteric. 2017;20(5):456–61.

    Article  CAS  PubMed  Google Scholar 

  38. Alder E. The Blatt-Kupperman menopausal index: a critique. Maturitas. 1998;29(1):19–24.

    Article  CAS  PubMed  Google Scholar 

  39. Moilanen JM, Mikkola TS, Raitanen JA, Heinonen RH, Tomas EI, Nygård C-H, Luoto RM. Effect of aerobic training on menopausal symptoms—a randomized controlled trial. Menopause. 2012;19(6):691–6.

    Article  PubMed  Google Scholar 

  40. Mansikkamäki K, Nygård C-H, Raitanen J, Kukkonen-Harjula K, Tomás E, Rutanen R, Luoto R. Hot flushes among aging women: a 4-year follow-up study to a randomised controlled exercise trial. Maturitas. 2016;88:84–9.

    Article  PubMed  Google Scholar 

  41. Shepherd-Banigan M, Goldstein K, Coeytaux R, McDuffie J, Goode A, Kosinski A, Van Noord M, Befus D, Adam S, Masilamani V. Improving vasomotor symptoms; psychological symptoms; and health-related quality of life in peri- or post-menopausal women through yoga: an umbrella systematic review and meta-analysis. Complement Ther Med. 2017;34:156–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Cramer H, Peng W, Lauche R. Yoga for menopausal symptoms—a systematic review and meta-analysis. Maturitas. 2018;109:13–25.

    Article  PubMed  Google Scholar 

  43. Cardiovascular diseases (CVDs). Fact sheet: World Health Organisation. 2017. http://www.who.int/mediacentre/factsheets/fs317/en/.

  44. Wilkins E, Wilson L, Wickramasinghe K, Bhatnagar P, Leal J, Luengo-Fernandez R, Burns R, Rayner M, Townsend N. European cardiovascular disease statistics 2017. Brussels: European Heart Network; 2017. http://www.ehnheart.org/cvd-statistics.html.

    Google Scholar 

  45. Cardiovascular risk factors: World Heart Federation. https://www.world-heart-federation.org/resources/risk-factors/.

  46. Milic J, Glisic M, Voortman T, Borba LP, Asllanaj E, Rojas LZ, Troup J, Kiefte-de Jong JC, van Beeck E, Muka T. Menopause, ageing, and alcohol use disorders in women. Maturitas. 2018;111:100–9.

    Article  PubMed  Google Scholar 

  47. Cardiovascular disease. World Health Organisation. http://www.who.int/cardiovascular_diseases/en/.

  48. Mente A, de Koning L, Shannon HS, Anand SS. A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med. 2009;169(7):659–69.

    Article  CAS  PubMed  Google Scholar 

  49. Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002;13(1):3–9.

    Article  CAS  PubMed  Google Scholar 

  50. Nordmann AJ, Nordmann A, Briel M, Keller U, Yancy WS, Brehm BJ, Bucher HC. Effects of low-carbohydrate vs low-fat diets on weight loss and cardiovascular risk factors: a meta-analysis of randomized controlled trials. Arch Intern Med. 2006;166(3):285–93.

    Article  CAS  PubMed  Google Scholar 

  51. Sacks FM, Lichtenstein AH, Wu JH, Appel LJ, Creager MA, Kris-Etherton PM, Miller M, Rimm EB, Rudel LL, Robinson JG. Dietary fats and cardiovascular disease: a presidential advisory from the American Heart Association. Circulation. 2017;136(3):e1–e23.

    Article  PubMed  Google Scholar 

  52. Willett WC, Sacks F, Trichopoulou A, Drescher G, Ferro-Luzzi A, Helsing E, Trichopoulos D. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr. 1995;61(6):1402S–6S.

    Article  CAS  PubMed  Google Scholar 

  53. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med. 2003;348(26):2599–608.

    Article  PubMed  Google Scholar 

  54. Papadaki A, Johnson L, Toumpakari Z, England C, Rai M, Toms S, Penfold C, Zazpe I, Martínez-González MA, Feder G. Validation of the English Version of the 14-Item Mediterranean Diet Adherence Screener of the PREDIMED Study, in People at High Cardiovascular Risk in the UK. Nutrients. 2018;10(2):E138.

