Menopause and Body Composition: A Complex Field

Abstract

Given that menopause affects about half of the world's midlife population, it is crucial to understand its impact beyond traditional menopausal symptomology. For instance, many women, while transitioning through menopause, experience profound changes in body composition. These changes may contribute to postmenopausal reductions in metabolic health. This narrative review explores the influence of menopause on skeletal muscle and adipose tissue, highlighting the decline in muscle mass and strength and the gain and redistribution of adipose tissue, particularly the increase in visceral adiposity. Although menopausal changes in body composition are seemingly extensively studied, the longitudinal studies are not that common, and the precise mechanisms driving body composition changes remain unclear, with uncertainties surrounding the roles of hormonal shifts compared with regular aging, energy balance, and lifestyle factors. Notably, it remains debated whether menopause or estrogen meaningfully influences resting energy expenditure. The review also considers the potential mitigating effects of menopausal hormone therapy and regular exercise. Understanding these changes is essential for developing effective strategies to support women's health during and after menopause.

Keywords

menopausal transition - fat-free mass - fat mass - energy expenditure - energy balance

Publication History

Article published online:
09 June 2025

• References

• 1 McLaughlin JF, Brock KM, Gates I. et al. Multivariate Models of Animal Sex: Breaking Binaries Leads to a Better Understanding of Ecology and evolution. Integr Comp Biol 2023; 63 (04) 891-906
• 2 Gatenby C, Simpson P. Menopause: PHYSIOLOGY, definitions, and symptoms. Best Pract Res Clin Endocrinol Metab 2024; 38 (01) 101855
• 3 Harlow SD, Gass M, Hall JE. et al; STRAW + 10 Collaborative Group. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. J Clin Endocrinol Metab 2012; 97 (04) 1159-1168
• 4 Matthews J, Gustafsson JA. Estrogen signaling: a subtle balance between ER alpha and ER beta. Mol Interv 2003; 3 (05) 281-292
• 5 Khosla S, Melton III LJ, Riggs BL. The unitary model for estrogen deficiency and the pathogenesis of osteoporosis: is a revision needed?. J Bone Miner Res 2011; 26 (03) 441-451
• 6 Karlamangla AS, Burnett-Bowie SM, Crandall CJ. Bone health during the menopause transition and beyond. Obstet Gynecol Clin North Am 2018; 45 (04) 695-708
• 7 Liu JH. Sarcopenia and menopause. Menopause 2023; 30 (02) 119-120
• 8 Wright VJ, Schwartzman JD, Itinoche R, Wittstein J. The musculoskeletal syndrome of menopause. Climacteric 2024; 27 (05) 466-472
• 9 Heymsfield SB, Brown J, Ramirez S, Prado CM, Tinsley GM, Gonzalez MC. Are lean body mass and fat-free mass the same or different body components? A critical perspective. Adv Nutr 2024; 15 (12) 100335
• 10 Kurina LM, Gulati M, Everson-Rose SA. et al. The effect of menopause on grip and pinch strength: results from the Chicago, Illinois, site of the Study of Women's Health Across the Nation. Am J Epidemiol 2004; 160 (05) 484-491
• 11 Bondarev D, Finni T, Kokko K. et al. Physical performance during the menopausal transition and the role of physical activity. J Gerontol Ser A 2021; 76 (09) 1587-1590
• 12 Greeves JP, Cable NT, Reilly T, Kingsland C. Changes in muscle strength in women following the menopause: a longitudinal assessment of the efficacy of hormone replacement therapy. Clin Sci (Lond) 1999; 97 (01) 79-84
• 13 Sipilä S, Taaffe DR, Cheng S, Puolakka J, Toivanen J, Suominen H. Effects of hormone replacement therapy and high-impact physical exercise on skeletal muscle in post-menopausal women: a randomized placebo-controlled study. Clin Sci (Lond) 2001; 101 (02) 147-157
• 14 Ronkainen PHA, Kovanen V, Alén M. et al. Postmenopausal hormone replacement therapy modifies skeletal muscle composition and function: a study with monozygotic twin pairs. J Appl Physiol 2009; 107 (01) 25-33
• 15 Xu Y, Deng KL, Xing TF, Mei YQ, Xiao SM. Effect of hormone therapy on muscle strength in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Menopause 2020; 27 (07) 827-835
• 16 Cruz-Jentoft AJ, Bahat G, Bauer J. et al; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 2019; 48 (01) 16-31
• 17 Dodds RM, Syddall HE, Cooper R. et al. Grip strength across the life course: normative data from twelve British studies. PLoS ONE 2014; 9 (12) e113637
• 18 Jackson AS, Janssen I, Sui X, Church TS, Blair SN. Longitudinal changes in body composition associated with healthy ageing: men, aged 20-96 years. Br J Nutr 2012; 107 (07) 1085-1091
• 19 Gába A, Přidalová M. Age-related changes in body composition in a sample of Czech women aged 18-89 years: a cross-sectional study. Eur J Nutr 2014; 53 (01) 167-176
