BACKGROUND: Menopause is associated with increased risk of cardiovascular disease and the causal factors have been proposed to be the loss of estrogen and the subsequent alterations of the hormonal milieu. However, which factors that contribute to the deterioration of cardio-metabolic health in postmenopausal women is debated as the menopausal transition is also associated with increased age and fat mass. Furthermore, indications of reduced cardio-metabolic adaptations to exercise in postmenopausal women add to the adverse health profile.

OBJECTIVE: To evaluate risk factors for type 2 diabetes and cardiovascular disease in late pre- and early postmenopausal women, matched by age and body composition, and investigate the effect of high-intensity training.

METHODS: A 3-month high-intensity aerobic training intervention, involving healthy, non-obese, late pre- (n=40) and early postmenopausal (n=39) women was conducted and antropometrics, body composition, blood pressure (BP), lipid profile, glucose tolerance and maximal oxygen consumption (VO2-max) were determined at baseline and after the intervention.

RESULTS: At baseline, the groups matched in antropometrics and body composition, and only differed by 4.2 years in age (mean [95% confidence limits] 49.2 [48.5-49.9] vs. 53.4 [52.4-54.4] years). Time since last menstrual period for the postmenopausal women was (3.1 [2.6-3.7] years). Hormonal levels (estrogen, follicle stimulation hormone, luteinizing hormone) confirmed menopausal status. At baseline the postmenopausal women had higher total cholesterol (p<0.001), low density lipoprotein-cholesterol (LDL-C) (p<0.05) and high density lipoprotein-cholesterol (HDL-C) (p<0.001) than the premenopausal women. The training intervention reduced body weight (p<0.01), waist circumference (p<0.01) and improved body composition by increasing lean body mass (p<0.001) and decreasing fat mass (p<0.001) similarly in both groups. Moreover, training resulted in lower diastolic BP (p<0.05), resting heart rate (p<0.001), total cholesterol (p<0.01), LDL-C (p<0.01), total cholesterol/HDL-C index (p<0.01), and improved plasma insulin concentration during the oral glucose tolerance test (p<0.05) in both groups.

CONCLUSION: Cardiovascular risk factors are similar in late pre- and early postmenopausal women, matched by age and body composition, with the exception that postmenopausal women have higher HDL-C and LDL-C levels. A three month intervention of high-intensity aerobic training reduces risk factors for type 2 diabetes and cardiovascular disease to a similar extent in late pre- and early postmenopausal women.