Cardiorespiratory fitness, physical activity, and vasomotor symptoms of menopause

Vasomotor symptoms of menopause (VMS) are purportedly linked to cardio-autonomic dysfunction. Higher cardiorespiratory fitness and moderate-vigorous intensity physical activity (MVPA) protect against cardio-autonomic dysfunction and might protect against VMS. Our purpose was to determine associations of fitness and MVPA with severe VMS (sVMS).

CARDIA participants with evidence of menopause transition by the year 30 examination (Y30) who completed a baseline fitness test and attended the Y30 examination were included. MVPA was determined with accelerometry at Y20. sVMS were identified using surveys. The proportion of participants with sVMS according to quartiles of baseline fitness was determined with χ2 tests. Differences in baseline and Y20 fitness and Y20 MVPA between sVMS groups were evaluated with Wilcoxon tests. Associations of fitness and MVPA with sVMS were evaluated using Poisson regression with robust SEs, adjusted for age, race, study center, smoking, body mass index, Y30 self-reported total PA, and Y30 hormone use.

Of 1,808 participants (median age=56 y [IQR: 53, 58], 49.5% Black race), 32.2% had sVMS. sVMS prevalence decreased as baseline fitness quartile increased: Q1: 38%, Q2: 37%, Q3: 28%, and Q4: 25%. Participants with sVMS had lower baseline fitness (480 [398, 570s] vs. 496 [420, 600 s]) and Y20 fitness, both P<0.001. Y20 MVPA was lower (22 [13, 38min/day] vs. 26 [16, 43 min/day]) in those with sVMS, P<0.02. After adjustment, neither baseline nor Y20 fitness nor MVPA was associated with sVMS.

Fitness and MVPA in young or mid-adulthood were not independently associated with severe VMS. Other mitigation strategies seem necessary.