Menopausal status and physical performance in midlife: findings from a British birth cohort study

Objective: To test the associations of menopausal status, timing of menopause, and hysterectomy with physical performance at age 53 years. Design: Using data on women participating in the Medical Research Council National Survey of Health and Development who have been followed up since birth in March 1946 (N = 1,386), associations of interest were examined. Menopausal status, grip strength, chair rises, and standing balance time were assessed at age 53, and covariates were measured across life. Results: Women who were postmenopausal and not using hormone therapy at age 53 had lower mean grip strength than women who were still pre- or perimenopausal at this age. However, this trend of decreasing grip strength across the three natural menopausal categories (from pre- to postmenopausal) was explained by current body size. Those women who had undergone hysterectomy before age 40 had significantly weaker grip strength than women who had undergone hysterectomy at later ages; in fully adjusted analyses, those women who had a hysterectomy before age 40 had a mean grip strength 5.21 kg (95% CI: 2.18-8.25) lower than women who had a hysterectomy between ages 50 and 53. There were no significant associations between menopausal status or age at hysterectomy and chair rise or standing balance time and also no significant associations between timing of menopause and any of the performance measures. Conclusions: Women who have hysterectomies at young ages represent a group who may require more support than other women to achieve and maintain good physical performance, especially muscle strength, in midlife.