The association between menopausal status and depressive symptoms varies with increasing levels of physical activity, according to study results published in Menopause.

Using data from the Estrogenic Regulation of Muscle Apoptosis (ERMA) study, investigators aimed to examine the relationship between menopausal status and mental wellbeing and determine whether the relationship is affected by physical activity.

A total of 1098 women aged 47 to 55 years were grouped based on their menopausal status into premenopausal (n=304), early perimenopausal (n=198), late perimenopausal (n=209), and postmenopausal (n=387) groups.

Menopausal status was assessed based on self-reported bleeding and serum concentrations of follicle-stimulating hormone. Menopausal symptoms were collected by questionnaire and mental wellbeing was measured using multiple assessment tools, including the 20-item Center for Epidemiological Studies Depression Scale, the International Positive and Negative Affect Schedule Short Form, and the 5-item Satisfaction with Life Scale. Women also ranked their level of physical activity on a 7-point scale.


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Depressive symptom scores were significantly lower among premenopausal women (mean, 0.42) compared with early perimenopausal (mean, 0.51; P =.038) and postmenopausal women (mean, 0.49; P =.035), indicating less depressive symptoms. In an adjusted model for depressive symptoms, menopausal status was significantly associated with depressive symptoms (P <.001). When menopausal symptoms were included in the analysis, the association was attenuated but remained present. No significant association between menopausal status and negative or positive affectivity or life satisication were observed.

In premenopausal and early perimenopausal women, the mean depressive score was lower among those with high levels of physical activity compared with those with medium or low physical activity levels (P <.05 for both). Among the postmenopausal women, a high or medium activity level was associated with lower depressive scores compared with a low activity level (P <.001 for both).

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Women with high physical activity levels scored significantly higher in measures of positive affectivity and life satisfaction than women with low activity levels in all menopausal status groups.

The researchers noted that the cross-sectional nature of the study represented a limitation, as they could not control for initial levels of depressive symptoms or the duration of menopause. In addition, the directionality of the association between physical activity and mental wellbeing could not be determined.

“This study showed that while menopausal status is associated with elevated depressive symptomatology, it does not compromise positive mental well-being (ie, life satisfaction or positive affectivity). A high level of physical activity, irrespective of menopausal status, was related to better mental well-being, particularly to a lower level of depressive symptoms and higher levels of satisfaction with life and positive affect,” the study authors concluded. “Thus physical activity might alleviate the potential negative influence of menopause on mental well-being.”

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Reference

Bondarev D, Sipilä S, Finni T, et al. The role of physical activity in the link between menopausal status and mental well-being. Menopause. 2020;27(4):398-409.