    Article  PubMed  Google Scholar 

  55. Sofi F, Dinu M, Pagliai G, Marcucci R, Casini A. Validation of a literature-based adherence score to Mediterranean diet: the MEDI-LITE score. Int J Food Sci Nutr. 2017;68(6):757–62.

    Article  PubMed  Google Scholar 

  56. Rosato V, Temple NJ, La Vecchia C, Castellan G, Tavani A, Guercio V. Mediterranean diet and cardiovascular disease: a systematic review and meta-analysis of observational studies. Eur J Nutr. 2017:1–19.

    Google Scholar 

  57. Toobert DJ, Glasgow RE, Strycker LA, Barrera M, Radcliffe JL, Wander RC, Bagdade JD. Biologic and quality-of-life outcomes from the Mediterranean lifestyle program: a randomized clinical trial. Diabetes Care. 2003;26(8):2288–93.

    Article  PubMed  Google Scholar 

  58. Ros E, Martínez-González MA, Estruch R, Salas-Salvadó J, Fitó M, Martínez JA, Corella D. Mediterranean diet and cardiovascular health: teachings of the PREDIMED Study. Adv Nutr. 2014;5(3):330S–6S.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  59. Barzi F, Woodward M, Marfisi R, Tavazzi L, Valagussa F, Marchioli R. Mediterranean diet and all-causes mortality after myocardial infarction: results from the GISSI-Prevenzione trial. Eur J Clin Nutr. 2003;57(4):604–11.

    Article  CAS  PubMed  Google Scholar 

  60. Steinberg D, Bennett GG, Svetkey L. The DASH diet, 20 years later. JAMA. 2017;317(15):1529–30.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Salehi-Abargouei A, Maghsoudi Z, Shirani F, Azadbakht L. Effects of dietary approaches to stop hypertension (DASH)-style diet on fatal or nonfatal cardiovascular diseases—incidence: a systematic review and meta-analysis on observational prospective studies. Nutrition. 2013;29(4):611–8.

    Article  PubMed  Google Scholar 

  62. Schwingshackl L, Hoffmann G. Diet quality as assessed by the Healthy Eating Index, the Alternate Healthy Eating Index, the Dietary Approaches to Stop Hypertension score, and health outcomes: a systematic review and meta-analysis of cohort studies. J Acad Nutr Diet. 2015;115(5):780–800.e5.

    Article  PubMed  Google Scholar 

  63. Nowson CA, Wattanapenpaiboon N, Pachett A. Low-sodium dietary approaches to stop hypertension–type diet including lean red meat lowers blood pressure in postmenopausal women. Nutr Res. 2009;29(1):8–18.

    Article  CAS  PubMed  Google Scholar 

  64. Abdelhamid A, Brown T, Brainard J, Biswas P, Thorpe G, Deane K, AlAbdulghafoor F, Summerbell C, Worthington H, Song F. Omega 3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2018;(7):CD003177.

    Google Scholar 

  65. Eckel N, Li Y, Kuxhaus O, Stefan N, Hu FB, Schulze MB. Transition from metabolic healthy to unhealthy phenotypes and association with cardiovascular disease risk across BMI categories in 90 257 women (the Nurses’ Health Study): 30 year follow-up from a prospective cohort study. Lancet Diabetes Endocrinol. 2018;6(9):714–24.

    Article  Google Scholar 

  66. Lean ME, Leslie WS, Barnes AC, Brosnahan N, Thom G, McCombie L, Peters C, Zhyzhneuskaya S, Al-Mrabeh A, Hollingsworth KG. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018;391(10120):541–51.

    Article  PubMed  Google Scholar 

  67. Williams RL, Rollo ME, Schumacher T, Collins CE. Diet quality scores of Australian adults who have completed the healthy eating quiz. Nutrients. 2017;9(8):E880.

    Article  PubMed  Google Scholar 

  68. Lewis JR, Radavelli-Bagatini S, Rejnmark L, Chen JS, Simpson JM, Lappe JM, Mosekilde L, Prentice RL, Prince RL. The effects of calcium supplementation on verified coronary heart disease hospitalization and death in postmenopausal women: a collaborative meta-analysis of randomized controlled trials. J Bone Miner Res. 2015;30(1):165–75.

