Changes in Menopausal Risk Factors in Early Postmenopausal Osteopenic Women After 13 Months of High-Intensity Exercise: The Randomized Controlled ACTLIFE-RCT.

M Hettchen, S von Stengel, M Kohl, Marie H Murphy, M Shojaa, M Ghasemikaram, L Bragonzoni, F Benvenuti, C Ripamonti , MG Benedetti , M Julin, T Risto, W Kemmler

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The menopausal transition is a critical period in women’s lives. Exercise might be the most promising non-pharmaceutic intervention to address the large variety of risk factors related to the pronounced estradiol decline during peri- and early-postmenopause. The aim of this study was to determine the effect of an 18-month multipurpose exercise program on risk factors and symptoms related to the menopausal transition. Fifty-four women 1– 5 years postmenopause with osteopenia or osteoporosis were randomly assigned 1) to a high impact weight-bearing/high-intensity/velocity resistance training group (EG: n=27) exercising three times a week or 2) to an attendance control group (CG: n=27) that performed low-intensity exercise once a week. Both groups were supplemented with cholecalciferol and calcium. The primary study endpoint was bone mineral density (BMD) at lumbar spine (LS) and total hip, secondary outcomes were lean body mass (LBM), total and abdominal body percentage, metabolic syndrome Z-Score (MetS-Z), menopausal symptoms and muscle strength and power. Due to COVID-19, the study was stopped after 13 months. We observed significant effects for BMD-LS (EG: 0.002± .018 versus CG: − .009± 0.018 mg/cm2, p=0.027) but not for BMD total hip (EG: − 0.01± .016 versus CG: − .009± 0.020 mg/cm2, p=0.129). LBM improved significantly in the EG and decreased in the CG (0.39± 1.08 vs − 0.37± 1.34 kg, p=0.026). Total and abdominal body fat improved significantly in the EG and was maintained in the CG (− 1.44± 1.49 vs − 0.02± 1.55 kg, p=0.002 and -1.50± 2.33 vs 0.08± 2.07 kg, p=0.011). Significant effects in favor of the EG were also determined for menopausal symptoms (p=0.029), hip/leg extension strength (p< 0.001) and power (p< 0.001). However, changes of the MetS-Z did not differ significantly (p=0.149) between EG and CG. In summary, with minor exceptions, we demonstrated the effectiveness of a multipurpose exercise protocol dedicated to early-postmenopausal women on various risk factors and complaints related to the menopausal transition.
Original languageEnglish
Pages (from-to)83-96
Number of pages14
JournalClinical Interventions in Aging
Publication statusPublished (in print/issue) - 11 Jan 2021

Bibliographical note

Funding Information:
This study is one of the intellectual outputs of the project “ACTLIFE-Physical activity the tool to improve the quality of life in osteoporosis people” and had grant support from the European Union’ s Erasmus Plus Sport program under grant agreement No. 2017-2128/001-001. W e further acknowledge support by Deutsche Forschungsgemeinschaft and Friedrich-Alexander-University Erlangen-Nürnberg within the funding program “Open Access Publishing”. However , the funding sources had no role in the design of this study nor its execution, analyses, interpretation of the data, or decision to submit results.

Publisher Copyright:
© 2021 Hettchen et al.

Copyright 2021 Elsevier B.V., All rights reserved.


  • Bone mineral density
  • Early postmenopause
  • Multipurpose exercise
  • Bone Density
  • Lumbar Vertebrae/diagnostic imaging
  • Risk Reduction Behavior
  • Humans
  • Middle Aged
  • Risk Factors
  • Bone Diseases, Metabolic/diagnosis
  • Osteoporosis, Postmenopausal/diagnosis
  • Bone Density Conservation Agents/therapeutic use
  • Metabolic Syndrome/prevention & control
  • COVID-19/epidemiology
  • Postmenopause
  • Female
  • Outcome Assessment, Health Care
  • High-Intensity Interval Training/methods


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