Impact of Sex Hormones on Physical Performance in Midlife Women
Overview
This study investigated associations between sex steroid hormones and physical performance in 484 Australian women aged around 45 years. Estrone was negatively associated with chair rise performance, while dihydrotestosterone (DHT) and sex hormone–binding globulin (SHBG) were positively associated with standing balance.
Background
Sex steroids regulate reproductive and nonreproductive systems and decline with age, potentially affecting muscle function and increasing fall risk. Women experience a sharper decline in estrogen during menopause, which may contribute to earlier loss of muscle strength compared to men. Estrogen receptors in muscle tissue influence protein synthesis and metabolism, while testosterone may stimulate muscle growth directly or via conversion to estradiol. Understanding hormone-performance relationships during midlife can clarify mechanisms underlying musculoskeletal health in women.
Data Highlights
Hormone
Association with Physical Performance
Effect Size (Fully Adjusted)
95% Confidence Interval
Estrone (E1)
Negative with chair rise performance
−0.2
−0.3 to −0.002
Dihydrotestosterone (DHT)
Positive with standing balance (lower odds of poor balance)
OR 0.7 (approximate)
0.6 to 0.9
Sex Hormone–Binding Globulin (SHBG)
Positive with standing balance (lower odds of poor balance)
OR 0.7 (approximate)
0.5 to 0.9
Key Findings
Higher estrone concentrations were associated with poorer chair rise performance.
Higher DHT concentrations were linked to better standing balance, reducing odds of poor balance by approximately 30%.
Higher SHBG concentrations were also associated with better standing balance, similarly reducing odds of poor balance.
No significant associations were found between other measured sex steroids and handgrip strength or chair rise after full adjustment.
Age and body size may influence the relationship between sex hormones and physical performance.
Clinical Implications
Monitoring sex hormone levels, particularly estrone, DHT, and SHBG, may provide insight into midlife women's muscle function and fall risk. Interventions targeting hormonal balance could potentially improve physical performance and reduce musculoskeletal decline during the menopausal transition. Clinicians should consider hormonal status alongside age and body composition when assessing physical function in this population.
Conclusion
Sex steroids, especially estrone, DHT, and SHBG, are associated with specific aspects of physical performance in midlife women. These findings highlight the complex role of sex hormones in muscle function during the menopausal transition and underscore the need for further research to inform targeted interventions.
References
Menarche-to-PreMenopause Study, 2024 -- The Impact of Sex Hormones on Physical Performance in Midlife Women
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