Skip to main content
SpringerLink
Log in

Exercise for Health for Early Postmenopausal Women

A Systematic Review of Randomised Controlled Trials

  • Review Article
  • Published:
Sports Medicine Aims and scope Submit manuscript

Abstract

Women who pass menopause face many changes that may lead to loss of health-related fitness (HRF), especially if sedentary. Many exercise recommendations are also relevant for early postmenopausal women; however, these may not meet their specific needs because the recommendations are based mainly on studies on men. We conducted a systematic review for randomised, controlled exercise trials on postmenopausal women (aged 50 to 65 years) on components of HRF. HRF consists of morphological fitness (body composition and bone strength), musculoskeletal fitness (muscle strength and endurance, flexibility), motor fitness (postural control), cardiorespiratory fitness (maximal aerobic power, blood pressure) and metabolic fitness (lipid and carbohydrate metabolism). The outcome variables chosen were: bodyweight; proportion of body fat of total bodyweight (F%); bone mineral density (BMD); bone mineral content (BMC); various tests on muscle performance, flexibility, balance and coordination; maximal oxygen consumption (V̇O2max); resting blood pressure (BP); total cholesterol (TC); high-density lipoprotein-cholesterol; low-density lipoprotein-cholesterol; triglycerides; blood glucose and insulin.

The feasibility of the exercise programme was assessed from drop-out, attendance and injury rates. Twenty-eight randomised controlled trials with 2646 participants were assessed. In total, 18 studies reported on the effects of exercise on bodyweight and F%, 16 on BMD or BMC, 11 on muscular strength or endurance, five on flexibility, six on balance or coordination, 18 on V̇O2max, seven on BP, nine on lipids and two studies on glucose an one on insulin. Based on these studies, early postmenopausal women could benefit from 30 minutes of daily moderate walking in one to three bouts combined with a resistance training programme twice a week. For a sedentary person, walking is feasible and can be incorporated into everyday life. A feasible way to start resistance training is to perform eight to ten repetitions of eight to ten exercises for major muscle groups starting with 40% of one repetition maximum. Resistance training initially requires professional instruction, but can thereafter be performed at home with little or no equipment as an alternative for a gym with weight machines. Warm-up and cool-down with stretching should be a part of every exercise session. The training described above is likely to preserve normal bodyweight, or combined with a weight-reducing diet, preserve BMD and increase muscle strength. Based on limited evidence, such exercise might also improve flexibility, balance and coordination, decrease hypertension and improve dyslipidaemia.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Table AI

Similar content being viewed by others

References

  1. Sowers MR, La Pietra M. Menopause: its epidemiology and potential association with chronic diseases. Epidemiol Rev 1995; 17: 287–302

    PubMed  CAS  Google Scholar 

  2. Pate RR, Pratt M, Blair SN, et al. Physical activity and health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995; 273: 402–7

    Article  PubMed  CAS  Google Scholar 

  3. American College of Sports Medicine (ACSM). Position stand on the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 1998; 30: 975–91

    Article  Google Scholar 

  4. Mosca L, Manson JAE, Sutherland SE, et al. AHA scientific statement: cardiovascular disease in women. Circulation 1997; 96: 2468–82

    Article  PubMed  CAS  Google Scholar 

  5. Mosca L, Grundy SM, Judelson D, et al. AHA/ACC Scientific statement: consensus panel statement: guide to preventive cardiology for women. Circulation 1999; 99: 2480–4

    Article  PubMed  CAS  Google Scholar 

  6. Jakicic JM, Clark K, Coleman E, et al. Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc 2001; 33: 2145–57

    Article  PubMed  CAS  Google Scholar 

  7. National Institutes of Health (NIH). Consensus Conference: osteoporosis: factors contributing to osteoporosis. J Nutr 1986; 116: 316–9

    Google Scholar 

  8. American College of Sports Medicine (ACSM). Position stand on physical activity, physical fitness and hypertension. Med Sci Sports Exerc 1993; 25(10): i–x

    Google Scholar 

  9. American College of Sports Medicine (ACSM). Position stand on exercise and physical activity for older adults. Med Sci Sports Exerc 1998; 30: 992–1008

    Article  Google Scholar 

  10. Hollmann W. Changes in the capacity for maximal and continuous effort in relation to age. In: Jokl E, Simon E, editors. International research in sport and physical education. Springfield (IL): C.C. Thomas, 1964: 369–71

