Resistance training for postmenopausal women: systematic review and meta-analysis

Abstract

Importance: Numerous studies have been published assessing the effects of resistance muscle training to mitigate menopausal symptoms, given the endocrine muscle function and its metabolic regulation. Therefore, mapping and synthesizing high-quality studies are necessary to help clinical decisions.Objective: The aim of this study was to assess the effects (benefits and harms) of resistance muscle training for postmenopausal women.Evidence Review: Electronic searches were conducted in MEDLINE (via PubMed), EMBASE, CENTRAL, PEDro, LILACS, and SPORTDiscus up to December 2021. Two independent reviewers selected the retrieved references and extracted relevant data from included studies. The methodological quality (risk of bias) using the Cochrane Risk of Bias table and the certainty of the evidence (GRADE approach) were assessed.Findings: Twelve randomized clinical trials (n = 452) with unclear to high risk of bias were identified. Compared with no exercise, resistance training (up to 16 weeks) seems to promote an improvement in functional capacity (mean difference [MD], 2.90 points; 95% CI, 0.60-5.20) and bone mineral density (MD, 0.10; 95% CI, 0.10-0.10) and a reduction in the hot flash frequency (13/29 vs 1/29; risk ratio, 13.0; 95% CI, 1.82-93.01) and fat mass (MD, −3.15; 95% CI, −6.68 to 0.38), and no differences were observed between groups regarding abdominal circumference and body mass index. When compared with aerobic exercises, resistance training may result in a reduction of hot flash frequency (7/ 18 vs 14/18; risk ratio, 0.50; 95% CI, 0.27-0.94) and fat mass (MD, −7.80; 95% CI, −14.02 to −1.58) and no difference in the quality of life and body mass index. Regarding safety, no serious adverse events were reported. Based on the GRADE approach, the certainty of this evidence was graded as very low to low, leading to imprecisely estimated effects.Conclusions and Relevance: Resistance muscle training seems to improve postmenopausal symptoms and functional capacity. Given the low to very low certainty of the evidence, further randomized clinical trials with higher methodological quality and better reports are still needed. As an implication for clinical practice, health professionals should consider individualized aspects such as the previous history of exercise practice, physical capacity, and adaptation period.

Treatments and Management of Menopausal Symptoms: Current Status and Future Challenges

“…• avoiding triggers (e.g., spicy foods, lights, comforters, and predictable emotional reactions); • cool down the environment (e.g., by turning down the thermostat, using fans, and cooling gel pads [gel-filled sheets that are placed on a mattress and dissipate body heat]); • Wearing layered clothing, which can be removed when needed can help; and • exercise and weight loss [86][87][88][89][90][91]. Devices that cool skin receptors may help some women; they can be worn as cuffs or necklaces or placed on the neck's back.…”

The impact of physical activity and exercise interventions on symptoms for women experiencing menopause: overview of reviews

“…One high-quality review 49 reported a bene t of resistance training on incidence of moderate or severe hot ash episodes. This is based on a single, very small RCT (58 participants) and the effect estimate re ects high levels of imprecision.…”

“…One high-quality review 49 included one RCT (36 participants) comparing aerobic versus resistance training for 8 weeks. No differences were observed in total menopause quality-of-life domains.…”

“…One high-quality 49 review reported an effect favouring resistance training over aerobic exercise on frequency of hot ash symptoms based on one RCT (36 participants). Due to the small sample size, this result is subject to a high level of imprecision.…”

Physical activity and menopausal symptoms: evaluating the contribution of obesity, fitness, and ambient air pollution status

“…It is unclear whether air pollution can also contribute to a more problematic menopause transition in the form of increased menopausal symptoms. Although studies on possible protective role of PA with respect to the symptoms of menopause exist, 53‐56 more research is needed to better understand whether these benefits are realized to the same extent within environments with varying levels of ambient air pollution, while accounting for the effects of important covariates such as fitness level, body composition status, or neuroticism, all which have been also associated with menopausal symptoms 42,57,58 . In this study, we used data from the Healthy Aging in Industrial Environment Program 4 (4HAIE) study to examine the associations between daily PA (Fitbit steps) and menopausal symptoms in a subsample of middle-aged women recruited from the 4HAIE cohort residing in areas of high versus low relative ambient air pollution.…”