    Article  CAS  PubMed  Google Scholar 

  69. Willcox BJ, Curb JD, Rodriguez BL. Antioxidants in cardiovascular health and disease: key lessons from epidemiologic studies. Am J Cardiol. 2008;101(10):S75–86.

    Article  CAS  Google Scholar 

  70. Myung S-K, Ju W, Cho B, Oh S-W, Park SM, Koo B-K, Park B-J. Efficacy of vitamin and antioxidant supplements in prevention of cardiovascular disease: systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;346:f10.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  71. George ES, Marshall S, Mayr HL, Trakman GL, Tatucu-Babet OA, Lassemillante ACM, Bramley A, Reddy AJ, Forsyth A, Tierney AC, Thomas CJ, Itsiopoulos C, Marx W. The effect of high-polyphenol extra virgin olive oil on cardiovascular risk factors: a systematic review and meta-analysis. Crit Rev Food Sci Nutr. 2018;30:1–24.

    Article  CAS  Google Scholar 

  72. Aung T, Halsey J, Kromhout D, Gerstein HC, Marchioli R, Tavazzi L, Geleijnse JM, Rauch B, Ness A, Galan P. Associations of Omega-3 fatty acid supplement use with cardiovascular disease risks: meta-analysis of 10 trials involving 77 917 individuals. JAMA Cardiol. 2018;3(3):225–34.

    Article  PubMed  Google Scholar 

  73. Marshall S, van der Meij B. Fish and omega-3 intake and health in older people. Maturitas. 2018;115:117–8.

    Article  PubMed  Google Scholar 

  74. Lavie CJ, Arena R, Swift DL, Johannsen NM, Sui X, Lee D-C, Earnest CP, Church TS, O’keefe JH, Milani RV. Exercise and the cardiovascular system: clinical science and cardiovascular outcomes. Circ Res. 2015;117(2):207–19.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Exercise: American Heart Association 2014. www.heart.org/HEARTORG/HealthyLiving/PhysicalActivity/FitnessBasics/American-Heart-Association-Recommendations-for-Physical-Activity-in-Adults.

  76. Celis-Morales CA, Lyall DM, Welsh P, Anderson J, Steell L, Guo Y, Maldonado R, Mackay DF, Pell JP, Sattar N. Association between active commuting and incident cardiovascular disease, cancer, and mortality: prospective cohort study. BMJ. 2017;357:j1456.

    Article  PubMed  Google Scholar 

  77. Chomistek AK, Cook NR, Rimm EB, Ridker PM, Buring JE, Lee IM. Physical activity and incident cardiovascular disease in women: is the relation modified by level of global cardiovascular risk? J Am Heart Assoc. 2018;7(12):e008234.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Cotterell N, Buffel T, Phillipson C. Preventing social isolation in older people. Maturitas. 2018;113:80–4.

    Article  PubMed  Google Scholar 

  79. Annweiler C, Noublanche F, Jaglin-Grimonprez C, Bubien Y. Built environments for frail older adults: the now and next. Maturitas. 2018;116:137–8.

    Article  PubMed  Google Scholar 

  80. Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA. Osteoporosis in the European Union: medical management, epidemiology and economic burden. Arch Osteoporos. 2013;8(1-2):136.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Kanis JA, Cooper C, Rizzoli R, Abrahamsen B, Al-Daghri NM, Brandi ML, Cannata-Andia J, Cortet B, Dimai HP, Ferrari S, Hadji P, Harvey NC, Kraenzlin M, Kurth A, McCloskey E, Minisola S, Thomas T, Reginster JY, European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int. 2017;28:2023–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Thulkar J, Singh S, Sharma S, Thulkar T. Preventable risk factors for osteoporosis in postmenopausal women: systematic review and meta-analysis. J Midlife Health. 2016;7(3):108–13.

