Women's Health Info

Navigating Physical Health & Function in Menopause

How physical health & function during & after menopause affect activities of daily living

  • Some women experience declines in physical functioning during the perimenopause and post-menopause, but these changes do not significantly impact the ability to perform activities of daily living (i.e., live independently and care for one’s self).
  • Hormonal changes, particularly the decline in estrogen levels, are associated with declines in skeletal muscle mass and physical functioning performance during the menopausal transition.
  • The Study of Women’s Health Across the Nation (SWAN) seeks to understand how physical functioning changes across the midlife and menopausal transition, the severity of these changes, and any implications for women as they age.

  • Nearly 1 in 5 women aged 40-55 years reported some limitations in physical functioning. These difficulties increase with age, with nearly 50% of women aged 56-66 years experiencing physical functioning limitations.

  • Not all women experience a worsening of physical functioning during midlife. In fact, some women (14-55%) experience improvements in physical functioning during midlife. Regular exercise, including aerobic, strength training, and flexibility exercises, is crucial for maintaining skeletal muscle mass and overall physical function. Even a little boost in these activities now may pay dividends in the long run.

  • During menopause, women typically gain fat mass and lose lean mass. Women with more lean mass and less fat mass have better physical functioning, including faster walking speed, more leg strength and quicker stair-climbing speed.

Understanding changes in physical health as women age

Beyond its well-known effects on reproductive health, menopause also influences various aspects of other physical functions. Physical functioning encompasses the ability to perform everyday tasks with ease, such as walking, climbing stairs, bending and lifting objects. These activities, often taken for granted, form the cornerstone of independent living and overall well-being.

The midlife period, specifically between 40-64 years, is a pivotal time for changes in women’s physical functioning. In the United States, even though women tend to outlive men, they experience more disability and challenges in physical functioning. This is also a critical time period for determining future health, as many women start to develop inflammation, arthritis, bone loss and other health concerns that affect them later in life.
Nearly 1 in 5 women aged 40-55 years reported some limitations in physical functioning. This difficulty increases with age, with nearly 50% of women aged 56-66 years experiencing physical functioning limitations.

Understanding these changes during midlife is crucial for maintaining overall health and quality of life later on. The effect these changes have on one’s ability to perform activities of daily living is highly significant.

Research shows how physical health & function are impacted by menopause.

SWAN is a long-term, multi-racial and ethnic, and multicenter research project that aims to understand the physical, biological, and psychosocial changes that occur in women during the menopause transition. Researchers are examining various aspects, including hormone levels, sleep patterns, cardiovascular health, bone density, and psychological well-being. By studying a diverse population of women over time, SWAN aims to provide comprehensive insights into the menopause transition and its impact on women's health.

SWAN study implications for physical ability in menopause & beyond

Health changes, per above, can also have several other key implications, outlined below.

Physical functioning, healthy aging & the effect on activities of daily living

In the context of healthy aging, measures of physical functioning are crucial. Poor physical functioning in SWAN was associated with worse cardiovascular health and higher diabetes risk.

Additionally, many midlife women have chronic conditions such as knee osteoarthritis, peripheral nerve impairment and depressive symptoms, which are all associated with worse physical functioning and more disability. Such issues can have a major impact on performing activities of daily living.

Social determinants of physical functioning

SWAN research has examined social factors that may explain the observed differences in standard midlife physical functioning performance across racial and ethnic groups; in SWAN, Japanese women had better physical functioning compared to white women, but Black and Hispanic women had poorer physical functioning compared to white women. These differences were partially explained by variations in socioeconomic status, body mass index, pain, and physical activity patterns across the race/ethnic groups.

Maintaining or improving physical function during midlife

Findings suggest that adherence to a healthy lifestyle is important for physical functioning. Women who did not smoke, engaged in regular physical activity, and maintained a healthy diet had better physical function as compared to women who had unhealthy lifestyle behaviors.

Women who consumed more fruits, vegetables, and fiber and less fat had better physical function. Furthermore, women who participated in high levels of physical activity, like running or walking very quickly, or in moderate levels of physical activity, like brisk walking or vacuuming, had better physical functioning than women with low physical activity.

Key physical health & function takeaways for women

The aging process, particularly midlife aging, is not synonymous with declines in physical functioning. In fact, findings from SWAN demonstrate that reports of physical functioning limitations are highly variable over time in individual women, thereby challenging the assumption of aging as a period of steady decline and highlighting the midlife as a life stage that may be particularly amenable for interventions to improve physical function. In particular, addressing conditions such as arthritis that onset during midlife and are associated with physical function limitations may be an important strategy to promote long-term well-being. The midlife period presents a unique opportunity to intervene and improve physical functioning trajectories.

Additionally, staying curious and engaged by learning new things and pursuing interests, practicing sun safety, maintaining a healthy weight, limiting alcohol consumption, and avoiding smoking contribute to overall longevity and well-being. By prioritizing physical activity, women can support their bone health, muscle strength, cardiovascular health, weight management and mental well-being, ultimately enhancing their quality of life as they age.

Latest Physical Function News

What we are still learning about physical function & menopause

The SWAN study has made significant contributions to our understanding of the menopause transition and beyond, but there is still ongoing research to deepen our understanding of this time in women’s lives. Researchers continue to explore the complex interplay between physical function, hormonal changes, body composition, and lifestyle factors.



Reviewed by:

Carrie A Karvonen-Gutierrez, PhD, MPH, Associate Professor, University of Michigan
Nanette Santoro, MD, Professor, University of Colorado Denver