• 20 Hughes VA, Frontera WR, Roubenoff R, Evans WJ, Singh MAF. Longitudinal changes in body composition in older men and women: role of body weight change and physical activity. Am J Clin Nutr 2002; 76 (02) 473-481
• 21 Kyle UG, Melzer K, Kayser B, Picard-Kossovsky M, Gremion G, Pichard C. Eight-year longitudinal changes in body composition in healthy Swiss adults. J Am Coll Nutr 2006; 25 (06) 493-501
• 22 Svendsen OL, Hassager C, Christiansen C. Age- and menopause-associated variations in body composition and fat distribution in healthy women as measured by dual-energy X-ray absorptiometry. Metabolism 1995; 44 (03) 369-373
• 23 Panotopoulos G, Ruiz JC, Raison J, Guy-Grand B, Basdevant A. Menopause, fat and lean distribution in obese women. Maturitas 1996; 25 (01) 11-19
• 24 Sternfeld B, Bhat AK, Wang H, Sharp T, Quesenberry Jr CP. Menopause, physical activity, and body composition/fat distribution in midlife women. Med Sci Sports Exerc 2005; 37 (07) 1195-1202
• 25 Abildgaard J, Pedersen AT, Green CJ. et al. Menopause is associated with decreased whole body fat oxidation during exercise. Am J Physiol Endocrinol Metab 2013; 304 (11) E1227-E1236
• 26 Park YM, Jankowski CM, Ozemek C, Hildreth KL, Kohrt WM, Moreau KL. Appendicular lean mass is lower in late compared with early perimenopausal women: potential role of FSH. J Appl Physiol 2020; 128 (05) 1373-1380
• 27 Sipilä S, Törmäkangas T, Sillanpää E. et al. Muscle and bone mass in middle-aged women: role of menopausal status and physical activity. J Cachexia Sarcopenia Muscle 2020; 11 (03) 698-709
• 28 Gould LM, Gordon AN, Cabre HE. et al. Metabolic effects of menopause: a cross-sectional characterization of body composition and exercise metabolism. Menopause 2022; 29 (04) 377-389
• 29 Sowers M, Zheng H, Tomey K. et al. Changes in body composition in women over six years at midlife: ovarian and chronological aging. J Clin Endocrinol Metab 2007; 92 (03) 895-901
• 30 Lovejoy JC, Champagne CM, de Jonge L, Xie H, Smith SR. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond) 2008; 32 (06) 949-958
• 31 Franklin RM, Ploutz-Snyder L, Kanaley JA. Longitudinal changes in abdominal fat distribution with menopause. Metabolism 2009; 58 (03) 311-315
• 32 Abdulnour J, Doucet E, Brochu M. et al. The effect of the menopausal transition on body composition and cardiometabolic risk factors: a Montreal-Ottawa New Emerging Team group study. Menopause 2012; 19 (07) 760-767
• 33 Greendale GA, Sternfeld B, Huang M. et al. Changes in body composition and weight during the menopause transition. JCI Insight 2019; 4 (05) e124865
• 34 Dehghan A, Vasan SK, Fielding BA, Karpe F. A prospective study of the relationships between change in body composition and cardiovascular risk factors across the menopause. Menopause 2021; 28 (04) 400-406
• 35 Ho SC, Wu S, Chan SG, Sham A. Menopausal transition and changes of body composition: a prospective study in Chinese perimenopausal women. Int J Obes (Lond) 2010; 34 (08) 1265-1274
• 36 Marlatt KL, Redman LM, Beyl RA. et al. Racial differences in body composition and cardiometabolic risk during the menopause transition: a prospective, observational cohort study. Am J Obstet Gynecol 2020; 222 (04) 365.e1-365.e18
• 37 Juppi HK, Sipilä S, Cronin NJ. et al. Role of menopausal transition and physical activity in loss of lean and muscle mass: a follow-up study in middle-aged Finnish women. J Clin Med 2020; 9 (05) 1588
• 38 Liao S, Zhao L, Huang C. et al. One-year trajectories of nutritional status in perimenopausal women: a community-based multi-centered prospective study. BMC Public Health 2024; 24 (01) 914
• 39 Davis SR, Lambrinoudaki I, Lumsden M. et al. Menopause. Nat Rev Dis Primers 2015; 1 (01) 15004
• 40 Marlatt KL, Pitynski-Miller DR, Gavin KM. et al. Body composition and cardiometabolic health across the menopause transition. Obesity (Silver Spring) 2022; 30 (01) 14-27
• 41 Guo SS, Zeller C, Chumlea WC, Siervogel RM. Aging, body composition, and lifestyle: the Fels Longitudinal Study. Am J Clin Nutr 1999; 70 (03) 405-411
• 42 Buckinx F, Landi F, Cesari M. et al. Pitfalls in the measurement of muscle mass: a need for a reference standard. J Cachexia Sarcopenia Muscle 2018; 9 (02) 269-278
• 43 Addison O, Marcus RL, Lastayo PC, Ryan AS. Intermuscular fat: a review of the consequences and causes. Int J Endocrinol 2014; 2014: 309570
• 44 Marcus RL, Addison O, Kidde JP, Dibble LE, Lastayo PC. Skeletal muscle fat infiltration: impact of age, inactivity, and exercise. J Nutr Health Aging 2010; 14 (05) 362-366
• 45 Delmonico MJ, Harris TB, Visser M. et al; Health, Aging, and Body. Longitudinal study of muscle strength, quality, and adipose tissue infiltration. Am J Clin Nutr 2009; 90 (06) 1579-1585
