THE IMPACT OF PHYSICAL ACTIVITY AND NUTRITIONAL CORRECTION ON THE QUALITY OF LIFE OF WOMEN DURING MENOPAUSE: LITERATURE REVIEW
DOI:
https://doi.org/10.32782/pub.health.2025.2.21Keywords:
menopause, quality of life, physical activity, nutritional correction, phytotherapyAbstract
Topicality. Menopause is a key stage in a woman’s life, this transition is characterized by significant hormonal changes that provoke a wide range of vasomotor, urogenital and psychosomatic symptoms that can significantly impair quality of life. Although hormone replacement therapy is effective, there is a growing need for objective assessmentand implementation of safe non-pharmacological strategies, such as physical activity, dietary supplements and herbal medicine, to improve overall well-being.Aim and objectives. The aim of this study is to systematically review the available scientific works on the implementation of effective non-pharmacological strategies to improve the quality of life of women during menopause.Research methods. For the review, a search was conducted in scientific databases (PubMed, Scopus, Web of Science)using keywords related to menopause, physical activity, nutrition and quality of life. Original articles, randomized controlled trials, and reviews of nonpharmacological interventions were included. Publication selection was performedby two independent reviewers in two stages (title/abstract screening and full-text assessment) to ensure relevance andobjectivity.Results. Regular physical activity, in particular aerobic exercise, is recognized as a first-line nonpharmacological intervention, as it not only reduces the risk of chronic diseases, but also effectively alleviates vasomotor, mental, social,and physical manifestations of menopause. Physical exercise is a vital tool to combat central obesity and sarcopenia,processes that are accelerated by hormonal changes and significantly increase the risk of metabolic syndrome (up to60%). Additionally, strength training is necessary to improve muscle activity and bone density.In parallel, nutrition plays a key role, especially in bone health: bone loss accelerates dramatically during menopause, increasing the risk of osteoporosis. Therefore, optimal calcium and vitamin D intake is critical to prevent fractures.The diet should be nutritionally complete, with adequate protein to maintain muscle mass. In addition, the targetedinclusion of phytoestrogens (e.g. from soy, flaxseed, St. John’s wort, fennel) has proven highly effective as an alternativeto hormonal drugs for the relief of vasomotor, psychological and sexual symptoms.Conclusions. The comprehensive integration of physical activity and nutritional correction constitutes a fundamental non-drug strategy to maintain health and improve the quality of life of women during menopause. Aerobic and strengthtraining effectively reduce the severity of menopausal symptoms, while strategic planning of a diet enriched with calcium,vitamin D, and phytoestrogens serves as a vital therapeutic tool for preventing osteoporosis and metabolic disorders.
References
Ghazanfarpour M., Kaviani M., Abdolahian S., et al. The relationship between women’s attitude towards menopause and menopausal symptoms among postmenopausal women. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology. 2015. Vol. 31. № 11. P. 860–865. https://doi.org/10.3109/09513590. 2015.1056138
Arar M. A., Erbil N. The effect of menopausal symptoms on women’s daily life activities. Przeglad menopauzalny = Menopause review. 2023. Vol. 22. № 1. P. 6–15. https://doi.org/10.5114/pm.2023.126436
Khatoon F, Sinhal P, Shahid S, et al. Assessment of menopausal symptoms using modified menopause rating scale (MRS) in women of Northern India. Int J Reprod Contracept Obstet Gynecol. 2018. Vol. 7. Р. 947–951.
Ghazanfarpour M., Sadeghi R., Latifnejad Roudsari R., et al. Effects of red clover on hot flash and circulating hormone concentrations in menopausal women: a systematic review and meta-analysis. Avicenna journal of phytomedicine. 2015. Vol. 5. № 6. Р. 498–511.
