Does exercising during peri- or early post-menopause prevent bone and muscle loss: A systematic review

INTRODUCTION: The highest rate of bone and muscle loss occurs during the menopause transition. Yet, most clinical exercise trials have excluded peri- and early post-menopausal female participants. This systematic review aimed to determine (1) the effects of exercise on bone and muscle health during the menopause transition; and (2) which types of exercise are most effective for preventing bone and muscle mass loss during the menopause transition. METHODS: Articles were retrieved from five electronic databases (MEDLINE, Embase, CENTRAL, CINAHL, and SPORTDiscus). Inclusion criteria included: (1) randomized controlled trial (RCT); (2) 45-to 60-year-old and peri- or early post-menopausal females; (3) reported bone mineral density (BMD) or lean mass. RESULTS: Six studies met inclusion criteria; two evaluated peri-menopausal and four investigated early post-menopausal female participants. All studies had low quality of evidence, and high risk of bias. Strength training, endurance training, and Tai Chi did not improve areal BMD (aBMD) or lean mass during peri-menopause. Strength training and walking benefited total body, hip, spine, femoral neck, and trochanter aBMD and lean mass during early post-menopause. When grouped by exercise type, strength training improved aBMD at all sites but not all strength training studies showed improvements in lean mass. Walking improved total hip aBMD only. CONCLUSION: Due to the limited number of studies and variety of interventions, it remains inconclusive which training method is optimal to prevent bone and muscle loss during the menopause transition. Future strength training RCTs should include longer duration interventions that compare effects between peri- and early post-menopausal female participants.