• 46 Fukumoto Y, Ikezoe T, Yamada Y. et al. Skeletal muscle quality assessed from echo intensity is associated with muscle strength of middle-aged and elderly persons. Eur J Appl Physiol 2012; 112 (04) 1519-1525
• 47 Goodpaster BH, Carlson CL, Visser M. et al. Attenuation of skeletal muscle and strength in the elderly: the Health ABC Study. J Appl Physiol 2001; 90 (06) 2157-2165
• 48 Keller K, Engelhardt M. Strength and muscle mass loss with aging process. Age and strength loss. Muscles Ligaments Tendons J 2014; 3 (04) 346-350
• 49 Goodpaster BH, Park SW, Harris TB. et al. The loss of skeletal muscle strength, mass, and quality in older adults: the health, aging and body composition study. J Gerontol A Biol Sci Med Sci 2006; 61 (10) 1059-1064
• 50 Pöllänen E, Sipilä S, Alen M. et al. Differential influence of peripheral and systemic sex steroids on skeletal muscle quality in pre- and postmenopausal women. Aging Cell 2011; 10 (04) 650-660
• 51 Juppi HK, Sipilä S, Fachada V. et al. Total and regional body adiposity increases during menopause-evidence from a follow-up study. Aging Cell 2022; 21 (06) e13621
• 52 Bondarev D, Laakkonen EK, Finni T. et al. Physical performance in relation to menopause status and physical activity. Menopause 2018; 25 (12) 1432-1441
• 53 Sowers M, Tomey K, Jannausch M, Eyvazzadeh A, Nan B, Randolph Jr J. Physical functioning and menopause states. Obstet Gynecol 2007; 110 (06) 1290-1296
• 54 Taaffe DR, Sipilä S, Cheng S, Puolakka J, Toivanen J, Suominen H. The effect of hormone replacement therapy and/or exercise on skeletal muscle attenuation in postmenopausal women: a yearlong intervention. Clin Physiol Funct Imaging 2005; 25 (05) 297-304
• 55 Dieli-Conwright CM, Spektor TM, Rice JC, Sattler FR, Schroeder ET. Hormone therapy attenuates exercise-induced skeletal muscle damage in postmenopausal women. J Appl Physiol 2009; 107 (03) 853-858
• 56 Pesonen H, Laakkonen EK, Hautasaari P. et al. Perimenopausal women show modulation of excitatory and inhibitory neuromuscular mechanisms. BMC Womens Health 2021; 21 (01) 133
• 57 Larsson L, Sjödin B, Karlsson J. Histochemical and biochemical changes in human skeletal muscle with age in sedentary males, age 22–65 years. Acta Physiol Scand 1978; 103 (01) 31-39
• 58 Volpi E, Sheffield-Moore M, Rasmussen BB, Wolfe RR. Basal muscle amino acid kinetics and protein synthesis in healthy young and older men. JAMA 2001; 286 (10) 1206-1212
• 59 Balagopal P, Rooyackers OE, Adey DB, Ades PA, Nair KS. Effects of aging on in vivo synthesis of skeletal muscle myosin heavy-chain and sarcoplasmic protein in humans. Am J Physiol 1997; 273 (04) E790-E800
• 60 Welle S, Thornton C, Jozefowicz R, Statt M. Myofibrillar protein synthesis in young and old men. Am J Physiol 1993; 264 (5, Pt 1): E693-E698
• 61 Shefer G, Van de Mark DP, Richardson JB, Yablonka-Reuveni Z. Satellite-cell pool size does matter: defining the myogenic potency of aging skeletal muscle. Dev Biol 2006; 294 (01) 50-66
• 62 Kadi F, Charifi N, Denis C, Lexell J. Satellite cells and myonuclei in young and elderly women and men. Muscle Nerve 2004; 29 (01) 120-127
• 63 Collins BC, Arpke RW, Larson AA. et al. Estrogen regulates the satellite cell compartment in females. Cell Rep 2019; 28 (02) 368-381.e6
• 64 Pérez-Gómez J, Rytter N, Mandrup C. et al. Menopausal transition does not influence skeletal muscle capillary growth in response to cycle training in women. J Appl Physiol 2021; 131 (01) 369-375
• 65 Qaisar R, Renaud G, Hedstrom Y. et al. Hormone replacement therapy improves contractile function and myonuclear organization of single muscle fibres from postmenopausal monozygotic female twin pairs. J Physiol 2013; 591 (09) 2333-2344
• 66 Kim YJ, Tamadon A, Park HT, Kim H, Ku SY. The role of sex steroid hormones in the pathophysiology and treatment of sarcopenia. Osteoporos Sarcopenia 2016; 2 (03) 140-155
• 67 Enns DL, Tiidus PM. The influence of estrogen on skeletal muscle: sex matters. Sports Med 2010; 40 (01) 41-58
• 68 Cabelka CA, Baumann CW, Collins BC. et al. Effects of ovarian hormones and estrogen receptor α on physical activity and skeletal muscle fatigue in female mice. Exp Gerontol 2019; 115: 155-164
• 69 Baltgalvis KA, Greising SM, Warren GL, Lowe DA. Estrogen regulates estrogen receptors and antioxidant gene expression in mouse skeletal muscle. PLoS ONE 2010; 5 (04) e10164
• 70 La Colla A, Vasconsuelo A, Milanesi L, Pronsato L. 17β-estradiol protects skeletal myoblasts from apoptosis through p53, Bcl-2, and FoxO families. J Cell Biochem 2017; 118 (01) 104-115
• 71 Torres MJ, Kew KA, Ryan TE. et al. 17β-Estradiol directly lowers mitochondrial membrane microviscosity and improves bioenergetic function in skeletal muscle. Cell Metab 2018; 27 (01) 167-179.e7
