Iranian Society of Gynecology Oncology

Document Type : Original Research Article


1 Department of Sport Sciences, School of Education and Psychology, Shiraz University, Shiraz, Iran

2 College of Education, Sultan Qaboos University, Muscat, Oman


Background & Objective: Some evidence has shown the beneficial effects of exercise on reducing menopausal symptoms. However, the effect of type of exercise (aquatic and land-based exercise) and cessation of exercise is still unknown. The aim of this study was to compare the menopausal symptoms in two aquatic and land-based trained groups before and after cessation of exercise due to COVID-19 outbreak.
Materials & Methods: 90 postmenopausal women participated in the study voluntarily. The daily and sport physical activities and menopausal symptoms were assessed through interviews three months after cessation of sport activities and qestions were designed and obtained from daily physical activity form and menopausal rating scale (MRS) questionnaire respectively.
Results: Before the cessation of exercise, the somatic, psychological, and sexual symptoms of menopause were lower in both active groups than the inactive group, while there was no significant difference in three categories of menopausal symptoms between aquatic and land-based exercise groups. After the cessation of exercise, menopausal symptoms in the two groups of previously active women increased significantly compared to the inactive group, so that there was no significant difference in menopausal symptoms between the exercise and inactive groups.
Conclusion: aquatic and land-based exercise reduces the symptoms of menopause similarly, while the beneficial effects of exercise on menopausal symptoms can disappear after the cessation of exercise for three months.


