Longitudinal assessment of the menopausal transition, endogenous sex hormones, and perception of physical functioning: the Study of Women's Health Across the Nation.
BACKGROUND
To evaluate the longitudinal associations between menopausal status, related hormonal changes, and level of self-reported physical functioning.


METHODS
Study included 2,495 women (age: 45-57 between 2000 and 2001) from the Study of Women's Health Across the Nation. Physical functioning scale of the Medical Outcomes Study Short-Form (SF-36; score 0-100) was categorized as: no limitation (86-100), moderate limitation (51-85), and substantial limitation (0-50). Study variables were collected between 2000 (visit-04) and 2011 (visit-12) at five timepoints. Statistical models were adjusted for age at visit-04, time since visit-04, ethnicity, site, economic status, level and change in body mass index, level and change in physical activity, and presence of comorbid conditions.


RESULTS
In final models, natural and surgical postmenopausal women had significantly higher odds of functional limitation, compared with premenopausal women. Less reduction in estradiol and testosterone since visit-04 were significantly associated with lower odds of functional limitation, while greater increase in sex hormone-binding globulin was associated with higher odds of functional limitation.


CONCLUSIONS
Our findings suggest the menopause-related changes in endogenous sex hormones as a possible mechanism of action to explain the greater limitation in physical functioning reported in women at midlife.
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania. elkhoudarys@edc.pitt.edu.
Samar R
SR
El Khoudary
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania.
Candace K
CK
McClure
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania.
Trang
T
VoPham
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor.
Carrie A
CA
Karvonen-Gutierrez
Kaiser Permanente Division of Research, Oakland, California.
Barbara
B
Sternfeld
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania.
Jane A
JA
Cauley
Center for Global Health Boonshoft School of Medicine, Wright State University, Dayton, Ohio.
Naila
N
Khalil
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pennsylvania.
Kim
K
Sutton-Tyrrell
D000203:Activities of Daily Living; D000328:Adult; D015331:Cohort Studies; D005260:Female; D012739:Gonadal Steroid Hormones / Q000502:physiology*; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D009043:Motor Activity; D057566:Self Report; D016387:Women's Health
D012739:Gonadal Steroid Hormones
Epidemiology; Functional performance; Geriatric endocrinology; Menopause.; Physical function