Menopause hormone therapy and physical performance: The Canadian Longitudinal Study on Aging

Objective: To examine the association between menopause hormone therapy (MHT) and physical performance among women from the Canadian Longitudinal Study on Aging.

Study design: Cross-sectional study of 12,506 postmenopausal Canadian women.

Main outcome measures: Grip strength (kg), gait speed (m/s), timed up and go (s), chair rise (s), and balance (s) were assessed following standard procedures. The association between MHT and physical performance was evaluated using linear regression models adjusted for age, education, study site, smoking, alcohol consumption, body mass index, diabetes, hypertension, and hysterectomy. Sensitivity analyses were conducted according to age at study visit (<65 vs. ≥65 years), body mass index (<25 kg/m² vs. ≥25 kg/m²), physical activity level (less vs. more active), duration and type of MHT, and time of starting MHT after menopause.

Results: Compared with those who never used MHT, prior or current use was associated with better performance on the timed up and go test (β: -0.19; 95%CI: -0.28; -0.11) and faster gait speed (β = 0.01, 95%CI = 0.00; 0.02). No association was found for grip strength, balance, and chair rise. Results did not change by body mass index, physical activity, or duration of MHT use. When stratified by age at study visit, the effect remained significant only in among those aged 65 years or more. Starting MHT <5 years after menopause was associated with better physical performance.

Conclusions: MHT was associated with better physical performance in gait speed and timed up and go tests. The cross-sectional design of the study limits causal interpretation. Prospective studies are needed to confirm our results.