Main Subjects

1. Wu F, Zhao S, Yu B, Chen Y-M, Wang W, Song Z-G, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579(7798):265-9. [DOI:10.1038/s41586-020-2008-3] [PMID] [PMCID]
2. Hall G, Laddu DR, Phillips SA, Lavie CJ, Arena R. A tale of two pandemics: How will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another? Prog Cardiovasc Dis. 2021;64:108. [DOI:10.1016/j.pcad.2020.04.005] [PMID] [PMCID]
3. Halabchi F, Ahmadinejad Z, Selk-Ghaffari M. COVID-19 epidemic: exercise or not to exercise; that is the question. Asian J Sports Med. 2020;11(1):e102630. [DOI:10.5812/asjsm.102630]
4. Gozuyesil E, Gokyildiz Surucu S, Alan S. Sexual function and quality-of-life-related problems during the menopausal period. J Health Psychol. 2018;23(14):1769-80. [DOI:10.1177/1359105317742194] [PMID]
5. Farzaneh A, Koushkie Jahromi M, Salesi M, Rostami R. The Ameliorating Impact of Pilates Training on Anxiety and Body Mass Index in Menopausal Symptoms. Women's Health Bull. 2020;7(4):46-53.
6. Blümel JE, Fica J, Chedraui P, Mezones-Holguín E, Zuñiga MC, Witis S, et al. Sedentary lifestyle in middle-aged women is associated with severe menopausal symptoms and obesity. Menopause. 2016;23(5):488-93. [DOI:10.1097/GME.0000000000000575] [PMID]
7. Dąbrowska-Galas M, Dąbrowska J, Ptaszkowski K, Plinta R. High Physical Activity Level May Reduce Menopausal Symptoms. Medicina. 2019;55(8):E466. [DOI:10.3390/medicina55080466] [PMID] [PMCID]
8. Sternfeld B, Guthrie KA, Ensrud KE, LaCroix AZ, Larson JC, Dunn AL, et al. Efficacy of Exercise for Menopausal Symptoms: A Randomized Controlled Trial. Menopause. 2014;21(4):330-8. [DOI:10.1097/GME.0b013e31829e4089] [PMID] [PMCID]
9. de Azevedo Guimarães AC, Baptista F. Influence of habitual physical activity on the symptoms of climacterium/menopause and the quality of life of middle-aged women. Int J Women's Health. 2011;3:319-28. [DOI:10.2147/IJWH.S24822] [PMID] [PMCID]
10. Morardpour F, Jahromi MK, Fooladchang M, Rezaei R, Khorasani MRS. Association between physical activity, cardiorespiratory fitness, and body composition with menopausal symptoms in early postmenopausal women. Menopause. 2020;27(2):230-7. [DOI:10.1097/GME.0000000000001441] [PMID]
11. Sydora BC, Turner C, Malley A, Davenport M, Yuksel N, Shandro T, et al. Can walking exercise programs improve health for women in menopause transition and postmenopausal? Findings from a scoping review. Menopause. 2020;27(8):952-63. [DOI:10.1097/GME.0000000000001554] [PMID]
12. Becker BE. Aquatic Therapy: Scientific Foundations and Clinical Rehabilitation Applications. PM&R. 2009;1(9):859-72. [DOI:10.1016/j.pmrj.2009.05.017] [PMID]
13. Dong R, Wu Y, Xu S, Zhang L, Ying J, Jin H, et al. Is aquatic exercise more effective than land-based exercise for knee osteoarthritis? Medicine. 2018;97(52):e13823. [DOI:10.1097/MD.0000000000013823] [PMID] [PMCID]
14. Bocalini DS, Serra AJ, Murad N, Levy RF. Water- versus land-based exercise effects on physical fitness in older women. Geriatr Gerontol Int. 2008;8(4):265-71. [DOI:10.1111/j.1447-0594.2008.00485.x] [PMID]
15. Waller B, Ogonowska-Słodownik A, Vitor M, Rodionova K, Lambeck J, Heinonen A, et al. The effect of aquatic exercise on physical functioning in the older adult: a systematic review with meta-analysis. Age Ageing. 2016;45(5):593-601. [DOI:10.1093/ageing/afw102] [PMID]
16. Williams RE, Barreria TV, Tseh W. Fitness-related benefits: land-based versus aqua-base. J Sports Med Phys Fitness. 2019;60(1):26-31. [DOI:10.23736/S0022-4707.19.09675-0] [PMID]
17. Moreira LDF, Fronza FCAO, dos Santos RN, Teixeira LR, Kruel LFM, Lazaretti-Castro M. High-intensity aquatic exercises (HydrOS) improve physical function and reduce falls among postmenopausal women. Menopause. 2013;20(10):1012-9. [DOI:10.1097/GME.0b013e3182850138] [PMID]
18. Siqueira US, Valente LGO, de Mello MT, Szejnfeld VL, Pinheiro MM. Effectiveness of Aquatic Exercises in Women With Rheumatoid Arthritis: A Randomized, Controlled, 16-Week Intervention-The HydRA Trial. Am J Phys Med Rehabil. 2017;96(3):167-75. [DOI:10.1097/PHM.0000000000000564] [PMID]