    Google Scholar 

  11. Kilbom A, Åstrand I. Physical training with submaximal intensities in women II: effect in cardiac output. Scand J Clin Lab Invest 1971; 28: 163–75

    Article  PubMed  CAS  Google Scholar 

  12. Willmore JH, Costill DL. Physiology of sport and exercise. Champaign (IL): Human Kinetics, 1994

    Google Scholar 

  13. Wasserman K, Hansen JE, Sue DY, et al. In: Weinberg R, editor. Principles of exercise testing and interpretation including pathophysiology and clinical applications. Baltimore (MD): Lippincott Williams & Wilkins, 1999

  14. Bouchard C, Shephard RJ. Physical activity, fitness, and health: the model and key concepts. In: Bouchard C, Shephard RJ, Stephens T, editors. Physical activity, fitness, and health. Champaign (IL): Human Kinetics, 1994: 77–88

    Google Scholar 

  15. Sackett DL, Straus SE, Richardson WS, et al. Evidence-based medicine: how to practice and teach EBM. 2nd ed. London: Churchill Livingston, 2000

    Google Scholar 

  16. Cowan MM, Gregory LW. Responses of pre- and post-menopausal females to aerobic conditioning. Med Sci Sports Exerc 1985; 17: 138–43

    PubMed  CAS  Google Scholar 

  17. Elliott KJ, Sale C, Cable NT. Effects of resistance training and detraining on muscle strength and blood lipid profiles in postmenopausal women. Br J Sports Med 2002; 36: 340–5

    Article  PubMed  CAS  Google Scholar 

  18. Grove KA, Londeree BR. Bone density in postmenopausal women: high impact vs low impact exercise. Med Sci Sports Exerc 1992; 24: 1190–4

    PubMed  CAS  Google Scholar 

  19. King A, Haskell WL, Young DR, et al. Long-term effects of varying intensities and formats of physical activity on participation rates, fitness, and lipoproteins in men and women aged 50 to 65 years. Circulation 1995; 91: 2596–604

    Article  PubMed  CAS  Google Scholar 

  20. Iwamoto J, Takeda T, Ichimura S. Effect of exercise training and detraining on bone mineral density in postmenopausal women with osteoporosis. J Orthop Sci 2001; 6: 128–32

    Article  PubMed  CAS  Google Scholar 

  21. Moreau KL, Degarmo R, Langley J, et al. Increasing daily walking lowers blood pressure in postmenopausal women. Med Sci Sports Exerc 2001; 33: 1825–31

    Article  PubMed  CAS  Google Scholar 

  22. Ready AE, Drinkwater DT, Ducas J, et al. Walking reduces elevated cholesterol in women postmenopause. Can J Cardiol 1995; 11: 905–12

    PubMed  CAS  Google Scholar 

  23. Revel M, Mayoux-Benhamou MA, Rabourdin JP, et al. One-year psoas training can prevent lumbar bone loss in postmenopausal women: a randomized controlled trial. Calcif Tissue Int 1993; 53: 307–11

    Article  PubMed  CAS  Google Scholar 

  24. Smidt GL, Shen-Yu L, O’Dwyer KD, et al. The effect of high-intensity trunk exercise on bone mineral density of postmenopausal women. Spine 1992; 17: 280–5

    Article  PubMed  CAS  Google Scholar 

  25. Staffileno BA, Braun LT, Rosensen RS. The accumulative effects of physical activity in hypertensive postmenopausal women. J Cardiovasc Risk 2001; 8: 283–90

    Article  PubMed  CAS  Google Scholar 

  26. Toobert DJ, Glasgow RE, Radcliffe JL. Physiological and related behavioural outcomes from the Womens Lifestyle Heart Trial. Ann Behav Med 2000; 22: 1–9

    Article  PubMed  CAS  Google Scholar 

  27. Verity LS, Ismail AH. Effects of exercise on cardiovascular disease risk in women with NIDDM. Diabetes Res 1989; 6: 27–35

    Article  CAS  Google Scholar 

  28. De Vito G, Bernardi M, Forte R, et al. Effects of a low-intensity conditioning programme on V̇O2max and maximal instantaneous peak power in elderly women. Eur J Appl Physiol 1999; 80: 227–32

