Walking off Postmenopausal Decreases in bone mineral density, aerobic fitness, muscle strength, and balance

Researchers writing in the medical journal Physical Therapy say that “Menopause may induce a phase of rapid decreases in bone mineral density, aerobic fitness, muscle strength, and balance, especially in sedentary women.”
Asikainen TM, Suni JH, Pasanen ME, Oja P, Rinne MB, Miilunpalo SI, Nygard CH, Vuori IM.

Effect of brisk walking in 1 or 2 daily bouts and moderate resistance training on lower-extremity muscle strength, balance, and walking performance in women who recently went through menopause: a randomized, controlled trial. Phys Ther. 2006 Jul;86(7):912-23.

From the article abstract:
BACKGROUND AND PURPOSE: Menopause may induce a phase of rapid decreases in bone mineral density, aerobic fitness, muscle strength, and balance, especially in sedentary women. The purpose of this study was to examine the effects and feasibility of an exercise program of 1 or 2 bouts of walking and resistance training on lower-extremity muscle strength (the force-generating capacity of muscle), balance, and walking performance in women who recently went through menopause.

SUBJECTS AND METHODS: The subjects were 134 women who recently went through menopause. The study was a 15-week, randomized, controlled trial with continuous and fractionated exercise groups. The outcomes assessed were lower-extremity muscle strength, balance, and walking time over 2 km. Feasibility was assessed by questionnaires, interviews, and training logs.

RESULTS: One hundred twenty-eight women completed the study. Adherence to the study protocol was 92%. Both continuous and fractionated exercise groups improved equally in lower-extremity muscle strength and walking time but not in balance. Almost 70% of the subjects considered the program to be feasible. Two daily walking sessions caused fewer lower-extremity problems than did continuous walking.

DISCUSSION AND CONCLUSION: Brisk walking combined with moderate resistance training is feasible and effective. Fractionating the walking into 2 daily sessions is more feasible than continuous walking.

Postmenopause and Cognitive Performance

Researchers writing in the medical journal Maturitas look into the nature of cognitive decline across a range of functions within a period of 5 years from early to late postmenopausal stage.

Elsabagh S, Hartley DE, File SE. Cognitive function in late versus early postmenopausal stage.
Maturitas. 2007 Jan 20;56(1):84-93.

CONCLUSIONS: Although there were no differences in attention, verbal fluency and memory, executive function was significantly poorer in the late postmenopausal stage women, suggesting that this aspect of cognition deteriorates more rapidly than other functions. This change was independent of change in age, suggesting that hormonal changes between the early and late postmenopausal stages may be responsible.

Cognitive Function

Eating Fish Slows Aging of the Brain
In brief, researchers looked at people 65 years of age and over to see if intakes of fish and omega-3 fatty acids protected against “age-related cognitive decline.”

Green Tea and Cognitive Function
Researchers writing in the American Journal of Clinical Nutrition say that green tea consumption can improve cognitive function. The researchers measured the effects of drinking 3 cups a week, 4 to 6 cups a week, and two cups a day.

Poor Sleep and Cognitive Function
Researchers writing in the medical journal The Journals of Gerontology Series A: Biological Sciences and Medical Sciences say that Disturbed Sleep was related to poorer cognition.

Nutrition in Brain Development and Aging: Role of Essential Fatty Acids
Researchers writing in the the medical journal Nutrition Reviews say that essential fatty acids (EFAs) are increasingly seen to be of value in limiting the cognitive decline during aging.

Physical Function and Future Dementia
Medical researchers writing in the medical journal the Archives of Internal Medicine say that “Lower levels of physical performance were associated with an increased risk of dementia and AD (Alzheimer’s Disease)

Postmenopause and Cognitive Performance
Researchers writing in the medical journal Maturitas look into the nature of cognitive decline across a range of functions within a period of 5 years from early to late postmenopausal stage.

Low Estradiol Levels and Cognitive Function
Researchers writing in the medical journal Neurobiology of Aging, say that “Older women with low estradiol levels were more likely to experience decline in global cognitive function and verbal memory, and a similar trend was observed for verbal memory in men.”

Women With Higher Levels of Estrogen Have Prettier Faces

Researchers at the University of St. Andrews in Scotland announced that women who had higher amounts of estrogen in their urine were found to be more attractive than women who had lesser amounts. READ IT HERE

 

Menopause and Heart Disease

Researchers writing in the medical journal Climacteric say that “an ideal hormone replacement therapy that can overcome hypertension, prevent body weight gain and control serum triglycerides offers an important advance in cardiovascular risk management during the menopause.”

Rosano GM, Vitale C, Tulli A. Managing cardiovascular risk in menopausal women.Rosano GM, Vitale C, Tulli A. Climacteric. 2006 Sep;9(5):19-27

From the article abstract:
“Blood pressure control and prevention of glucose intolerance are primary factors in overcoming the increased cardiovascular risks in menopausal women.

This heightened risk may partially be explained by the metabolic syndrome – a precursor of type 2 diabetes – in which the renin-angiotensin-aldosterone system may play a pivotal role.

