Eligible participants ( n = 1627) were invited and 1393 came to the laboratory for a health interview and to give a fasting blood sample. A written invitation to take part in the study was sent to 6878 potential participants. Exclusion criteria were a self‐reported body mass index > 35 kg/m 2, being currently pregnant or lactating, conditions affecting ovarian function, oral or transdermal oestrogen‐containing hormonal preparations or other medications affecting ovarian function, and chronic diseases or medications seriously affecting muscle function. 27 In brief, women aged 47 to 55 years living in the city of Jyväskylä or neighbouring municipalities were randomly selected from the Finnish National Registry. A detailed description of participant recruitment and categorization into menopausal groups has been reported earlier. We also investigated simultaneous associations of ALM and femoral neck BMD with current physical activity in the four menopausal groups.ĭata from the Estrogenic Regulation of Muscle Apoptosis (ERMA) study were utilized. This study investigated differences between 47 to 55‐year‐old premenopausal, early perimenopausal, late perimenopausal, and postmenopausal women in appendicular LM (ALM), appendicular LM index (ALMI), femoral neck BMD, and T‐score. Whether physical activity is an effective tool to counteract potential deterioration in muscle and bone during the menopausal transition and thus postpone or prevent sarcopenia and osteoporosis in later life remains partly unresolved. 25 However, hormonal changes seem to be the major contributors to the changes in muscle 11, 12 and bone tissue 26 in women undergoing the menopausal transition, whereas the level of physical activity seems to play a lesser role during this phase of life. 13, 14, 21, 22, 23 Because of the obvious beneficial effects of physical activity on muscle and bone health, physical activity is recommended for the prevention and treatment of osteoporosis 24 and sarcopenia. 18, 19, 20 Accordingly, adaptations of bone and muscle tissue to reduced or increased loading conditions coincide. 15, 16, 17 According to the biomechanical coupling theory, bone adapts its mass, architecture, and strength to changes in stress and strain induced by gravitational loading and muscle activity. 13, 14 Accumulating evidence shows that both muscle and bone have endocrine and paracrine properties and that muscle and bone cells secrete numerous biochemical compounds that interact with each other. Muscle and bone tissues have a close developmental and functional relationship. 12 These findings suggest that muscle tissue may be sensitive to menopausal hormonal changes in middle‐aged women. 11 Similarly, our genetically controlled case control study showed a 2% larger thigh muscle cross‐sectional area in sisters using hormone replacement therapy compared with their non‐using cotwins. 9 We have also shown a 3% net increase in total body LM and a 5% increase in thigh muscle cross‐sectional area after 1 year of hormone replacement therapy, started during the early postmenopausal years, compared with placebo treatment. 4 A few studies also suggest that menopausal hormonal changes have an effect on the decline in lean mass (LM) among middle‐aged women 9, 10 and that the decline continues up to 2 years after the final menstrual period. 6, 7 Earlier studies have shown a progressive decline in hip bone mineral density (BMD) from premenopausal to postmenopausal status and a significant association between BMD decline and either an increase in FSH 8 or a decline in estradiol levels. The contribution of menopause‐related hormonal changes, especially in oestrogens, is known to lead to bone loss through increased bone turnover with a net deficit in bone formation relative to bone resorption. Muscle and bone mass decline with aging, increasing the risk for sarcopenia and osteoporosis in later life. To understand and to promote women's health and well‐being during aging, the role of the menopausal transition on health determinants that go beyond the reproductive functions and organs need to be investigated and acknowledged. 1, 2, 4 As the average menopausal age varies between 46 and 52 years, 5 women spend more than one‐third of their lives in postmenopausal status. 1, 2, 3 Hormonal changes start approximately 5 years before and continue years after the final menstrual period. The menopausal transition phase includes elevation of the serum follicle‐stimulating hormone (FSH) concentration and a decline in the estradiol concentration, both of which exhibit wide interindividual variation. During midlife, women experience drastic hormonal changes due to ovarian aging and the consequent menopausal transition. Female sex hormones have wide‐ranging effects on women's health and well‐being over the lifespan.

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