• 72 Juppi HK, Korhonen TM, Sievänen T. et al. Menopausal transition alters female skeletal muscle transcriptome. Transl Exerc Biomed 2024; 1 (01) 43-59
• 73 Ronkainen PHA, Pöllänen E, Alén M. et al. Global gene expression profiles in skeletal muscle of monozygotic female twins discordant for hormone replacement therapy. Aging Cell 2010; 9 (06) 1098-1110
• 74 Pöllänen E, Ronkainen PH, Suominen H. et al. Muscular transcriptome in postmenopausal women with or without hormone replacement. Rejuvenation Res 2007; 10 (04) 485-500
• 75 Jin F, Wang YF, Zhu ZX. Association between serum estradiol level and appendicular lean mass index in middle-aged postmenopausal women. World J Orthop 2024; 15 (01) 45-51
• 76 Smith GI, Yoshino J, Reeds DN. et al. Testosterone and progesterone, but not estradiol, stimulate muscle protein synthesis in postmenopausal women. J Clin Endocrinol Metab 2014; 99 (01) 256-265
• 77 Soltani Z, Shahrokhi N, Karamouzian S. et al. Does progesterone improve outcome in diffuse axonal injury?. Brain Inj 2017; 31 (01) 16-23
• 78 Gourlay ML, Specker BL, Li C, Hammett-Stabler CA, Renner JB, Rubin JE. Follicle-stimulating hormone is independently associated with lean mass but not BMD in younger postmenopausal women. Bone 2012; 50 (01) 311-316
• 79 Yin M, Zhang H, Liu Q. et al. Determination of skeletal muscle mass by aspartate aminotransferase/alanine aminotransferase ratio, insulin and FSH in Chinese women with sarcopenia. BMC Geriatr 2022; 22 (01) 893
• 80 Veldhuis-Vlug AG, Woods GN, Sigurdsson S. et al. Serum FSH is associated with BMD, bone marrow adiposity, and body composition in the AGES-Reykjavik Study of Older Adults. J Clin Endocrinol Metab 2021; 106 (03) e1156-e1169
• 81 Ongaro L, Zhou X, Wang Y. et al. Muscle-derived myostatin is a major endocrine driver of follicle-stimulating hormone synthesis. Science 2025; 387 (6731) 329-336
• 82 Bergen III HR, Farr JN, Vanderboom PM. et al. Myostatin as a mediator of sarcopenia versus homeostatic regulator of muscle mass: insights using a new mass spectrometry-based assay. Skelet Muscle 2015; 5 (01) 21
• 83 Ferrucci L, Fabbri E. Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat Rev Cardiol 2018; 15 (09) 505-522
• 84 Pfeilschifter J, Köditz R, Pfohl M, Schatz H. Changes in proinflammatory cytokine activity after menopause. Endocr Rev 2002; 23 (01) 90-119
• 85 Dalle S, Rossmeislova L, Koppo K. The role of inflammation in age-related sarcopenia. Front Physiol 2017; 8: 1045
• 86 Kim SH, Jeong JB, Kang J. et al. Association between sarcopenia level and metabolic syndrome. PLOS ONE 2021; 16 (03) e0248856
• 87 Kyle UG, Genton L, Slosman DO, Pichard C. Fat-free and fat mass percentiles in 5225 healthy subjects aged 15 to 98 years. Nutrition 2001; 17 (7-8): 534-541
• 88 Kuk JL, Saunders TJ, Davidson LE, Ross R. Age-related changes in total and regional fat distribution. Ageing Res Rev 2009; 8 (04) 339-348
• 89 Snel M, Jonker JT, Schoones J. et al. Ectopic fat and insulin resistance: pathophysiology and effect of diet and lifestyle interventions. Int J Endocrinol 2012; 2012: 983814
• 90 Manolopoulos KN, Karpe F, Frayn KN. Gluteofemoral body fat as a determinant of metabolic health. Int J Obes (Lond) 2010; 34 (06) 949-959
• 91 Fox CS, Massaro JM, Hoffmann U. et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation 2007; 116 (01) 39-48
• 92 Tchernof A, Després JP. Pathophysiology of human visceral obesity: an update. Physiol Rev 2013; 93 (01) 359-404
• 93 Ambikairajah A, Walsh E, Tabatabaei-Jafari H, Cherbuin N. Fat mass changes during menopause: a metaanalysis. Am J Obstet Gynecol 2019; 221 (05) 393-409.e50
• 94 Kanaley JA, Sames C, Swisher L. et al. Abdominal fat distribution in pre- and postmenopausal women: the impact of physical activity, age, and menopausal status. Metabolism 2001; 50 (08) 976-982
• 95 Douchi T, Yonehara Y, Kawamura Y, Kuwahata A, Kuwahata T, Iwamoto I. Difference in segmental lean and fat mass components between pre- and postmenopausal women. Menopause 2007; 14 (05) 875-878
• 96 Lee CG, Carr MC, Murdoch SJ. et al. Adipokines, inflammation, and visceral adiposity across the menopausal transition: a prospective study. J Clin Endocrinol Metab 2009; 94 (04) 1104-1110
• 97 Greendale GA, Han W, Finkelstein JS. et al. Changes in regional fat distribution and anthropometric measures across the menopause transition. J Clin Endocrinol Metab 2021; 106 (09) 2520-2534
• 98 Samargandy S, Matthews KA, Brooks MM. et al. Abdominal visceral adipose tissue over the menopause transition and carotid atherosclerosis: the SWAN heart study. Menopause 2021; 28 (06) 626-633
• 99 Saunders MJ, Blevins JE, Broeder CE. Effects of hydration changes on bioelectrical impedance in endurance trained individuals. Med Sci Sports Exerc 1998; 30 (06) 885-892