Hickey M., Szabo R. A., Hunter M. S. Non-hormonal treatments for menopausal symptoms. BMJ (Clinical research ed.). 2017. Vol. 359, j5101. https://doi.org/10.1136/bmj.j5101
Brzezinski A. Menopausal symptoms: not just estrogen deficiency. Menopause. 2019. Vol. 26. № 3. Р. 229–230 . https://doi.org/10.1097/GME.0000000000001290
Nazarpour S., Simbar M., Ramezani Tehrani F., Alavi Majd, H. Factors associated with quality of life of postmenopausal women living in Iran. BMC women’s health. 2020. Vol. 20. № 1. Р. 104. https://doi.org/10.1186/s12905-020-00960-4
Barghandan N., Dolatkhah N., Eslamian F., et al. Association of depression, anxiety and menopausal-related symptoms with demographic, anthropometric and body composition indices in healthy postmenopausal women. BMC women’s health. 2021. Vol. 21. № 1. Р. 192. https://doi.org/10.1186/s12905-021-01338-w
Kulasingam S., Moineddin R., Lewis J. E., Tierney M. C. The validity of the Menopause Specific Quality of Life Questionnaire in older women. Maturitas. 2008. Vol. 60. № 3-4. Р. 239–243. https://doi.org/10.1016/j.maturitas.2008.07.002
Nikpour S., Haghani H. The effect of exercise on quality of life in postmenopausal women referred to the Bone densitometry centers of Iran University of Medical Sciences. Journal of mid-life health. 2014. Vol. 5. № 4. Р. 176–179. https://doi.org/10.4103/0976-7800.145156
Williams R. E., Levine K. B., Kalilani L., et al. Menopause-specific questionnaire assessment in US population-based study shows negative impact on health-related quality of life. Maturitas. 2009. Vol. 62. № 2. Р. 153–159. https://doi.org/10.1016/j.maturitas.2008.12.006
Tang Y., Ma R., Zhang L., et al. Effectiveness and safety of hormone replacement therapy in the treatment of menopausal syndrome: a meta-analysis. American journal of translational research. 2025. Vol. 17. № 1. Р. 1–15. https://doi.org/10.62347/UGLT3830
Bahri N., Yoshany N., Morowatisharifabad, et al. The effects of menopausal health training for spouses on women’s quality of life during menopause transitional period. Menopause. 2016. Vol. 23. № 2. Р. 183–188. https://doi.org/10.1097GME.0000000000000588
Guedes De Aguiar E. O., Moreira Marconi E., Monteiro-Oliveira B. B., et al. Whole-Body Vibration Exercise Improves the Functionality in Postmenopausal Women: A Systematic Review. Iranian journal of public health. 2023. Vol. 52. № 3. Р. 476–487. https://doi.org/10.18502/ijph.v52i3.12131
Balan A., Moga M. A., Neculau A. E., et al. Royal Jelly and Fermented Soy Extracts-A Holistic Approach to Menopausal Symptoms That Increase the Quality of Life in Pre- and Post-menopausal Women: An Observational Study. Nutrients. 2024. Vol. 16. № 5. Р. 649. https://doi.org/10.3390/nu16050649
Imhof M., Gocan A., Imhof M., Schmidt M. Soy germ extract alleviates menopausal hot flushes: placebo-controlled double-blind trial. European journal of clinical nutrition. 2018. Vol. 72. № 7. Р. 961–970. https://doi.org/10.1038/s41430- 018-0173-3
Ehsanpour, S., Salehi, K., Zolfaghari, B., Bakhtiari, S. The effects of red clover on quality of life in post-menopausal women. Iranian journal of nursing and midwifery research. 2012. Vol. 17. № 1. Р. 34–40.
Mohammady M., Janani L., Jahanfar S., Mousavi M. S. Effect of omega-3 supplements on vasomotor symptoms in menopausal women: A systematic review and meta-analysis. European journal of obstetrics, gynecology, and reproductive biology. 2018. Vol. 228. Р. 295–302. https://doi.org/10.1016/j.ejogrb.2018.07.008
Physical Activity Guidelines Advisory Committee report. To the Secretary of Health and Human Services. Part A: executive summary. Nutrition reviews. 2008. Vol. 67. № 2. Р. 114–120. https://doi.org/10.1111/j.1753-4887.2008.00136.x
Vallance J. K., Murray T. C., Johnson S. T., Elavsky S. Quality of life and psychosocial health in postmenopausal women achieving public health guidelines for physical activity. Menopause. 2010. Vol. 17. № 1. Р. 64–71. https://doi.org/ 10.1097/gme.0b013e3181b6690c
