Physical Activity Levels Linked to Reduced Stress With Ovarian Aging

Laurie Barclay
January 3, 2008 — High levels of physical activity in community-dwelling women were related to lower levels of stress, anxiety, and depression accompanying ovarian aging, but not to lower levels of vasomotor symptoms, according to the results of an ongoing, longitudinal cohort study, which is reported in the January issue of Medicine and Science in Sports and Exercise.
"Physical activity has been proposed as an intervention for preventing or attenuating menopause-related vasomotor symptoms as well as other psychological symptoms such as anxiety and depression but to date the evidence regarding the benefit of physical activity is varied," write Deborah B. Nelson, PhD, from Temple University in Philadelphia, Pennsylvania, and colleagues. "Current studies examining the usefulness of physical activity in preventing or attenuating vasomotor symptoms have been mixed and the number of studies assessing the role of physical activity on other symptoms such as depression, stress and anxiety has been minimal."
The objective of The Penn Study of Ovarian Aging study was to assess whether physical activity, measured by expended kilocalories per week (kcal/week), was associated with decreased risk for menopausal symptoms among African American and Caucasian women.
During an 8-year period, the investigators measured level of physical activity and menopausal symptoms, including hot flashes, depression, anxiety, stress, and vasomotor, physiologic, and somatic symptom summaries, in 401 women. Women in the top tertile of physical activity expended at least 1450 kcal/week; those in the middle tertile, 644 to 1450 kcal/week; and in the bottom tertile, less than 644 kcal/week.
At each period, regression models were used to estimate the independent effect of physical activity, after adjustment for covariates and hormone levels, on psychological and vasomotor symptoms. Results were stratified by menopausal status, race, and smoking status.
In the overall analysis, only perceived stress was associated with level of physical activity. Compared with women in the lowest tertile of activity, women in both the middle and top tertiles of physical activity reported lower mean levels of stress. Analysis by menopausal stage revealed that compared with inactive postmenopausal women, active postmenopausal women continued to report lower mean levels of anxiety, stress, and depressive symptoms.
There was no apparent association between level of physical activity and reports of hot flashes, even after adjustment for variability in hormonal changes.
"Among a cohort of community dwelling women, high levels of physical activity were related to lower levels of stress during an 8 year follow-up period," the study authors write. "In addition, levels of anxiety, stress and depression were lowest among physically active postmenopausal women compared to inactive women in the same menopausal grouping."
Limitations of the study include low prevalence of women with current depressive symptoms, resulting in insufficient power to detect associations of menopausal symptoms with physical activity in this subgroup; measurement of physical activity conducted approximately every 2 years during the 8-year follow-up period; both physical activity and hot flashes collected via self-report; use of a limited number of physical activity questions to estimate expended kcal/week; cross-sectional assessments of physical activity and menopausal symptoms; inability to examine the effect of current physical activity on the severity of hot flashes; lack of data regarding other personality characteristics including neuroticism or coping styles; and inability to adjust for the use of other types of complementary and alternative therapies.
"These results suggest that maintaining or increasing physical activity during the menopausal transitional period and postmenopause may assist in reducing a variety of psychological symptoms including anxiety, stress and depression," the study authors conclude. "It is possible that the conflicting findings regarding the effect of physical activity on vasomotor symptoms reported in the literature could be accounted for by variability in the changes in endogenous reproductive hormones given regular exercise above some undefined threshold. Additional studies of the effects of a wide range of physical activity levels, before and after the final menstrual period, on vasomotor menopausal symptoms that include measurements of reproductive hormones are needed to explore this hypothesis."
Med Sci Sports Exerc. 2008;00:000-000.