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When approaching middle age, many women begin to experience various menopausal symptoms, such as reduced sleep quality, hot flashes, and irregular periods. The reason behind these are the changes in hormonal milieu. During the menopausal transition, the estradiol decreases while the follicle-stimulating hormone increases. The main female hormone, estradiol in particular is known to have positive effects on several body tissues, such as muscle and bone. After menopause, women's risk of e.g., developing cardiovascular diseases and type II diabetes increases and remains high for the rest of their life.

Additionally, mid-life women may observe changes in body composition. Although there is a reasonable amount of research related to menopause, many details about the significance of hormonal changes for body composition have yet to be clarified.

- In particular, there is a lack of longitudinal research that focuses on the time of the most dramatic hormonal changes, i.e. the menopausal transition, says doctoral researcher Hanna-Kaarina Juppi.

In this study, we wanted to investigate specifically in longitudinal data how the menopausal transition and menopause affect women's body adiposity, markers of metabolic health, the amount of muscle mass, and the properties of muscle tissue. Based on the results, the menopausal transition increases body fat mass and directs fat especially to the mid-region. In addition, the study revealed that muscle mass decreases and there are expression changes of certain muscle tissue genes.

- The proteins encoded by these genes have been previously connected to e.g., muscle regeneration and energy metabolism, Juppi continues.

Healthy lifestyles can slow down changes in body composition

The research also investigated whether midlife physical activity, diet quality, and the use of hormone therapy were related to body composition and markers of metabolic health

- We found that women who were more physically active and ate more healthily had more muscle mass and less fat mass in the whole body and also in the mid-region, says Juppi.

On a smaller sample of hormone therapy users also indicated that the use of hormone preparations is connected to a higher muscle mass and a lower amount of middle body fat. The relatively healthy lifestyles of the subjects on average may also have contributed to the fact that the blood metabolic health markers did not weaken despite the increase in fat mass.

Menopause affects your health for the rest of your life

The results of the study confirm previously made observations about the significance of menopause for the development of middle-body obesity and the reduction of muscle mass and offer new targets at the molecular level for elucidating more precise mechanisms.

- Since women can live more than a third of their life in postmenopause, it is important to better understand the factors that predispose them to health deterioration, Juppi adds.

The results especially emphasize the importance of physical activity and a healthy diet, and possibly also the use of hormone replacement therapy products, in maintaining health and well-being in middle-age and beyond.

The study has been funded by the Finnish Academy.

M.Sc. Hanna-Kaarina Juppi defends her doctoral dissertation in Gerontology and Public Health "Associations of the Menopausal Transition with Body Composition: Examining the Influence of Hormonal Changes, Muscle RNA Signaling and Lifestyle Habits" 9.6.2023 at 12.00 in Seminaarimäki auditorium C1. Opponent is Docent Hanna Savolainen-Peltonen (HUS, Finland) and Custos Associate Professor Eija Laakkonen (Ģ��ֱ��). The doctoral dissertation is held in Finnish.

Publication details

The thesis “Associations of the Menopausal Transition with Body Composition: Examining the Influence of Hormonal Changes, Muscle RNA Signaling and Lifestyle Habits” is available in the JYX repository:

Hanna-Kaarina Juppi graduated from Järvenpää high school in 2006. She graduated with a master's degree in philosophy in 2014 from Tampere University majoring in biochemistry and as a biomedical laboratory scientist in 2017 from Tampere University of Applied Sciences. Juppi started as a research assistant in Assistant Professor Eija Laakkonens’s research group in 2017 and continued with the same project as a doctoral researcher at the end of the summer of 2018.