Approved Research

Exploring the modifiable and non-modifiable factors influencing the musculoskeletal health of postmenopausal women

Lay summary

The menopause is a timepoint in a woman's life where there is a significant reduction in the strength and function of muscle and bone. This results in women being at far greater risk of sustaining a fracture after 50 years of age, when compared to men. Muscle function is also an important risk factor for a person's risk of suffering a fall. Crucially, each fall an individual experiences represents an increased risk of having a fracture resulting from the impact of hitting the ground. As a result, investigating both the muscle and bone health of postmenopausal women is of clear importance.

Muscle and bone health within postmenopausal women are influenced by controllable (e.g., nutrition, physical activity, medication use) and non-controllable factors (e.g., genetics, surgical menopause, age at menopause). Previous studies examining the effects of many of these factors on muscle and bone in postmenopausal women, however, are limited by the lack of thorough data collection of relevant measurements that impact muscle and bone (i.e., information on hormone replacement therapy use [HRT], reporting of age at menopause and nutritional intake related factors). The detailed reporting of participant menopause characteristics within the UK Biobank allows for these limitations to be reduced.

Muscle and bone deficits in women who have had surgical menopause (i.e., surgical removal of the ovaries) have not been sufficiently examined to date. This is largely due to the difficulties in recruiting women who have had a surgical menopause to participate in studies. Some research suggests that following surgical menopause, women may have poorer bone health than women who experience naturally occurring menopause, with very little being known about the effects that surgical menopause has on muscle function. Recent evidence has shown an important role of oestrogen in maintaining good muscle function. Furthermore, the effect that HRT and commonly prescribed bone medication (i.e., bisphosphonates), as well as the effect physical activity and nutrition, have in preventing muscle and bone loss in this population also remains unclear. This is of particular importance given that there appears to be varying rates of bone loss depending on how many years it has been since a woman has experienced menopause. Other important factors surrounding HRT use, such as the number of years post menopause when starting HRT use, remains to be clearly described.