• 100 Ouchi N, Parker JL, Lugus JJ, Walsh K. Adipokines in inflammation and metabolic disease. Nat Rev Immunol 2011; 11 (02) 85-97
• 101 Sowers MR, Wildman RP, Mancuso P. et al. Change in adipocytokines and ghrelin with menopause. Maturitas 2008; 59 (02) 149-157
• 102 Pernoud LE, Gardiner PA, Fraser SD, Dillon-Rossiter K, Dean MM, Schaumberg MA. A systematic review and meta-analysis investigating differences in chronic inflammation and adiposity before and after menopause. Maturitas 2024; 190: 108119
• 103 Carr MC. The emergence of the metabolic syndrome with menopause. J Clin Endocrinol Metab 2003; 88 (06) 2404-2411
• 104 Steiner BM, Berry DC. The regulation of adipose tissue health by estrogens. Front Endocrinol (Lausanne) 2022; 13: 889923
• 105 Pouliot M-C, Després J-P, Moorjani S. et al. Regional variation in adipose tissue lipoprotein lipase activity: association with plasma high density lipoprotein levels. Eur J Clin Invest 1991; 21 (04) 398-405
• 106 Ahmed F, Kamble PG, Hetty S. et al. Role of estrogen and its receptors in adipose tissue glucose metabolism in pre- and postmenopausal women. J Clin Endocrinol Metab 2022; 107 (05) e1879-e1889
• 107 Blouin K, Nadeau M, Mailloux J. et al. Pathways of adipose tissue androgen metabolism in women: depot differences and modulation by adipogenesis. Am J Physiol Endocrinol Metab 2009; 296 (02) E244-E255
• 108 Pedersen SB, Kristensen K, Hermann PA, Katzenellenbogen JA, Richelsen B. Estrogen controls lipolysis by up-regulating α2A-adrenergic receptors directly in human adipose tissue through the estrogen receptor α. Implications for the female fat distribution. J Clin Endocrinol Metab 2004; 89 (04) 1869-1878
• 109 Anderson EJ, Lavoie HB, Strauss CC, Hubbard JL, Sharpless JL, Hall JE. Body composition and energy balance: lack of effect of short-term hormone replacement in postmenopausal women. Metabolism 2001; 50 (03) 265-269
• 110 Ibrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev 2010; 11 (01) 11-18
• 111 Butera PC. Estradiol and the control of food intake. Physiol Behav 2010; 99 (02) 175-180
• 112 Gorzek JF, Hendrickson KC, Forstner JP, Rixen JL, Moran AL, Lowe DA. Estradiol and tamoxifen reverse ovariectomy-induced physical inactivity in mice. Med Sci Sports Exerc 2007; 39 (02) 248-256
• 113 Stelmanska E, Kmiec Z, Swierczynski J. The gender- and fat depot-specific regulation of leptin, resistin and adiponectin genes expression by progesterone in rat. J Steroid Biochem Mol Biol 2012; 132 (1-2): 160-167
• 114 Lacasa D, Le Liepvre X, Ferre P, Dugail I. Progesterone stimulates adipocyte determination and differentiation 1/sterol regulatory element-binding protein 1c gene expression. potential mechanism for the lipogenic effect of progesterone in adipose tissue. J Biol Chem 2001; 276 (15) 11512-11516
• 115 Pektaş M, Kurt AH, Ün İ, Tiftik RN, Büyükafşar K. Effects of 17β-estradiol and progesterone on the production of adipokines in differentiating 3T3-L1 adipocytes: Role of Rho-kinase. Cytokine 2015; 72 (02) 130-134
• 116 Cagnacci A, De Toni A, Caretto S. et al. Cyclic progestin administration increases energy expenditure and decreases body fat mass in perimenopausal women. Menopause 2006; 13 (02) 197-201
• 117 Uchishiba M, Yamamoto S, Takeda A. et al. Progesterone treatment reduces food intake and body weight in ovariectomized female rats. Steroids 2024; 203: 109367
• 118 Mattick LJ, Bea JW, Singh L. et al. Serum follicle-stimulating hormone and 5-year change in adiposity in healthy postmenopausal women. J Clin Endocrinol Metab 2022; 107 (08) e3455-e3462
• 119 Hall KD. What is the required energy deficit per unit weight loss?. Int J Obes (Lond) 2008; 32 (03) 573-576
• 120 Heymsfield SB, Smith B, Dahle J. et al. Resting energy expenditure: from cellular to whole-body level, a mechanistic historical perspective. Obesity (Silver Spring) 2021; 29 (03) 500-511
• 121 Pontzer H. Energy constraint as a novel mechanism linking exercise and health. Physiology (Bethesda) 2018; 33 (06) 384-393
• 122 Pontzer H, Yamada Y, Sagayama H. et al; IAEA DLW Database Consortium. Daily energy expenditure through the human life course. Science 2021; 373 (6556) 808-812
• 123 Tooze JA, Schoeller DA, Subar AF, Kipnis V, Schatzkin A, Troiano RP. Total daily energy expenditure among middle-aged men and women: the OPEN Study. Am J Clin Nutr 2007; 86 (02) 382-387
• 124 Melanson EL, Gavin KM, Shea KL. et al. Regulation of energy expenditure by estradiol in premenopausal women. J Appl Physiol 2015; 119 (09) 975-981
• 125 Gavin KM, Melanson EL, Hildreth KL, Gibbons E, Bessesen DH, Kohrt WM. A randomized controlled trial of ovarian suppression in premenopausal women: no change in free-living energy expenditure. Obesity (Silver Spring) 2020; 28 (11) 2125-2133