Daley A., Stokes-Lampard H., Thomas A., MacArthur C. Exercise for vasomotor menopausal symptoms. The Cochrane database of systematic reviews. 2014. Vol. 11. CD006108. https://doi.org/10.1002/14651858.CD006108.pub4
Sternfeld, B., Dugan, S. Physical activity and health during the menopausal transition. Obstetrics and gynecology clinics of North America. 2011. Vol. 38. № 3. Р. 537–566. https://doi.org/10.1016/j.ogc.2011.05.008
Pettee Gabriel K., Mason J. M., Sternfeld B. Recent evidence exploring the associations between physical activity and menopausal symptoms in midlife women: perceived risks and possible health benefits. Women’s midlife health. 2015. Vol. 1. № 1. https://doi.org/10.1186/s40695-015-0004-9
Portman D. J., Gass M. L. Vulvovaginal Atrophy Terminology Consensus Conference Panel. Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women’s Sexual Health and the North American Menopause Society. Maturitas. 2014. Vol. 79. № 3. Р. 349–354. https://doi.org/10.1016/j. maturitas.2014.07.013
Donato G. B., Fuchs S. C., Oppermann K., et al. Association between menopause status and central adiposity measured at different cutoffs of waist circumference and waist-to-hip ratio. Menopause. 2016 Vol. 13. № 2. Р. 280–285. https://doi.org/10.1097/01.gme.0000177907.32634.ae
Netjasov A. S., Vujović S., Ivović M., et al. Relationships between obesity, lipids and fasting glucose in the menopause. Srpski arhiv za celokupno lekarstvo 2013. Vol. 141. № 1-2. Р. 41–47. https://doi.org/10.2298/sarh1302041s
Greendale G. A., Sternfeld B., Huang M., et al. Changes in body composition and weight during the menopause transition. JCI insight. 2019. Vol. 4. № 5. e124865. https://doi.org/10.1172/jci.insight.124865
Sowers M., Zheng H., Tomey K., et al. Changes in body composition in women over six years at midlife: ovarian and chronological aging. The Journal of clinical endocrinology and metabolism. 2007. Vol. 92. № 3. Р. 895–901. https://doi.org/10.1210/jc.2006-1393
Basolo A., Bechi Genzano S., Piaggi P., et al. Energy Balance and Control of Body Weight: Possible Effects of Meal Timing and Circadian Rhythm Dysregulation. Nutrients. 2021. Vol. 13. № 9. Р. 3276. https://doi.org/10.3390/nu13093276
Legendre G., Ringa V., Panjo H., et al. Incidence and remission of urinary incontinence at midlife: a cohort study. BJOG : an international journal of obstetrics and gynaecology. 2015. Vol. 122. № 6. Р. 816–824. https://doi.org/10.1111/1471- 0528.12990
Markwald R. R., Iftikhar I., Youngstedt S. D. Behavioral Strategies, Including Exercise, for Addressing Insomnia. ACSM’s health & fitness journal. 2018. Vol. 22. № 2. Р. 23–29. https://doi.org/10.1249/FIT.0000000000000375
Dugan S. A., Bromberger J. T., Segawa E., et al. Association between physical activity and depressive symptoms: midlife women in SWAN. Medicine and science in sports and exercise. 2015. Vol. 47. № 2. Р. 335–342. https://doi.org/10.1249/MSS.0000000000000407
Asghari M., Mirghafourvand M., Mohammad-Alizadeh-Charandabi S., et al. Effect of aerobic exercise and nutrition educationon quality of life and early menopause symptoms:A randomized controlled trial. Women & health. 2017. Vol. 57. № 2. Р. 173–188. https://doi.org/10.1080/03630242.2016.1157128
Taebi M., Abdolahian S., Ozgoli G., et al. Strategies to improve menopausal quality of life: A systematic review. Journal of education and health promotion. 2018. Vol. 7. № 93. https://doi.org/10.4103/jehp.jehp_137_17
Li W. C., Chen Y. C., Yang R. S., Tsauo J. Y. Effects of exercise programmes on quality of life in osteoporotic and osteopenic postmenopausal women: a systematic review and meta-analysis. Clinical rehabilitation. 2009. Vol. 23. № 10. Р. 888–896. https://doi.org/10.1177/0269215509339002
Capel-Alcaraz A. M., García-López H., Castro-Sánchez A. M., et al. The Efficacy of Strength Exercises for Reducing the Symptoms of Menopause: A Systematic Review. Journal of clinical medicine. 2023. Vol. 12. № 2. Р. 548. https://doi.org/10.3390/jcm12020548