    Article  Google Scholar 

  29. Asikainen T-M, Miilunpalo S, Oja P, et al. Walking trials in postmenopausal women: effect of one vs two daily bouts on aerobic fitness. Scand J Med Sci Sports 2002; 12: 99–105

    Article  PubMed  Google Scholar 

  30. Asikainen T-M, Miilunpalo S, Oja P, et al. Randomized, controlled walking trials in postmenopausal women: the minimum dose to improve aerobic fitness? Br J Sports Med 2002; 36: 189–94

    Article  PubMed  Google Scholar 

  31. Bassey EJ, Rothwell MC, Littlewood JJ, et al. Pre- and postmenopausal women have different bone mineral density responses to the same high-impact exercise. J Bone Miner Res 1998; 13: 1805–13

    Article  PubMed  CAS  Google Scholar 

  32. Bemben DA, Fetters NL, Bemben MG, et al. Musculoskeletal responses to high- and low-intensity resistance training in early postmenopausal women. Med Sci Sports Exerc 2000; 32: 1949–57

    Article  PubMed  CAS  Google Scholar 

  33. Bravo G, Gauthier P, Roy P-M, et al. Impact of a 12-month exercise program on the physical and psychological health in osteopenic women. J Am Geriatr Soc 1996; 44: 756–62

    PubMed  CAS  Google Scholar 

  34. Brooke-Wavell K, Jones PR, Hardman AE. Brisk walking reduces calcaneal bone loss in post-menopausal women. Clin Sci (Lond) 1997; 92: 75–80

    CAS  Google Scholar 

  35. Chow R, Harrison JE, Notarius C. Effect of two randomized exercise programmes on bone mass of healthy postmenopausal women. BMJ 1987; 295: 1441–4

    Article  PubMed  CAS  Google Scholar 

  36. Milliken LA, Going SB, Houtkooper LB, et al. Effects of exercise training on bone remodelling, insulin-like growth factors, and bone mineral density in postmenopausal women with and without hormone replacement therapy. Calcif Tissue Int 2003; 72: 478–84

    Article  PubMed  CAS  Google Scholar 

  37. Cussler EC, Lohman TG, Going SB, et al. Weight lifted in strength training predicts bone change in postmenopausal women. Med Sci Sports Exerc 2003; 35: 10–7

    Article  PubMed  Google Scholar 

  38. Hamdorf PA, Withers RT, Penhall RK, et al. Physical training effects on the fitness and habitual activity patterns of elderly women. Arch Phys Med Rehabil 1992; 73: 603–8

    PubMed  CAS  Google Scholar 

  39. Hatori M, Hasegawa A, Adachi H, et al. The effects of walking at the anaerobic threshold level on vertebral bone loss in postmenopausal women. Calcif Tissue Int 1993; 52: 411–4

    Article  PubMed  CAS  Google Scholar 

  40. Heikkinen J, Kyllonen E, Kurttila-Matero E, et al. HRT and exercise: effects on bone density, muscle strength and lipid metabolism: a placebo controlled 2-year prospective trial on two estrogen-progestin regimens in healthy postmenopausal women. Maturitas 1997; 26: 139–49

    Article  PubMed  CAS  Google Scholar 

  41. Heinonen A, Oja P, Sievanen H, et al. Effect of two training regimens on bone mineral density in healthy perimenopausal women: a randomized, controlled trial. J Bone Miner Res 1998; 13: 483–90

    Article  PubMed  CAS  Google Scholar 

  42. Hopkins DR, Murrah B, Hoeger WW, et al. Effect of low-impact dance on the functional fitness of elderly women. Gerontologist 1990; 30: 189–92

    Article  PubMed  CAS  Google Scholar 

  43. Irwin ML, Yasui Y, Cornelia MU. Effects of exercise on total and intra-abdominal body fat in postmenopausal women: a randomized controlled trial. JAMA 2003; 289: 323–30

    Article  PubMed  Google Scholar 

  44. Kerr D, Ackland T, Maslen B. Resistance training over 2 year increases bone mass in calcium-replete postmenopausal women. J Bone Miner Res 2001; 16: 175–81

    Article  PubMed  CAS  Google Scholar 

  45. King AC, Haskell WL, Taylor CB, et al. Group- vs home-based exercise training in healthy older men and women: a community-based clinical trial. JAMA 1991; 266: 1535–42

