Longitudinal assessment of the menopausal transition, endogenous sex hormones, and perception of physical functioning: the Study of Women's Health Across the Nation

Abstract

Background: To evaluate the longitudinal associations between menopausal status, related hormonal changes, and level of self-reported physical functioning.

Methods: Study included 2,495 women (age: 45-57 between 2000 and 2001) from the Study of Women's Health Across the Nation. Physical functioning scale of the Medical Outcomes Study Short-Form (SF-36; score 0-100) was categorized as: no limitation (86-100), moderate limitation (51-85), and substantial limitation (0-50). Study variables were collected between 2000 (visit-04) and 2011 (visit-12) at five timepoints. Statistical models were adjusted for age at visit-04, time since visit-04, ethnicity, site, economic status, level and change in body mass index, level and change in physical activity, and presence of comorbid conditions.

Results: In final models, natural and surgical postmenopausal women had significantly higher odds of functional limitation, compared with premenopausal women. Less reduction in estradiol and testosterone since visit-04 were significantly associated with lower odds of functional limitation, while greater increase in sex hormone-binding globulin was associated with higher odds of functional limitation.

Conclusions: Our findings suggest the menopause-related changes in endogenous sex hormones as a possible mechanism of action to explain the greater limitation in physical functioning reported in women at midlife.

Keywords: Epidemiology; Functional performance; Geriatric endocrinology; Menopause.; Physical function.