The role of physical activity in the relationship between menopausal status, physical performance and mental well-being

Abstract

Middle adulthood is often characterized by an onset of a decline in physiological functioning and fluctuations in mental well-being. However, it also represents a time of high functioning in many areas of life. Among women, menopausal status may explain these confusing views. This study investigates physical performance and mental well-being among middle-aged women in relation to their menopausal status. It also explores the role of physical activity in the relationship between menopausal status, physical performance, and mental well-being. The study utilized cross-sectional (n=1098) and longitudinal data (n=232) from the Estrogen Regulation of Muscle Apoptosis study, which involved Finnish (Jyväskylä area) women aged 47 to 55. Menopausal status (pre-, peri-, or postmenopause) was established by hormonal analysis and bleeding diaries. Perimenopausal women were followed-up until postmenopausal (mean follow-up time 15.6 months). Physical performance was assessed by muscle strength, muscle power, and walking. Positive (life satisfaction and positive affectivity) and negative (depressive symptoms and negative affectivity) dimensions of mental well-being and physical activity were assessed with questionnaires. Handgrip strength and muscle power were lower in postmenopausal women compared to premenopausal women. The longitudinal data indicated a decline in knee extension strength and muscle power. Postmenopausal women reported greater levels of depressive symptoms than premenopausal women. Higher levels of physical activity were associated with greater knee extension strength and walking distance among peri- and postmenopausal groups and greater muscle power irrespective of menopausal status. After their menopausal transition, women with higher levels of physical activity showed a greater increase in handgrip strength but a greater decline in knee extension strength and power than less physically active women. Higher levels of physical activity were associated with lower level of depressive symptoms and greater level of positive mental well-being irrespective of the menopausal status. Of the investigated physical performance measures, only six-minute walking distance had an independent positive association with positive mental well-being. High physical activity seems to enable a greater capacity to counteract the observed negative influence of the postmenopausal status on muscle strength and power and mental well-being. In addition, aerobic capacity related to physical performance has unique importance for positive mental well-being. Keywords: menopause, physical activity, physical performance, mental well-being