May 28, 2019
2 min read

Premature menopause affects physical functioning in women

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A cohort of Canadian women who entered natural menopause before age 40 years had a slower gait speed during an assessment of physical functioning when compared with women who entered menopause at age 50 to 54 years, study data show.

“Menopause is associated with estrogen decline, and earlier ages at menopause entail longer exposure to the potentially adverse consequences of this decline, including osteoporosis and cardiovascular disease, both of which contribute to physical function decline,” Maria P. Velez, MD, PhD, assistant professor in the department of obstetrics and gynecology at Queen’s University in Ontario, Canada, and colleagues wrote in the study background. “Although the effect of age at menopause on bone density loss is well recognized, its effect on skeletal muscle mass and strength has been less studied.”

Velez and colleagues analyzed data from 9,920 menopausal women who took part in the Canadian Longitudinal Study on Aging, which included participants from seven cities across Canada. Women who had a hysterectomy before menopause were excluded because the age at which this surgical procedure was performed was not available. Age at natural menopause was categorized into five groups: younger than 40 years (premature), aged 40 to 44 years (early), aged 45 to 49 years, aged 50 to 54 years and aged at least 54 years. Researchers used linear regression analyses to assess the association between age at natural menopause and gait speed (n = 9,718) and grip strength (n = 8,867) adjusted for age, education, BMI, smoking status, use of hormone therapy, height and province of residence.

The mean age at natural menopause for the cohort was 50 years, with 3.8% of women experiencing premature menopause and 8.7% of women experiencing early menopause. Average gait speed for the cohort was 0.97 m per second, and average grip strength was 26.6 kg. Researchers found that age at natural menopause was associated with both gait speed and grip strength.

Compared with the reference group of women who entered menopause at age 50 to 54 years, women with premature menopause had a mean –0.054 m per second lower gait speed (P < .001), equivalent to 5.5% slower, according to researchers, with results persisting after adjustment for age and site. In a fully adjusted model, the association was attenuated to a mean difference of 0.032 m per second (P = .016). An observed difference in gait speed between the reference group and women who entered menopause after age 55 years did not rise to significance in the fully adjusted model, according to researchers.


“Low education, shorter height, being overweight or obese and smoking were related to lower gait speed,” the researchers wrote. There were no observed associations between grip strength and age at natural menopause in fully adjusted models.

“Our results do not support our hypothesis that women who experience menopause at later ages would perform better in physical performance tests (ie, grip strength and gait speed) than would women who experience menopause at earlier ages,” the researchers wrote. “We, however, found that premature menopause was associated with 0.032 m/s less gait speed, a clinically relevant difference with important consequences for future health and quality of life for women.”

The researchers noted that women who experience premature menopause should be considered a “clinical priority group” for the promotion of healthy aging initiatives that have been demonstrated to improve physical function, such as physical activity interventions and nutritional supplementation. – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.