    PubMed  PubMed Central  Google Scholar 

  83. Abrahamsen B, Van Staa T, Ariely R, Olson M, Cooper C. Excess mortality following hip fracture: a systematic epidemiological review. Osteoporos Int. 2009;20(10):1633–50.

    Article  CAS  PubMed  Google Scholar 

  84. CKS Osteoporosis—prevention of fragility fractures NICE. 2016. https://cks.nice.org.uk/osteoporosis-prevention-of-fragility-fractures.

  85. Hita-Contreras F, Bueno-Notivol J, Martínez-Amat A, Cruz-Díaz D, Hernandez AV, Pérez-López FR. Effect of exercise alone or combined with dietary supplements on anthropometric and physical function measures in community-dwelling elderly people with sarcopenic obesity: a meta-analysis of randomized controlled trials. Maturitas. 2018;116:24–35.

    Article  PubMed  Google Scholar 

  86. Koutsofta I, Mamais I, Chrysostomou S. The effect of protein diets in postmenopausal women with osteoporosis: systematic review of randomized controlled trials. J Women Aging. 2019;31:117–39.

    Article  PubMed  Google Scholar 

  87. Rizzoli R, Biver E, Bonjour J-P, Coxam V, Goltzman D, Kanis J, Lappe J, Rejnmark L, Sahni S, Weaver C. Benefits and safety of dietary protein for bone health—an expert consensus paper endorsed by the European Society for Clinical and Economical Aspects of Osteoporosis, osteoarthritis, and musculoskeletal diseases and by the International Osteoporosis Foundation. Osteoporos Int. 2018;29:1933–48.

    Article  CAS  PubMed  Google Scholar 

  88. Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intakes. Canberra: National Health and Medical Research Council; 2005. https://www.nhmrc.gov.au/guidelines-publications/n35-n36-n37.

  89. Calcium Factsheet: National Institute of Health. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/.

  90. Healthy eating for strong bones: National Osteoporosis Society. https://nos.org.uk/information/healthy-living-and-risk/healthy-eating-for-strong-bones/.

  91. Anderson JJB. Nutrition and bone health. In: Mahan LK, Escott-Stump S, editors. Krause’s food & nutrition therapy. 12th ed. St. Louis, MO: Elsevier; 2008.

    Google Scholar 

  92. Moschonis G, Katsaroli I, Lyritis GP, Manios Y. The effects of a 30-month dietary intervention on bone mineral density: the Postmenopausal Health Study. Br J Nutr. 2010;104(1):100–7.

    Article  CAS  PubMed  Google Scholar 

  93. Salamone LM, Cauley JA, Black DM, Simkin-Silverman L, Lang W, Gregg E, Palermo L, Epstein RS, Kuller LH, Wing R. Effect of a lifestyle intervention on bone mineral density in premenopausal women: a randomized trial. Am J Clin Nutr. 1999;70(1):97–103.

    Article  CAS  PubMed  Google Scholar 

  94. Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med. 1992;327(23):1637–42.

    Article  CAS  PubMed  Google Scholar 

  95. Grossman DC, Curry SJ, Owens DK, Barry MJ, Caughey AB, Davidson KW, Doubeni CA, Epling JW, Kemper AR, Krist AH. Vitamin D, calcium, or combined supplementation for the primary prevention of fractures in community-dwelling adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(15):1592–9.

    Article  PubMed  Google Scholar 

  96. Cano A, Chedraui P, Goulis DG, Lopes P, Mishra G, Mueck A, Senturk LM, Simoncini T, Stevenson JC, Stute P. Calcium in the prevention of postmenopausal osteoporosis: EMAS clinical guide. Maturitas. 2018;107:7–12.

    Article  CAS  PubMed  Google Scholar 

  97. Compston J, Cooper A, Cooper C, Gittoes N, Gregson C, Harvey N, Hope S, Kanis J, McCloskey E, Poole K. UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos. 2017;12(1):43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  98. Shea B, Wells G, Cranney A, Zytaruk N, Robinson V, Griffith L, Ortiz Z, Peterson J, Adachi J, Tugwell P. VII. Meta-analysis of calcium supplementation for the prevention of postmenopausal osteoporosis. Endocr Rev. 2002;23(4):552–9.

