There is strong evidence to suggest that increased levels of physical activity led to lower increases in weight and preserved or increased muscle mass throughout the menopause.
A literature review of the evidence found three prospective cohort studies and one non-randomised intervention study which showed an inverse association between physical activity and weight gain (1).
A longitudinal cohort study in Finland found that those who undertook increased levels of physical activity preserved more of their lean muscle mass than those who were sedentary (2). This was independent of the form of exercise undertaken.
There are multiple randomised controlled trials examining the effect of resistance training on weight and muscle mass in menopausal women. These trials, consisting of varying programs (8-16 weeks) of three to five times a week resistance training for thirty to sixty minutes, all showed a significant decrease in body fat percentage and increased muscle strength and endurance (3,4,5,6,7).
A yearlong randomised control trial with sixty minutes of aerobic exercise five times a week demonstrated a significant improvement in body mass index in post-menopausal women (8). This is further supported by both cross-sectional and longitudinal studies which showed those post-menopausal who were more active had lower body mass indexes and lower levels of weight gain (9,10).
However, the type, timing, dose and frequency of physical activity to best manage a post or peri-menopausal woman’s weight has not been fully determined.
Quality of Evidence
Quality of Evidence: Grade A – a literature review and RCTs consistently support physical activity as a mode of promoting weight loss and increasing muscle mass in menopausal women.
Strength of Recommendation
Strength of Recommendation: Grade 1 – multiple RCTs and literature review
Physical activity should be promoted as a way of limiting weight gain and loss of muscle mass during the menopausal period or as an adjunct to nutrition in aiding weight loss. The form of physical activity that is most effective has not yet been determined but both aerobic and resistance training appear to have a good effect on body composition.
- Pettee Gabriel, K., Mason, J. and Sternfeld, B., 2015. Recent evidence exploring the associations between physical activity and menopausal symptoms in midlife women: perceived risks and possible health benefits. Women’s Midlife Health, 1(1).
- Juppi, H. K., Sipila, S., Cronin, N. J., Karvinen, S., Karppinen, J. E., Tammelin, T. H., Aukee, P., Kovanen, V., Kujala, U. M. and Laakkonen, E. K. (2020) ‘Role of Menopausal Transition and Physical Activity in Loss of Lean and Muscle Mass: A Follow-Up Study in Middle-Aged Finnish Women’, Journal of Clinical Medicine, 9(5).
- Carneiro, M. A. S., de Oliveira, G. N., de Sousa, J. F. R., Orsatti, C. L., Murta, E. F. C., Michelin, M. A., Cyrino, E. S. and Orsatti, F. L. (2021) ‘Effect of whole-body resistance training at different load intensities on circulating inflammatory biomarkers, body fat, muscular strength, and physical performance in postmenopausal women’, Applied Physiology Nutrition and Metabolism, 46(8), pp. 925-933.
- Neves, L. M., Fortaleza, A. C., Rossi, F. E., Diniz, T. A., Codogno, J. S., Gobbo, L. A., Gobbi, S. and Freitas, I. F. (2017) ‘Functional training reduces body fat and improves functional fitness and cholesterol levels in postmenopausal women: a randomized clinical trial’, Journal of Sports Medicine and Physical Fitness, 57(4), pp. 448-+.
- Bonganha, V., Modeneze, D. M., Madruga, V. A. and Vilarta, R. (2012) ‘Effects of resistance training (RT) on body composition, muscle strength and quality of life (QoL) in postmenopausal life’, Archives of Gerontology and Geriatrics, 54(2), pp. 361-365.
- Valeh, S., Fatolahi, H. and Azarbayjani, M. A. (2020) ‘Effect of eight weeks of low, moderate, and high-intensity TRX training on hot flashes, mood, fat percentage, and muscular endurance in postmenopausal women’, Apunts-Medicina De L Esport, 55(207), pp. 97-103.
- Nunes, P. R. P., Barcelos, L. C., Oliveira, A. A., Furlanetto, R., Martins, F. M., Orsatti, C. L., Resende, E. and Orsatti, F. L. (2016) ‘Effect of resistance training on muscular strength and indicators of abdominal adiposity, metabolic risk, and inflammation in postmenopausal women: controlled and randomized clinical trial of efficacy of training volume’, Age, 38(2).
- Courneya, K. S., McNeil, J., O’Reilly, R., Morielli, A. R. and Friedenreich, C. M. ‘Dose-Response Effects of Aerobic Exercise on Quality of Life in Postmenopausal Women: results from the Breast Cancer and Exercise Trial in Alberta (BETA)’.
- Kroemeke, A., Zajac-Gawlak, I., Pospiech, D., Gaba, A., Pridalova, M. and Pelclova, J. (2014) ‘Postmenopausal obesity: 12,500 steps per day as a remedy? Relationships between body composition and daily steps in postmenopausal women’, Menopause Review-Przeglad Menopauzalny, 13(4), pp. 227-232.
- Sims, S. T., Larson, J. C., Lamonte, M. J., Michael, Y. L., Martin, L. W., Johnson, K. C., Sarto, G. E. and Stefanick, M. L. (2012) ‘Physical Activity and Body Mass: Changes in Younger versus Older Postmenopausal Women’, Medicine and Science in Sports and Exercise, 44(1), pp. 89-97.
- Canario, A. C. G., Cabral, P. U., Spyrides, M. H., Giraldo, P. C., Eleuterio, J. and Goncalves, A. K. (2012) ‘The impact of physical activity on menopausal symptoms in middle-aged women’, International Journal of Gynecology & Obstetrics, 118(1), pp. 34-36.
- Glouzon, B. K. J., Barsalani, R., Lagace, J. C. and Dionne, I. J. (2015) ‘Muscle mass and insulin sensitivity in postmenopausal women after 6-month exercise training’, Climacteric, 18(6), pp. 846-851.
- Marin-Cascales, E., Alcaraz, P. E., Ramos-Campo, D. J. and Rubio-Arias, J. A. (2018) ‘Effects of multicomponent training on lean and bone mass in postmenopausal and older women: a systematic review’, Menopause-the Journal of the North American Menopause Society, 25(3), pp. 346-356.
- Yeh, M., Liao, R., Hsu, C., Chung, Y. and Lin, J., 2018. Exercises improve body composition, cardiovascular risk factors and bone mineral density for menopausal women: A systematic review and meta-analysis of randomized controlled trials. Applied Nursing Research, 40, pp.90-98.