Exercise in the menopause – an update A. Pines and E. M. Berry* Department of Medicine ‘T’, Ichilov Hospital, Tel-Aviv; *Department of Human Nutrition & Metabolism, The Braun School of Public Health and Community Medicine, Hebrew University- Hadassah Medical School, Jerusalem, Israel Key words: MENOPAUSE, EXERCISE ABSTRACT One of the most important components of lifestyle relates to physical activity. Sedentary people fare less well than those who exercise regularly. The benefits of exercise can be demonstrated in many organs of the body. The most frequently studied effect of exercise is reduction in cardiovascular morbidity and mortality, but positive effects on the musculoskeletal system, breast cancer, mood and cognition, and quality of life have been recorded as well. In many cases, a dose–response was evident, and even a mild to moderate degree of activity, performed only a few times weekly, may carry significant merits. The following article reviews this topic and brings updated information on the benefits of exercise on postmenopausal health. INTRODUCTION It has been known for a long time that physical activity is a powerful means for the promotion of all aspects of human health. Spending time in the ‘gym’ became fashionable in many places around the globe, in part because of the related social aspects. However, exercise as a medical interven- tion means being active rather than sedentary, and moving your body on a regular basis. In order to achieve medical goals by exercise, one needs several weekly sessions, not too long, not too hard. Energy expenditure during recreational activity may be calculated by simple grading (mild, moderate, vigorous exercise) or by a more scientific measurement using metabolic equivalent tasks (METs) per hour. One MET is the amount of energy spent at rest. Two METs mean that the energy expended is twice that at rest. A useful table at http://healthfullife.umdnj.edu/archives/ METsTbl.htm shows how many METs are ex- pended during various types of physical activities and sports. The following manuscript summarizes the main issues pertinent to the beneficial effects of physical activity in menopausal women. EXERCISE AND CARDIOVASCULAR DISEASE The most studied area in this respect is, of course, the association between exercise, physical fitness and cardiovascular morbidity and mortality 1 . The pathophysiological basis for the reduction in cardiovascular risk lies in the diversity of meta- bolic effects attributable to exercise. Exercise lowers body mass index (BMI), decreases total body fat as well as subcutaneous and visceral fat, diminishes the waist circumference, improves the maximal oxygen consumption, carbohydrate handling and the lipid profile, lowers blood pressure, and is associated with better endothelial function and thinner intima-media dimension 2 . These changes may account also for the neurop- sychological benefits of physical activity, ex- pressed in lessening of the symptoms of anxiety and depression 3 . The two major observational studies on post- menopausal women, the Nurses’ Health Study (NHS) and the Women’s Health Initiative (WHI), presented quantitative data on exercise and primary prevention of coronary artery disease 4–6 . Correspondence: Professor A. Pines, Department of Medicine ‘T’, Ichilov Hospital, 6 Weizman Street, Tel-Aviv 64239, Israel CLIMACTERIC 2007;10(Suppl 2):42–46 ª 2007 International Menopause Society DOI: 10.1080/13697130701600153