    Article  PubMed  CAS  Google Scholar 

  46. Lindheim SR, Notelovitz M, Feldman EB, et al. The independent effects of exercise and estrogen on lipids and lipoproteins in postmenopausal women. Obstet Gynecol 1994; 83: 167–72

    PubMed  CAS  Google Scholar 

  47. Mitchell SL, Grant S, Aitchison T. Physiological effects of exercise on post-menopausal osteoporotic women. Physiotherapy 1998; 84: 157–63

    Article  Google Scholar 

  48. Nelson ME, Fiatarone MA, Morganti CM, et al. Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures. JAMA 1994; 272: 1909–14

    Article  PubMed  CAS  Google Scholar 

  49. Nelson ME, Fiatarone MA, Layne JE, et al. Analysis of body-composition techniques and models for detecting change in soft tissue with strength training. Am J Clin Nutr 1996; 63: 678–86

    PubMed  CAS  Google Scholar 

  50. Ready E, Naimark B, Ducas J, et al. Influence of walking volume on health benefits in women post-menopause. Med Sci Sports Exerc 1996; 28(9): 1097–105

    Article  PubMed  CAS  Google Scholar 

  51. Shinkai S, Watanabe S, Kurokawa Y. Effects of 12 weeks of aerobic exercise plus dietary restriction on body composition, resting energy expenditure and aerobic fitness in mildly obese middle-aged women. Eur J Appl Physiol 1994; 68: 258–65

    Article  CAS  Google Scholar 

  52. Sinaki M, Wahner H, Offord K, et al. Efficacy of nonloading exercises in prevention of vertebral bone loss in postmenopausal women: a controlled trial. Mayo Clin Proc 1989; 64: 762–9

    Article  PubMed  CAS  Google Scholar 

  53. Suominen H, Taaffe DR, Ollikainen S, et al. Additive effects of high-impact physical exercise and estrogen replacement therapy on calcaneal bone mineral density in postmenopausal women: a randomized placebo-controlled study [abstract]. J Bone Miner Res 1999; 14: S185

    Google Scholar 

  54. Cheng S, Sipila S, Taaffe DR. Change in bone mass distribution induced by hormone replacement therapy and high-impact physical exercise in post-menopausal women. Bone 2002; 31: 126–35

    Article  PubMed  CAS  Google Scholar 

  55. Stefanic ML, Mackey S, Sheehan M, et al. Effects of diet and exercise in men and postmenopausal women with low levels of HDL cholesterol and high levels of LDL cholesterol. N Engl J Med 1998; 339: 12–20

    Article  Google Scholar 

  56. Svendsen OL, Hassanger C, Christiansen C. Effect of energy-restrictive diet, with or without exercise, on lean tissue mass, resting metabolic rate, cardiovascular risk factors, and bone in overweight postmenopausal women. Am J Med 1993; 95: 131–40

    Article  PubMed  CAS  Google Scholar 

  57. Uusi-Rasi K, Kannus P, Cheng S, et al. Effect of Alendronate and exercise on bone and physical performance of postmenopausal women. Bone 2003; 33: 132–43

    Article  PubMed  CAS  Google Scholar 

  58. Kyllonen ES, Heikkinen JE, Vaananen HK. Influence of es-trogen-progestin replacement therapy and exercise on lumbar spine mobility and low back symptoms in healthy early postmenopausal female population: a 2-year randomized, controlled trial. Eur Spine J 1998; 7: 381–6

    Article  PubMed  CAS  Google Scholar 

  59. Morganti CM, Nelson ME, Fiatarone MA, et al. Strength improvements with 1 yr of progressive resistance training in older women. Med Sci Sports Exerc 1995; 27: 906–12

    PubMed  CAS  Google Scholar 

  60. Itoi E, Sinaki M. Effect of back-strengthening exercise on posture in healthy women 49 to 65 years of age. Mayo Clin Proc 1994; 69: 1054–9

    Article  PubMed  CAS  Google Scholar 

  61. Sipila S, Taaffe DR, Cheng S, et al. Effects of hormone replacement therapy and high-impact physical exercise on skeletal muscle in post-menopausal women: a randomized, controlled study. Clin Sci (Lond) 2001; 101: 147–57

    Article  CAS  Google Scholar 

  62. Busby J, Notelovitz M, Putney K, et al. Exercise, high-density lipoprotein-cholesterol, and cardiorespiratory function in climacteric women. South Med J 1988; 7: 769–73