• 126 Geisler C, Braun W, Pourhassan M. et al. Gender-specific associations in age-related changes in resting energy expenditure (REE) and MRI measured body composition in healthy Caucasians. J Gerontol A Biol Sci Med Sci 2016; 71 (07) 941-946
• 127 Karppinen JE, Wiklund P, Ihalainen JK. et al. Age but not menopausal status is linked to lower resting energy expenditure. J Clin Endocrinol Metab 2023; 108 (11) 2789-2797
• 128 Johnstone AM, Murison SD, Duncan JS, Rance KA, Speakman JR. Factors influencing variation in basal metabolic rate include fat-free mass, fat mass, age, and circulating thyroxine but not sex, circulating leptin, or triiodothyronine. Am J Clin Nutr 2005; 82 (05) 941-948
• 129 Benton MJ, Hutchins AM, Dawes JJ. Effect of menstrual cycle on resting metabolism: a systematic review and meta-analysis. PLOS ONE 2020; 15 (07) e0236025
• 130 Löfberg IE, Karppinen JE, Laatikainen-Raussi V. et al. Resting energy expenditure, metabolic and sex hormones in two phases of the menstrual and hormonal contraceptive cycles. Med Sci Sports Exerc 2024; 56 (12) 2285-2295
• 131 Bessesen DH, Cox-York KA, Hernandez TL. et al. Postprandial triglycerides and adipose tissue storage of dietary fatty acids: impact of menopause and estradiol. Obesity (Silver Spring) 2015; 23 (01) 145-153
• 132 Hodson L, Harnden K, Banerjee R. et al. Lower resting and total energy expenditure in postmenopausal compared with premenopausal women matched for abdominal obesity. J Nutr Sci 2014; 3: e3
• 133 Duval K, Prud'homme D, Rabasa-Lhoret R. et al. Effects of the menopausal transition on energy expenditure: a MONET Group Study. Eur J Clin Nutr 2013; 67 (04) 407-411
• 134 Weidlinger S, Winterberger K, Pape J. et al. Impact of estrogens on resting energy expenditure: a systematic review. Obes Rev 2023; 24 (10) e13605
• 135 Aubertin-Leheudre M, Goulet EDB, Dionne IJ. Enhanced rate of resting energy expenditure in women using hormone-replacement therapy: preliminary results. J Aging Phys Act 2008; 16 (01) 53-60
• 136 dos Reis CMRF, de Melo NR, Meirelles ES, Vezozzo DP, Halpern A. Body composition, visceral fat distribution and fat oxidation in postmenopausal women using oral or transdermal oestrogen. Maturitas 2003; 46 (01) 59-68
• 137 Marlatt KL, Lovre D, Beyl RA. et al. Effect of conjugated estrogens and bazedoxifene on glucose, energy and lipid metabolism in obese postmenopausal women. Eur J Endocrinol 2020; 183 (04) 439-452
• 138 Blondin DP, Haman F, Swibas TM. et al. Brown adipose tissue metabolism in women is dependent on ovarian status. Am J Physiol Endocrinol Metab 2024; 326 (05) E588-E601
• 139 Day DS, Gozansky WS, Van Pelt RE, Schwartz RS, Kohrt WM. Sex hormone suppression reduces resting energy expenditure and beta-adrenergic support of resting energy expenditure. J Clin Endocrinol Metab 2005; 90 (06) 3312-3317
• 140 Grant LK, Coborn JE, Cohn A. et al. Sleep fragmentation and estradiol suppression decrease fat oxidation in premenopausal women. J Clin Endocrinol Metab 2022; 107 (08) e3167-e3176
• 141 Dhurandhar NV, Schoeller D, Brown AW. et al; Energy Balance Measurement Working Group. Energy balance measurement: when something is not better than nothing. Int J Obes (Lond) 2015; 39 (07) 1109-1113
• 142 Guérin E, Biagé A, Goldfield G, Prud'homme D. Physical activity and perceptions of stress during the menopause transition: a longitudinal study. J Health Psychol 2019; 24 (06) 799-811
• 143 Grisotto G, Raguindin PF, Glisic M. et al. Menopausal transition is not associated with dietary change in Swiss women. J Nutr 2021; 151 (05) 1269-1276
• 144 Macdonald HM, New SA, Reid DM. Longitudinal changes in dietary intake in Scottish women around the menopause: changes in dietary pattern result in minor changes in nutrient intake. Public Health Nutr 2005; 8 (04) 409-416
• 145 Duval K, Prud'homme D, Rabasa-Lhoret R. et al. Effects of the menopausal transition on dietary intake and appetite: a MONET Group Study. Eur J Clin Nutr 2014; 68 (02) 271-276
• 146 Sullivan EL, Daniels AJ, Koegler FH, Cameron JL. Evidence in female rhesus monkeys (Macaca mulatta) that nighttime caloric intake is not associated with weight gain. Obes Res 2005; 13 (12) 2072-2080
• 147 Sullivan EL, Shearin J, Koegler FH, Cameron JL. Selective estrogen receptor modulator promotes weight loss in ovariectomized female rhesus monkeys (Macaca mulatta) by decreasing food intake and increasing activity. Am J Physiol Endocrinol Metab 2012; 302 (07) E759-E767
• 148 Ravussin E, Swinburn BA. Pathophysiology of obesity. Lancet 1992; 340 (8816) 404-408
• 149 Péronnet F, Haman F. Low capacity to oxidize fat and body weight. Obes Rev 2019; 20 (10) 1367-1383
• 150 Smith-Ryan AE, Cabre HE, Moore SR. Active women across the lifespan: nutritional ingredients to support health and wellness. Sports Med 2022; 52 (Suppl. 01) 101-117