Trujillo-Muñoz P. J., Sánchez-Ojeda M. A., Rodríguez-Huamán E. C., et al. Effects of Physical Exercise on Symptoms and Quality of Life in Women in Climacteric: A Systematic Review and Meta-Analysis. Healthcare. 2025. Vol. 13. № 6. Р. 644. https://doi.org/10.3390/healthcare13060644
Nicula R., Costin N. Management of endometrial modifications in perimenopausal women. Clujul medical. 2015. Vol. 88. №. 2. Р. 101–110. https://doi.org/10.15386/cjmed-421
Avis N. E., Levine B. J., Danhauer S., Coeytaux R. R. A pooled analysis of three studies of nonpharmacological interventions for menopausal hot flashes. Menopause. 2019. Vol. 26. № 4. Р. 350–356. https://doi.org/10.1097/GME.0000000000001255
Watson J., Lee M., Garcia-Casal M. N. Consequences of Inadequate Intakes of Vitamin A, Vitamin B12, Vitamin D, Calcium, Iron, and Folate in Older Persons. Current geriatrics reports. 2018. Vol. 7. № 2. Р. 103–113. https://doi.org/10.1007/s13670-018-0241-5
Lethaby A., Marjoribanks J., Kronenberg F., et al. Phytoestrogens for menopausal vasomotor symptoms. The Cochrane database of systematic reviews. 2013. Vol. 12. Р. CD001395. https://doi.org/10.1002/14651858.CD001395.pub4
Sirotkin A. V., Harrath A. H. Phytoestrogens and their effects. European journal of pharmacology. 2014. Vol. 741. Р. 230–236. https://doi.org/10.1016/j.ejphar.2014.07.057
Abdali K, Dowran P, Emamghoreishi M, et al. Comparison of the effect of Foeniculum vulgare and St John’s wort (Hypericum perforatum) on the climacteric symptoms and sexual activity in menopausal woman. Int J Adv Biotechnol Res. 2016. Vol. 7. Р. 148–54.
Abedinzade M., Nasri S., Jamal Omodi M., et al. Efficacy of Trigonella foenum-graecum Seed Extract in Reducing Metabolic and Inflammatory Alterations Associated With Menopause. Iranian Red Crescent medical journal. 2015. Vol. 17. № 11. e26685. https://doi.org/10.5812/ircmj.26685
Aarshageetha P., Janci P. R. R., Tharani, N. D. Role of Alternate Therapies to Improve the Quality of Life in Menopausal Women: A Systematic Review. Journal of mid-life health. 2023. Vol. 14. № 3. Р. 153–158. https://doi.org/10.4103/jmh. jmh_222_22
Charde S. H., Joshi A., Raut J. A Comprehensive Review on Postmenopausal Osteoporosis in Women. Cureus. 2023. Vol. 15. № 11. e48582. https://doi.org/10.7759/cureus.48582
Ji M. X., Yu Q. Primary osteoporosis in postmenopausal women. Chronic diseases and translational medicine. 2015. Vol. 1. № 1. Р. 9–13. https://doi.org/10.1016/j.cdtm.2015.02.006
Christiansen C., Riis B. J., Rødbro P. Prediction of rapid bone loss in postmenopausal women. Lancet. 1987. Vol. 1. № 8542. Р. 1105–1108. https://doi.org/10.1016/s0140-6736(87)91671-0
Yordanov A., Vasileva-Slaveva M., Tsoneva E., et al. Bone Health for Gynaecologists. Medicina. 2025. Vol. 61. № 3. Р. 530. https://doi.org/10.3390/medicina61030530
Holick M. F., Binkley N. C., Bischoff-Ferrari H. A., et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. The Journal of clinical endocrinology and metabolism. 2011. Vol. 96. № 7. Р. 1911–1930. https://doi.org/10.1210/jc.2011-0385
Wallace T. C., Frankenfeld C. L. Dietary Protein Intake above the Current RDA and Bone Health: A Systematic Review and Meta-Analysis. Journal of the American College of Nutrition. 2017. Vol. 36. № 6. Р. 481–496. https://doi.org/10.1080/07315724.2017.1322924
Bolland M. J., Leung W., Tai V., et al. Calcium intake and risk of fracture: systematic review. BMJ (Clinical research ed.). 2015. Vol. 351. h4580. https://doi.org/10.1136/bmj.h4580
Ahn H., Park Y. K. Sugar-sweetened beverage consumption and bone health: a systematic review and meta-analysis. Nutrition journal. 2021. Vol. 20. № 1. Р. 41. https://doi.org/10.1186/s12937-021-00698-1
Rizzoli R., Chevalley T. Nutrition and Osteoporosis Prevention. Current osteoporosis reports. 2024. Vol. 22. № 6. Р. 515–522. https://doi.org/10.1007/s11914-024-00892-0
