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Exercise Before Menopause Plays Critical Role in Later-in-Life Health

Older woman exercising

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Key Takeaways

  • Women who exercise before going through menopause may improve their heart health in the long term.
  • The result comes due to better formation of capillaries in the muscles when younger, which affects blood flow and reduces risk of insulin resistance.
  • Older women in the study did not see improvements in capillary formation, making it essential to log the workouts when younger.

Women who exercise regularly before going through menopause may significantly lower their risks for cardiovascular issues later in life, according to a study published in the Journal of Physiology.

Although previous research has linked exercise with more efficient heart function, that's actually not the only mechanism that's at play as women age. The recent study pointed out that estrogen is protective of heart and blood vessels. Because of that, as estrogen drops during menopause, the small blood vessels in muscles throughout the body are less able to grow compared to younger women.

Focus on Blood Vessels

In the recent study, researchers looked at two groups of women: 12 were between 59 to 70 years old (postmenopausal); and five were between 21 to 28 years old (premenopausal).

Both groups had a muscle biopsy from the thigh before starting, and then were trained over an eight-week period using spin bikes, at moderate to high intensity. By the end of the study period, the older group showed a 15% increase in their fitness.

But the younger group showed an increase in the number of capillaries in skeletal muscle tissue at the end of the study, while the older group did not, according to study co-author Line Norregaard Olsen, PhD(c) at the University of Copenhagen’s Department of Nutrition, Exercise and Sports.

"Capillaries help sugar and fat absorb more efficiently into your muscles. That has a significant effect on insulin resistance," says Olsen. "So, if you have less ability to grow new capillaries or increase the efficiency of your existing capillaries, it can affect cardiovascular health."

The link between estrogen loss and negative changes in blood vessels has been studied before. Commentary in Advanced Journal of Vascular Medicine, for example, noted that vascular aging appears to become accelerated during menopause. This could contribute to symptoms like hot flashes and sleep disturbance. Like the recent study, the commentators here suggested regular exercise as a way to preserve vascular health.

Line Norregaard Olsen, PhD(c)

The main message here is that women benefit from being physically active before menopause, because their estrogen levels are still high.

— Line Norregaard Olsen, PhD(c)

Connection With Insulin

Insulin is a key hormone that regulates many cellular functions, including the way we use glucose and handle fats. With insulin resistance, the body is less able to do this regulation, which can lead to:

  • Inflammatory response
  • Cell damage
  • High triglycerides
  • Lower levels of the "good" cholesterol, HDL
  • Higher levels of the "bad" one, LDL
  • Plaque formation in the arteries
  • Higher risk of diabetes

All of these factors can contribute to cardiovascular disease. Although the recent study is just a starting point—the small sample size and limited timeframe are major limitations—it does indicate exercise as a good strategy for better heart health as you age.

Start Moving Now, Reduce Risks Later

Exercise is good for everyone, but women experiencing menopause and beyond should be especially diligent about using this tactic for heart health. Before menopause, women have a lower risk of cardiovascular disease than men, but that changes after they've gone through menopause.

In addition to the type of changes in blood vessel formation found in the recent study, complex hormonal shifts come at the same time as other aging effects, such as reduced muscle mass and increased abdominal fat—which have both been associated with increased cardiovascular risk.

Hormone replacement therapy (HRT), a common strategy for addressing menopause symptoms like hot flashes as well as improving bone density, seems like it would help mitigate the higher cardiovascular risk issue, but results on that have been mixed, according to Pamela Ouyang, MBBS, MD, director of the Women's Cardiovascular Health Center at Johns Hopkins Medicine.

She notes that research doesn't support cardiovascular benefits from HRT, and in fact, some studies have shown a slight increase for blood clotting and stroke. As a result of those findings, Ouyang says hormone therapy isn't recommended for cardiac disease prevention after menopause.

Know Your Numbers

No matter what your age or activity level, Ouyang suggests being familiar with the numbers that affect cardiovascular health, particularly blood pressure and cholesterol levels.

"This is especially important if cardiovascular disease runs in your family," she says. "As women age, they should also consider seeing a specialist, like a cardiologist, if they have more risk factors when it comes to heart health."

And, adds Olsen, get serious about your activity level.

"The main message here is that women benefit from being physically active before menopause, because their estrogen levels are still high," Olsen says. "They have a better starting point when entering menopause, compared to trying to address the situation afterward. As with everything else, prevention is always preferable to treatment."

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