• 151 Sanchez BN, Volek JS, Kraemer WJ, Saenz C, Maresh CM. Sex differences in energy metabolism: a female-oriented discussion. Sports Med 2024; 54 (08) 2033-2057
• 152 Karppinen JE, Juppi HK, Hintikka J. et al. Associations of resting and peak fat oxidation with sex hormone profile and blood glucose control in middle-aged women. Nutr Metab Cardiovasc Dis 2022; 32 (09) 2157-2167
• 153 Gallagher D, Kovera AJ, Clay-Williams G. et al. Weight loss in postmenopausal obesity: no adverse alterations in body composition and protein metabolism. Am J Physiol Endocrinol Metab 2000; 279 (01) E124-E131
• 154 Cano A, Ventura L, Martinez G. et al. Analysis of sex-based differences in energy substrate utilization during moderate-intensity aerobic exercise. Eur J Appl Physiol 2022; 122 (01) 29-70
• 155 D'Souza AC, Wageh M, Williams JS. et al. Menstrual cycle hormones and oral contraceptives: a multimethod systems physiology-based review of their impact on key aspects of female physiology. J Appl Physiol 2023; 135 (06) 1284-1299
• 156 Jeukendrup AE, Wallis GA. Measurement of substrate oxidation during exercise by means of gas exchange measurements. Int J Sports Med 2005; 26 (Suppl. 01) S28-S37
• 157 Norman RJ, Flight IH, Rees MC. Oestrogen and progestogen hormone replacement therapy for peri-menopausal and post-menopausal women: weight and body fat distribution. Cochrane Database Syst Rev 2000; (02) CD001018
• 158 Sørensen MB, Rosenfalck AM, Højgaard L, Ottesen B. Obesity and sarcopenia after menopause are reversed by sex hormone replacement therapy. Obes Res 2001; 9 (10) 622-626
• 159 Salpeter SR, Walsh JME, Ormiston TM, Greyber E, Buckley NS, Salpeter EE. Meta-analysis: effect of hormone-replacement therapy on components of the metabolic syndrome in postmenopausal women. Diabetes Obes Metab 2006; 8 (05) 538-554
• 160 Greising SM, Baltgalvis KA, Lowe DA, Warren GL. Hormone therapy and skeletal muscle strength: a meta-analysis. J Gerontol A Biol Sci Med Sci 2009; 64 (10) 1071-1081
• 161 Javed AA, Mayhew AJ, Shea AK, Raina P. Association between hormone therapy and muscle mass in postmenopausal women: a systematic review and meta-analysis. JAMA Netw Open 2019; 2 (08) e1910154
• 162 Davis SR, Baber R, Panay N. et al. Global consensus position statement on the use of testosterone therapy for women. J Clin Endocrinol Metab 2019; 104 (10) 4660-4666
• 163 Islam RM, Bell RJ, Green S, Page MJ, Davis SR. Safety and efficacy of testosterone for women: a systematic review and meta-analysis of randomised controlled trial data. Lancet Diabetes Endocrinol 2019; 7 (10) 754-766
• 164 Davis SR, Walker KZ, Strauss BJG. Effects of estradiol with and without testosterone on body composition and relationships with lipids in postmenopausal women. Menopause 2000; 7 (06) 395-401
• 165 Kristensen K, Pedersen SB, Vestergaard P, Mosekilde L, Richelsen B. Hormone replacement therapy affects body composition and leptin differently in obese and non-obese postmenopausal women. J Endocrinol 1999; 163 (01) 55-62
• 166 Crespo CJ, Smit E, Snelling A, Sempos CT, Andersen RE. NHANES III. Hormone replacement therapy and its relationship to lipid and glucose metabolism in diabetic and nondiabetic postmenopausal women: results from the Third National Health and Nutrition Examination Survey (NHANES III). Diabetes Care 2002; 25 (10) 1675-1680
• 167 Pentti K, Tuppurainen MT, Honkanen R. et al. Hormone therapy protects from diabetes: the Kuopio osteoporosis risk factor and prevention study. Eur J Endocrinol 2009; 160 (06) 979-983
• 168 Savolainen-Peltonen H, Tuomikoski P, Korhonen P. et al. Cardiac death risk in relation to the age at initiation or the progestin component of hormone therapies. J Clin Endocrinol Metab 2016; 101 (07) 2794-2801
• 169 Napolitano A, Zanin R, Palma F. et al. Body composition and resting metabolic rate of perimenopausal women using continuous progestogen contraception. Eur J Contracept Reprod Health Care 2016; 21 (02) 168-175
• 170 Davis SR, Baber RJ. Treating menopause - MHT and beyond. Nat Rev Endocrinol 2022; 18 (08) 490-502
• 171 “The 2022 Hormone Therapy Position Statement of The North American Menopause Society” Advisory Panel. The 2022 hormone therapy position statement of the North American Menopause Society. Menopause 2022; 29 (07) 767-794
• 172 Sims ST, Kubo J, Desai M. et al. Changes in physical activity and body composition in postmenopausal women over time. Med Sci Sports Exerc 2013; 45 (08) 1486-1492
• 173 Friedenreich CM, Woolcott CG, McTiernan A. et al. Adiposity changes after a 1-year aerobic exercise intervention among postmenopausal women: a randomized controlled trial. Int J Obes (Lond) 2011; 35 (03) 427-435