    Article  CAS  PubMed  Google Scholar 

  99. Tai V, Leung W, Grey A, Reid IR, Bolland MJ. Calcium intake and bone mineral density: systematic review and meta-analysis. BMJ. 2015;351:h4183.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  100. Bischoff-Ferrari HA, Dawson-Hughes B, Baron JA, Burckhardt P, Li R, Spiegelman D, Specker B, Orav JE, Wong JB, Staehelin HB. Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr. 2007;86(6):1780–90.

    Article  CAS  PubMed  Google Scholar 

  101. Warensjö E, Byberg L, Melhus H, Gedeborg R, Mallmin H, Wolk A, Michaëlsson K. Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study. BMJ. 2011;342:d1473.

    Article  PubMed  PubMed Central  Google Scholar 

  102. Harvey NC, Biver E, Kaufman J-M, Bauer J, Branco J, Brandi ML, Bruyère O, Coxam V, Cruz-Jentoft A, Czerwinski E. The role of calcium supplementation in healthy musculoskeletal ageing. Osteoporos Int. 2017;28(2):447–62.

    Article  CAS  PubMed  Google Scholar 

  103. Wallace RB, Wactawski-Wende J, O’Sullivan MJ, Larson JC, Cochrane B, Gass M, Masaki K. Urinary tract stone occurrence in the Women’s Health Initiative (WHI) randomized clinical trial of calcium and vitamin D supplements. Am J Clin Nutr. 2011;94(1):270–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  104. Prentice R, Pettinger M, Jackson R, Wactawski-Wende J, Lacroix A, Anderson G, Chlebowski R, Manson J, Van Horn L, Vitolins M. Health risks and benefits from calcium and vitamin D supplementation: Women’s Health Initiative clinical trial and cohort study. Osteoporos Int. 2013;24(2):567–80.

    Article  CAS  PubMed  Google Scholar 

  105. Chung M, Tang AM, Fu Z, Wang DD, Newberry SJ. Calcium intake and cardiovascular disease risk: an updated systematic review and meta-analysis. Ann Intern Med. 2016;165(12):856–66.

    Article  PubMed  Google Scholar 

  106. Kopecky SL, Bauer DC, Gulati M, Nieves JW, Singer AJ, Toth PP, Underberg JA, Wallace TC, Weaver CM. Lack of evidence linking calcium with or without vitamin D supplementation to cardiovascular disease in generally healthy adults: a clinical guideline from the National Osteoporosis Foundation and the American Society for Preventive Cardiology. Ann Intern Med. 2016;165(12):867–8.

    Article  PubMed  Google Scholar 

  107. Pérez-López FR, Brincat M, Erel CT, Tremollieres F, Gambacciani M, Lambrinoudaki I, Moen MH, Schenck-Gustafsson K, Vujovic S, Rozenberg S. EMAS position statement: vitamin D and postmenopausal health. Maturitas. 2012;71(1):83–8.

    Article  PubMed  CAS  Google Scholar 

  108. Rejnmark L, Bislev LS, Cashman KD, Eiríksdottir G, Gaksch M, Grübler M, Grimnes G, Gudnason V, Lips P, Pilz S. Non-skeletal health effects of vitamin D supplementation: a systematic review on findings from meta-analyses summarizing trial data. PLoS One. 2017;12(7):e0180512.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  109. NICE Guidelines [PH56]. Vitamin D: increasing supplement use in at-risk groups. London: NICE; 2014.

    Google Scholar 

  110. Hill TR, Aspray TJ. Vitamin D prescribing in older people in the UK depends on postcode. Maturitas. 2017;99:109–13.

    Article  PubMed  Google Scholar 

  111. Scientific Advisory Council on Nutrition Vitamin D and Health Report: Scientific Advisory Council. https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-report.

  112. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, Orav JE, Stuck A, Theiler R, Wong JB, Egli A, Kiel DP, Henschkowski J. Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. BMJ. 2009;339:b3692.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  113. Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, Thoma A, Kiel DP, Henschkowski J. Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Arch Intern Med. 2009;169(6):551–61.