Once diabetes occurs, the cardiovascular risk is considerably greater in postmenopausal women than in men – especially if hypertension is also present.

An additional risk factor, weight gain, is common in postmenopausal women not treated with hormone replacement therapy.

Rigorous control of blood pressure has been shown to be particularly beneficial in women with metabolic syndrome; a reduction in blood pressure can reduce the mortality rate of ischemic stroke.

The administration of hormone replacement therapy can also reduce the likelihood of coronary heart disease in postmenopausal women; therefore therapy should be started early in the menopausal transition to maximize cardiovascular protection. As such, an ideal hormone replacement therapy that can overcome hypertension, prevent body weight gain and control serum triglycerides offers an important advance in cardiovascular risk management during the menopause.”

Hot Flashes and Sleep

Researchers writing in the medical journal Menopause say that ambient temperature and REM sleep patterns effect sleep in postmenopausal women.

Freedman RR, Roehrs TA.Effects of REM sleep and ambient temperature on hot flash-induced sleep disturbance. Menopause. 2006 Jul-Aug;13(4):576-83.

From the study abstract:
OBJECTIVE:: To determine whether hot flashes produce sleep disturbance in postmenopausal women.

DESIGN:: This study was performed in a university medical center laboratory with 18 postmenopausal women with hot flashes, six with no hot flashes, and 12 cycling women, all healthy and medication free. Polysomnography, skin and rectal temperatures, and skin conductance to detect hot flashes were recorded for four nights.

Nights 2, 3, and 4 were run at 30 degrees C (86 degrees F), 23 degrees C (about 73.5 degrees F), and 18 degrees C (about 64.5 degrees F) in randomized order.

RESULTS:: During the first half of the night, the women with hot flashes had significantly more arousals and awakenings than the other two groups and the 18 degrees C ambient temperature (about 64.5 degrees F) significantly reduced the number of hot flashes.

These effects did not occur in the second half of the night. In the first half of the night, most hot flashes preceded arousals and awakenings. In the second half, this pattern was reversed.

CONCLUSIONS: In the second half of the night, rapid eye movement sleep suppresses hot flashes and associated arousals and awakenings. This may explain previous discrepancies between self-reported and laboratory-reported data in postmenopausal women with hot flashes.

Maintaining Muscle Strength May Counteract Postmenopausal Bone Loss

Sirola J, Rikkonen T, Tuppurainen M, Honkanen R, Jurvelin JS, Kroger H. Maintenance of muscle strength may counteract weight-loss-related postmenopausal bone loss-a population-based approach. Osteoporos Int. 2006 Feb 21.

Researchers writing in the medical journal Osteoporosis International say that maintaining muscle strength may counteract postmenopausal bone loss related to weight loss and that exercise that improves muscle strength may be encouraged for postmenopausal women with weight loss intentions for other health reasons.

From the study abstract:
INTRODUCTION: “Weight loss significantly increases postmenopausal bone loss, but the effects of muscle strength change on weight-loss-associated bone loss remain unclear. The study population, 587 peri- and postmenopausal women, was a random sample of the original Osteoporosis Risk Factor and Prevention Study (OSTPRE) study cohort in Kuopio, Finland.

Bone mineral density (BMD) at the lumbar spine (LS) and femoral neck (FN) was measured with dual x-ray absorptiometry, and grip strength was measured with a pneumatic squeeze dynamometer at baseline in 1989-1991 and at the 10-year follow-up in 1999-2001.

METHODS: Women were divided into three groups according to change in age-grouped grip-strength quartile in both of the measurements: “decreased”, “maintained” , and “improved”.

In addition, the study sample was divided into two groups according to weight change during the follow-up: weight losers and weight gainers.

RESULTS: There were no differences in the change status of grip (muscle) strength between the weight loss and weight gain groups.

Women losing weight during the follow-up and within the improved grip-strength-change group had a significantly lower bone loss rate compared with those in the maintained and decreased grip-strength-change groups.

This was in contrast to women who gained weight during the follow-up (not significant between any grip-strength-change groups). Furthermore, women who lost body weight and were in the improved grip-strength-change group had a bone loss rate comparable with that of the women who gained body weight (not significant).

CONCLUSION: The present study suggests that maintaining muscle strength may counteract postmenopausal bone loss related to weight loss. Accordingly, exercise that improves muscle strength may be encouraged for postmenopausal women with weight loss intentions for other health reasons.”

Menopause and Peri-Menopause Blog

Question from Radio Show Caller
Caller: I entered menopause or peri-menopause just a few years ago, I found some things that worked for me, and now they are no longer working even though I am on bio-identical hormones. I started having the nights sweats, the fatigue, moodiness and things like that. I have tried several estrogens and several different things. So far, no luck, meaning I am experiencing those symptoms still, and I have occasional periods. What do I do?

Dr. Darrow: You need to get your hormone levels checked. If you have occasional periods then you are still peri-menopausal, which is the most difficult phase, because at that stage your ovaries are erratically putting out different amounts of hormones, it is very tough at that stage to really get someone on track.