    Google Scholar 

  63. Asikainen T-M, Miilunpalo S, Kukkonen-Harjula K, et al. Walking trials in postmenopausal women: effect of low doses of exercise and exercise fractionization on coronary risk factors. Scand J Med Sci Sports 2003; 13: 284–92

    Article  PubMed  Google Scholar 

  64. Woolf-May K, Kearney EM, Owen A, et al. The efficacy of accumulated short bouts versus single daily bouts of brisk walking in improving aerobic fitness and blood lipid profiles. Health Educ Res 1999; 14: 803–14

    Article  PubMed  CAS  Google Scholar 

  65. Jadad AR, Moore RA, Carron DC, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 1996; 17: 1–12

    Article  PubMed  CAS  Google Scholar 

  66. Schulz KF, Chalmers I, Hayes RJ, et al. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995; 273: 408–12

    Article  PubMed  CAS  Google Scholar 

  67. Guyatt GH, Sackett DL, Cook DJ. Users’ guides to medical literature II: how to use an article about therapy or prevention A: are the results of the study valid? JAMA 1993; 270: 2598–601

    Article  PubMed  CAS  Google Scholar 

  68. Guyatt GH, Sackett DL, Cook DJ. Users’ guides to the medical literature II: how to use an article about therapy or prevention B: what were the results and will they help me in caring for my patients? JAMA 1994; 271: 59–63

    Article  PubMed  CAS  Google Scholar 

  69. Oxman AD, Cook DJ, Guyatt GH. Users’ guides to the medical literature VI: how to use an overview. JAMA 1994; 272: 1367–71

    Article  PubMed  CAS  Google Scholar 

  70. Oxman AD, Sackett DL, Guyatt GH. Users’ guides to the medical literature I: how to get started. JAMA 1993; 270: 2093–5

    Article  PubMed  CAS  Google Scholar 

  71. Oja P. Intensity and frequency of physical conditioning as determinants of the cardiovascular response of middle-aged men at rest and during exercise [dissertation]. State College (PA): The Pennsylvania State University, 1973

    Google Scholar 

  72. King AC, Haskell WL, Young DR, et al. Long-term effects of varying intensities and formats of physical activity on participation rates, fitness, and lipoproteins in men and women aged 50 to 65 Years. Circulation 1995; 91: 2596–604

    Article  PubMed  CAS  Google Scholar 

  73. Fogelholm M, Kukkonen-Harjula K. Does exercise training prevent weight gain: a systematic review. Obes Rev 2000; 1: 95–111

    Article  PubMed  CAS  Google Scholar 

  74. Rantanen T. Muscle strength, disability and mortality. Scand J Med Sci Sports 2003; 13: 3–8

    Article  PubMed  CAS  Google Scholar 

  75. Herbert RD, Gabriel M. Effects of stretching before and after exercising on muscle soreness and risks of injury: systematic review. BMJ 2002; 325: 468–70

    Article  PubMed  Google Scholar 

  76. Kannus P, Khan KM. Prevention of falls and subsequent injuries in elderly people: a long way to go in both research and practice. CMAJ 2001; 165: 587–8

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The writers want to express warm thanks to Ms Birgitta Järvinen, M.A., and Ms Outi Ansamaa at the library of UKK Institute. Also warm thanks to Ms Päivi Viitanen for preparing the tables.

The authors received no extra funding for preparation of this review and have no conflicts of interests relevant to the contents of this review.

Author information

Authors and Affiliations

  1. UKK Institute for Health Promotion Research, Tampere, Finland

    Tuula-Maria Asikainen, Katriina Kukkonen-Harjula & Seppo Miilunpalo

  2. Department of Clinical Physiology, Satakunta Central Hospital, Sairaalantie 3, Pori, FIN-28500, Finland

    Tuula-Maria Asikainen

Authors
  1. Tuula-Maria Asikainen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katriina Kukkonen-Harjula
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Seppo Miilunpalo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tuula-Maria Asikainen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Asikainen, TM., Kukkonen-Harjula, K. & Miilunpalo, S. Exercise for Health for Early Postmenopausal Women. Sports Med 34, 753–778 (2004). https://doi.org/10.2165/00007256-200434110-00004

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-200434110-00004

Keywords

Search

Navigation