Physiological alterations around the menopause transition—A 2‐year follow‐up in PRE, PERI, and POST menopause females

Abstract Introduction The menopause transition is a critical period marked by significant physiological adaptations. Data on the dynamic changes in body composition and metabolism during this transition are limited. The purpose was to determine body composition and metabolic changes over a 2‐year follow‐up in a cross‐sectional sample of premenopausal (PRE), perimenopausal (PERI), and postmenopausal (POST) females. Methods Twenty‐three females who previously participated in a cross‐sectional study returned for a 2‐year follow‐up visit were classified as PRE, PERI, or POST based on menstrual history and a Menopause Health Questionnaire. Muscle size [muscle cross‐sectional area (mCSA)] and muscle quality [echo intensity, (EI)] were evaluated in the vastus lateralis with ultrasound. Bone mass and body composition were assessed using dual‐energy X‐ray absorptiometry, and metabolic flexibility through submax exercise with indirect calorimetry. Results At the 2‐year follow‐up, POST females had an increase in EI (change: 26.93 ± 12.82 a.u., group×time p‐adjusted = 0.001) with no change in mCSA (change: −2.03 ± 2.40 cm², group×time p = 0.980). PERI compared to PRE females had lower total bone mass (group×time p‐adjusted = 0.029) with an even lower bone mass in POST compared to PERI females (group×time p‐adjusted = 0.023). No differences in metabolic flexibility at any exercise intensity were observed between groups over time (group×time p = ≥ 0.05). Conclusion This study highlights a decline in muscle quality and total bone mass despite stable muscle size, emphasizing the need for targeted exercise and nutrition interventions to support muscle and bone health in females around the menopause transition.