    Article  CAS  PubMed  Google Scholar 

  114. Reid IR, Bolland MJ, Grey A. Effects of vitamin D supplements on bone mineral density: a systematic review and meta-analysis. Lancet. 2014;383(9912):146–55.

    Article  CAS  PubMed  Google Scholar 

  115. Avenell A, Mak JCS, O’Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev. 2014;(4):CD000227.

    Google Scholar 

  116. Weaver C, Alexander D, Boushey C, Dawson-Hughes B, Lappe J, LeBoff M, Liu S, Looker A, Wallace T, Wang D. Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int. 2016;27(1):367–76.

    Article  CAS  PubMed  Google Scholar 

  117. Crandall CJ, Aragaki AK, LeBoff MS, Li W, Wactawski-Wende J, Cauley JA, Margolis KL, Manson JE. Calcium plus vitamin D supplementation and height loss: findings from the Women’s Health Initiative calcium plus vitamin D clinical trial. Menopause. 2016;23(12):1277–86.

    Article  PubMed  PubMed Central  Google Scholar 

  118. Siminoski K, Jiang G, Adachi J, Hanley D, Cline G, Ioannidis G, Hodsman A, Josse R, Kendler D, Olszynski W. Accuracy of height loss during prospective monitoring for detection of incident vertebral fractures. Osteoporos Int. 2005;16(4):403–10.

    Article  CAS  PubMed  Google Scholar 

  119. Liu J, Ho SC, Su Y-X, Chen W-Q, Zhang C-X, Chen Y-M. Effect of long-term intervention of soy isoflavones on bone mineral density in women: a meta-analysis of randomized controlled trials. Bone. 2009;44(5):948–53.

    Article  CAS  PubMed  Google Scholar 

  120. Yang T-S, Wang S-Y, Yang Y-C, Su C-H, Lee F-K, Chen S-C, Tseng C-Y, Jou H-J, Huang J-P, Huang K-E. Effects of standardized phytoestrogen on Taiwanese menopausal women. Taiwan J Obstet Gynecol. 2012;51(2):229–35.

    Article  PubMed  Google Scholar 

  121. Marini H, Minutoli L, Polito F, Bitto A, Altavilla D, Atteritano M, Gaudio A, Mazzaferro S, Frisina A, Frisina N. Effects of the phytoestrogen genistein on bone metabolism in osteopenic postmenopausal women: a randomized trial. Ann Intern Med. 2007;146(12):839–47.

    Article  PubMed  Google Scholar 

  122. Arcoraci V, Atteritano M, Squadrito F, D’Anna R, Marini H, Santoro D, Minutoli L, Messina S, Altavilla D, Bitto A. Antiosteoporotic activity of genistein aglycone in postmenopausal women: evidence from a post-hoc analysis of a multicenter randomized controlled trial. Nutrients. 2017;9(2):179.

    Article  PubMed Central  CAS  Google Scholar 

  123. Howe TE, Rochester L, Neil F, Skelton DA, Ballinger C. Exercise for improving balance in older people. Cochrane Database Syst Rev. 2011;(11). http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004963.pub3/abstract.

  124. Karlsson MK, Magnusson H, von Schewelov T, Rosengren BE. Prevention of falls in the elderly—a review. Osteoporos Int. 2013;24(3):747–62.

    Article  CAS  PubMed  Google Scholar 

  125. Ambrose AF, Cruz L, Paul G. Falls and fractures: a systematic approach to screening and prevention. Maturitas. 2015;82(1):85–93.

    Article  PubMed  Google Scholar 

  126. Grossman DC, Curry SJ, Owens DK, Barry MJ, Caughey AB, Davidson KW, Doubeni CA, Epling JW, Kemper AR, Krist AH. Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;319(16):1696–704.

    Article  PubMed  Google Scholar 

  127. Kirkwood RN, de Souza MB, Mingoti SA, Faria BF, Sampaio RF, Resende RA. The slowing down phenomenon: what is the age of major gait velocity decline? Maturitas. 2018;115:31–6.

    Article  Google Scholar 

  128. Santos L, Elliott-Sale KJ, Sale C. Exercise and bone health across the lifespan. Biogerontology. 2017;18(6):931–46.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  129. Woodward MJ, Lu CW, Levandowski R, Kostis J, Bachmann G. The exercise prescription for enhancing overall health of midlife and older women. Maturitas. 2015;82(1):65–71.