19. Guo L, Ren L, Zhang C. Relationship between depression and inflammatory factors and brain-derived neurotrophic factor in patients with perimenopause syndrome. Exp Ther Med. 2018;15(5):4436-40. [DOI:10.3892/etm.2018.5985] [PMID] [PMCID]
20. Thurston RC, El Khoudary SR, Sutton-Tyrrell K, Crandall CJ, Gold E, Sternfeld B, et al. Are Vasomotor Symptoms Associated with Alterations in Hemostatic and Inflammatory Markers? Findings from the Study of Women's Health Across the Nation. Menopause. 2011;18(10):1044-51. [DOI:10.1097/gme.0b013e31821f5d39] [PMID] [PMCID]
21. Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149-60. [DOI:10.3758/BRM.41.4.1149] [PMID]
22. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-95. [DOI:10.1249/01.MSS.0000078924.61453.FB] [PMID]
23. Schneider H, Heinemann L, Rosemeier H-P, Potthoff P, Behre H. The Menopause Rating Scale (MRS): reliability of scores of menopausal complaints. Climacteric. 2000;3(1):59-64. [DOI:10.3109/13697130009167600] [PMID]
24. Shorey S, Ang L, Lau Y. Efficacy of mind-body therapies and exercise-based interventions on menopausal-related outcomes among Asian perimenopause women: A systematic review, meta-analysis, and synthesis without a meta-analysis. J Adv Nurs. 2020;76(5):1098-110. [DOI:10.1111/jan.14304] [PMID]
25. Aminimoghaddam S, Abolghasem N. A Review of Management of Perimenopausal Hot Flashes. J Obstet Gynecol Cancer Res. 2022;4(1):5-11. [DOI:10.30699/jogcr.4.1.5]
26. Freedman RR. Hot flashes: behavioral treatments, mechanisms, and relation to sleep. Am J Med. 2005;118(12):124-30. [DOI:10.1016/j.amjmed.2005.10.022] [DOI:10.1016/j.amjmed.2005.09.046] [PMID]
27. Portugal EMM, Cevada T, Monteiro-Junior RS, Guimarães TT, da Cruz Rubini E, Lattari E, et al. Neuroscience of Exercise: From Neurobiology Mechanisms to Mental Health. Neuropsychobiology. 2013;68(1):1-14. [DOI:10.1159/000350946] [PMID]
28. Melancon M, Lorrain D, Dionne I. Exercise and sleep in aging: Emphasis on serotonin. Pathol Biol. 2014;62(5):276-83. [DOI:10.1016/j.patbio.2014.07.004] [PMID]
29. Nemčić T, Budišin V, Vrabec-Matković D, Grazio S. Comparison of the Effects of Land-Based and Water-Based Therapeutic Exercises on The Range of Motion and Physical Disability in Patients with Chronic Low-Back Pain: Single-Blinded Randomized Study. Acta Clinica Croatica. 2013;52(3.):321-6.
30. Bayraktar D, Guclu-Gunduz A, Lambeck J, Yazici G, Aykol S, Demirci H. A comparison of water-based and land-based core stability exercises in patients with lumbar disc herniation: a pilot study. Disabil Rehabil. 2016;38(12):1163-71. [DOI:10.3109/09638288.2015.1075608] [PMID]
31. Britto A, Rodrigues V, Dos Santos AM, Rizzini M, Britto P, Britto L, et al. Effects of water- and land-based exercises on quality of life and physical aspects in women with fibromyalgia: A randomized clinical trial. Musculoskeletal Care. 2020;18(4):459-66. [DOI:10.1002/msc.1481] [PMID]
32. Parsons TJ, Sartini C, Welsh P, Sattar N, Ash S, Lennon LT, et al. Physical Activity, Sedentary Behavior, and Inflammatory and Hemostatic Markers in Men. Med Sci Sports Exerc. 2017;49(3):459-65. [DOI:10.1249/MSS.0000000000001113] [PMID] [PMCID]
33. Falconer C, Cooper A, Walhin J, Thompson D, Page A, Peters T, et al. Sedentary time and markers of inflammation in people with newly diagnosed type 2 diabetes. Nutr Metab Cardiovasc Dis. 2014;24(9):956-62. [DOI:10.1016/j.numecd.2014.03.009] [PMID] [PMCID]
34. McCarthy M, Raval AP. The peri-menopause in a woman's life: a systemic inflammatory phase that enables later neurodegenerative disease. J Neuroinflammation. 2020;17(1):1-14. [DOI:10.1186/s12974-020-01998-9] [PMID] [PMCID]
35. Celestrin CP, Rocha GZ, Stein AM, Guadagnini D, Tadelle RM, Saad MJ, et al. Effects of a four week detraining period on physical, metabolic, and inflammatory profiles of elderly women who regularly participate in a program of strength training. Eur Rev Aging Phys Act. 2020;17(1):1-10. [DOI:10.1186/s11556-020-00244-8] [PMID] [PMCID]
36. Nishida Y, Hosomi S, Fujimoto K, Nakata R, Itani S, Ohminami M, et al. Effect of the Coronavirus Disease 2019 Lockdown on Lifestyle Factors in Japanese Patients with Inflammatory Bowel Disease. Intern Med. 2022;61(9):1329-36. [DOI:10.2169/internalmedicine.8825-21] [PMID] [PMCID]