Progesterone is probably the most important thing that you can have in your system because it is a relaxant, it modulates the amount of estrogen so you don’t get it too high, like those months that you are flaring with estrogen and probably moody and feeling a little bit out of whack and retaining fluids, etc.

The way I like people to take Progesterone is by pill just before they go to sleep, I give it to men and women. For women, it is the most relaxing of all the hormones, it also helps build bone. I don’t know if you had a bone densitometry taken recently but it is something that is very important, if you need one you can always call our clinic because that tells the tale right there if you have enough estrogen, testosterone and progesterone because those hormones build up the bone structure, it is most important to maintain the bones, because if the bones are demineralizing, there is a risk of fracture.

You need to have your hormone levels checked. You also need to have very adequate levels of testosterone, not the levels that a man has, but the upper levels that a strong young women has and if you are peri-menopausal, I am not sure how old you are.

Caller: I am 54

Dr. Darrow: Then your Testosterone level has probably dropped down to nothing, it does for most women, and that, in it of itself, once supplemented, can bring you back into alignment. It is also good for the libido and quality of life and the ability to accomplish things.

Estrogen Selected Research

Estrogen and Women’s Heart Disease
Grodstein F, Stampfer MJ. Estrogen for women at varying risk of coronary disease. Maturitas 1998;30:19-26.

Study: Researchers cited that estrogen was beneficial for heart disease risk. “However, few studies have assessed the impact of estrogen use among women with a distinctly higher cardiovascular risk.”

The researchers stated: “Analysis of the effect of estrogen within different risk factor categories in the 16-year follow up of the Nurses’ Health Study confirms that although relevant risk estimates are highly similar, the magnitude of the protective effect of estrogen is more pronounced among women with high baseline risk of disease.”

Estrogen, Depression, and Blood Pressure

Canada SA, Hofkamp M, Gall EP, et al. Estrogen replacement therapy, subsyndromal depression, and orthostatic blood pressure regulation. Behav Med. 2003;29:101-106.

Study: From the abstract: “Although estrogen replacement therapy (ERT) alleviates depressed moods in postmenopausal women, it is not known whether ERT is equally effective in reducing affective and somatic depressive complaints. One of the authors’ goals in this study was to examine possible differences between women receiving and not receiving ERT.”

The researchers stated: “The authors studied a group of postmenopausal women. Somatic symptoms in the ERT group were significantly lower than in the Non-ERT group. Affective scores were only marginally lower in the ERT group…In response to orthostatic challenge, the change in systolic blood pressure was significantly smaller in the ERT group. Apparently ERT is associated with more effective blood pressure regulation.”

Breast Cancer and Estrogen Replacement Therapy
Researchers writing in the August 6, 2005 edition of the British Medical Journal say maybe the risk of developing breast cancer from estrogen replacement therapy is not as great as everyone thought.

The researchers noted that estrogen therapy accounted for eight additional cases out of 10,000 women.

In 2002, headlines cited that researchers discovered that estrogen therapy could double the risk for getting breast cancer.Read abstract

Estrogen and Physical Appearance
Women With Higher Levels of Estrogen Have Prettier Faces
Researchers at the University of St. Andrews in Scotland announced that women who had higher amounts of estrogen in their urine were found to be more attractive than women who had lesser amounts.

What Effects Does Estrogen Have On The Skin?
Researchers have found that “Estrogen loss at menopause has a profound influence on skin.” Writing in the medical journal Climacteric, study authors noted, “Estrogen treatment in postmenopausal women has been repeatedly shown to increase collagen content, dermal thickness and elasticity, and data on the effect of estrogen on skin water content are also promising.”

Hormone Replacement Therapy and Possible Cardiovascular Benefits in Women
Researchers writing in the medical journal Climacteric say that “Women who receive 2-3 years of HRT after menopause do not have increased all-cause mortality, and results of the present study suggest relative cardiovascular benefits compared to those who had not used hormones.” Read more

Estrogen and Sun Damaged Skin
Researchers at the University of Michigan Department of Dermatology are currently recruiting subjects to participate in a study to test Estrogen’s effect on the skin.

Risk of stroke and hormone replacement therapy
Researchers writing in the medical journal Maturitas say that there is no significant association between hormone therapy and risk of total stroke in women during 10.5 years follow-up.

Postmenopause and periodontal disease
A recent study in the Journal of Periodontology says that in an 11.7 year follow up, 57.5 percent of women lost at least one tooth after menopause.

The Use of Testosterone with Estrogen and Progestogen and It’s Effect on Breast Cell Proliferation

Researchers writing in the medical journal Menopause say “Addition of testosterone may counteract breast cell proliferation as induced by estrogen/progestogen therapy in postmenopausal women.”

Hofling M, Hirschberg A, Skoog L, Tani E, Hagerstrom T, von Schoultz, B. Testosterone inhibits estrogen/progestogen-induced breast cell proliferation in postmenopausal women. Menopause. 13 November 2006

Conclusions: Addition of testosterone may counteract breast cell proliferation as induced by estrogen/progestogen therapy in postmenopausal women.

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