    Article  PubMed  Google Scholar 

  130. Wu Y-T, Matthews FE, Brayne C. Dementia: time trends and policy responses. Maturitas. 2014;79(2):191–5.

    Article  PubMed  Google Scholar 

  131. Wu Y-T, Fratiglioni L, Matthews FE, Lobo A, Breteler MM, Skoog I, Brayne C. Dementia in western Europe: epidemiological evidence and implications for policy making. Lancet Neurol. 2016;15(1):116–24.

    Article  PubMed  Google Scholar 

  132. Blom K, Emmelot-Vonk MH, Koek HDL. The influence of vascular risk factors on cognitive decline in patients with dementia: a systematic review. Maturitas. 2013;76(2):113–7.

    Article  PubMed  Google Scholar 

  133. Haring B, Leng X, Robinson J, Johnson KC, Jackson RD, Beyth R, Wactawski-Wende J, von Ballmoos MW, Goveas JS, Kuller LH. Cardiovascular disease and cognitive decline in postmenopausal women: results from the Women’s Health Initiative Memory Study. J Am Heart Assoc. 2013;2(6):e000369.

    Article  PubMed  PubMed Central  Google Scholar 

  134. Staubo SC, Aakre JA, Vemuri P, Syrjanen JA, Mielke MM, Geda YE, Kremers WK, Machulda MM, Knopman DS, Petersen RC. Mediterranean diet, micronutrients and macronutrients, and MRI measures of cortical thickness. Alzheimers Dement. 2017;13(2):168–77.

    Article  PubMed  Google Scholar 

  135. Moore K, Hughes CF, Ward M, Hoey L, McNulty H. Diet, nutrition and the ageing brain: current evidence and new directions. Proc Nutr Soc. 2018;77(2):152–63.

    Article  PubMed  Google Scholar 

  136. Luciano M, Corley J, Cox SR, Hernández MCV, Craig LC, Dickie DA, Karama S, McNeill GM, Bastin ME, Wardlaw JM. Mediterranean-type diet and brain structural change from 73 to 76 years in a Scottish cohort. Neurology. 2017;88(5):449–55.

    Article  PubMed  PubMed Central  Google Scholar 

  137. Wu L, Sun D. Adherence to Mediterranean diet and risk of developing cognitive disorders: an updated systematic review and meta-analysis of prospective cohort studies. Sci Rep. 2017;7:41317.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  138. Psaltopoulou T, Sergentanis TN, Panagiotakos DB, Sergentanis IN, Kosti R, Scarmeas N. Mediterranean diet, stroke, cognitive impairment, and depression: a meta-analysis. Ann Neurol. 2013;74(4):580–91.

    Article  PubMed  Google Scholar 

  139. Valls-Pedret C, Sala-Vila A, Serra-Mir M, Corella D, De la Torre R, Martínez-González MÁ, Martínez-Lapiscina EH, Fitó M, Pérez-Heras A, Salas-Salvadó J. Mediterranean diet and age-related cognitive decline: a randomized clinical trial. JAMA Intern Med. 2015;175(7):1094–103.

    Article  PubMed  Google Scholar 

  140. Hodge A, Almeida OP, English DR, Giles GG, Flicker L. Patterns of dietary intake and psychological distress in older Australians: benefits not just from a Mediterranean diet. Int Psychogeriatr. 2013;25(3):456–66.

    Article  PubMed  Google Scholar 

  141. Samieri C, Morris M-C, Bennett DA, Berr C, Amouyel P, Dartigues J-F, Tzourio C, Chasman DI, Grodstein F. Fish intake, genetic predisposition to Alzheimer’s disease and decline in global cognition and memory in five cohorts of older persons. Am J Epidemiol. 2018;187(5):933–40.

    Article  PubMed  Google Scholar 

  142. Cederholm T. Fish consumption and omega-3 fatty acid supplementation for prevention or treatment of cognitive decline, dementia or Alzheimer’s disease in older adults–any news? Curr Opin Clin Nutr Metab Care. 2017;20(2):104–9.