• 174 Son WM, Pekas EJ, Park SY. Twelve weeks of resistance band exercise training improves age-associated hormonal decline, blood pressure, and body composition in postmenopausal women with stage 1 hypertension: a randomized clinical trial. Menopause 2020; 27 (02) 199-207
• 175 Cebula A, Tyka AK, Tyka A. et al. Physiological response and cardiorespiratory adaptation after a 6-week Nordic Walking training targeted at lipid oxidation in a group of post-menopausal women. PLOS ONE 2020; 15 (04) e0230917
• 176 Dupuit M, Maillard F, Pereira B, Marquezi ML, Lancha Jr AH, Boisseau N. Effect of high intensity interval training on body composition in women before and after menopause: a meta-analysis. Exp Physiol 2020; 105 (09) 1470-1490
• 177 Dupuit M, Rance M, Morel C. et al. Moderate-intensity continuous training or high-intensity interval training with or without resistance training for altering body composition in postmenopausal women. Med Sci Sports Exerc 2020; 52 (03) 736-745
• 178 Magalhães ACL, Carvalho VF, Cruz SPD, Ramalho A. Dose-response relationship of resistance training on metabolic phenotypes, body composition and lipid profile in menopausal women. Int J Environ Res Public Health 2022; 19 (16) 10369
• 179 Dam TV, Dalgaard LB, Ringgaard S. et al. Transdermal estrogen therapy improves gains in skeletal muscle mass after 12 weeks of resistance training in early postmenopausal women. Front Physiol 2021; 11: 596130
• 180 Dam TV, Dalgaard LB, Thomsen CB. et al. Estrogen modulates metabolic risk profile after resistance training in early postmenopausal women: a randomized controlled trial. Menopause 2021; 28 (11) 1214-1224
• 181 Heikkinen J, Kyllönen E, Kurttila-Matero E. et al. HRT and exercise: effects on bone density, muscle strength and lipid metabolism. A placebo controlled 2-year prospective trial on two estrogen-progestin regimens in healthy postmenopausal women. Maturitas 1997; 26 (02) 139-149
• 182 Wu L, Chen R, Ma D, Zhang S, Walton-Moss B, He Z. Effects of lifestyle intervention improve cardiovascular disease risk factors in community-based menopausal transition and early postmenopausal women in China. Menopause 2014; 21 (12) 1263-1268
• 183 Silva TR, Oppermann K, Reis FM, Spritzer PM. Nutrition in menopausal women: a narrative review. Nutrients 2021; 13 (07) 2149
• 184 Lombardo M, Perrone MA, Guseva E. et al. Losing weight after menopause with minimal aerobic training and mediterranean diet. Nutrients 2020; 12 (08) 2471
• 185 Tariq B, Phillips S, Biswakarma R, Talaulikar V, Harper JC. Women's knowledge and attitudes to the menopause: a comparison of women over 40 who were in the perimenopause, post menopause and those not in the peri or post menopause. BMC Womens Health 2023; 23 (01) 460
• 186 Dintakurti N, Kalyanasundaram S, Jha P, Talaulikar V. An online survey and interview of GPs in the UK for assessing their satisfaction regarding the medical training curriculum and NICE guidelines for the management of menopause. Post Reprod Health 2022; 28 (03) 137-141
• 187 Altman DG, Bland JM. Absence of evidence is not evidence of absence. BMJ 1995; 311 (7003) 485
• 188 Mazzolari R, Porcelli S, Bishop DJ, Lakens D. Myths and methodologies: the use of equivalence and non-inferiority tests for interventional studies in exercise physiology and sport science. Exp Physiol 2022; 107 (03) 201-212
• 189 Bader N, Bosy-Westphal A, Dilba B, Müller MJ. Intra- and interindividual variability of resting energy expenditure in healthy male subjects – biological and methodological variability of resting energy expenditure. Br J Nutr 2005; 94 (05) 843-849
• 190 Quaye E, Chacko S, Chung ST, Brychta RJ, Chen KY, Brown RJ. Energy expenditure due to gluconeogenesis in pathological conditions of insulin resistance. Am J Physiol Endocrinol Metab 2021; 321 (06) E795-E801
• 191 Urlacher SS, Snodgrass JJ, Dugas LR. et al. Constraint and trade-offs regulate energy expenditure during childhood. Sci Adv 2019; 5 (12) eaax1065
• 192 Brock DW, Tompkins CL, Fisher G, Hunter GR. Influence of resting energy expenditure on blood pressure is independent of body mass and a marker of sympathetic tone. Metabolism 2012; 61 (02) 237-241
• 193 Nappi RE, Chedraui P, Lambrinoudaki I, Simoncini T. Menopause: a cardiometabolic transition. Lancet Diabetes Endocrinol 2022; 10 (06) 442-456
• 194 Reimer RA, Debert CT, House JL, Poulin MJ. Dietary and metabolic differences in pre- versus postmenopausal women taking or not taking hormone replacement therapy. Physiol Behav 2005; 15; 84 (02) 303-312
• 195 Monda V, Salerno M, Fiorenzo M. et al. Role of sex hormones in the control of vegetative and metabolic functions of middle-aged women. Front Physiol 2017; (08) 773
• 196 Lwin R, Darnell B, Oster R, Lawrence J, Foster J, Azziz R, Gower BA. Effect of oral estrogen on substrate utilization in postmenopausal women. Fertil Steril 2008; 90 (04) 1275-1278