    CAS  PubMed  Google Scholar 

  143. Andrieu S, Guyonnet S, Coley N, Cantet C, Bonnefoy M, Bordes S, Bories L, Cufi M-N, Dantoine T, Dartigues J-F. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol. 2017;16(5):377–89.

    Article  CAS  PubMed  Google Scholar 

  144. Soininen H, Solomon A, Visser PJ, Hendrix SB, Blennow K, Kivipelto M, Hartmann T, Hallikainen I, Hallikainen M, Helisalmi S. 24-month intervention with a specific multinutrient in people with prodromal Alzheimer’s disease (LipiDiDiet): a randomised, double-blind, controlled trial. Lancet Neurol. 2017;16(12):965–75.

    Article  PubMed  PubMed Central  Google Scholar 

  145. Annweiler C, Doineau L, Gerigne L, Provendier A, Karras SN, Beauchet O, Fantino B, Duval GT. Vitamin D and subjective memory complaint in community-dwelling older adults. Curr Alzheimer Res. 2018;15(7):664–70.

    Article  CAS  PubMed  Google Scholar 

  146. Aspell N, Lawlor B, O’Sullivan M. Is there a role for vitamin D in supporting cognitive function as we age? Proc Nutr Soc. 2018;77(2):124–34.

    Article  PubMed  Google Scholar 

  147. Marx W, Kelly JT, Marshall S, Cutajar J, Annois B, Pipingas A, Tierney A, Itsiopoulos C. Effect of resveratrol supplementation on cognitive performance and mood in adults: a systematic literature review and meta-analysis of randomized controlled trials. Nutr Rev. 2018;76(6):432–43.

    Article  PubMed  Google Scholar 

  148. Lamport DJ, Dye L, Wightman JD, Lawton CL. The effects of flavonoid and other polyphenol consumption on cognitive performance: a systematic research review of human experimental and epidemiological studies. Nutr Aging. 2012;1(1):5–25.

    Google Scholar 

  149. Marx W, Firth J, Lane M, Rocks T, Rusunen A, Loughman A, Lopresti A, Marshall S, Berk M, Sarris J, Jacka F, Dean O. The effect of saffron supplementation on symptoms of depression and anxiety: a systematic review and meta-analysis. Nutr Rev. 2019 May 28. pii:nuz023. https://doi.org/10.1093/nutrit/nuz023.

    Article  Google Scholar 

  150. Soni M, Orrell M, Bandelow S, Steptoe A, Rafnsson S, d’Orsi E, Xavier A, Hogervorst E. Physical activity pre-and post-dementia: English Longitudinal Study of Ageing. Aging Ment Health. 2017;17:1–7.

    Google Scholar 

  151. Mikkelsen K, Stojanovska L, Polenakovic M, Bosevski M, Apostolopoulos V. Exercise and mental health. Maturitas. 2017;106:48–56.

    Article  PubMed  Google Scholar 

  152. Shiue I. Gardening is beneficial for adult mental health: Scottish Health Survey, 2012–2013. Scand J Occup Ther. 2016;23(4):320–5.

    Article  PubMed  Google Scholar 

  153. Husk K, Lovell R, Garside R. Prescribing gardening and conservation activities for health and wellbeing in older people. Maturitas. 2018;110:A1–2.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Bond Institute of Health and Sport, Robina, QLD, Australia

    Skye Marshall

  2. University of Oxford, Oxford, UK

    Margaret Rees

  3. Faculty of Medicine, University of Glasgow, Glasgow, UK

    Margaret Rees

  4. Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA

    Margaret Rees

Authors
  1. Skye Marshall
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Margaret Rees
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Margaret Rees .

Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Zaragoza Facultad de Medicina, Zaragoza, Spain

    Faustino R. Pérez-López

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Marshall, S., Rees, M. (2019). Managing Menopause and Post-reproductive Health: Beyond Hormones and Medicines. In: Pérez-López, F. (eds) Postmenopausal Diseases and Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-13936-0_29

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-13936-0_29

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-13935-3

  • Online ISBN: 978-3-030-13936-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation